PURPOSE There is an epidemic of pediatric overweight and obesity leading to type 2 diabetes in youth. The purpose of this review is to describe the multiple paths of influence on the food environment of youth and to identify diabetes education strategies focused on early prevention of overweight and obesity. METHODS A review of relevant professional literature was conducted. RESULTS Models of obesity prevention in youth need to address genetic factors that influence the development of food preferences in the young child, parenting influences on eating pattern development, and access and availability of foods in the physical environment of the child. CONCLUSIONS Early intervention with parents of young children is required to prevent the development of eating patterns that lead to pediatric obesity and type 2 diabetes in youth. Diabetes educators need to be able to inform parents of the multiple paths of influence on the food environment of the child and suggest strategies to encourage the development of positive food preferences and intake.