Observations on Vietnam: Economic Growth, Metabolic Shifts, and the Wisdom of the Elderly

Ninh Binh

    Looking over the skylines of Hanoi or Ho Chi Minh City today reveals a country undergoing a profound transformation, with cultural shifts sweeping across the nation. Middle- and low-income countries are undergoing what researchers term the "Nutrition Transition," moving from traditional, labor-intensive diets of Vietnamese and Malay grandparents to an era dominated by convenience foods, refined sugars, and sedentary digital lifestyles.[1,2] While Vietnam's economy is rapidly advancing—evident to visitors through bustling businesses and widespread construction—the overall health of its population is suffering a hidden toll. Even on Phu Quoc Island last week, I observed roads cordoned off for new hotels and businesses, indicating the peak of tourism driven by lower prices relative to Thailand. To address the rising rates of obesity and non-communicable diseases among young people everywhere, we must examine how cultures are shifting toward processed foods and away from fostering healthy minds and bodies. 

    

    People are increasingly spending time on social media, playing video games, and using motorcycles, shifting from a culture once driven by labor. Vietnamese youth should revisit the ancestral wisdom found in traditional Vietnamese cuisine and morning sidewalk routines that have preserved the culture for centuries. As an American, I have learned a great deal about Vietnam through its cuisine and daily life during my six weeks here, and I observe that traditional wellness practices among youth are gradually fading. If cultural change continues, the elders' knowledge of healthy living could be lost forever, much like old roads that are paved over.

The Rice Balance and Glycemic Control

Vegetarian Buffet in Phu Quoc 

    The nutrition transition in Vietnam reflects a rise in overweight individuals, linked to a fundamental shift in how the body metabolizes energy. Over the past decade, obesity rates, especially among children, have increased as traditional fiber-rich diets have given way to ultra-processed foods.[1,2] As I walk through various areas, I see street vendors offering snacks and drinks high in salt and sugar, far removed from the wholesome foods historically central to Vietnamese cuisine. While many still enjoy traditional dishes such as phở and tofu with steamed rice or noodles, even these staples now pose hidden health risks. 

    White rice is integral to Vietnamese culture, but recent global research links high refined white rice consumption to a greater risk of Type 2 diabetes.[3] I recall being in India and struggling to find foods low in refined starches, as most local options centered on white rice; only in Bangalore did I see whole grains like ragi mudde. As in India, the Vietnamese diet relies heavily on white rice, primarily due to economic factors. Rice is a satiating food, and, from a governmental perspective, prioritizing rice cultivation is reasonable to combat starvation and malnutrition. However, with increased food access, subsidizing rice over fresh fruits and vegetables might be more harmful than beneficial for the population. 

    Vietnamese typically see rice as the centerpiece of their lunch and dinner, with other foods as sides. It's concerning that diabetes and chronic metabolic diseases are on the rise.[9] The goal isn't to abandon rice as a cultural heritage but to find a balance. Eating white rice alone leads to quick blood sugar spikes due to its high glycemic load. However, pairing it with high-fiber foods and healthy fats—such as fatty fish and abundant local vegetables—and serving smaller portions (e.g., half a cup instead of two) can promote metabolic health. Although brown rice is less refined and higher in fiber than white rice, it is often more expensive and less popular among locals. Instead of simply replacing white rice with brown rice, I recommend changing perceptions—consume less rice and include more vegetables, fruits, and healthy proteins for a more sustainable, nourishing meal. 

Bioactive Compounds and Traditional Ingredients

Hot Cacao Drink 

    To navigate the nutrition transition, it's important to look at the fiber-rich and fermented foods that Vietnam's ancestors included in their diet. For example, sweet potato leaves, known as rau lang, are a common leafy green dish popular at many restaurants and cơm bình dân shops. They contain bioactive compounds and antioxidants that support heart health and help regulate blood glucose.[4] In Western countries, rau lang is comparable to Swiss chard and dark spinach, both of which are among the most nutrient-dense foods available. 

    Similarly, fermented fish products like mắm, often called fish sauce in the West, are essential to Vietnamese cuisine and are rich in GABA, a compound known to help regulate blood pressure and enhance metabolic health.[5] I didn't realize before coming to Vietnam that fish sauce is a fermented food. As research increasingly highlights the benefits of fermented foods for the gut microbiome, it's exciting to see that fish sauce might be a healthier alternative to the sugary, high-fat sauces used in other dishes. 

    Even daily coffee and tea consumption across cultures serves as a "metabolic accelerator." Vietnam, known for its widespread use of matcha, black coffee, and oolong tea, offers drinks like fermented rice tea and cafe moui—a rich black coffee topped with cream—at nearly every street corner. Bioactive compounds such as Chlorogenic Acid (CGA) in coffee and EGCG in tea help "brown" human fat cells, transforming them into calorie-burning machines that could combat obesity internally. These traditional ingredients act as a biological shield against processed sugars prevalent in modern diets. However, a concern is that while many people regularly consume these drinks for their health benefits, they often contain added sugar, cream, and other unnecessary additives—highly palatable and encouraging overconsumption. These ingredients can do more harm than good, reducing the benefits of the natural compounds present in tea and coffee, which have been part of human diets for centuries. We should promote beverages that are low in sugar or made with natural ingredients, rather than those containing artificial syrups and processed creams. Warning labels on sugary products about their health risks should be more common, particularly when consumed in excess. Ultimately, we aim to prevent adolescents from replacing nourishing meals with sugary drinks such as strawberry matcha lattes, which do not provide the essential nutrients needed for brain and body health. 

Community Movement vs. Isolated Exercise

Hiking in Sapa 

    In America, "exercise" is often viewed as a solitary activity, typically done in a basement or at the gym. Despite Americans being among the most frequent gym-goers worldwide, they still experience high obesity rates. This is likely because most Americans engage in only a few hours of "intense" exercise per week, while the remainder of the time is spent sitting at desks or watching Netflix on the couch. In contrast, Vietnam has a long history of communal exercise. Whether it’s Tai Chi by the lake or elders playing đá cầu on the sidewalk, activities labeled as "Exercise and Sports" (EAS) have traditionally been a crucial part of Vietnamese public health. 

    The country is becoming more sedentary despite increasing connectivity. As people stay busier and more engaged with screens, their physical activity decreases.[6] I often see elderly individuals outdoors at 6 AM, with women dancing in groups to lively music or using outdoor equipment. While many still utilize public spaces, the popularity of motorbikes and technology means exercise is no longer a daily necessity for everyone. Motorbikes speed past on every street, and fewer young people prefer walking as their main transportation. Even a brief 15-minute walk to the store, often replaced by scooters to save time, harms physical health. We should promote the use of sidewalks as exercise spaces. Consistent physical activity, such as the communal morning walk, supports metabolic health and reduces the risk of chronic illness later in life. I don’t want to see the elderly sitting on tiny stools all day. Instead, I want to observe greater energy among people practicing traditional Chinese exercises and see young people returning to physical activity, reaping long-term mental and physical health benefits. 

Digital Influences and Long-term Bone Health

    Unfortunately, the modern environment is pushing back through our screens. Vietnamese youth are increasingly trapped in a digital "Body-Image Loop" on platforms like TikTok, where idealized beauty standards and "Before-After" transformation videos trigger impulsive purchases of quick-fix beauty products.[7] This digital distraction encourages sedentary lifestyles, diverting people from the communal rituals that once promoted health. Comparing oneself to others on social media can harm self-esteem and lead to unhealthy behaviors to cope or mimic the images portrayed online. The rise of social media has created a hazardous environment where youth may sacrifice their health and become distracted from outdoor activities and real-life experiences beyond the screen. 

    One example of how social media use coupled with a poor diet—often lacking enough calcium and Vitamin D—contributes to chronic diseases is the osteoporosis crisis in Asia, notably in Vietnam. By 2050, it is projected that more than half of global hip fractures will occur in this region.[10] Given the high prevalence of lactose intolerance, there is a need for improved strategies to incorporate bone-protective nutrients through fermented dairy products, such as yogurt or fortified milk, to help preserve bone structure as people age.[10] Public education on diverse exercise routines—such as resistance training and cardiovascular activities—and on maintaining a whole foods diet rich in calcium and Vitamin D is essential to combat osteoporosis. This is just one facet of what can be done to transform chronic disease management through lifestyle changes. 

Reclaiming Ancestral Wisdom for Future Health

    To me, traditional eating habits are incredibly important; as the saying goes, they help us remember who we are.[9] I think about my own ethnic roots, where my mother’s family is Greek, and the Mediterranean diet, known worldwide for promoting longevity and fighting chronic diseases. Whether it's Greece's olive oil and wild greens or Vietnam's fish sauce and sweet potato leaves, these diets offer more than nutrition—they provide a sense of identity and social connection that processed fast food cannot match. We need to encourage young people to reconnect with their health traditions—put down Instagram and Snapchat, learn to cook traditional family dishes, and see their elders’ wisdom not as outdated but as essential survival knowledge for today’s world. Sadly, many have become distracted from the natural gifts of the earth, which have provided us with bok choy, golden kiwis, and summer peaches. Meanwhile, culture has shifted toward convenience foods that are making the world sicker every day. If we want to reverse the rising global crisis of obesity and diabetes, we must wake up and learn from our elders about the healing power of natural foods. 

    There are many lessons Americans could learn from traditional Vietnamese practices that are still widely observed today. In the US, we're used to "solo" eating—quick, oversized portions eaten alone, whether in the car or at a desk with cereal. I note that in Vietnam, people often share meals with friends or family, using food not only for nourishment but also to strengthen social bonds. Americans could incorporate elements of Vietnamese dining style, such as a focus on vibrant local vegetables, naturally balanced portions, and communal sharing. This can reduce feelings of isolation and overeating linked to the typical Western diet. We don't need to eat solely for health—it's about community, nourishment, and connection. Supporting local produce vendors, inviting friends for healthy meals, or taking walks with family can foster well-being. Remember, we have God and each other to combat environmental influences that threaten our health and to help us be our best, healthiest selves. 

    Vietnamese elders have taught me that we must bridge the gap between traditional ways and our rapidly changing world. We need to ensure that economic growth and technological advancements do not sacrifice our lives.

---

References

1. Ho NT, Bangsberg D, Hermiston ML, et al. Overweight & obesity epidemic, temporal trends and regional disparities in physical growth of Vietnamese children. Sci Rep. 2026;16(1).

2. Vu LH, Nguyen AN. The nutrition transition in Vietnam: evidence from national household survey data 2012–2020. Crit Public Health. 2026;36(1).

3. Bhavadharini B, Mohan V, Dehghan M, et al. White rice intake and incident diabetes: a study of 132,373 participants in 21 countries. Diabetes Care. 2020;43(11):2643-2650.

4. Nguyen HC, Chen CC, Lin KH, et al. Bioactive compounds, antioxidants, and health benefits of sweet potato leaves. Molecules. 2021;26(7):1820.

5. Utama GL, Inayah DN, Nurmilah S, et al. Fish-based traditional fermented products in Asia: a functional food rich in GABA for hypertension control. Cogent Food Agric. 2026;12(1).

6. Vuong QH, Hoang AD, Vuong TT, et al. Factors associated with the regularity of physical exercises in Vietnam. Sustainability. 2018;10(11):3828.

7. Hoang TTV, Bui TLT, Hoang GN, et al. Literature review the effect body image on Vietnamese youths’ buying behaviors in TikTok. Int J Soc Sci Hum Res. 2025;8(4):2174-2180.

8. Wang Q, Hu GL, Qiu MH, et al. Coffee, tea, and cocoa in obesity prevention: Mechanisms of action and future prospects. Curr Res Food Sci. 2024;8:100741.

9. Vue W, Wolff C, Goto K. Hmong food helps us remember who we are: perspectives of food culture and health among Hmong women with young children. J Nutr Educ Behav. 2011;43(3):199-204.

10. Jiao HT, Yue YS, Yuan S, et al. Is it advisable for Asians to drink milk, especially those at risk of osteoporosis? Front Nutr. 2025;12:1586623.