Abstract
I am pleased to announce that this year we will be launching a “Lifestyle Medicine in Asia Section” in the American Journal of Lifestyle Medicine.
As lifestyle medicine has continued to spread around the world, there is perhaps no geographical area outside of the United States where it has become more influential than in Asia. Within Asia, lifestyle medicine has become particularly prominent in China and Japan.
There are many reasons for the rising interest and growth in lifestyle medicine in these 2 countries. These reasons include the longstanding historical interest in the role of lifestyle medicine in promoting positive health and well-being, both in China and Japan, as well as the realities of modern circumstances, which further underscore the need and value of lifestyle medicine.
In China, lifestyle medicine is highly compatible with many of the core principles of Traditional Chinese Medicine (TCM). The basic idea of disease prevention and treatment through lifestyle medicine strongly aligns with the concept of “treating disease before it occurs” which is a hallmark of TCM.
TCM is a practice spanning thousands of years in China. In fact, as early as 2600 BC, the book then known as the Yellow Emperor’s Classic Internal Medicine was the first Chinese medical theory book which combined traditional Chinese medical theory, diagnosis, treatment and prevention in health care by linking these concepts to diet, meditation, and exercise. 1 In more recent times, the formal promotion of lifestyle and health in China started in the 1980s, perhaps even earlier. One of the most well-known studies that emanated from China was the Da Qing Diabetes Prevention Outcome Study. 2 This was a 6-year research trial which combined lifestyle interventions (diet, exercise, and weight loss) in individuals with prediabetes. This study showed that this intervention reduced the incidence of diabetes by 51%, which was 43% lower than the control group. These findings are often quoted as consistent with the U.S. Diabetes Prevention Program (DPP), 3 which found similar results.
The DPP showed that individuals who lost a small amount of weight (5-7%), improved their nutritional practices, such as consuming more fruits and vegetables and whole grains, and engaged in regular moderate-intensity physical activity, lowered their risk of diabetes by 58%.
The history of lifestyle and health concepts in Japan is equally long. Medical practice in Japan was dominated by Eastern Asian medical practices for many centuries. The oldest medical text, Ishinpo, published in 982 AD emphasized that Japanese people should not ingest meat or milk and emphasized the positive effects of hot bathing for recovery of illnesses and injuries, as well as emphasizing the high value of exercising in nature (forest bathing). 4
The modern impetus behind the lifestyle medicine movement in China has come in response to major health threats in China, which mirror global trends. For example, non-communicable diseases accounted for 91% of all deaths and 86.7 % of all disability-adjusted life years (DALYs) in China in 2021. 5 In response, the Chinese government released the “Healthy China 2030 Blueprint” to address these new health challenges. 6 This report emphasized the need to shift the health care system from disease-oriented treatments to one that prioritized disease prevention. The emphasis on disease prevention, in turn, resulted in a high-level of interest in lifestyle medicine in China.
The leading cardiovascular hospital in China, the Fuwai Hospital in Beijing, has assumed the leadership role in this area and established the first Center for Lifestyle Medicine in a tertiary care hospital in China. The Fuwai Hospital has recruited over 100 other hospitals to join in the “Healthy China Campaign.” The Fuwai Hospital is the largest cardiovascular hospital in the world and is also known as the National Center for Cardiovascular Disease (NCCD).
Establishing the Center for Lifestyle Medicine at this prestigious hospital has shown that a major academic medical center can begin to reconfigure traditional care models to address challenges of the emerging health risks in China. I am proud that I have played a role in establishing the Center for Lifestyle Medicine at the Fuwai Hospital. The third edition of my Lifestyle Medicine textbook was translated into Chinese in 2024 by individuals at Fuwai Hospital and has provided authoritative academic support for the emergence of lifestyle medicine in China. 7
Following the modern emergence of lifestyle medicine in Japan in the 1980s and early 1990s, the Japanese Society for Lifestyle Medicine was established in 2017. The Japanese Government has issued multiple directives and even laws mandating that Japanese individuals pay closer attention to lifestyle practices and habits. Lifestyle medicine practices helped change the leading causes of death in Japan. 8 For example, in the 1950s, elevated blood pressure from high salt intake caused stroke to replace tuberculosis as the leading cause of death in Japan. Lifestyle medicine practices played a significant role in reducing salt intake from food by utilizing fresh food products. Cigarette smoking was also reduced. I was pleased to give the opening keynote address for the Japanese Society of Lifestyle Medicine in 2023 which focused on some of the benefits that lifestyle medicine has brought to Japan.
With all of this as background, we are delighted to launch a “Lifestyle Medicine in Asia Section” in AJLM. To guide this process, I have appointed 2 Chinese clinicians and scholars: Drs. Xuezhu Sun and Xue Feng as Editorial Board members to guide this process in China. These investigators wrote an important article in AJLM entitled “Lifestyle Medicine in China: The Fuwai Hospital Lifestyle Medicine Initiative.” 9 They are the key leaders of the Center for Lifestyle Medicine in Beijing. They will be advised by a group of distinguished physician scientists who will serve as editorial advisors for the Chinese portion of the “Lifestyle Medicine Asia” section of AJLM.
For the Japanese section of the “Lifestyle Medicine Asia” section, I have appointed Drs. Tamami Shirai, Kazuyo Tsushita, and Yutaka Matsuoka to serve as co-editors. Two of these physician scientists wrote a superb article in AJLM entitled “Lifestyle Medicine and Japan’s Longevity Miracle.” 10 They will also be advised by a group of distinguished Japanese physician scientists.
In the year to come, we hope to publish several articles on Lifestyle Medicine in China as well as articles concerning Lifestyle Medicine in Japan. We also hope that other countries in Asia will also submit articles for consideration in the “Lifestyle Medicine in Asia Section.” In particular, I recognize that there is a robust lifestyle medicine movement in Korea. I was delighted to provide the opening keynote address for the Korean College of Lifestyle Medicine in 2025. 11
The inauguration of a “Lifestyle Medicine in Asia Section” recognizes the global reach of lifestyle medicine. This, of course, is also underscored by the World Health Organization (WHO) initiative to combat non-communicable diseases. WHO has reported that over 74% of all mortality each year around the world comes largely from daily poor lifestyle habits and actions. 12
Given the robust background of lifestyle medicine, including lifestyle practices and their role in good health, from both an historical and modern basis in China and Japan, the lifestyle medicine movement will benefit from learning more about the nuances of how positive lifestyle habits and practices utilized in various cultures can contribute to health improvement around the world.
I continue to believe that lifestyle medicine will play a significant role in countries all around the world. In fact, the habits and practices of lifestyle medicine, which represent its core elements, have the potential to enhance the health and save the lives of millions of people worldwide!