With the onslaught of energy dense dietary intake, sedentary lifestyle, increasing BMIs and related complications including diabetes, there is a clear priority and policy environment to optimise lifestyle and prevent these major public health issues. As with all successful public health advances, we will need a multifaceted, persistent, progressive program to address lifestyle, obesity and diabetes prevention. In this update, a broader public health context will be set and a review of recent initiatives and trials in this area summarised.