Preventive strategies against weight gain and obesity

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Abstract
Summary: A well‐resourced, comprehensive, population‐based set of strategiesis needed to attenuate and eventually reverse the current trendsof increasing obesity prevalence now apparent in most countries.The Epidemiological Triad (host, vector, environment) has provento be a robust model for other epidemics and is applied to obesity. Host‐based strategies are primarily educational and these tend to bemost effective among people with higher incomes and higher educational attainment.The main vectors for a high‐energy intake are energy‐dense foodsand drinks and large portion sizes and, for low energy expenditure,machines that promote physical inactivity. Vector‐based strategiesthat alter food formulation can have a significant impact, particularlythrough influencing common, high‐volume foods. The increasingly ‘obesogenic’ environmentsare probably the main driving forces for the obesity epidemic. Thereare many environmental strategies that can influence the physical,economic, policy or socio‐cultural environments, but the evidencebase for these potentially powerful interventions is small. ­Childrenshould be the priority population for interventions, and improvingthe general socio‐economic conditions for disadvantaged, marginalizedor poor population sectors is also a central strategy for obesityprevention. The key settings for interventions are schools, homes,neighbourhoods, primary health care services and communities. Thekey macroenvironments for interventions are the transport and infrastructuresector, the media and the food sector.