Wijesuriya M, et al. – This research examined the impact of a pragmatic tri–monthly lifestyle modification (LSM) programme (P–LSM) versus a less–intensive 12–monthly control LSM (C–LSM) intervention on the onset of cardio–metabolic disease in individuals aged 5–40 years with risk factors for type 2 diabetes mellitus (T2DM). A marked reduction was noted in the incidence of predictors of cardio–metabolic disease via a pragmatic LSM programme. Hence, the significance of early intervention was underscored during this study, in young, at–risk participants.