Lifestyle Medicine and Asthma in Viet Nam: Environmental Exposures, Physical Activity, and Anti-Inflammatory Treatment

Lifestyle Medicine and Asthma in Viet Nam: Environmental Exposures, Physical Activity, and Anti-Inflammatory Treatment

Primary category: Evidence & Clinical Practice

Secondary category: Health Equity & Planetary Health

Article type: VLMA Perspective

Last reviewed: October 30, 2026

A person living with asthma may notice that breathing becomes more difficult when air quality is poor. They begin avoiding outdoor exercise, keeping their windows closed, and trying to identify everything that might trigger their symptoms. After several months of feeling better, they may also wonder whether their inhaled medication is still necessary.

These decisions are understandable, but they involve different aspects of asthma management. Reducing exposure to smoke, air pollution, and relevant allergens may help prevent symptoms. Regular physical activity can improve fitness and quality of life. Neither approach, however, necessarily provides sufficient control of airway inflammation or protection against severe exacerbations.

Asthma presents an important challenge for Lifestyle Medicine. Healthy behaviors can support respiratory health, but their benefits depend on the person's clinical condition, treatment, and environment. Advice about avoiding triggers, exercising, or changing daily routines needs to complement appropriate asthma care rather than become a reason to delay or discontinue effective treatment.

This is particularly relevant in Viet Nam, where healthcare professionals need to consider differences in living and working conditions, occupational exposures, access to respiratory services, and the practical difficulties patients may face when following treatment recommendations.

The Global Initiative for Asthma (GINA) released its updated strategy report in May 2026, followed by a summary guide in July and an executive summary published in October. These documents provide an important current reference for understanding how environmental and lifestyle-related interventions fit within contemporary asthma management.

For the Vietnam Lifestyle Medicine Alliance (VLMA), the question is how evidence-based lifestyle support can help people with asthma remain healthy and active while recognizing the medical treatment required to control the disease and prevent serious complications.

Asthma Control Is More Than Feeling Well

Asthma is a heterogeneous respiratory disease usually characterized by chronic airway inflammation. Common symptoms include wheezing, breathlessness, chest tightness, and coughing, which vary over time and in intensity.

These symptoms are associated with variable expiratory airflow limitation. Some patients experience frequent respiratory difficulties, while others may go for long periods without noticeable symptoms.

Someone may report feeling well during a routine consultation but experience substantial breathlessness during a respiratory infection or after exposure to smoke. Another person may gradually avoid exercise and other activities that provoke symptoms, creating the impression that their asthma is adequately controlled.

The absence of troublesome symptoms does not necessarily mean that the person has a low risk of future exacerbations.

GINA 2026 emphasizes that asthma management should address both current symptom control and future risks, including severe exacerbations, persistent airflow limitation, and treatment-related adverse effects.

The World Health Organization's fact sheet updated on April 28, 2026, estimates that asthma affected approximately 363 million people worldwide in 2023 and caused about 442,000 deaths. Although effective treatments are available, asthma continues to impose a substantial burden on patients, families, and healthcare systems.

Accurate diagnosis remains essential. GINA recommends confirming asthma through a history of typical variable respiratory symptoms together with objective evidence of variable expiratory airflow limitation whenever possible. Spirometry with bronchodilator responsiveness testing is commonly used, although additional or repeated testing may be necessary in selected circumstances.

Normal spirometry during a single consultation does not necessarily exclude asthma, especially when symptoms fluctuate or the patient is already receiving treatment.

Other respiratory and cardiovascular conditions can produce similar symptoms. Persistent cough, exercise-related breathlessness, or recurrent wheezing should not automatically be attributed to asthma without appropriate assessment.

This is particularly important when someone has carried an asthma diagnosis for many years without adequate documentation or continues to experience symptoms despite apparently appropriate treatment.

Before increasing medication or recommending additional lifestyle interventions, clinicians may need to reassess the diagnosis, inhaler technique, adherence, associated conditions, and other possible explanations for persistent symptoms.

Environmental Triggers: Identifying What Actually Matters

Environmental exposures can influence asthma symptoms and exacerbation risk, but their effects differ between patients.

Tobacco smoke, air pollution, occupational sensitizers, irritant gases, and certain airborne allergens may contribute to worsening respiratory symptoms. However, the presence of a potential trigger does not establish that it is clinically important for every individual exposed to it.

This distinction is particularly relevant when discussing allergens.

Someone with confirmed sensitization to house dust mites may have different needs from a person whose symptoms are mainly associated with workplace fumes. A child who experiences exacerbations primarily during respiratory infections may not benefit from the same environmental interventions as an adult with occupational asthma.

GINA 2026 does not recommend allergen avoidance as a general strategy for everyone with asthma.

For patients with clinically relevant sensitization, reducing exposure may be reasonable. However, the evidence supporting many individual household interventions remains limited, and some measures can be expensive, difficult to maintain, or disruptive to everyday life.

Replacing furniture, purchasing several air-cleaning devices, or removing household pets may create considerable financial and emotional costs without a predictable clinical benefit.

Environmental assessment should therefore begin with a careful history. Healthcare professionals need to understand where symptoms occur, whether they change across environments, which exposures are plausible, and whether allergy testing or other investigations are indicated.

Persistent indoor dampness and mold deserve particular attention. Evidence reviewed by GINA indicates that addressing dampness and mold contamination can reduce asthma symptoms and medication use in some adults. However, effective remediation depends on housing conditions and the underlying source of moisture.

For some households, correcting leaks, improving ventilation, or addressing building defects may be more relevant than purchasing additional products.

The aim is not to create an environment free from every possible allergen. It is to identify exposures that are clinically meaningful, consider which can reasonably be reduced, and assess whether the intervention contributes to better asthma outcomes.

Air Pollution and the Limits of Individual Control

Air pollution is an important environmental concern in respiratory health.

Exposure to particulate matter, nitrogen dioxide, ozone, and other pollutants has been associated with asthma symptoms, exacerbations, and increased healthcare utilization.

The World Health Organization identifies indoor and outdoor air pollution among the factors associated with asthma development and worsening respiratory symptoms.

For people with established asthma, recommendations should reflect the severity of exposure, current disease control, and the activities being considered.

During periods of particularly poor air quality, reducing strenuous outdoor activity, changing the time or location of exercise, or using a less polluted indoor environment may help limit exposure.

However, this does not mean that everyone with asthma should routinely avoid outdoor activities whenever air quality is less than ideal.

The benefits of regular physical activity remain important. The World Health Organization's guidance on personal interventions for air pollution emphasizes balancing these benefits against exposure-related risks and considering the location, timing, and intensity of activity.

Indoor air quality also requires attention. Tobacco smoke, cooking emissions, burning materials, incense smoke, and other household sources may contribute to respiratory irritation. Cleaner cooking arrangements, appropriate ventilation, and avoiding indoor smoking can reduce relevant exposures where feasible.

Simply opening windows, however, is not always beneficial when outdoor pollution is high. Indoor air cleaners may reduce certain pollutants under suitable conditions, but their effectiveness depends on the product, environment, and source of exposure.

A commercial air-purification device should not be presented as a substitute for appropriate asthma medication or broader exposure control.

Individual recommendations also have practical limitations.

Someone whose occupation requires outdoor work may have little control over when or where exposure occurs. A family living near a busy road may not be able to relocate. Another household may lack the financial resources to make substantial improvements to its living environment.

These circumstances affect whether medical recommendations can realistically be followed.

For healthcare professionals, recognizing such limitations is important. Continued exposure does not necessarily indicate that a patient has ignored medical advice or lacks motivation.

Reducing air pollution at a population level also requires action through environmental policy, transport, industry, urban planning, housing, and occupational protection.

This connection between respiratory health and the conditions in which people live is relevant to health equity and planetary health. It highlights why environmental risks cannot be addressed entirely through individual behavior change.

Occupational Asthma Requires Timely Recognition

Workplace exposures deserve particular attention because asthma may develop as a result of occupational sensitization or become worse in an existing work environment.

Certain occupations involve exposure to dust, chemical fumes, cleaning agents, aerosols, or substances capable of causing respiratory irritation or sensitization.

A person may notice that symptoms worsen during working days and improve on weekends or holidays. However, these patterns are not always obvious, particularly when exposure has continued over many years.

GINA recommends asking patients with adult-onset asthma about their occupational history, relevant airborne exposures, and whether symptoms improve when they are away from work.

When occupational asthma is suspected, objective assessment and timely specialist referral are important. Continued exposure to a causative sensitizer may worsen the disease and affect long-term outcomes.

The US National Institute for Occupational Safety and Health also emphasizes reducing or eliminating causative workplace exposure alongside appropriate medical treatment.

The appropriate response, however, is not simply to tell someone to leave their job.

Employment changes can have substantial financial, social, and family consequences. Where appropriate, healthcare professionals may need to coordinate with occupational health services, employers, and relevant specialists to identify feasible protective measures.

Clinical assessment should guide decisions about respiratory health while recognizing that workplace changes involve responsibilities beyond the individual patient.

For Viet Nam, occupational asthma provides an example of how clinical care, workplace safety, and social determinants of health intersect.

Lifestyle Medicine can support awareness of environmental risks and healthier working conditions, but it does not replace specialist diagnosis or the professional responsibilities involved in occupational asthma management.

Physical Activity Should Remain Part of Life With Asthma

Some people with asthma gradually avoid physical activity because they associate exercise with wheezing, coughing, or breathlessness.

Someone who develops symptoms while running may stop participating in sports. A child who experiences repeated exercise-related respiratory problems may become reluctant to join school activities. Over time, reduced activity can lower physical conditioning and make ordinary exertion more difficult.

However, breathlessness during exercise is not always caused by asthma.

Reduced fitness, obesity, dysfunctional breathing, inducible laryngeal obstruction, cardiovascular disease, and other conditions may produce overlapping symptoms.

Exercise-related respiratory complaints therefore require appropriate clinical consideration rather than an automatic recommendation to exercise more or avoid activity.

For people with asthma, regular physical activity provides important general health benefits, including improvements in cardiorespiratory fitness, cardiovascular health, and quality of life.

GINA 2026 also recognizes that aerobic exercise training may produce modest improvements in asthma control and lung function in some patients, although it has not been shown to consistently reduce airway inflammation.

These findings support encouraging people with asthma to remain physically active, but the expected benefits should not be overstated.

For someone with well-controlled asthma, regular physical activity is generally appropriate. For a person experiencing exercise-induced bronchoconstriction, management may include optimizing underlying asthma treatment, using an appropriate warm-up strategy, and following a clinician-directed medication plan when indicated.

Exercise selection and progression should reflect symptoms, physical capacity, associated medical conditions, and treatment needs.

Significant breathlessness, chest discomfort, faintness, or unexpected deterioration during exercise requires medical reassessment rather than simply increasing training intensity.

Children and adolescents with asthma should also be supported to participate in physical education, sports, and recreational activities whenever safely possible.

The objective is not to restrict movement because someone has an asthma diagnosis. It is to achieve sufficient disease control and appropriate support so that the person can participate confidently and safely.

Breathing Techniques May Help, but Their Benefits Have Limits

Breathing exercises, yoga, mindfulness, and other practices involving controlled breathing are sometimes promoted as alternatives to conventional asthma treatment.

Some structured breathing techniques may improve symptom-related distress, perceived breathlessness, or quality of life in selected patients.

However, available evidence does not consistently demonstrate that breathing exercises improve objective lung function or prevent severe asthma exacerbations.

GINA recognizes breathing exercises as a possible complement to pharmacological treatment rather than a replacement for it.

This distinction is important because someone may feel calmer or more comfortable after using a breathing technique while underlying airway inflammation remains insufficiently controlled.

Improving the experience of breathlessness and reducing the risk of severe exacerbations are different treatment outcomes.

Patients who find breathing exercises helpful may continue using them when appropriate, but these practices should not be promoted as methods capable of curing asthma, permanently eliminating airway inflammation, or making prescribed inhaled corticosteroids unnecessary.

The same caution applies to commercial programs that promise to restore normal breathing through lifestyle interventions alone.

Professional educational materials should describe what the available evidence supports without implying benefits that have not been established.

Why Anti-Inflammatory Treatment Remains Essential

One of the most important principles in contemporary asthma management is that rapid symptom relief alone is not sufficient treatment.

Short-acting bronchodilators can rapidly relieve bronchoconstriction, but they do not adequately address the chronic airway inflammation associated with asthma when used alone.

A person relying exclusively on a short-acting beta-2 agonist may experience temporary relief while remaining at risk of a severe exacerbation.

GINA 2026 strongly recommends treatment containing inhaled corticosteroids for adults, adolescents, children aged 6–11 years, and most preschool-aged children with asthma. It recommends against relying on short-acting beta-2 agonists alone as an ongoing asthma treatment strategy.

The purpose of inhaled corticosteroid-containing treatment is not simply to reduce current symptoms. It also helps reduce the risk of severe exacerbations and other adverse outcomes.

For adults and adolescents, GINA 2026 identifies two main treatment tracks.

The preferred approach, Track 1, uses low-dose inhaled corticosteroid–formoterol as an anti-inflammatory reliever.

At the lower treatment steps, this combination may be used when symptoms occur without scheduled daily maintenance treatment. At higher steps, it is used for both scheduled maintenance treatment and additional symptom relief, an approach known as maintenance-and-reliever therapy.

This strategy has been shown to reduce severe exacerbations compared with treatment approaches relying on short-acting bronchodilator relievers.

Track 2 provides alternative approaches for patients when the preferred strategy is not suitable or available, or when other clinical considerations support an alternative regimen.

In the 2026 update, these alternatives include as-needed inhaled corticosteroid combined with a short-acting beta-2 agonist, either in a suitable combination inhaler or through separately prescribed inhalers used according to a clinician-directed plan.

Depending on the treatment step, scheduled maintenance treatment with an inhaled corticosteroid or an inhaled corticosteroid–long-acting bronchodilator combination may also be required.

Where an anti-inflammatory reliever is unavailable, GINA includes alternative arrangements involving an appropriate reliever and maintenance anti-inflammatory treatment, with particular attention to adherence and exacerbation risk.

The 2026 update also expands anti-inflammatory reliever options for children aged 6–11 years, with recommendations that differ according to age, treatment step, and the available evidence.

These approaches must not be interpreted as interchangeable across all products, treatment steps, or age groups.

In particular, not every combination of an inhaled corticosteroid and a long-acting bronchodilator is suitable for use as a reliever or in maintenance-and-reliever therapy.

Different inhaler formulations have different pharmacological properties, evidence bases, age indications, and dosing requirements.

Treatment selection must take account of the specific medicine, the patient's age, asthma severity, history of exacerbations, associated conditions, availability, and the approved indications and regulatory requirements applicable in Viet Nam.

The GINA strategy provides international evidence-based recommendations. It does not independently establish that every formulation or treatment approach described in the document is approved, available, or reimbursed in Viet Nam.

For professional education, the central message is that asthma management requires appropriate anti-inflammatory treatment, including for people who experience relatively infrequent symptoms.

Understanding that principle is different from providing an individualized prescribing protocol.

Feeling Better Does Not Automatically Mean Treatment Can Stop

A person whose asthma has remained well controlled for several months may naturally wonder whether their maintenance treatment is still necessary.

They may have returned to normal activities, stopped waking at night because of coughing, and rarely needed additional symptom relief.

These improvements matter, but they do not establish that asthma has permanently resolved.

Asthma remains a variable condition, and symptoms can recur following respiratory infections, environmental exposures, or other changes in circumstances.

GINA 2026 recommends reviewing treatment regularly and considering a reduction in treatment intensity when good control has been maintained for approximately two to three months and the clinical circumstances are appropriate.

The purpose of stepping down treatment is to identify the lowest effective regimen that maintains symptom control and reduces exacerbation risk while limiting unnecessary medication exposure.

Before changing treatment, clinicians should consider previous exacerbations, lung function, relevant risk factors, inhaler technique, adherence, and the patient's ability to recognize deterioration.

GINA specifically advises against completely discontinuing inhaled corticosteroids in adults and adolescents with asthma, except when a carefully supervised temporary interruption is necessary for appropriate diagnostic assessment.

Treatment reduction should therefore be a planned clinical decision with monitoring and follow-up, rather than a change patients make independently because they feel well.

This becomes particularly relevant when lifestyle improvements occur alongside effective medical treatment.

A person may begin exercising regularly, reduce smoke exposure, and improve overall health while continuing prescribed medication. Those improvements should not automatically be attributed to lifestyle changes alone or interpreted as evidence that anti-inflammatory treatment is no longer required.

Inhaler Technique and Treatment Access Matter

Even an appropriately selected medicine may provide less benefit if the inhaler is not used correctly.

Incorrect inhaler technique is a common and potentially correctable contributor to inadequate asthma control.

Someone may use a prescribed inhaler every day but have difficulty coordinating inhalation with device activation. Another person may use a dry-powder device without generating sufficient inspiratory flow for effective medication delivery.

Patients may also misunderstand the difference between maintenance and reliever treatment, particularly when more than one inhaler is prescribed.

GINA 2026 emphasizes checking inhaler technique, adherence, and other modifiable factors before escalating treatment.

Healthcare professionals should therefore do more than ask whether a patient takes medication.

Where appropriate, observing the person using their actual inhaler and asking them to demonstrate the technique can reveal difficulties that would otherwise remain unnoticed.

Patient education should explain the purpose of each medication, how the prescribed device should be used, and when additional medical assistance is necessary.

Adherence requires a similarly practical and respectful approach.

Someone may take less medication than prescribed because of concerns about corticosteroid safety, difficulty obtaining refills, treatment costs, an inconvenient dosing schedule, or misunderstanding of the plan.

These barriers should be explored rather than interpreted automatically as unwillingness to follow medical advice.

Inhaled corticosteroids may cause local adverse effects, including oral candidiasis and voice changes. Appropriate inhaler technique, use of a spacer when indicated, and rinsing the mouth after relevant inhalations may help reduce some of these effects.

Medication review should also consider the risks associated with unnecessarily high doses of inhaled corticosteroids and repeated systemic corticosteroid treatment.

GINA 2026 additionally recognizes the relative environmental impact of different inhaler devices as one consideration when selecting treatment.

This is relevant to sustainable healthcare, but environmental considerations should not override clinical effectiveness, medication availability, the patient's ability to use the device correctly, or treatment safety.

Where more than one clinically appropriate and accessible inhaler is available, differences in environmental impact can form part of shared decision-making.

However, an inhaler with a potentially lower environmental impact is not a better choice if the person cannot use it effectively or the required medicine is unavailable.

The priority is to maintain effective asthma control with a suitable treatment regimen that the patient can use correctly and sustain.

Severe Asthma Requires More Than Additional Lifestyle Advice

Some patients continue to experience substantial symptoms or recurrent severe exacerbations despite prescribed treatment.

Before classifying asthma as severe or increasing treatment intensity, clinicians need to reassess the diagnosis and identify potentially modifiable contributors.

These may include incorrect inhaler technique, inadequate adherence, continued tobacco exposure, occupational sensitizers, associated medical conditions, and other causes of respiratory symptoms.

GINA 2026 provides structured guidance for evaluating difficult-to-treat and severe asthma.

When clinically indicated, specialist assessment may include evaluation of inflammatory phenotype, relevant biomarkers, and eligibility for advanced treatment, including biologic therapies.

These treatments target specific disease mechanisms and are not interchangeable options for every patient.

A person with repeated severe exacerbations should not simply receive further advice about nutrition, stress management, breathing techniques, or household air quality without an appropriate review of medical treatment.

Repeated courses of oral corticosteroids also deserve attention because cumulative systemic exposure is associated with substantial adverse effects, including metabolic, cardiovascular, skeletal, and infectious complications.

Contemporary asthma management increasingly emphasizes reducing unnecessary systemic corticosteroid exposure while ensuring that acute exacerbations receive appropriate treatment.

Lifestyle-related interventions can remain beneficial, particularly when they address tobacco use, physical inactivity, obesity, or relevant environmental exposures.

However, they should complement appropriate specialist care rather than delay it.

Recognizing Exacerbations and Supporting Safe Follow-Up

A severe asthma exacerbation can occur even in someone whose symptoms were previously infrequent.

Patients and caregivers therefore need to understand how to recognize worsening asthma, follow the treatment plan provided by their clinician, and seek medical assistance when symptoms do not respond appropriately.

GINA recommends a personalized asthma action plan, presented in written, digital, or pictorial form as appropriate to the patient's needs.

The plan should distinguish usual treatment from the steps to take when symptoms worsen, including when urgent medical assessment is required.

Because reliever regimens differ, action plans need to reflect the specific medicines prescribed. Instructions designed for someone using inhaled corticosteroid–formoterol as a reliever may differ from those for someone receiving another treatment approach.

Severe or rapidly worsening breathlessness, inability to speak normally because of respiratory distress, marked drowsiness, confusion, or other signs of serious respiratory compromise require urgent medical assessment.

Breathing exercises, relaxation techniques, or adjustments to environmental exposure should never be treated as substitutes for emergency care.

Follow-up after an exacerbation is equally important.

Healthcare professionals should consider whether anti-inflammatory treatment was appropriate, whether inhaler technique or adherence contributed to the episode, and whether the patient understands the action plan.

An exacerbation may also reveal a need for additional investigation, closer monitoring, or specialist referral.

Successful acute treatment should therefore be connected to a plan for reducing the risk of future deterioration.

Asthma Care in Viet Nam: Existing Clinical Guidance and Quality Standards

Viet Nam has established national professional guidance addressing asthma diagnosis and treatment.

On April 24, 2020, the Ministry of Health issued Decision No. 1851/QĐ-BYT, promulgating guidance for diagnosing and treating asthma in adults and children aged 12 years and older.

The document addresses clinical assessment, diagnosis, pharmacological management, patient education, inhaler technique, and treatment of exacerbations.

On December 24, 2021, Decision No. 5850/QĐ-BYT introduced a clinical pathway for diagnosing and treating asthma in the same age group.

Separate national guidance also exists for younger children. Decision No. 3686/QĐ-BYT dated August 23, 2020, addresses asthma diagnosis and treatment in children aged five to under 12 years.

These documents provide important professional references for asthma care in Vietnamese healthcare facilities.

International recommendations, including GINA 2026, offer more recent evidence and updated treatment strategies. However, their publication does not automatically replace applicable Vietnamese professional guidance or establish the approval of particular medicines and treatment regimens.

Healthcare professionals need to consider national requirements, available scientific evidence, approved products, and individual patient circumstances.

A further development in Viet Nam concerns quality assessment.

On November 1, 2023, the Ministry of Health issued Decision No. 4032/QĐ-BYT, introducing pilot quality-assessment criteria for services diagnosing, treating, and managing asthma and chronic obstructive pulmonary disease.

The criteria address several components of reliable respiratory care, including professional training, appropriate diagnostic testing, medication availability, disease-control assessment, patient education, and service management.

The decision describes implementation on a pilot basis for hospitals providing the relevant services.

It should not be interpreted as establishing a mandatory national accreditation or certification program, nor as evidence that all healthcare facilities have achieved the specified criteria.

Nevertheless, the document provides a useful Vietnamese reference for understanding how comprehensive respiratory services can be evaluated.

For healthcare organizations, the opportunity is not necessarily to create a separate Lifestyle Medicine service for asthma. It is to integrate appropriate environmental assessment, physical activity support, smoking cessation, and health education into established respiratory care.

Such integration should strengthen diagnostic reliability, medication use, self-management, and follow-up rather than create parallel treatment arrangements.

Making Asthma Recommendations Practical for Patients

Consider a person with asthma who experiences worsening symptoms during daily travel through heavy traffic and has stopped exercising because of breathlessness.

A simple response might be to recommend avoiding outdoor activities, closing windows, and purchasing an air purifier.

However, these measures may not address the main reason the person is experiencing symptoms.

A more useful clinical assessment would first examine whether the asthma diagnosis is appropriate, whether current treatment adequately controls symptoms, and whether medication is being used correctly.

The clinician could then explore the relationship between symptoms and environmental exposures, distinguish exercise-induced bronchoconstriction from other causes of breathlessness, and consider which changes are feasible.

If air pollution is a relevant trigger, modifying the timing or location of physical activity may be helpful. If inhaler technique is incorrect, improving medication delivery may provide greater benefit than additional environmental restrictions.

If symptoms remain frequent despite appropriate management, further evaluation or specialist referral may be necessary.

The person's work schedule, household environment, financial resources, and access to follow-up should also influence the plan.

For children with asthma, communication between healthcare professionals, caregivers, and schools can help support participation in physical education and appropriate responses to worsening symptoms.

For people with suspected occupational asthma, coordination with relevant clinical and workplace services may be necessary.

Individualized care should identify which interventions are clinically relevant, how they can be implemented safely, and what support the person needs to follow the plan.

Measuring Improvement Beyond Counseling and Medication Counts

Healthcare organizations may report how many patients received advice about avoiding asthma triggers, stopping smoking, or increasing physical activity.

These measures can describe service activity, but they do not establish whether asthma care has improved.

Meaningful evaluation needs to consider both current symptom control and future risk.

Relevant outcomes may include daytime and nighttime symptoms, activity limitations, lung function where appropriate, exacerbations, emergency visits, hospital admissions, and the need for systemic corticosteroid treatment.

Reliever medication use may also provide useful information, but it needs to be interpreted according to the prescribed treatment regimen.

A patient using an anti-inflammatory reliever may have a different treatment pattern from someone receiving maintenance medication with another reliever strategy.

Healthcare organizations can also examine whether asthma diagnoses have been adequately supported, whether inhaler technique and adherence are assessed, whether patients understand their action plans, and whether follow-up occurs after exacerbations.

The quality of environmental interventions should also be evaluated realistically.

A recommendation to reduce smoke exposure or modify occupational conditions is useful when the exposure is clinically relevant and the intervention is feasible. Where patients cannot reasonably change their circumstances, additional clinical, workplace, or community support may be needed.

Patient-reported outcomes are equally important.

For someone who previously avoided exercise because of fear of breathlessness, returning to regular activity may represent meaningful improvement. For a child, consistent school attendance and participation in recreational activities may be important goals.

These improvements should be considered alongside asthma control and safety, not as substitutes for them.

The broader objective is to determine whether care helps patients function better while reducing avoidable risks.

Professional Responsibilities and Legal Boundaries in Viet Nam

Lifestyle Medicine can contribute to professional education, health promotion, prevention, and appropriate aspects of chronic disease management.

However, diagnosing asthma, interpreting pulmonary function tests, prescribing or adjusting medication, managing acute exacerbations, and determining specialist treatment needs are regulated clinical activities.

In Viet Nam, these activities are governed by the Law on Medical Examination and Treatment No. 15/2023/QH15, as amended, and applicable implementing regulations.

Consolidated Document No. 26/VBHN-VPQH dated February 26, 2026, provides an updated consolidated reference to the law.

The Law on Disease Prevention No. 114/2025/QH15, effective July 1, 2026, also establishes a broader framework relevant to preventing noncommunicable diseases and addressing associated health risk factors.

These laws should not be interpreted as creating independent clinical practice authority through Lifestyle Medicine education or international certification.

Healthcare professionals must act within their qualifications, competence, and legally authorized scopes of practice.

Physicians and other appropriately qualified healthcare professionals may undertake clinical activities within their respective responsibilities. Nurses, pharmacists, rehabilitation professionals, clinical nutrition professionals, and health educators may contribute to patient education and support in accordance with their applicable roles.

Health coaching or Lifestyle Medicine certification does not independently authorize a person to diagnose asthma, prescribe medication, or alter individualized clinical treatment.

Where identifiable patient information, respiratory monitoring records, or other health data are collected or processed, applicable confidentiality and personal data protection obligations must also be respected.

These include the Law on Personal Data Protection No. 91/2025/QH15 and Government Decree No. 356/2025/NĐ-CP, both effective January 1, 2026.

International recommendations may inform professional education and clinical review, but their implementation must remain consistent with Vietnamese professional requirements, approved medicines, available services, and individual patient circumstances.

Implications for the Vietnam Lifestyle Medicine Alliance

Asthma illustrates the importance of integrating Lifestyle Medicine into established healthcare rather than presenting it as a separate approach capable of replacing treatment.

Smoking cessation, appropriate physical activity, targeted environmental risk reduction, and support for healthy behaviors can contribute to comprehensive asthma management.

However, their clinical benefits vary, and none should be assumed to provide the same protection against severe exacerbations as appropriately indicated anti-inflammatory medication.

For VLMA, an appropriate contribution is to support healthcare professionals in understanding these differences through evidence-based education, critical interpretation of research, and scientific knowledge exchange.

Relevant educational topics may include environmental triggers, exercise-related respiratory symptoms, correct inhaler use, patient self-management, and the distinction between symptom relief and exacerbation prevention.

Professional discussion may also examine how healthcare organizations connect lifestyle-related support with clinical assessment, patient education, and continuity of respiratory care.

Such work would benefit from collaboration with appropriately qualified respiratory specialists and other healthcare professionals where relevant.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. Its activities focus on evidence-based professional education, capability development, scientific knowledge exchange, and collaboration.

VLMA does not independently provide asthma diagnosis, medication prescribing, pulmonary function testing, emergency respiratory treatment, or individualized clinical rehabilitation.

Its contribution lies in strengthening professional understanding and supporting the responsible application of evidence within authorized healthcare services.

Healthy Living and Effective Asthma Treatment Belong Together

Living well with asthma should not mean avoiding every activity that might cause breathlessness or trying to create an environment free from every potential trigger.

For many people, effective asthma care makes it possible to return to physical activity, participate in school or work, and manage everyday life with greater confidence.

Environmental measures, appropriate exercise, and healthy behaviors can support these goals. Yet their effectiveness depends on the individual's condition, relevant exposures, and access to appropriate medical care.

Anti-inflammatory treatment remains central to reducing the risk of severe exacerbations. Accurate diagnosis, correct inhaler technique, personalized action plans, and appropriate follow-up are equally important to achieving reliable care.

For healthcare professionals in Viet Nam, the opportunity is to bring these elements together without asking patients to choose between a healthy lifestyle and effective medical treatment.

A person with asthma should not have to stop exercising simply because they have a respiratory diagnosis, nor should improvement in symptoms become a reason to discontinue prescribed treatment without clinical review.

The contribution of Lifestyle Medicine is to help people live healthier, more active lives with asthma while ensuring that appropriate anti-inflammatory treatment, clinical safety, and prevention of severe exacerbations remain central to care.

Selected References

1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2026 update. May 2026.

2. Global Initiative for Asthma. 2026 Summary Guide for Asthma Management and Prevention. July 2026.

3. Reddel HK, Allan K, Bacharier LB, et al. 2026 Global Initiative for Asthma (GINA) Strategy Report: Executive Summary and Key Changes. American Journal of Respiratory and Critical Care Medicine. Published online October 8, 2026. DOI: 10.1093/ajrccm/aamag542.

4. World Health Organization. Asthma. Fact sheet. Updated April 28, 2026.

5. World Health Organization. Personal Interventions and Risk Communication on Air Pollution. Meeting report. September 4, 2020.

6. World Health Organization. Air Pollution: Personal Interventions and Risk Communication. Questions and answers. October 4, 2024.

7. US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Treating Work-related Asthma.

8. Ministry of Health of Viet Nam. Decision No. 1851/QĐ-BYT Issuing the Guidelines for Diagnosis and Treatment of Asthma in Adults and Children Aged 12 Years and Older. April 24, 2020.

9. Ministry of Health of Viet Nam. Decision No. 3686/QĐ-BYT Issuing the Guidelines for Diagnosis and Treatment of Asthma in Children Aged Five to Under 12 Years. August 23, 2020.

10. Ministry of Health of Viet Nam. Decision No. 5850/QĐ-BYT Issuing the Clinical Pathway for Diagnosis and Treatment of Asthma in Adults and Children Aged 12 Years and Older. December 24, 2021.

11. Ministry of Health of Viet Nam. Decision No. 4032/QĐ-BYT Issuing Pilot Quality Assessment Criteria for Asthma and Chronic Obstructive Pulmonary Disease Diagnosis, Treatment and Management Services. November 1, 2023.

12. Office of the National Assembly of Viet Nam. Consolidated Document No. 26/VBHN-VPQH: Law on Medical Examination and Treatment. February 26, 2026.

13. National Assembly of Viet Nam. Law on Disease Prevention No. 114/2025/QH15. December 10, 2025. Effective July 1, 2026.

14. National Assembly of Viet Nam. Law on Personal Data Protection No. 91/2025/QH15. June 26, 2025. Effective January 1, 2026.

15. Government of Viet Nam. Decree No. 356/2025/NĐ-CP Detailing Selected Provisions and Implementation Measures of the Law on Personal Data Protection. December 31, 2025. Effective January 1, 2026.

16. Rea BL, Cheema S, Lanza S, et al. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2026;20(3):443–451. DOI: 10.1177/15598276251379821.

Editorial and Professional Scope Note

This article presents an educational and professional perspective of the Vietnam Lifestyle Medicine Alliance on the contribution and limitations of evidence-based Lifestyle Medicine in asthma care, based on information reviewed through October 30, 2026.

It is intended for professional information, education, and scientific knowledge exchange. It does not constitute a clinical practice guideline, individualized medical advice, an asthma diagnostic or treatment protocol, exercise prescription, medication recommendation, or authoritative interpretation of Vietnamese law.

Vietnam Lifestyle Medicine Alliance (VLMA) is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. VLMA is not a licensed medical examination or treatment facility, respiratory care provider, medical licensing authority, or healthcare accreditation organization. It does not independently diagnose asthma, prescribe or adjust asthma medications, perform pulmonary function testing, manage acute exacerbations, or provide individualized clinical rehabilitation.

Clinical assessment, diagnosis, prescribing, respiratory treatment, specialist referral, and follow-up must be undertaken by appropriately qualified and authorized healthcare professionals and facilities within their applicable scopes of practice and in accordance with relevant Vietnamese requirements.

Environmental modifications, physical activity, breathing exercises, and other lifestyle-related interventions should not delay or replace indicated anti-inflammatory treatment, appropriate monitoring, specialist evaluation, or emergency care. Improvement in symptoms does not independently establish that prescribed asthma medication can be reduced or discontinued.

International clinical guidelines, scientific studies, and professional frameworks are cited for educational purposes. Their inclusion does not imply that these recommendations automatically have regulatory force in Viet Nam or that VLMA has formally adopted, delivered, validated, endorsed, or certified any asthma management or treatment program discussed in this article.

The illustrative patient situations are hypothetical and do not describe actual VLMA clinical activities or identifiable patients.