Efforts to combat childhood obesity should start much earlier, even before conception, say researchers. Obesity clearly begins early – in fact, before pregnancy, the researchers wrote in the June issue of Childhood Obesity. Markers for later heart disease appear in 3-year-olds, they stated. They suggested a multidisciplinary approach to break the cycle of obesity moving from generation to generation is needed. The team include six experts from institutions across the country and conducted a review of more than 1,000 studies and discussions about efforts underway, the LA Times reported. “High-risk adolescent girls become high-risk mothers who have high-risk infants, who in turn become high-risk children and adolescents,” the researchers explained. To break the cycle, the researchers propose two ideas: First, intervene before, during and after pregnancy and with very young children. Second, use a “systems” approach that would combine efforts in various settings and account for behaviour and environmental factors. A systems approach “focuses on the interconnections between different aspects of the environment and between individuals and the environment,” rather than a traditional approach with several components, said the researchers. That would mean aligning priorities in such settings as schools and health agencies. They noted several “whole community” efforts, such as the Shape Up Somerville (Mass.) program, and stressed aiming such efforts much earlier should be tested. Behind the efforts is evidence of many contributors to obesity: parental weight, weight gain during pregnancy, rapid weight gain in infancy, lack of activity and others.