Overweight and obesity, one of the major risk factors for the development of type 2 diabetes. Obesity is the main modifiable risk factor for 90 per cent of all cases of diabetes. Levels of overweight are increasing dramatically among children, resulting in more and more childhood cases of type 2 diabetes, a condition that until recently affected primarily adults. The aim of the campaign is to convey the message that simple and inexpensive lifestyle changes such as increased physical activity and healthy food choices can be effective in countering the serious human and social consequences that would result from a worsening of the diabetes epidemic.

Obesity results when the size or number of fat cells in a person's body increases. When a person gains weight, these fat cells first increase in size and later in number. Overweight and obesity can cause diabetes, and contribute to high blood pressure, high cholesterol, infertility, birth complications and arthritis. Obesity is largely preventable through changes in lifestyle, especially diet.

Obesity is most commonly assessed by a single measure, the Body Mass Index (BMI), which uses a mathematical formula based on a person's height and weight.

Waist circumference is also increasingly recognized as a simple means of identifying obesity. This measurement in combination with BMI has shown to be the best predictor of obesity and its associated health risks.

The twin epidemics of diabetes and obesity already represent the biggest public health challenge of the 21 st century. It is no longer possible to rely only on management and prevention strategies that focus on the individual. Responses are required at the population level as well. Since major changes in both physical inactivity and food explain the development of the obesity and diabetes crisis, rational measures to address both issues are needed. The epidemic of obesity and diabetes has developed in spite of decades of national and local efforts to emphasize the value of `balanced diets' and to stress the importance of moderate daily exercise. Health education should, therefore, also be designed to support other measures. These include:

Providing children with a wide variety of physical activities.

Appropriate urban environments that encourage healthy lifestyle habits for all.

Teaching healthy eating habits and providing nutritious foods in schools

Monitoring the weight of children.

Food labelling.

Smaller portion sizes.

Lower prices for healthy foods.

It is important to establish strong national systems and partnerships that enable governments, civil society, and the private sector to evaluate and implement effective new policies. Given the epidemic of obesity and the increased incidence of diabetes that is likely to follow, systems to ensure annual monitoring of diabetes prevalence in populations should be established. It is already late, but a global effort can be made to transform diets, encourage less dependence on motorized transport, and promote efforts to restore physical activity into our daily lives.

The Time to Act is now!