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Addressing noncommunicable disease at the population level: a focus on diabetes

Pamela A Dyson

The prevalence of both noncommunicable disease and Type 2 diabetes is increasing worldwide, and much of this increase is explained by lifestyle factors and obesity. There is now robust evidence from randomized, controlled trials in high-risk individuals that lifestyle interventions, including diet and physical activity, can reduce both obesity and progression to Type 2 diabetes. There is some evidence of translation of these trials to the wider community, but most local and national programs utilize the high-risk approach and fail to address noncommunicable disease and Type 2 diabetes prevention at the population level. This review addresses the measures needed to introduce Type 2 prevention at the community level, summarizes the multiple stakeholder approach and reviews the evidence for efficacy of population-based prevention.