Our current environment is distinctly different from the one our ancestors encountered several centuries or even just a century ago. One would thus argue that obesity may be, in part, the result of several factors set in motion by changes in the environment we live in, including the immediate availability of food at the expense of a lower cost and less physical labor, less physical activity, and possibly potential hormonal and epige-netic effects. Questions related to these notions are not only what the best interventions, including diet and exercise, should be, but also how could one help people adhere to an appropriate intervention program for the long term?
Two commonly attacked environmental factors are food marketing practices and institutionally and technologically driven reductions in physical activity. Yet, many have argued that, despite emerging data from controlled interventional studies, available data supporting the above are largely circumstantial and observational in nature. We all realize, however, that if we are to make pervasive and enduring changes to the prevalence of obesity and associated comorbidities, it is likely that we will need to make pervasive and enduring changes to the ways we live across our entire lifespan and these changes are admittedly difficult to implement.
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