According to the latest European cardiovascular disease (CVD) statistics from the British Heart Foundation, CVD is estimated to cost the EU economy some €169 billion a year. Sixty-two per cent of this is health care costs, 21 per cent in lost productivity and 17 per cent in informal care.
Speaking at the Raisio Benecol Hearts and Minds Symposium in Brussels last week, Professor Klõr said that since many chronic diseases, such as cardiovascular and coronary heart disease, are basically self-inflicted and lifestyle dependent, it follows that lifestyle modification is a cost-effective prevention and treatment measure.
He drew on findings of the PROCAM Munster Heart Study carried out between 1979 and 1991, which found that the risk factors for people who have experienced coronary events, in ascending order of prevalence were: diabetes mellitus; family history of myocardial infarction; LCL cholesterol; triglyceride levels; HDL cholesterol; cholesterol; hypertension; and smoking.
In those without coronary events, hypertension was the greatest risk factor at 31 percent prevalence, followed by smoking at 29.9 percent.
While nothing can be done about personal and family history, diet is amongst the modifiable factors - along with smoking, cholesterol and triglyceride levels, obesity and exercise.
"Changes in nutrition are most important for successful lifestyle modification," Klõr said.
Achieving these lifestyle changes requires a new approach, however, since it seems the 'change the patient' approach to nutritional therapy through diet counseling, education and cooking course, has failed.
Each year, cardiovascular disease accounts for 1.9 million deaths in the EU - that is, 42 percent of all deaths. It also accounts for 18 percent of the EU disease burden.
Although the British Heart Foundation report concedes that mortality, incidence and case fatality of CVD is decreasing in Northern, Western and Southern European, in some parts of Central and Eastern Europe it is actually rising.
"It is unrealistic to expect people to look at the cholesterol content in every product they buy, and it will continue to be unrealistic," said Klõr.
Rather, the new approach should be to 'change the food' - that is, put bioactive compounds into ordinary foods to prevent and treat chronic diseases, which will make it easier for consumers and patients to adhere to long-term therapeutic strategies.
While functional ingredients should be undetectable in smell, taste and texture, they should be developed with the same attention to efficacy and safety as drugs, providing human studies to substantiate the health claim.
This is crucial to acceptance by the medical community, which is not fully positive about functional foods at the moment as it does not know much about it. Professor Klõr added that marketing measures should include the medical community, as well as consumers and patients.
"When doctors have understood what to tell the patient, they want to tell them," he said.
However the medical community is just one of the players affecting the development of functional foods in Europe. The others are the food industry, consumer readiness, governments, and organizations with support function.
As far as the regulatory state of play, Professor Klõr believes there is still some way to go before his ideal across-the-board scenario becomes reality:
"We have to convince the EU to change and start putting the right ingredients into food. It is not approved at a political level yet - although it is putting out research grants into functional foods. There is no follow through."
Cooperation between all of these players is also crucial; Klõr pointed out that consumers more readily pay attention to advice they see on television or read in magazines, than that provided by food company salesmen.
This tendency again underscores the importance of having medical practitioners on board, to ensure that patients and consumers hear the message.
As to whether it is appropriate to apply functional foods across the general population, a portion of which will have no need of the bioactive compounds, he said: "We have got to realize that the general public is at risk from heart disease. Do we wait until the disease is there, or start earlier?"