1. Primordial prevention by Sorin Ursoniu, MD, PhD

2. Why is primordial prevention important?

3. Learning & Performance Objectives

4. Prevention Disease prevention includes measures not only to prevent the occurrence of disease, such as risk factor reduction, but also to arrest its progress and reduce its consequences once established.

5. Levels of prevention (I)

6. Levels of prevention (II)

7. Definition Primordial prevention is defined as prevention of risk factors themselves, beginning with change in social and environmental conditions in which these factors are observed to develop, and continuing for high risk children, adolescents and young adults.

8. Primordial prevention, a relatively new concept, is receiving special attention in the prevention of chronic diseases. For example, many adult health problems (e.g. obesity, hypertension) have their early origins in childhood, because this is the time when lifestyles are formed.

9. General access to energy- dense diets coupled with typically sedentary urban lifestyles creates a trend toward obesity and chronic disease.

10. It is important to change the milieu that promotes major risk factor development. Primordial prevention calls for changing the socio-economic status of society. A better socio-economic status correlates inversely with lifestyle factors like smoking, abnormal food patterns and exercise.

11. Primordial prevention begins in childhood when health risk behaviour begins. Parents, teachers and peer groups are important in imparting health education to children.

12. Cost-effectiveness of primordial prevention

13. The cost of prevention: can we afford it? can we afford not to do it?

14. Examples of primordial prevention actions (I): National policies and programmes on nutrition involving the agricultural sector, the food industry, and the food import-export sector

15. Examples of primordial prevention actions (II): Comprehensive policies to discourage smoking

16. Examples of primordial prevention actions (III): Programmes to promote regular physical activity

17. Responsibilities for primordial prevention: Government Professional and non- governmental organisations Industry Hospitals, health clinics, health practitioners and health-care workers

18. Making major changes in lifestyle (I)

19. Making major changes in lifestyle (II)

20. Perspectives: