The Mental and Physical Health Benefits of Green Exercise

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					The Mental and Physical
Health Benefits of Green
        Exercise




   Health and Social Care – Views of the Future
        University of Essex, July 12th 2006

             Professor Jules Pretty
         Department of Biological Sciences
               Hunter-gatherers for ~300,000 generations
               Agriculture for ~600 generations




5 M years BP
                                                     First cities
                                                     (Uruk, Babylon, Ur)


                                                 Rural and urban world population, 1950-2030

                                             6

                                             5

                                             4




                                   billion
                                                                                               Urban
                                             3
                                                                                               Rural
                                             2

                                             1

                                             0




                                               50
                                               55
                                               60
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                                               90
                                               95
                                               00
                                               05
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                                               15
                                               20
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                                               30
                                             19
                                             19
                                             19
                                             19
                                             19
                                             19
                                             19
                                             19
                                             19
                                             19
                                             20
                                             20
                                             20
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                                             20
Modern cities
Urbanisation

  Industrialised society: 6-8 generations
Nutrition Transition
    • Nutrition transition
          • Shift from traditional and local foods, mixed diets,
            high in fruit and vegetables
          • To refined cereals and sugars, more fats, more
            processed foods, fewer vegetables

    • Mediterranean diet – gold standard
          • Fruit & veg; olive oil, fish, meat
          • Low in saturated fats and sugar


    • Large increase in diet-related chronic
      diseases in adults (and now in children)
          • Coronary heart disease, strokes, type II diabetes,
            cancers (30% caused by diet), obesity
          • Obesity affects > 22% of adults and 16% of
            children in the UK
Physical Activity Transition
      • Dramatic fall in physical activity in past
        50 years
             • More sedentary lifestyles – both work and leisure
               time
             • Both less walking, cycling and less organised
               sports
             • Ave adult – marathon a week less per week
      • UK
             • Only one third of adults take the 30 minutes
               moderate exercise 5x per week
             • Less exercise in schools, 60% of primary school
               children are driven to school
The Concept of Green Exercise
Physical Activity                            Exposure to Nature
Known to have positive
                                               Known to have positive
effects on physical and
                                               effects on mental health
     mental health




                      Green Exercise
               To what extent does physical activity
              in the presence of green space affect
                 mental and physical well-being?
Psychological benefits of
nature
  • The Biophilia hypothesis
     – Closeness to nature increases well-being
         • as well as increasing the likelihood of understanding and caring
           for nature

     – Biophilia – holds that we have “an innate sensitivity to and
       need for other living things – as we have co-existed for
       thousands of generations”
         • Nature has a positive and negative emotional impact on us


  • Why do people all over the world have a negative
    response to spiders and snakes?
         • And not modern dangers such as guns and cars?
A room with a view
 • Prisoners
       • Comparison of those in cells facing farmland/trees
         or prison yard
       • Those with nature views – 24% fewer sick cell visits
 • Hospital patients
       • Comparison of patients in rooms looking out on
         brick walls or trees
       • Patients with nature views
           – Stayed in hospital for less time
           – Less medication & fewer negative comments in
             nurses’ notes
 • Nature distraction therapy
       • Bronchoscopy patients – nature scene placed at
         bedside (still, not moving), and patients provided
         with tape of nature sounds
       • Significantly better pain control
                » Total cost significantly less than cost of drugs
Exposure to nature
• Dental patients
      • Observing a live aquarium before treatment - more
        relaxed
• Plants in offices & homes
      • Improve mood and relaxation
      • No plants – more stress
      • Plants
          – less staff absenteeism
          – Less expenditure on drugs and surgery
• Healing gardens in hospitals
      • Patients report positive changes in mood when visiting
        gardens
• Pet owners
      • Lower blood pressure and cholesterol levels than non-
        owners (Australia)
      • Fewer visits to doctor (USA)
      • Dog-owners after heart attacks 6x more likely to
        survive a year after trauma than non-owners
Therapeutic
landscapes
   • Evidence should not be a surprise
         • Yet it does not form much of a part of
           conservation, health, planning, food, agriculture
           or environmental agendas
   • Wild places, countryside and urban green
     space could be promoted as part of
     health service
         • 1.2 billion visits to country
         • 5 billion visits to urban parks


   • Important part of personal identity created
     through interactions in specific places
         • What we are is partly constructed through
           relationships with people and nature
         • If we lack relationships and connections
             – Lose sense of personal identity and self-esteem
Rural and urban
views
  • Green exercise research
       • Controlled conditions (100
         subjects)
       • Comparison of 4 types of views
         while running on treadmill
  • Measured two effects
       • Of difference scenes
       • Of physical activity
                                                                                                               Figure 1: Change in mean arterial blood pressure after exercise whilst


Rural and Urban                                                                                          96
                                                                                                                                     viewing different scenes




                                                                  Mean arterial blood pressure (mm Hg)
                                                                                                         94




Views                                                                                                    92

                                                                                                         90

                                                                                                         88


• Blood pressure                                                                                         86

                                                                                                         84
                                                                                                                                                                               Rural pleasant
                                                                                                                                                                               Rural unpleasant


      • Decline greatest in rural pleasant                                                               82
                                                                                                                                                                               Urban pleasant
                                                                                                                                                                               Urban unpleasant
                                                                                                                                                                               Control

      • Increased with urban views
                                                                                                         80




        relative to control                                                                                   Figure 2: Change in self-esteem after exercise whilst viewing different
                                                                                                                                             scenes



• Self-esteem
                                                                                                                                                                            Rural pleasant
                                                                                         16
                                                                                                                                                                            Rural unpleasant
                                                                                                                                                                            Urban pleasant
                                                                                                                                                                            Urban unpleasant

      • All improvements                                                                 17                                                                                 Control




                                                 Index of Self-Esteem
      • Best with rural pleasant and                                                     18



        urban pleasant                                                                   19


      • Unpleasant scenes made self-
                                                                                         20
        esteem worse relative to control
• Mood                                                                                                        Figure 3: Change in Total Mood Disturbance (TMD) after exercise
                                                                                                                              whilst viewing different scenes
                                                                                                                                                                          Rural Pleasant **


      • Significant improvement in total
                                                                                                                                                                          Rural Unpleasant NS
                                                                             135
                                                                                                                                                                          Urban Pleasant **
                                                                             137                                                                                          Urban Unpleasant NS

        mood disturbance                                                     139

                                                                             141
                                                                                                                                                                          Control *




      • Biggest improvements seen in
                                             Index of TMD



                                                                             143

                                                                             145

        rural and urban pleasant                                             147

                                                                             149

        conditions                                                           151

                                                                             153

                                                                             155
From Green Exercise to Green
Care and Green Design
      • Green Care
        • Laboratory study of effects of views on cardiac
          rehabilitation patients
        • Working with The Wilderness Foundation to assess
          effects of adventure therapy
        • Care Farming – the use of farms and agricultural
          landscapes for the promotion of physical health and
          mental well-being
        • Comparison of 6 week programmes for CBT and
          Green Exercise
      • Green Design
        • Incorporating nature, art and health at hospitals
        • Analysis of environmental improvements for the
          Environment Agency
Policy Challenges
1. Increase the number of people
  participating in green exercise,
  especially
  – those suffering ill-health
  – those not accessing countryside or green spaces
2. Increase the rate of use by those
  already participating
• Health Recommendations
  • Green exercise saves money for NHS
  • Prescribe Gr Ex for those with sedentary
    lifestyles & overweight problems
  • Redesign hospital grounds and views
    from window
           Green Exercise
• Brings mental, physical and social health benefits
       • Even from short exposure

• Health benefits will lead to avoided public health costs
  (and so save money)

• Added reason to protect and conserve both countryside
  and urban green space

• Many opportunities available
      • Already accessed by reasonably healthy
      • But need to do much more for other social groups

• Get to children early to change long-term behaviour
        • Forest Schools

				
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