Author + information
- Valentin Fuster, MD, PhD∗ ()
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address correspondence to:
Dr. Valentin Fuster, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York 10029.
History is filled with colorful lore of unlikely allies who forge a common pathway for a higher purpose. One of my favorites surrounds the relationship between conservative Mayor Richard J. Daley of Chicago and the vibrant artistic master, Pablo Picasso. Although architect William Hartmann helped to facilitate the process to erect the 50-foot-tall, 162-ton sculpture that now stands outside of the Daley Center at 50 West Washington Street in Chicago, Illinois, contemporaries of both individuals attest to the unlikely nature of its occurrence, given the staunch nature of the 2 men (1,2). It took 4 years of maneuvering and negotiations until they broke ground in 1967. At the unveiling of the now-famed “Chicago Picasso” (formally unnamed), Daley famously stated, “We dedicate this celebrated work this morning with the belief that what is strange to us today will be familiar tomorrow” (2).
In medicine, we have become appropriately cautious about forging relationships with members of industry, especially when their commercially driven goals can sometimes contradict our health-focused goals as cardiovascular specialists. In fact, I recently wrote an Editor’s Page criticizing the tobacco industry, wherein I petitioned governmental agencies to monitor, expose, and address the aggressive tactics of tobacco companies (3). Despite this pejorative example, there are also multiple examples of how partnering with industry can prove very successful for populations of people if the partners are engaged and working toward aligned goals.
In contrast to a confrontation with the tobacco industry (which could never have aligned goals with health care specialists), the food industry can be characterized on a far more progressive basis. For example, a European reformulation effort to improve nutrition, increase physical activity, and reduce sodium intake resulted in an alliance between European health and governmental agencies and the food industries. In 2007, a group of European specialists began a white paper that led to the 2008 European Union Framework for National Salt Initiatives, which pledged a reduction in salt consumption of at least 16% in 4 years (Figure 1). The efforts specifically focused on soups, fish products, and potato, as well as a concentrated assessment of foods served in restaurants and catering services. As a result of early successes with these efforts, the European Commission compiled the 2008 High Level Group on Nutrition and Physical Activity. With the European Commission’s inclusion, these initiatives grew across the continent through the hard work of many individuals and governmental agencies. Later, the 2012 Framework on Saturated Fats pledged to reduce saturated fat consumption by at least 5% in 4 years and an additional 5% by 2020, compared with 2012. Not only were there national initiatives examining the intake of fats, oils, and margarine, but the governmental agencies again worked with the restaurant industry to identify “best in class” foods. As a natural progression of these efforts, the 2015 Framework sought a 10% reduction in added sugars by 2020, focusing on sweetened soft drinks, confectionary sugar, preserved fruits and vegetables, as well as desserts and ice cream.
Recognizing the importance of these efforts—and despite potentially affecting their bottom lines—the following parties signed the National Agreement to Improve Product Composition 2014–2020 in support of the European Union frameworks on nutrition:
• Dutch Food Retail Organisation (CBL)
• Federation of the Dutch Food Industry (FNLI)
• Royal Dutch Hotel and Catering Association (KHN)
• Dutch Catering Association (Veneca)
• Minister of Health, Welfare and Sport (VWS)
The scope of the agreement aims “in particular at salt, saturated fat and calories (sugar and fat), although it also has the wider ambition of making the range of products as a whole healthier” (4). Importantly, these organizations are actively participating. Every year, these umbrella organizations of the food sectors ask their members about compliance with the maximum contents. The progress made in improvements to product composition for salt, saturated fat, and calorie content (sugar and/or [saturated] fat) is monitored at the product level. The National Institute for Public Health and the Environment (RIVM) carries out this monitoring using the food database LEDA (Levensmiddelendatabank). Companies are required to make data about their product composition publicly available. Also, salt consumption is determined every 4 to 5 years on the basis of 24-h urine collection. The Ministry of Health, Welfare and Sport finances the monitoring (4). This food industry alliance is serving as a true partner in bettering the health of the European community.
What about the United States and the rest of the world? We all can contribute if we recognize our sense of responsibility for the health of our current and future generations. Medical and health journals can also play an important role in advocating for these efforts globally, as I stated in my last Editor’s Page (3). In fact, this whole issue of the Journal is dedicated to topics that focus on cardiovascular health promotion—an area where we as cardiovascular specialists need to redirect our efforts. This change in approach may cause us to collaborate with unlikely allies, but as Picasso said, “Action is the foundational key to success” (5).
- American College of Cardiology Foundation
- ↵Lanier P. Pablo and the boss: the amazing story of Chicago's Picasso. Available at: http://interactive.wttw.com/a/main.taf-p=1,7,1,1,39.html. Accessed July 3, 2016.
- ↵Artner AG. Chicago’s Picasso sculpture. Chicago Tribune. Available at: http://www.chicagotribune.com/news/nationworld/politics/chi-chicagodays-picasso-story-story.html. Accessed July 3, 2016.
- Fuster V.
- ↵National Agreement to Improve Product Composition 2014–2020. Available at: http://www.akkoordverbeteringproductsamenstelling.nl/en. Accessed July 6, 2016.
- ↵BrainyQuote.com. Pablo Picasso. Available at: http://www.brainyquote.com/quotes/quotes/p/pablopicas120309.html. Accessed July 9, 2016.