The tense food health debate in Brussels has just become more explosive as the announcement of the first draft of the EU’s cardiovascular health plan at the end of November, ahead of its expected official unveiling on December 16, sparked widespread criticism both within the Commission and from member states.
The plan’s proposal, spearheaded by EU Health Commissioner Olivér Várhelyi, to introduce an EU-wide “sin tax” on highly processed foods and drinks high in fat, sugar and salt by 2026 has proven to be a lightning rod for opposition.
Those familiar with the draft plan confirm that it is part of the commission’s broader efforts to address cardiovascular disease (CVD) risk factors such as alcohol, tobacco and diet. But critics argue that the approach rests on shaky scientific foundations and seeks blunt, cosmetic solutions to a public health challenge whose underlying causes remain poorly understood, as the misguided equation of certain foods with tobacco threatens to lead to ineffective policy.
Going forward, the EU would be better served by a more constructive food policy that promotes physical activity and health literacy, leverages digital innovations and is based on rigorous, evidence-based research.
A continental health plague
The severity of the cardiovascular crisis in Europe clearly requires ambitious and coordinated responses. According to the World Health Organization (WHO), around 10,000 people across Europe die every day from cardiovascular disease, mostly from sudden events such as heart attacks and strokes. In 2022, circulatory diseases caused 1.68 million deaths in the EU, about a third of the Union’s mortality – far higher than the 22.3% for cancer.
In addition, the continent faces stark geographic health disparities: in 2022, over half of all deaths in Bulgaria, Romania, Lithuania and Latvia were due to circulatory diseases, compared to less than a quarter in Cyprus, Belgium, the Netherlands, France and Denmark. According to the OECD and EU report Health at a Glance: Europe 2024, the significant gap between Eastern and Western Europe is due to a number of key factors, including different smoking rates, differences in public health spending and health education.
Nevertheless, these countries are united in finding answers to a common challenge that remains their greatest health threat, with most EU member states already pursuing national cardiovascular strategies tailored to local lifestyles, preferences and available funding. When Hungary first put forward the idea of a CVD measure at EU level last year, countries such as Germany, Austria and the Netherlands quickly pushed back. Berlin speaks for many national capitals in warning of policy overlap with the existing “European Plan to Fight Cancer” – which already faces implementation challenges – and argues that efforts should be aimed more broadly at non-communicable diseases (NCDs) and not just cardiovascular diseases.
Explain the effects of the food tax
Member States’ resistance to the CVD plan reveals a deeper problem within the Commission: the instinct to stack strategies and layers of administration without achieving results. The backlash is not just external: four directorates-general expressed opposition to the plan’s food tax proposal, reflecting long-standing complaints about the excessive centralization of the EU executive and weak cross-departmental coordination. Instead of evidence-based policy developed through consultation, the CVD process once again risks producing a blunt, unbalanced outcome.
In particular, the Directorate-General for Agriculture has raised “points of serious concern” and reminded the Commission that its recent “Vision for the future of agriculture and food” includes a commitment to carry out an impact assessment on highly processed foods (UPFs) before taking concrete policy measures. As EU Agriculture Commissioner Christophe Hansen has rightly emphasized, “food affordability for consumers should be our guiding principle” and not food taxation.
Reflecting concerns about the lack of evidence on the “sin tax”, DG AGRI has warned that the “scientific rigor” of the plan leaves much to be desired. In addition, the Commission’s Internal Market and Industry Department is calling for more research into “the extent to which food processing itself has a negative impact on health”. Meanwhile, DG Budget and Taxation also opposes the food tax, citing its lack of clarity and the risk that it could “seriously jeopardize” the EU’s long-term – and already difficult – budget negotiations.
Instead of a concrete roadmap, the EU’s CVD plan appears to offer a series of vague assumptions that lead to policy solutions before anchoring its causal logic in solid scientific evidence. Indeed, the plan’s apparent emphasis on “unhealthy” foods and its inclusion of this ill-defined category alongside tobacco reveals the fragility of its evidence base. Furthermore, the draft text appears to give far less weight to the main causes of cardiovascular disease and obesity, such as inadequate physical inactivity.
Better way forward
The Commission’s food tax proposal embodies its long-standing focus on negative punitive measures that lack a solid scientific basis to improve nutritional health and combat preventable diseases such as cardiovascular disease and cancer. If Brussels is serious about curbing the EU’s growing weight crisis – almost 51% and 17% of adults are now overweight and obese respectively, and the number of children in childhood is also increasing dramatically – it must adopt a positive policy approach that empowers individuals to lead a healthy, balanced lifestyle.
Importantly, this requires consideration of the full spectrum of biological, social, psychological and environmental factors that lead to obesity and cardiovascular disease. At a time when physical activity levels across Europe are at historic lows, the EU’s cardiovascular health plan does not contain a clear flagship initiative to promote sport and exercise, representing a major missed opportunity. Instead, EU action should support local authorities to expand access to sports infrastructure and green spaces – especially in low-income communities hit hardest by the crisis.
In addition, EU citizens would benefit from much stronger nutritional health literacy programs, particularly in schools, to promote informed choices from an early age. Greater focus must also be placed on personalized nutrition and the question of how digital tools can implement medical advice in daily practice. With its companion app that offers private messaging with nutritionists, sports trainers and psychologists, as well as personalized care pathways tailored to each phase of treatment, France-based Annette represents the innovative digital health solutions that Brussels should integrate into its CVD strategy.
Looking ahead, if Brussels implements its leaked cardiovascular health plan into law without addressing its shortcomings, the EU will have only a superficial response to a complex health crisis. In fact, a tobacco control-style food tax may grab headlines but fail to produce results. As the December 16 unveiling approaches, lawmakers should demand an evidence-based approach and smarter health policies that empower citizens to engage in more physical activity, nutrition education and personalized nutrition.
