Lifestyle Medicine and Planetary Health in Viet Nam: Why Human Health and Planetary Health Cannot Be Separated

Lifestyle Medicine and Planetary Health in Viet Nam: Why Human Health and Planetary Health Cannot Be Separated

Last reviewed: 21 September 2026

Lifestyle Medicine often begins with questions that feel very personal. What do we eat? How much do we move? Are we sleeping well? How do we manage stress? Are we exposed to tobacco, harmful alcohol use or other risky substances? Do we have meaningful social connections?

These behaviors matter, but none of them occurs in isolation. What people eat is shaped by food systems, price, availability and culture. Whether someone can walk or cycle depends partly on the streets, transport systems and neighborhoods around them. Sleep can be affected by heat, noise and housing conditions. Air quality shapes the conditions in which outdoor physical activity takes place. Access to green space can influence opportunities for movement, recovery and social interaction, while climate change can alter heat exposure, food security, infectious disease patterns, working conditions and the resilience of healthcare services.

This is where Lifestyle Medicine and Planetary Health meet. The two fields are not the same, but a healthcare approach focused on sustainable behavior change cannot fully understand human health while ignoring the environmental systems and living conditions that make healthier behaviors easier, harder, safer or less safe.

What is Planetary Health?

The Planetary Health Alliance describes Planetary Health as a solutions-oriented and transdisciplinary field and social movement concerned with understanding and addressing how human disruption of Earth's natural systems affects human health and other life on Earth.[1]

Planetary Health therefore goes beyond environmental protection in the conventional sense. Its starting point is health. Climate change, air pollution, biodiversity loss, land-use change, chemical pollution, degradation of marine and freshwater systems, and disruption of food systems are not only environmental concerns. They can affect patterns of disease, nutrition, mental health, infectious risks, livelihoods, displacement and the ability of communities and health systems to function.

The natural environment is therefore not simply the background in which health happens. Human health depends on functioning natural systems, while human activity can in turn alter those systems.

Why does Planetary Health now matter to Lifestyle Medicine practice?

Planetary Health is now explicitly reflected in the international Lifestyle Medicine competency framework.

The 2025 update of the Lifestyle Medicine Core Competencies revised the existing Planetary Health competency. The updated competency asks practitioners to examine the relationship between Lifestyle Medicine, Planetary Health and sustainable living. The same update added a new competency requiring Lifestyle Medicine interventions to be applied in the context of social determinants of health to improve health outcomes and health equity.[2]

The Planetary Health competency was also revised to emphasize the bidirectional relationship between human and planetary health and to strengthen attention to the health consequences and scientific evidence underlying that relationship.[2]

This is an important evolution because Lifestyle Medicine can otherwise be interpreted too narrowly as a set of individual behaviors. The current competency framework makes the context clearer: behavior occurs within social, economic, cultural, structural and environmental systems.

For Lifestyle Medicine, the question therefore becomes broader than simply, “What healthy choice should this person make?” It also becomes, “What conditions shape that choice, what are the health implications of those conditions, and how can we support health in ways that are realistic and sustainable?”

Why does this matter in Viet Nam?

The relationship is particularly relevant in Viet Nam because the country is experiencing several transitions at the same time: rapid urbanization, changing food environments, a growing burden of noncommunicable disease, population ageing and substantial exposure to climate and environmental risks.

In September 2025, the World Health Organization described Viet Nam as being at the frontline of climate-related health challenges, noting that it is among the countries highly exposed to climate change and its health impacts. Extreme heat, extreme weather events, climate-sensitive diseases and air pollution are among the interconnected environmental health challenges facing the country.[3]

In September 2026, the World Health Organization highlighted a new national scoping review of climate-sensitive diseases intended to strengthen Viet Nam's climate-health evidence base and policy response. Importantly, WHO noted that the review examines both infectious and noncommunicable diseases, reflecting growing evidence about the effects of climate-related exposures such as extreme heat on cardiovascular and respiratory health.[4]

The same WHO update reported that the Ministry of Health has incorporated climate and health considerations into the National Health Climate Change Adaptation Plan to 2030, the Disease Prevention Law and the National Target Programme on Healthcare, Population and Development for 2026–2035.[4]

Planetary Health is therefore not an imported concept with no connection to Vietnamese health priorities. Many of the underlying issues are already present in the country's health and development agenda. What is still developing is the ability to connect these issues more systematically with clinical care, professional education and Lifestyle Medicine.

Food connects personal health with planetary health

Nutrition provides one of the clearest connections.

In Lifestyle Medicine, dietary patterns matter because they influence cardiovascular disease, diabetes, obesity and other chronic conditions. But food also belongs to a much larger system involving agriculture, land use, water, energy, processing, transport, packaging, distribution and waste.

The updated Lifestyle Medicine competencies explicitly discuss the relationship between dietary patterns, human health and Planetary Health.[2]

This does not mean that Lifestyle Medicine should reduce nutrition to a carbon calculation, or that a dietary pattern considered environmentally preferable is automatically nutritionally appropriate for every person. Clinical nutrition still needs to consider medical conditions, age, nutritional requirements, food safety, affordability, culture and individual circumstances.

That distinction is particularly important in Viet Nam. Food culture, regional differences, household practices and the continuing coexistence of different forms of malnutrition mean that dietary models developed elsewhere should not simply be imported unchanged.

A more useful principle is to look for health and environmental co-benefits where they are supported by evidence. This can include supporting nutritious dietary patterns, emphasizing minimally processed foods where appropriate, reducing avoidable food waste and considering how healthier food systems can improve rather than restrict access to good nutrition.

Air pollution shows why healthy behavior depends partly on the environment

Physical activity is a core component of Lifestyle Medicine. Walking, cycling and other forms of outdoor activity can provide important health benefits, but the conditions in which those activities take place also matter.

The World Health Organization reports that air pollution contributes to stroke, heart disease, lung cancer, chronic obstructive pulmonary disease and respiratory infections. In Viet Nam, WHO has repeatedly cited an estimate of at least 70,000 deaths each year associated with air pollution.[5]

This illustrates a broader point. Advising someone to walk more is different from creating a neighborhood where walking is practical, safe and associated with lower exposure to harmful pollution. Encouraging cycling is different from having transport infrastructure that makes cycling safer and more accessible.

Lifestyle Medicine can operate within an individual consultation, but many of the environments that enable healthy behavior require action beyond the consultation room. For clinicians, this does not mean becoming urban planners or environmental regulators. It means recognizing that behavior is shaped by more than motivation and knowledge. Sometimes an important barrier is structural.

Heat changes the context of physical activity, sleep and chronic disease

Extreme heat creates another direct connection between environmental conditions and Lifestyle Medicine.

The World Health Organization identifies heat as an important environmental and occupational health hazard. Heat can exacerbate conditions including cardiovascular disease, diabetes, asthma and some mental health conditions, while increasing the risk of heat-related illness and other adverse outcomes. Vulnerability is influenced not only by age and medical status but also by occupation and socioeconomic circumstances.[6]

For Lifestyle Medicine, the implications extend beyond heat illness. Recommendations about physical activity may need to consider timing, occupational exposure, hydration and extreme-temperature conditions. Heat can affect the ability of people to work, exercise and travel safely, while severe heat events can also place pressure on electricity, transport and healthcare infrastructure.[6]

Sleep is relevant as well. A 2024 systematic review found that higher outdoor or indoor temperatures were generally associated with poorer sleep quality and quantity, with stronger effects during hotter periods and in some vulnerable populations.[7]

This does not mean that every Lifestyle Medicine consultation requires a climate assessment. It means that advice should remain responsive to the conditions in which patients actually live. A recommendation appropriate for one season, workplace, housing environment or region may need to be adapted in another.

The built environment can support or obstruct healthy living

Lifestyle Medicine often focuses on individual behaviors, but the built environment strongly influences whether those behaviors are realistic.

Neighborhoods that support safe walking, accessible transport, green space and opportunities for social interaction can create better conditions for physical activity and connectedness. Environments dominated by heavy traffic, long commuting times, unsafe roads, limited public space or excessive heat may create very different conditions.

The updated Lifestyle Medicine Planetary Health competency specifically considers built environments and urban green spaces as part of the relationship between human and planetary health.[2]

This is particularly relevant to a rapidly urbanizing country such as Viet Nam. Healthy cities are not created only through hospitals and clinics. Transport, housing, parks, schools, workplaces and urban design all contribute to the conditions in which health behaviors occur.

From a Lifestyle Medicine perspective, this changes some of the questions we ask. Instead of looking only at why someone is physically inactive, it may also be useful to understand whether their environment makes daily movement practical. Rather than treating social isolation entirely as an individual problem, we can also consider whether neighborhoods, workplaces and communities provide opportunities for meaningful connection.

Natural systems are part of the infrastructure for health

Planetary Health also asks us to think beyond climate change and air pollution.

Human health depends on functioning natural systems for clean air, clean water, food production, temperature regulation and many other ecosystem services. Environmental degradation can affect nutrition, infectious disease patterns, occupational health, mental well-being, livelihoods and community resilience.[1]

This does not mean that every ecological issue belongs within clinical Lifestyle Medicine. The fields have different scopes. The connection becomes relevant when environmental conditions materially affect human health or people's ability to maintain healthier lives.

Exposure to green and natural environments, for example, can intersect with physical activity, stress, recovery and social participation. At a larger scale, degradation of water, agricultural and coastal systems can affect food security, livelihoods and population health.

From a Planetary Health perspective, this broadens how we think about prevention. Prevention is not only about helping people modify risk after exposure occurs. It can also involve protecting the systems and environments that make health possible.

Health equity sits at the center of the relationship

One of the risks in Lifestyle Medicine is unintentionally implying that everyone has equal freedom to make healthy choices. In reality, people with lower incomes may have fewer food choices, less control over working hours, poorer housing or less access to green space. Outdoor workers may face greater heat exposure, while communities living in more polluted environments may experience risks they cannot remove through personal behavior.

Older adults, people living with chronic disease, people with disabilities and socially disadvantaged populations may also be more vulnerable to environmental hazards. The World Health Organization notes that vulnerability to heat is influenced by physiological factors as well as occupation, exposure and socioeconomic circumstances.[6]

The 2025 Lifestyle Medicine Core Competencies now explicitly require attention to social determinants of health, including the social and economic environments in which people live.[2]

The two perspectives therefore reinforce each other. Lifestyle Medicine without sufficient attention to social and environmental conditions can drift toward placing too much responsibility on individuals for circumstances they do not fully control. Planetary Health without sufficient attention to people's lived experience can become an abstract discussion about environmental systems.

Bringing them together keeps the focus on people, health, equity and the systems that shape all three.

Planetary Health is not a seventh Lifestyle Medicine pillar

It is important not to create a conceptual model that the international Lifestyle Medicine framework has not established.

Planetary Health should not simply be added to nutrition, physical activity, restorative sleep, stress management, connectedness and avoidance of risky substances as a “seventh pillar.” The current international competencies do not define it that way. Instead, Planetary Health appears within the foundational competencies of Lifestyle Medicine.[2]

Within Lifestyle Medicine, Planetary Health is therefore more appropriately understood as a cross-cutting context that interacts with several pillars rather than as an additional pillar.

Food connects nutrition with food systems and environmental impacts. Urban design connects physical activity and social connection with transport and land use. Heat can influence physical activity, sleep and chronic disease risk. Air pollution intersects with cardiovascular and respiratory health and with the conditions for outdoor activity. Social and environmental determinants influence people's ability to act on recommendations across several Lifestyle Medicine domains.

Seen this way, Planetary Health does not expand Lifestyle Medicine by adding another item to a checklist. It helps us understand more of the system surrounding that checklist.

Planetary Health does not replace clinical medicine, public health or environmental health

Planetary Health should not be used to blur professional roles.

Under the current Vietnamese healthcare licensing framework reviewed for this article, Planetary Health is not separately named as a clinical professional title or scope of practice. Ministry of Health regulations determine scopes of medical practice according to professional qualifications, competence and professional title, and list scopes for physicians and other regulated healthcare professions without establishing a separate Planetary Health scope.[8]

Participation in Planetary Health education, research or professional networks therefore does not independently authorize someone to diagnose disease, prescribe treatment or perform other regulated clinical activities.

Many Planetary Health interventions also sit outside healthcare. Energy policy, transport, agriculture, environmental regulation, housing, urban planning and climate adaptation require expertise from many sectors. This is one of the defining characteristics of the field: Planetary Health is explicitly transdisciplinary because protecting human health in the context of environmental change cannot be achieved by the health sector alone.[1]

For healthcare professionals, relevant roles may include understanding environmental determinants of health, recognizing clinically relevant exposures and risks, educating patients, adapting care when environmental conditions matter, contributing health evidence to multidisciplinary discussions and participating in appropriate education, research and quality-improvement activities.

What could this mean for Vietnamese healthcare organizations?

Hospitals and clinics do not need to create a “Planetary Health department” before they can begin considering these connections.

A healthcare organization developing Lifestyle Medicine services can ask whether environmental factors are relevant to the population it serves. A cardiometabolic program may consider heat and air pollution when advising about physical activity. A clinical nutrition program may discuss food-system and sustainability considerations when they are scientifically relevant and clinically appropriate. Occupational health services may need greater attention to heat exposure, while healthcare facilities themselves can consider whether their environments support walking, healthy food, green space, social connection and resilience to extreme weather.

The objective should not be to attach a Planetary Health label to every activity. It should be to identify situations in which understanding environmental conditions improves the quality, safety or relevance of healthcare.

This also creates opportunities for collaboration among clinicians, public health professionals, environmental health experts, researchers, architects, urban planners, universities, community organizations and policymakers. Such collaboration is particularly timely in Viet Nam, where the national climate-sensitive disease review highlighted by the World Health Organization in September 2026 is intended to strengthen evidence about both current and future climate-related disease risks.[4]

What could this mean for Lifestyle Medicine education in Viet Nam?

Planetary Health does not need to be taught as an isolated environmental lecture added to the end of a Lifestyle Medicine course. A more useful approach is to integrate relevant Planetary Health concepts into clinical and professional topics where they naturally belong.

Nutrition education can discuss food systems alongside human nutrition. Physical activity can include the built environment, air quality and heat. Sleep education can consider temperature and housing conditions where relevant. Stress and mental health education can address the health consequences of environmental disruption and disasters when appropriate. Health equity can be considered across all of these areas.

The objective is not to turn every healthcare professional into a climate scientist. It is to help professionals recognize when environmental conditions materially influence health, understand the limitations of purely individual-level advice and know when wider collaboration is needed.

This approach is consistent with the current Lifestyle Medicine competency framework, which now places Planetary Health and social determinants of health within its foundational competencies.[2]

A practical approach for VLMA

For the Vietnam Lifestyle Medicine Alliance, the relationship between Lifestyle Medicine and Planetary Health is not only theoretical. VLMA became a member organization of the Planetary Health Alliance in 2026. The Planetary Health Alliance's official member directory describes VLMA's educational direction as connecting human health with sustainable food systems, climate and air quality, the built environment, natural systems and health equity.[9]

The appropriate role for VLMA is not to claim that a Lifestyle Medicine organization can solve climate or environmental health problems. A more credible contribution is to strengthen professional understanding, translate relevant international evidence into the Vietnamese context, identify where local evidence is still limited and encourage appropriate collaboration across disciplines.

This could include educational resources for healthcare professionals, evidence reviews, seminars, locally relevant case discussions and, over time, research or implementation projects examining how environmental conditions interact with Lifestyle Medicine practice in Viet Nam.

That approach keeps VLMA within an appropriate professional and educational role while allowing it to contribute meaningfully to a larger international field.

From healthy choices to healthy conditions

Lifestyle Medicine remains deeply interested in the choices people make every day, but those choices do not occur in a vacuum. A person cannot choose clean air, an outdoor worker cannot individually lower an extreme outdoor temperature, and a family cannot redesign the streets around their home. People may also have limited control over food prices, housing quality, working conditions or access to green space.

At the same time, collective patterns of food production and consumption, transport, energy use and resource use can influence the environmental systems on which health depends. Human health and Planetary Health therefore cannot be treated as entirely separate conversations.

For Lifestyle Medicine in Viet Nam, the implication is not that environmental issues should replace clinical care or the six established pillars. It is that evidence-based Lifestyle Medicine becomes more realistic when it understands the environmental, social and economic conditions in which health behaviors take place.

The future of Lifestyle Medicine should therefore be about more than helping people make healthier choices. Alongside public health, environmental health and many other disciplines, it can also contribute to creating conditions in which healthier choices are safer, more accessible, more equitable and more sustainable.

References and further reading

1. Planetary Health Alliance. What is Planetary Health? Current definition and introductory resources. Reviewed September 2026.

2. Rea BL, Cheema S, Lanza S, Makinde MT, Matthews S, Palma M, Szentgyörgyi B, Karlsen MC. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2026;20(3):443–451. doi:10.1177/15598276251379821.

3. World Health Organization Viet Nam. Speech by Dr Angela Pratt at the Consultation Workshop on Climate Change and Health: Advancing Health Integration in Viet Nam's NDC 3.0. 23 September 2025.

4. World Health Organization Viet Nam. Speech of Dr Angela Pratt at Consultation Meeting to Validate Scoping Review Findings on Climate Change and Climate-Sensitive Diseases. 11 September 2026.

5. World Health Organization Viet Nam. Air Pollution in Viet Nam and related World Environment Day resources. Reviewed September 2026.

6. World Health Organization. Heat and Health. Updated 31 July 2026.

7. Chevance G, Minor K, Vielma C, Campi E, O'Callaghan-Gordo C, Basagaña X, Ballester J, Bernard P. A systematic review of ambient heat and sleep in a warming climate. Sleep Medicine Reviews. 2024;75:101915. doi:10.1016/j.smrv.2024.101915.

8. Ministry of Health of Viet Nam. Circular No. 32/2023/TT-BYT detailing a number of articles of the Law on Medical Examination and Treatment, as currently amended and applicable.

9. Planetary Health Alliance. Member Organizations: Vietnam Lifestyle Medicine Alliance. Year joined: 2026.

Professional and policy note: This resource is intended for professional education and general information. Planetary Health is a transdisciplinary field and does not independently create a clinical professional title, medical license or scope of practice in Viet Nam. Clinical activities should remain within applicable qualifications, authorized professional scopes and healthcare regulations. Environmental, urban, climate and other system-level interventions require appropriate collaboration with the relevant disciplines, organizations and competent authorities.

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VLMA is operated by Vietnam Lifestyle Medicine Alliance Company Limited, Enterprise Registration Number 0318902666.

VLMA is a Sister Organization of the Lifestyle Medicine Global Alliance and a Member Organization of the Planetary Health Alliance.

VLMA is not a medical service provider and does not issue medical licenses or IBLM certification.