Whilst the prevention of childhood obesity is the only viable, enduring, cost-effective solution to the obesity epidemic, effective methods for it remain elusive. Furthermore, strategies to influence obesogenic environments remain relatively unexplored. In order to be able to develop powerful population-level interventions and public health policies to prevent childhood obesity, it is important to understand its aetiology and those environments that are most amenable to measurable change. First, the present paper considers why we should be concerned about obesity in children, from both the perspective of the increased health risk to the individual and the high economic cost of treatment of obesity and related diseases, highlighting why the prevention of childhood obesity is important. Next, the determinants of health behaviour and the obesogenic environment are explored, which helps us to understand why the aetiology is so complex and that potential causal factors should not be considered in isolation, as the interaction between these factors is also important. The paper then considers the multi-factorial aetiology of childhood obesity and the rationale for the increasing trends in obesity that are evident, in order to understand what is changing in society and our children's behaviour that is triggering the positive energy balance leading to obesity. The review emphasises the need for multi-level approaches if we truly want to prevent childhood obesity. It also serves to highlight that there is a need to extend the current research base in order to build a well-founded framework to form the basis of a strategy for the prevention of childhood obesity.Aetiology of childhood obesity: Prevention of obesity: Obesogenic environments

This paper describes global (whole of Leeds) and local (super output area) analyses of the relationship between childhood obesity and many 'obesogenic environment' variables, such as deprivation, urbanisation, access to local amenities, and perceived local safety, as well as dietary and physical activity behaviours. The analyses identify the covariates with the strongest relationships with obesity, and highlight variation in these relationships across Leeds, thus identifying 'at-risk' populations. This paper seeks to demonstrate the importance of analysis at the micro-level in order to provide health planners with additional information with which to tailor interventions and health policies to prevent childhood obesity.

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BackgroundThe increasing incidence of type 2 diabetes mellitus is attributed to increasing weight, reduced physical activity, and poor diet quality. Lifestyle change in patients with pre-diabetes can reduce progression to diabetes but this is difficult to achieve in practice. AimTo study the effectiveness of a lifestyle-change intervention for pre-diabetes in general practice.

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