ABSTRACT
The concept, called primordial prevention, that a condition such as childhood obesity can be prevented by avoiding the development of risk factors in the population raises several questions. First, to what extent do we understand the biological and other drivers or risk factors for obesity? Second, do we have available biomarkers of exposure to such drivers in individuals or groups and/or other means of assessing their susceptibility before the condition becomes manifest? And third, do we have the means of preventing the condition? The concept of such prevention inevitably focuses attention on interventions starting in infancy (as reviewed in Chapter 34), when the trajectory of weight gain appears to be particularly important [1], but such interventions will need to be sustained through childhood if they are to be effective [2]. Other research raises the possibility that maternal body mass index (BMI) at conception or weight gain in pregnancy constitute independent risk factors for childhood obesity [3], suggesting that interventions may need to be started before the child is born. In turn, this leads to the concept that attention needs to be given to the preconception period if the risk of obesity in the next generation is to be minimized.
