Lifestyle medicine core competencies updated: Addressing today’s global health priorities   

The 2025 update adds one new competency and refines two others, bringing the total to 89. Together, these updates enhance lifestyle medicine’s capacity to tackle today’s most urgent issues, including health equity, planetary health, and nutrition in a complex food environment, as well as outlines a structure and timing for future global updates.  

By Brenda Rea, DrPH, RD, PT, DipABLM, FACLM, LM Intensivist  | ACLM Medical Director of Education 

October 16, 2025

Lifestyle medicine (LM) competencies define the knowledge and skills required to practice evidence-based LM across medical and healthcare disciplines. Since their first publication in 2010, the competencies have evolved to reflect the field’s expanding scope—first with an update in 2022, and now in 2025. 

As the field continues to grow and organize globally, the Lifestyle Medicine Global Alliance (LMGA) recognized the need for a structured, predictable process for competency review and revision. The new lifestyle medicine competency update schedule establishes major updates every six years starting in 2027 complemented by minor updates occurring between the major updates beginning in 2030. 

This framework is designed to shape professional knowledge and skills while informing curricular development and revisions of both the Lifestyle Medicine Board Review (LMBR) and Lifestyle Medicine Residency Curriculum (LMRC). However, these curricular changes will not be implemented immediately. Because of the scope and workload required, it will take two to three years after each competency update for full curricular integration. From there, an additional year will be needed before the changes are realized in the English American Board of Lifestyle Medicine certification exam in North America, and another year beyond that for translations into other languages for the International Board of Lifestyle Medicine certification exam. 

Due to the cost and workload associated with translations, the LMBR will only be translated following major LM Competency updates every six years, meaning only even-numbered editions (e.g., 4th, 6th) will undergo translation. This systematic process ensures that LM competencies are consistently aligned with emerging science and global health priorities while balancing the operational realities of curricular and certification development. 

The 2025 update introduces one new competency and refines two existing ones, bringing the total number of LM competencies to 89. These changes strengthen LM’s ability to address today’s most pressing challenges, from health equity to planetary health to nutrition in the modern food environment.

A new competency: social determinants of health (A9)    

The most significant addition in this update is Competency A9: Apply LM interventions in the context of social determinants of health (SDOH) to improve health outcomes and health equity. 

SDOH are estimated to influence up to 50% of health outcomes, yet traditional medical education has not adequately equipped practitioners to address them. By explicitly including SDOH, LM emphasizes that interventions must be designed with an awareness of patients’ social, cultural, and economic contexts. 

This competency prepares practitioners to: 

• Assess a patient’s social and economic environment. 

• Tailor interventions to be culturally relevant and realistic. 

• Collaborate across disciplines and with communities to address systemic barriers. 

By integrating SDOH into LM training, healthcare professionals can more effectively promote health equity and resilience, ensuring that interventions are not only clinically sound but also socially sustainable. 

Strengthening the link between human and planetary health (updated A8) 

The second update redefines the planetary health competency: 

• 2022 Competency A8: Explain the impact of lifestyle choices on planetary health and sustainable living. 

• 2025 Updated Competency A8: Examine the relationship between LM, planetary health, and sustainable living. 

This shift emphasizes the bidirectional relationship between human and planetary health. Not only do lifestyle choices impact the environment, but climate change, pollution, and ecosystem disruption directly affect human health outcomes—from respiratory illness and cardiovascular risk to food insecurity and allergy prevalence. 

LM practitioners are now guided to frame planetary health as inseparable from patient health, recognizing the scientific evidence linking sustainable living with improved outcomes for both individuals and communities. 

A clearer view on food processing and health (updated C5) 

The third update revises the nutrition-related food processing competency: 

• 2022 Competency C5: Describe how the level of processing in a food affects health and discuss the evidence base for these effects. 

• 2025 Updated Competency C5: Appraise the evidence base related to how the level and type of food processing affect health outcomes. 

This change reflects the need for practitioners to engage with the growing body of research on ultra-processed foods (UPFs) and their associations with obesity, type 2 diabetes, cardiovascular disease, cancer, and other chronic conditions. The update highlights that not all processing is harmful—techniques such as flash freezing or grain milling can preserve or even enhance nutritional value—while UPFs, with their high levels of additives and low nutrient density, carry clear health risks. 

By deepening practitioners’ understanding of food processing classifications and their implications, LM provides a stronger evidence-based foundation for guiding patients toward healthier dietary patterns. 

Looking ahead 

The 2025 LM Competency updates mark a critical step in aligning LM education and practice with global priorities: equity, sustainability, and nutrition quality. With a structured schedule for future updates, healthcare professionals can trust that competencies will remain timely, evidence-based, and globally relevant. 

By incorporating SDOH, strengthening the recognition of planetary health, and refining the approach to food processing, LM continues to provide a comprehensive framework for transforming health at the individual, community, and global level. 

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