At the fifty-third session of the Regional Committee for the Western Pacific in Kyoto, Japan, health policy-makers from 30 countries and areas of the Western Pacific participated in a round table on diet, physical activity and health that discussed how lifestyle changes can be achieved in whole populations. Reviewing successful experiences, participants stressed the need to build supportive environments to facilitate personal change. Many factors generate changes in disease patterns; to bring about positive changes in lifestyles, it will take an alliance of many partners in government, the private sector and civil society. This summary of ideas and experiences discussed at the ministerial round table will be one of the contributions from the Western Pacific Region to developing a global strategy on diet, physical activity and health.