Lifestyle Medicine for Children and Adolescents in Viet Nam: Healthy Development, Family-Centered Care and Chronic Disease Prevention

Lifestyle Medicine for Children and Adolescents in Viet Nam: Healthy Development, Family-Centered Care and Chronic Disease Prevention

Last reviewed: 29 September 2026

Healthy habits established early in life can influence health for decades. But applying Lifestyle Medicine to children and adolescents is not simply a matter of taking recommendations designed for adults and starting them earlier. Children are growing, and adolescents are developing physically, psychologically and socially. Their food, sleep, movement, relationships and exposure to health risks are shaped not only by individual choices, but also by parents and caregivers, schools, neighborhoods, digital environments and wider social conditions.

This makes Lifestyle Medicine highly relevant in younger populations, but also more complex. The goal is not to create a “perfect lifestyle,” focus narrowly on body weight, or place responsibility for health on a child. A more appropriate goal is to support healthy development, identify emerging risks early, help families create environments in which healthier behaviors are realistic, and connect children and adolescents with appropriate clinical care when lifestyle support alone is not enough. The 2025 Lifestyle Medicine Core Competencies support this broader perspective. They include social determinants of health, behavior change, mental and emotional health, social connection, interprofessional care and appropriately adapted physical activity interventions for children, adolescents and other populations with specific needs.[1]

Why does Lifestyle Medicine matter early in life?

Many behavioral patterns relevant to later health begin well before adulthood. Food preferences develop early, while movement, sleep and screen-related routines become embedded in family and school life. Adolescence is also a period when tobacco, nicotine, alcohol and other risk-taking behaviors may first appear, while academic pressure, social expectations and online environments can influence sleep, emotional well-being and social connection.

This does not mean that chronic disease is predetermined by childhood behavior. Genetics, biology, socioeconomic conditions, commercial influences, education, the built environment and access to healthcare all matter. Childhood and adolescence do, however, provide important opportunities to establish protective behaviors and identify emerging risks before cardiovascular, metabolic and other chronic diseases become established later in life.

These years are also critical for physical growth, brain development, bone health, emotional development and learning. Lifestyle interventions therefore need to support development rather than pursue adult clinical targets in isolation. For a child, eating less, weighing less or exercising harder is not automatically healthier. Appropriate care depends on age, developmental stage, growth trajectory, nutritional status, medical conditions, family circumstances and the wider environment in which the young person lives. This article focuses mainly on school-age children and adolescents, while recognizing that healthy development and the foundations of later health begin much earlier in life.

Viet Nam is facing a double burden of malnutrition

The Vietnamese context shows why a simple weight-centered approach would be inappropriate. Undernutrition and micronutrient deficiencies remain important in some populations, while overweight and obesity have increased substantially, particularly in urban settings. Data reported from the 2020 National Nutrition Survey indicated that among children and adolescents aged 5–19 years, 19.0% were classified as overweight and 8.1% as having obesity, with higher prevalence among boys and children living in urban areas.[2]

More recent evidence reinforces the need to address both ends of the nutritional spectrum. A nationally representative cross-sectional study conducted from January 2024 to June 2025 included 43,505 children aged 6–17 years across Viet Nam. It reported 20.7% with overweight and 11.4% with obesity, while 3.9% had stunting and 5.1% had thinness.[3] These estimates should not be directly compared with the 2020 survey as a time trend because the studies differed in age range, sampling and methodology. Together, however, they show that undernutrition remains present while excess weight has become an increasingly important health concern among Vietnamese school-age children.

Health behaviors are also changing. The 2019 Global School-based Student Health Survey, involving nearly 8,000 students aged 13–17 years, found that the proportion eating fast food at least once a week had increased from 30.2% in 2013 to 54.1% in 2019. The proportion reporting at least 60 minutes of physical activity per day on five or more days each week increased from 20.5% to 24.1%, but still represented only around one in four surveyed students. Electronic cigarette use was also emerging, with 2.6% reporting use nationally and 7.9% in Ha Noi and Ho Chi Minh City.[4] These data should not be treated as current 2026 prevalence estimates, but they remain an important nationally representative description of adolescent health behaviors in Viet Nam.

The policy environment is evolving as well. In 2025, Viet Nam adopted a revised Special Consumption Tax Law that brought certain sugar-sweetened beverages meeting the statutory definition, including beverages under the relevant national standard with more than 5 grams of sugar per 100 milliliters, within the special consumption tax framework. The law took effect on 1 January 2026, while the applicable tax rate is 8% from January 2027 and 10% from January 2028.[5] UNICEF also reported the introduction of School Meal Nutrition Guidelines in December 2025 and obesity-prevention activities reaching 9,678 students in Da Nang.[6] These developments reinforce an important point: children's health cannot depend only on individual motivation. Food environments, schools, families and public policy also matter.

Healthy eating for children is about nourishment, not restriction

Nutrition is one of the most visible areas of Lifestyle Medicine, but it requires particular care in children and adolescents. Growing bodies need adequate energy, protein, essential fats, vitamins, minerals and other nutrients, and requirements change with age, puberty, activity level and health status.

The World Health Organization's Healthy Diet fact sheet, updated in January 2026, emphasizes four core principles: adequacy, balance, moderation and diversity. It encourages dietary patterns based largely on a variety of minimally processed and nutrient-dense foods while limiting excessive free sugars, sodium and unhealthy fats. It also makes clear that children have nutritional requirements that differ from those of adults. Protein quality and digestibility deserve particular consideration during childhood and adolescence, and in some contexts animal-source foods remain important for nutrient adequacy, particularly in younger children.[7]

For Lifestyle Medicine in Viet Nam, healthy eating should therefore be adapted to Vietnamese food culture rather than imported as a rigid dietary identity. Rice and other grains, vegetables, fruits, legumes, tofu, fish, eggs, dairy where appropriate, nuts, seeds, meat and other familiar foods can all contribute to nutritionally appropriate eating patterns depending on age, health needs, cultural preferences and family circumstances. Where a plant-predominant eating pattern is used, the emphasis should be on increasing nutritious plant foods rather than automatically excluding animal-source foods.

Strict vegan diets require particular attention during childhood and adolescence. A 2025 position paper from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition concluded that current evidence is insufficient to determine with confidence whether strictly vegan diets consistently support normal childhood growth. It recommends regular nutritional counseling and monitoring, with particular attention to protein quality and nutrients including vitamin B12, calcium, iron and vitamin D.[8] Very-low-carbohydrate diets, fasting regimens and elimination diets likewise should not be routinely applied to growing children without an appropriate clinical reason and professional oversight.

Where a child has impaired growth, significant underweight or excess weight, food allergy, gastrointestinal disease, eating difficulties, suspected nutrient deficiency, obesity-related complications or another medical condition, individualized assessment may be required. Food should also not become a source of fear or moral judgment. Repeatedly criticizing a child's body, using shame to change eating behavior, or treating foods or children as “good” or “bad” can undermine both physical and emotional health. A healthier approach focuses on skills, routines, access, enjoyment, family meals where feasible and gradual improvements in the food environment.

Movement should support development, fitness and enjoyment

Physical activity in childhood does much more than influence body weight. It supports cardiovascular fitness, muscular and bone development, motor skills, cognition and mental health. World Health Organization guidance recommends that children and adolescents aged 5–17 undertake an average of at least 60 minutes per day of moderate-to-vigorous physical activity across the week, predominantly aerobic, with vigorous-intensity aerobic activity and activities that strengthen muscle and bone on at least three days each week.[9] Children under five have different age-specific movement and sedentary-behavior recommendations, so the 5–17-year recommendation should not simply be applied to younger children.

In practice, movement does not have to mean formal exercise. Walking, cycling, active play, dancing, swimming, sports, physical education and other forms of activity can all contribute. For many young people, the most sustainable form of physical activity is one they enjoy, can access safely and can continue.

Exercise prescription becomes more complex when a child has obesity, disability, cardiovascular or respiratory disease, musculoskeletal limitations or another health condition. The 2025 Lifestyle Medicine Core Competencies specifically recognize the need to adapt physical activity prescriptions for children, adolescents and other special populations.[1] In these circumstances, “exercise more” is not an adequate clinical instruction. Assessment, appropriate progression and referral to qualified professionals may be necessary.

Sedentary behavior also deserves attention, but screen use should not be treated as a single behavior. A young person may use a screen for schoolwork, communication, creative activities or entertainment. More useful questions include whether recreational screen use is displacing movement, sleep, face-to-face relationships or other important parts of daily life, and whether the digital environment is affecting mental health, safety or exposure to harmful commercial influences.

Sleep, mental health and social connection are part of healthy development

Sleep is sometimes treated as something children and adolescents can sacrifice for study, extracurricular activities or online life. Yet adequate, regular and good-quality sleep supports learning, attention, emotional regulation, metabolic health and physical development. Adolescence can be particularly challenging because biological changes in sleep timing may conflict with early school schedules, academic demands and late-night technology use.

Lifestyle Medicine can help by making sleep a routine part of health assessment rather than waiting until severe problems develop. Clinicians can ask about sleep duration and regularity, difficulty falling or staying asleep, daytime sleepiness, snoring, late-night screen use and the relationship between sleep, school performance and emotional functioning. Lifestyle support has clear limits, however. Persistent insomnia, significant daytime impairment, habitual loud snoring, witnessed breathing pauses or other features suggesting a sleep disorder require appropriate clinical assessment. General sleep-hygiene advice should not delay investigation of obstructive sleep apnea or another condition requiring diagnosis and treatment.

Children and adolescents also do not experience nutrition, physical activity and sleep independently of their emotional lives. Academic pressure, stress at home, bullying, loneliness, family conflict, violence, discrimination, social media experiences and uncertainty about the future can all affect health behaviors and well-being. The World Health Organization estimates that globally around one in seven people aged 10–19 experiences a mental health condition. Supportive families, schools and communities, regular physical activity, healthy sleep, coping skills and positive relationships can contribute to mental well-being, but they are not substitutes for mental healthcare when a disorder is present.[10]

Stress management should therefore not become a way of explaining depression, anxiety, self-harm or severe distress as failures of resilience. A young person with concerning mental health symptoms needs appropriate assessment and, when indicated, care from qualified mental health professionals. Lifestyle interventions may support that care, but should not be presented as replacements for it. Positive social connection is similarly broader than telling adolescents to “spend less time online.” Relationships with parents, caregivers, siblings, friends, teachers, teammates and communities can provide belonging and support, and online relationships can also be meaningful for some young people. The clinical task is to understand their quality and safety and whether the young person has people they trust and can turn to when needed.

Avoiding risky substances needs to begin before adulthood

Tobacco, nicotine, alcohol and other substance use often begin during adolescence, so prevention during this period can have implications far beyond the school years. The 2019 school health survey already documented electronic cigarette use among Vietnamese adolescents.[4] Viet Nam subsequently introduced a comprehensive prohibition on electronic cigarettes and heated tobacco products, effective from 1 January 2025. The prohibition covers production, trade, importation, harboring, transportation and use.[11]

For healthcare professionals, prevention should therefore go beyond asking whether an adolescent smokes conventional cigarettes. Age-appropriate assessment may need to include electronic nicotine products, alcohol and other substances, while communication should be sufficiently nonjudgmental for young people to answer honestly. When substance use is established, appropriate assessment, treatment or referral may be required rather than education alone.

Family-centered care does not mean blaming parents

One of the major differences between Lifestyle Medicine in adults and children is that children rarely control the environments in which most health behaviors occur. Parents and caregivers influence which foods are available at home, when meals occur, transportation, opportunities for activity, bedtime routines, healthcare access and many household norms. Their involvement is therefore important, but that does not mean every health problem is caused by parenting.

Families themselves operate within constraints. Food prices, housing, neighborhood safety, income, working hours, transportation, school schedules, caregiving responsibilities and access to recreation can all influence what is realistically possible. The 2025 Lifestyle Medicine Core Competencies formally added social determinants of health to the international competency framework, reinforcing the principle that interventions should be adapted to social, cultural and structural circumstances rather than assuming everyone has the same choices.[1]

Evidence from pediatric obesity care also illustrates why a family-centered and nonstigmatizing approach matters. The 2023 American Academy of Pediatrics clinical practice guideline recommends comprehensive obesity care that considers the child, family and wider social context and may involve nutrition, physical activity, behavioral treatment, pharmacotherapy and metabolic and bariatric surgery in appropriately selected patients.[12] This is a United States clinical guideline rather than a Vietnamese guideline, but it illustrates the broader international shift away from viewing childhood obesity simply as a failure of personal behavior.

For adolescents, family involvement should evolve with development. Young people need increasing participation in decisions about their own health, and clinicians should communicate with them respectfully rather than conducting every conversation only through parents or caregivers. Family-centered care works best when it creates support around a young person while preserving dignity, participation and developing autonomy.

Lifestyle Medicine should not reduce pediatric care to obesity prevention

The rise in childhood overweight and obesity makes metabolic health an important issue, but defining Lifestyle Medicine for children primarily as weight management would be a mistake. A child with obesity may also have micronutrient deficiencies, inadequate sleep, low fitness, anxiety or social isolation. A child whose body mass index falls within an expected range can still have poor dietary quality, physical inactivity, nicotine exposure, sleep problems or significant mental health concerns. At the other end of the spectrum, undernutrition and impaired growth remain important in parts of Viet Nam.

Growth measurements and body mass index-for-age can provide useful information, but they should be interpreted alongside growth trajectory, development, clinical history, nutritional status and other health indicators. Weight-related discussions should be respectful and clinically purposeful, particularly because weight stigma can itself cause harm and discourage engagement with healthcare.

Obesity is a complex chronic disease with biological, genetic, environmental, social and behavioral contributors. Lifestyle and behavioral interventions remain important components of care, but they should not be assumed to be the only treatment a child or adolescent may need. International pediatric practice increasingly recognizes that pharmacotherapy and metabolic and bariatric surgery may be appropriate for selected adolescents with obesity as part of comprehensive clinical care. Whether a particular medication, device or procedure is approved, available, indicated or legally usable in Viet Nam must be determined according to Vietnamese law, regulatory approvals, professional guidance and the circumstances of the individual patient.[12]

Lifestyle Medicine should therefore complement appropriate pediatric care rather than create an ideological choice between “lifestyle” and medical treatment.

Schools and communities are part of the health environment

Children spend a large part of their lives outside the clinic. Schools influence food, movement, learning and social relationships, while neighborhoods influence opportunities for walking, cycling, play, recreation and access to healthy food. Some of the strongest opportunities to support healthier development may therefore come from improving environments rather than giving more advice.

In January 2026, the World Health Organization released its first global guideline specifically addressing healthy school food environments. It recommends action on foods and beverages provided or sold at school, nutrition standards and changes to the school food environment that make healthier choices easier. The guideline reflects a broader shift away from relying solely on individual education toward creating environments that better support healthy behavior.[13]

Viet Nam's legal framework is moving in a similar preventive direction. The Law on Disease Prevention No. 114/2025/QH15 took effect on 1 July 2026 and covers communicable disease prevention, noncommunicable diseases, mental disorders and nutrition in disease prevention. Article 34 provides that nutrition in disease prevention should be addressed throughout the life course, adapted to age and population group, and appropriate to physical condition, Vietnamese culture and economic circumstances. Measures include nutritional screening, assessment and monitoring, nutrition counseling and education, and age- and population-appropriate nutritional interventions.[14]

This direction aligns closely with a central principle of Lifestyle Medicine: healthy choices become more achievable when families, schools, communities and systems make them realistic.

Clinical roles and legal boundaries still matter

Lifestyle Medicine does not itself confer a separate professional license or authorize healthcare professionals to work outside their legally permitted scope of practice in Viet Nam. Medical examination and treatment remain governed by Viet Nam's healthcare licensing and professional framework. The current consolidated text of the Law on Medical Examination and Treatment was issued as Consolidated Document No. 26/VBHN-VPQH on 26 February 2026.[15]

This distinction is especially important in children and adolescents. General health education is different from diagnosing disease, providing individualized medical treatment, prescribing or adjusting medication, managing obesity-related complications or treating a mental health disorder. Healthcare professionals should work within their qualifications, professional competence and authorized scope of practice and refer when a child's needs extend beyond that scope.

Vietnamese law also contains specific provisions governing how healthcare rights are exercised for patients who are minors. Article 15 of the Law on Medical Examination and Treatment provides that where a minor has a representative specified under the law, healthcare rights are exercised according to that representative's decision; where such a representative is unavailable, the decision is made by the person responsible for professional activities or the person on duty in charge of the healthcare facility.[15] Healthcare organizations and practitioners should therefore follow applicable law, implementing regulations and institutional procedures when clinical decisions involving minors require representation or consent.

Interprofessional care can be particularly valuable in this population. Depending on the young person's needs, care may involve physicians, nurses, appropriately qualified nutrition professionals, rehabilitation or exercise professionals, psychologists, mental health professionals and others working within their authorized roles. Teachers, schools, families and community organizations can also support health, but their contribution should not be confused with regulated clinical practice.

What could this mean for Lifestyle Medicine in Viet Nam?

The opportunity is broader than creating dedicated pediatric Lifestyle Medicine clinics. Lifestyle Medicine principles can be incorporated into pediatric and adolescent care by routinely asking about nutrition, physical activity, sleep, emotional well-being, social connection and substance exposure; identifying emerging risks; helping families make realistic changes; recognizing social barriers; and establishing clear pathways for further assessment or referral.

Healthcare organizations could integrate these elements into preventive care, pediatric and adolescent services, obesity and metabolic care, rehabilitation, mental health pathways and other existing services. Schools and community partners can contribute to health promotion, but programs should be evidence-based, appropriately governed and evaluated rather than assumed to be effective simply because they promote a “healthy lifestyle.”

Research is also important. Viet Nam needs continuing national and local evidence on diet, movement, sleep, digital behavior, mental health, family environments and the ways these factors cluster across different groups of children and adolescents. The 2024–2025 nationwide nutritional study is an important addition, but more longitudinal and intervention research will be needed to understand which family-, school- and healthcare-based approaches are effective, equitable, feasible and sustainable in Vietnamese settings.[3]

Success should not be measured only by changes on a scale. Healthy development includes appropriate growth and nutritional status, physical fitness, metabolic health, sleep, emotional well-being, social functioning, participation in education, quality of life and the development of health skills that young people can carry into adulthood.

The main message

Lifestyle Medicine has an important role in the health of children and adolescents, but it should not be reduced to telling young people to eat better, exercise more or lose weight. Children develop within families, schools, communities and wider social environments. Their health behaviors are influenced by what is available, affordable, safe, culturally familiar and supported by the people and systems around them.

For Viet Nam, a responsible approach should therefore be developmentally appropriate, family-centered, nonstigmatizing and evidence-based. It should support adequate nutrition and growth, regular movement, restorative sleep, emotional health, positive relationships and avoidance of risky substances, while recognizing social determinants and identifying when clinical assessment or treatment is needed. The purpose is not to medicalize childhood or demand perfect behavior. It is to give children and adolescents a stronger foundation for healthy development now while reducing avoidable health risks across the life course.

Professional education notice

This resource is intended for professional education and knowledge exchange. It does not constitute individualized medical advice, establish a Vietnamese clinical guideline, confer professional certification or scope of practice, or replace pediatric assessment, applicable clinical guidelines, professional judgment, licensing requirements or Vietnamese laws and regulations. Decisions concerning an individual child or adolescent should take account of age, development, growth and nutritional status, medical history, family circumstances and other relevant clinical factors.

References

1. Rea BL, Cheema S, Lanza S, et al. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2025. doi:10.1177/15598276251379821.

2. UNICEF East Asia and Pacific Regional Office. Childhood Overweight and Obesity in Viet Nam: A Landscape Analysis of the Extent and Risk Factors. National Nutrition Survey 2020 data.

3. The Updated Dual Burden of Malnutrition Among Vietnamese School-Aged Children: A Nationwide Cross-Sectional Study. Nutrients. 2025;17(21):3446. doi:10.3390/nu17213446.

4. World Health Organization Regional Office for the Western Pacific. Report of the 2019 Global School-based Student Health Survey in Viet Nam. 2022.

5. National Assembly of Viet Nam. Law on Special Consumption Tax No. 66/2025/QH15. Adopted 14 June 2025, effective 1 January 2026.

6. UNICEF Viet Nam. UNICEF's 2025 Impact in Viet Nam. Published 2026.

7. World Health Organization. Healthy Diet. Updated 26 January 2026.

8. Verduci E, Köglmeier J, Haiden N, et al. Vegan diet and nutritional status in infants, children and adolescents: A position paper based on a systematic search by the ESPGHAN Nutrition Committee. Journal of Pediatric Gastroenterology and Nutrition. 2025;81(5):1318–1345. doi:10.1002/jpn3.70182.

9. World Health Organization. Guidelines on Physical Activity and Sedentary Behaviour. 2020.

10. World Health Organization. Mental Health of Adolescents. Updated 1 September 2025.

11. World Health Organization Viet Nam. Breaking Free in Viet Nam: Former Vapers Share Their Path to Health. 14 August 2026; National Assembly of Viet Nam, Resolution No. 173/2024/QH15.

12. Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023;151(2). doi:10.1542/peds.2022-060640.

13. World Health Organization. Policies and Interventions to Create Healthy School Food Environments: WHO Guideline. 27 January 2026.

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

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

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