Can sustainable health behaviour contribute to ensure healthy lives and wellbeing for all at all ages (SDG 3)? A viewpoint


Sustainable health behaviours and, specifically, eating a sustainable diet and engaging in regular physical activity are health-promoting behaviours that can simultaneously contribute to reduction of greenhouse gases which are known to contribute to climate change. Good health usually facilitates societal development, and development often promotes improved health. However, while good health may be a prerequisite for societal development, some behavioural determinants of health, such as attitudes towards the environment, and people’s lifestyles and consumption patterns, can impede the sustainability of the development process in the longer term. This perspective paper argues that there is a need to rethink 21st century health promotion practices by pairing sustainability literacy with health promotion for changing dietary and physical activity behaviour patterns to improve population health and contribute to the achievement of Sustainable Development Goal 3 (to ensure healthy lives and promote wellbeing for all at all ages).


Gloria Macassa, Department of Occupational and Public Health Science, University of Gävle

EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal


United Nations. Resolution A/RES/70/1. Transforming our world: the 2030 agenda for sustainable development. United Nations; 2015. Accessed: 08 March 2021. Available from:

United Nations Development Programme. Sustainable development goals. Geneva: United Nations; 2015. Accessed: 08 March 2021. Available from:

World Health Organization. The Ottawa Charter for Health Promotion. Health promotion. Geneva: World Health Organization; 1986. Accessed: 08 March 2021. Available from: from:

Morton S, Pencheon D, Squires N. Sustainable development goals (SDGs) and their implementation. British Medical Bulletin 2017; 124:81-90. DOI:

Klarin T. The concept of sustainable development: from its beginning to the contemporary issues. Zagreb Int Rev Econom Business 2018;21:67-94. DOI:

Morelli J. Environmental sustainability: A definition for environmental professionals. J Environ Sustain 2011;1.2. DOI:

Vallance S, Perkins HC, Dixon JE. What is social sustainability? A clarification of concepts. Geoforum 2011;42:342-8. DOI:

Åhman H. Social sustainability – society at the intersection of development and maintenance. Local Environt 2013;18:1153-66. DOI:

WHO. Constitution of the World Health Organization. Geneva: World Health Organization; 2005.

Sartorius N. The meanings of health and its promotion. Croat Med J 2006;47:662–4.

Leonardi F. The definition of health: towards new perspectives. Int J Health Serv 2018;48:735-48. DOI:

World Health Organization. Health in the context of sustainable development: background document: prepared by Y. von Schirnding and C. Mulholland for WHO meeting: “making health central to sustainable development: planning the health agenda for the World Summit on Sustainable Development”. World Health Organization; 2002.

McMichael A. Population health as the “bottom line” of sustainability: a contemporary challenge for public health researchers. Eur J Public Health 2006;16:579-82. DOI:

Fortune K, Becerra-Posada F, Buss P, et al. Health promotion and the agenda for sustainable development, WHO Region of the Americas. Bull World Health Organ 2018;96:621-6. DOI:

Pedersen KB, Land B, Kjaergård B. Duality of health promotion and sustainable development perspectives on food waste reduction strategies. J Transdiscip Environ Stud 2015;14:6-18.

Labonté R. Health promotion in an age of normative equity and rampant inequality. Int J Health Policy Manag 2016;5:675-82. DOI:

Setti AFF. Health promotion in the implementation of SDG. In: Leal Filho W, Wall T, Azeiteiro U, Azul A, Brandli L, Özuyar P, Editors. Good health and well-being. encyclopedia of the UN sustainable development goals. Cham: Springer; 2018. p. 1-9.

Buttriss J, Riley H. Sustainable diets: Harnessing the nutrition agenda. Food Chemistry 2013;140:402-407. DOI:

Spencer G, Corbin JH, Miedema E. Sustainable development goals for health promotion: a critical frame analysis. Health Promot Int 2019;34:847-58. DOI:

Williams K, Dair C. A framework of sustainability behaviours that can be enabled through the design of the neighbourhood-scale developments. Sustain Devet 2007;15:160-73. DOI:

Short SE, Mollborn S. Social determinants and health behaviours: conceptual frames and empirical advances. Curr Opin Psychol 2015;5:78 84. DOI:

Bishop FL, Lauche R, Cramer H, et al. Health behaviour change and complementary medicine use: National health interview survey 2012. Medicina (Kaunas) 2019;55:632. DOI:

FAO, WHO. Sustainable healthy diets-guiding principles. Rome: FAO; 2019. Available from:

Bamberg S. Changing environmentally harmful behaviors: a stage model of self-regulated behavioural change. J Environ Psychol 2013;34:151-9. DOI:

White K, R Habib R, J. Hardisty DJ. How to SHIFT Consumer behaviours to be more sustainable: A literature review and guiding framework. J Mark 2019;83:22-49.¨ DOI:

Stern Paul C. Contributions of psychology to limiting climate change. Am Psychol 2011;66:303-14. DOI:

Corral-Verdugo V, Frías-Armenta M, García-Cadena C. Introduction to the psychological dimensions of sustainability. In: Corral-Verdugo V, Frías-Armenta M, García-Cadena C, Editors. Psychological Approaches to Sustainability. New York: Nova Science; 2010. p. 3-18.

De Young, R. Some psychological aspects of a reduced consumption lifestyle: The role of intrinsic satisfaction and competence motivation. Environ Behav 1996;28;358–409. DOI:

Iwata O. Coping style and three psychological measures associated with environmentally responsible behavior. Soc Behav Personal 2002;30:661–9. DOI:

Batson CD. The altruism question: Toward a social psychological answer. Hillsdale: Erlbaum; 1991.

Tapia-Fonllen C, Coral-Verdugo V, Fraijo-Sing B, Duron-Ramos MF. Assessing sustainable behaviour and its correlates:a measure of pro-ecological frugal, altruistic and equitable actions. Sustainability 2013;5:711-23. DOI:

Fanzo J, Davis C. Can diets be healthy, sustainable and equitable? Curr Obesity Rep 1019;8:495-503. DOI:

Ansari EW, Stibbe A. Public health and the environment: What skills for sustainability literacy and why? Sustainability 2009;1:425-440. DOI:

Payne L. Motivating sustainability literacy. ITALICS 2010;9:1-10. DOI:

FAO, IFAD, UNICEF, WFP, WHO. The State of Food Security and Nutrition in the World 2018: building climate resilience for food security and nutrition. Rome: FAO; 2018. Available from:

Haddad L, Hawkes C, Waage J, et al. Food systems and diets: facing the challenges of the 21st century. London: Global Panel on Agriculture and Food Systems for Nutrition; 2016. Accessed: 10 March 2021. Available from:

Bjørnarå HB, Torstveit MK, Slo TH, Bere E. Is there such a thing as sustainable physical activity? Scand J Med Sci Sports 2017;27:366-72. DOI:

Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol 2017;32:541-56. DOI:

Paluska SA, Schwenk TL. Physical activity and mental health. Current concepts. Sport Med 2000;29:167-80.

Hamer M, Chida Y. Active commuting and cardiovascular risk: a meta analytic review. Prev Med 2008;4:6:9-13. DOI:

de Nazelle A, Nieuwenhuijsen MJ, Anto JM, et al. Improving health through policies that promote active travel: a review of evidence to support integrated health impact assessment. Environ Int 2011;37:766-77. DOI:

Matthews CE, Jurj AL, Shu X-O, et al. Influence of exercise, walking, cycling, and overall non exercise physical activity on mortality in Chinese women. Am J Epidemiol 2007;165:1343–50. DOI:

Reiner M, Niermann C, Jekaic D, Woll A. Long-term health benefits-a systematic review of longitudinal studies. BMC Public Health 2013;13:813. DOI:

Westertep KR. Changes in physical activity over the lifespan: impact on body composition and sarcopenic obesity. Obes Rev 2018;19:S8-13. DOI:

Barker ME, Baird J, Tinati T, et al. Translating developmental origins: Improving the health of women and their children using a sustainable approach to behaviour change. Healthcare (Basel) 2017;5:17–30. DOI:

Bay JL, Mora HA, Sloboda DM, Morton SM. Adolescent understanding of DOHaD concepts: A school-based intervention to support knowledge translation and behaviour change. J Dev Orig Health Dis 2012;3:469-82. DOI:

Bay JL, Morton SM, Vickers MH. Realizing the potential of adolescence to prevent transgenerational conditioning of non-communicable disease risk: Multi-sectoral design frameworks. Healthcare (Basel) 2016;4:39. DOI:

Forum for the Future. Sustainability literacy: knowledge and skills for the future. Report of a consultation workshop. Forum for the Future; 2004.

Klöckner CA. The psychology of pro-environmental communication: beyond standard information strategies. London: Palgrave Macmillan; 2015. DOI:

Leverack G. The challenge of behaviour change and health promotion. Challenges 2017;8:25. DOI:

Bamberg S, Rees J, Seebauer S. Collective climate action: Determinants of participation intention in community-based pro-environmental initiatives. J Environ Psychol 2015;43:155-65. DOI:

Trudel R, Cotte J. Does it pay to be good? Sloan Manage Rev 2009;50:60-8.

Auger P, Devinney TM, Louviere JJ. Using best-worst scaling methodology to investigate consumer ethical beliefs across countries. J Bus Ethics 2007;70:229-326. DOI:

Bandura A. Self-efficacy: The exercise of control. New York: Worth Publishers; 1997.

Barbier EB, Burgess J. The sustainable development goals and the systems approach to sustainability. Economics Discussion Paper No. 2017-28. Available from: DOI:

UN. United Nations Sustainable Development Goals Platform. 2019. Accessed: 8 March 2021. Available from:

Nunes AR, Lee K, O’Riordan T. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being. BMJ Global Health 2016;1:e000068. DOI:

Buss PM, Fonseca LE, Galvão LAC, et al. Health in all policies in the partnership for sustainable development. Rev Panam Salud Publica 2016;40:186–91.

Gifford R, Nilsson A. Personal and social factors that influence pro-environmental concern and behaviour: A review. Int J Psychol 2014;49:141-57. doi: 10.1002/ijop.12034. DOI:

Ivanova D, Stadler K, Steen-Olsen K et al. Environmental impact assessment of household consumption. J Ind Ecol 2016;20:526-36. DOI:

Yamin P, Fei M, Saadi L, Levy S. Using social norms to change behaviour and increase sustainability in the real world: a systematic review of the literature. Sustainability 2019;11:5847. DOI:

Dawkins E, Axelsson K, Benoist L et al. Advancing sustainable consumption at the local government level: A literature review. J Clean Prod 2019;231:1450-1462. DOI:

Dooris M, Baybutt M. Connecting sustainable development and public health: A critical exploration with reference to NHS and criminal justice settings. Preston: University of Central Lancashire.

Adshead F, Thorpe A, Rutter J. Sustainable development and public health: a national perspective. J R Inst Public Health 2006;120:1102-5. DOI:

Public Health Agency of Canada. Sustainable development in public health: A long term journey begins. Ottawa: Public Health Agency of Canada; 2006.

Porritt J. Healthy environment-healthy people: the links between sustainable development and health. J R Inst Public Health 2005;119:952–3. DOI:

Pluye P, Potvin L, Denis JL. Making public health programs last: conceptualizing sustainability. Eval Program Plann 2004;27:121-33. DOI: