Are we really active in the prevention of obesity and type 2 diabetes at the community level?

The prevalence of type 2 diabetes is increasing rapidly worldwide. Much of this increase in type 2 diabetes epidemic is related to the increase in obesity. There is now firm evidence from randomised trials that type 2 diabetes is preventable by lifestyle modification influencing diet, physical activity and obesity. This prevention effect is sustainable for many years after cessation of active intervention. The slow progression in the development and implementation of population-based strategies in the prevention of obesity and its most common and serious co-morbidity, type 2 diabetes, is of great concern. We summarise published implementation programmes and describe briefly the activities carried out in Finland. In the Finnish implementation programme for the prevention of type 2 diabetes (FIN-D2D), it was found that it is possible to prevent type 2 diabetes "in real life" in the primary health-care settings. We point out that innovative strategic guidelines and their proper implementation are needed to prevent the diabetes epidemic. Among the different tools, also taxation and other regulation to promote healthy food selection and good interaction with the media should be considered. (C) 2010 Elsevier B. V. All rights reserved.