Speaker Abstract

National and International Strategies in the Prevention of Obesity and Diabetes

Bruce A. Reeder, University of Saskatchewan, S7N 5E5.

A strong positive relationship exists between obesity and the risk of developing Type 2 Diabetes Mellitus (DM). Up to 70% of Type 2 DM may be attributable to overweight and obesity (BMI >= 25), with the risk of DM especially high in those who are overweight in childhood, who show a progressive weight gain in young adulthood and who have an intra-abdominal accumulation of fat.

National and international strategies to prevent diabetes include disease-specific measures and broader efforts to prevent and reduce the prevalence of obesity. Secondary prevention by screening for impaired glucose tolerance and DM among adults and gestational DM among pregnant women followed by appropriate intervention, constitutes the principal disease-specific approach. The primary prevention of obesity has been attempted using 'high-risk' as well as 'population' approaches. Behavioral counseling, diet and exercise therapy delivered through health care settings to those at high risk of developing obesity has shown some limited success in achieving weight maintenance. Population approaches delivered through schools, workplaces, churches and other community settings have emphasized increased physical activity and reduced energy density of the diet. Although the prevalence of obesity has not been reduced in communities receiving such interventions, the rate of weight gain has been slowed.