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Ecotherapy: the Park Prescription

When you were a kid, did your Mom just tell you to “Go outside and play” like mine did? Turns out, she wasn’t just getting you out of her hair. She was doing something that was good for your health, something more than encouraging you to get some exercise. And now, doctors are doing the same, even for us grownups. Some are now writing prescriptions instructing their patients to spend a specific amount of time outdoors, in nature, each week.

Ecotherapy

It turns out that there are many heath benefits to spending time, not just outdoors, but in a natural setting. Ecotherapy is a newer scientific field that studies the effects of natural settings on our health. Studies comparing brain activity of healthy people after a 90 minute walk in nature, as compared to a similar walk in an urban setting, have shown reduced stress, anxiety and depression. They also found decreased repetitive thoughts, lower blood pressure and decreased levels of the stress hormone, cortisol, that raises blood pressure and cholesterol, causes inflammation and has other detrimental effects when it is elevated too long.

Benefits were noted after about 20 minutes, so each session in natural surroundings is recommended to be at least this long.

What are the benefits?

Exercise

First, there’s the most obvious: exercise. Many of us do something active while we’re outside and away from our entertaining screens. I’m sure you already know the benefits of exercise in improving health and reducing risk of many diseases from heart disease and cancer to the risk of falling, with a long list between these two, not to mention maintaining healthy bones and muscles.

Exercise is important for all ages and levels of fitness. I remember seeing an elderly woman in Spain, walking on the Paseo Maritimo with her walker, enjoying the sunshine and view of the Mediterranean in spite of her level of disability. Even a small amount of movement can maintain or improve your capacity for exercise and ability to function.

Mental health

You might be less aware of the mental health benefits of being outdoors, even if you’re just relaxing on a park bench. Appreciating nature’s beauty distracts us from our worries and even improves depression and anxiety. It’s just plain good for your mental health. I’ve found that a walk on the beach near my home, regardless of the weather, always makes me feel better when I’m upset about something. It even helps make a good mood better than ever!

Interestingly, even bringing the sounds of outdoors to those who cannot get outside is reported to make a difference in brain activity, directing attention outward, distracting focus from worrying about problems. Looking at pictures of nature, especially a favourite spot or a place you’d like to visit, is also helpful in distracting from inward-directed focus that occurs during anxiety, post-traumatic stress disorder and depression.

Immune system

But you may not realize that, when you’re outside in a natural setting, you also expose yourself to a variety of healthy microbes that are different from what are in your home, just by breathing. Some call this “forest bathing” but healthy microbiota exist in any park or garden with plants and trees, not just in large forests. Perhaps a better term is “nature bathing”, immersing yourself in nature.

Spending time outside in various natural settings increases the variety of microbes in our bodies, along with the exposure we choose when eating various fermented foods that contain microbes, like certain cheeses (cheddar, gouda, and mozzarella), yoghurt, kefir, miso, and fermented vegetables or pickles made without vinegar. Microbes we inhale eventually are swallowed and added to the mix. Scientists now recognize that the digestive system is much more than just a way to get nutrients into our bodies. The types and balance of bacteria, fungi and viruses living there (collectively called the microbiome) produce nutrients for us, influence our immune systems and even communicate with our brains.

And we can’t forget about COVID…

These days we have even more reason to spend time outdoors. We’ve learned that improved ventilation and maintaining space from others are important factors in reducing spread of viruses and being outside in fresh air provides ideal ventilation and plenty of space to spread out while still enjoying the company of others. Of course, it will still be a while until crowded venues, like outdoor concerts, are recommended but we’re seeing higher numbers allowed for outdoor activities than for indoor ones because of the infinite “air exchange” nature provides, the natural movement of air that carries away those nasty viruses, if any happen to be present.

So, don’t be surprised if the first prescription your doctor gives for a milder health complaint is a “Park Prescription” with instructions to spend a couple of hours a week at your local park or even just 20 minutes 3 times a week. In fact, the benefits of a Park Prescription could be expected to add to any other treatment you may need to use. If you have other health conditions, your doctor may also have additional advice or cautions as you start your “prescription”.

This is a world-wide movement inspired by Healthy Parks Healthy People, an initiative of the National Park Service in the UK and being promoted in Canada by Park Prescriptions, A Prescription for Nature.

You can read more about it below, but why wait for your doctor to tell you to get outside and enjoy nature? After over a year of COVID restrictions we all have at least a little COVID fatigue… the “COVID-osis” I wrote about a couple of weeks ago. Isn’t it great to know that just going outside and absorbing a little nature can get us on the road to a cure!

Note: The above photo is of a little creek flowing into the Saint John River (in the background), on a walking trail near the Princess Margaret Bridge in Fredericton.

#mentalhealth #forestbathing #NaturePrescription

References:

Health benefits of nature—Healthy by nature

PaRX– A Prescription for Nature

11 Probiotic Foods That Are Super Healthy—Healthline

Healthy Parks Healthy People—National Park Service

Sour mood getting you down? Get back to nature—Harvard Health Publishing

Spending time in nature helps mental health—CBC News

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Thoughts for the Holidays

As we head into a Christmas that is quite a change from usual, my thoughts turn to how different this entire year has been. I know I’m one of the lucky ones – being retired has meant dealing with fewer challenges than those who are still working. My fellow pharmacists, like so many health care workers, have had extra work and worries, trying to continue full health services while keeping themselves and their clients safe.

It seems like a good time to express thanks for the hard work of so many who are trying to keep the virus under control and minimize its impact as it continues to spread. I’d like to chime in with them to encourage everyone to help and to show their appreciation by doing everything they can to prevent virus transmission. Especially for front line health care workers in hospitals, fewer cases of COVID will mean their jobs will be safer and more manageable. So many hospital workers are exhausted and stressed way beyond normal.

Postponed plans…

I was really looking forward to going to Halifax to see our daughter’s beautiful new home and spend time with our family there. But, despite somewhat reduced cases (only 7 new cases yesterday, as I write this), central Nova Scotia is still under travel restrictions. Visiting there is not recommended, and 2 weeks of self-isolation would be required after our return.

So, unless conditions magically change, our visit will be postponed. As my husband says, we can go any time – it doesn’t have to be now. And our daughter has already given us several delightful video tours… with wonderful commentary!

But we are able to get together with my in-laws who live nearby. They’re a retired couple like us who mostly stay at home as the health experts advise. We also get together occasionally with a few of our (also retired or working-from-home) neighbours, keeping our “bubble” to about 10 people, as recommended now that we have only a few travel-related cases here in New Brunswick.

New Year’s resolutions?

So, I expect we’ll have extra time this holiday season that we can use wisely or waste away with worries. I read an Australian “midlife blogger”, Leanne, who writes the weekly blog, “Cresting the Hill”. She describes an alternative to New Year’s resolutions that I hadn’t heard of before: instead of traditional resolutions, at the beginning of each year, she chooses a Word of the Year… a word that will focus and inspire her throughout the year to move forward with her goals, new and old. It sounds like an interesting way to plan for a new year. I might just try it!

For 2021, I think I might choose “Health” as my word of the year – both mental and physical health (as you can’t have one without the other). I want to focus on Health for the environment, too, as we can’t be healthy without a healthy planet. Environmental health is a topic I’ve been wanting to write about, so perhaps you’ll be seeing more blogs from me about this topic in the coming year.

Holiday recommendations:

Meanwhile, here are a few holiday recommendations I came across that might help to keep your mind in a good place even if you can’t be where you want to be…

1. Sleep – When we don’t sleep enough, we are more likely to feel negative when things aren’t ideal, and just can’t feel our best when we’re overtired. A short nap (15 to 30 minutes) can help us increase energy and improve our outlook on the day, too.

2. Stay active – Although you may need to psyche yourself up a little to get outside when it’s cold and windy, fresh air and exercise can improve mood and contribute to good health, both mental and physical.

3. Address loneliness – When you contact friends and family, you’re not just helping to prevent yourself from being lonely… you’re helping someone else too. Whether you prearrange a time for a call, send a text or just ring and see if they have time to chat, the holidays are a time to reach out to others. Just a 5-minute call to say hello can bring happiness and connection. I’ve even gotten back to traditional snail mail a little – getting a card or letter can lift someone’s spirits for several days, as it can be re-read and enjoyed again and again. I think I’ll start writing more letters, even if I end up sending them electronically, but I like the idea of surprising others with a note or letter on real paper.

4. Eat well – Holidays and overindulgence go together. And there’s growing evidence that what we eat can influence our moods. Here’s a fun fact: did you know that turkey contains lots of tryptophan, an amino acid that is a precursor to serotonin (the substance increased by some antidepressants)? Some suggest that the tryptophan content of turkey may be part of the reason why we feel sleepy and contented after a big turkey dinner…

5. Align expectations – Some of us are at greater risk than others, should we become infected with the coronavirus, and need to take greater precautions. Others are returning to normal prematurely, due to “COVID fatigue” even though numbers of infections are peaking in many areas. Don’t hesitate to have a conversation about your comfort level regarding risk of exposure to the virus and respect the choices of others who decide to stay home. Although the holidays are important to many of us, as my husband says, it’s only a day, and we can celebrate later or enjoy the holiday in different ways. Keeping a small “bubble” this year can mean much less suffering later.

6. Limit “doomscrolling” – This is a new term being used for scrolling endlessly through bad news on the internet. While we want to keep up on current virus trends and recommendations, some are advising we should set a time limit for this somewhat depressing activity, then move on to more positive activities. I find it’s helpful to read about things we can do to make a difference… hence, this little list! But, especially before bedtime, read something happy or uplifting to help set you up for a good night’s sleep.

Although this will be a very different Christmas for many of us, making an effort to eat well, stay rested, and keep moving can help keep us healthy, mentally and physically. Even though we can’t gather together as we usually do this year, by reaching out in different ways, we can help others and ourselves enjoy the warm feelings of the holiday season.

So, this will be my last blog for 2020. Like many bloggers, I’ll take a bit of a break over the holidays when most people are too busy to read anyway! I’d like to wish you all happy holidays and a healthy and joyous new year in 2021, as we all recover gradually from the events of this unusual year. I can’t help thinking it will all make for interesting stories to tell our grandchildren who are not yet born… how everyone wore masks, washed their hands many times a day, and didn’t travel or visit hardly at all for a whole year to prevent spreading a nasty virus. And how almost everyone in the world lined up to get a vaccination that would protect us from the virus.

Hopefully we can also tell stories about how scientists learned what we needed to do to prevent another virus from jumping from animals to humans and wreaking havoc across the world again…

Stay safe, stay home and stay well until we have it all under control, and I wish you a happy and healthy 2021! Jeannie

Articles:

Christmas 2020: How to protect mental health – Medical News Today

Cresting the Hill – Leanne in Australia

The role of diet and nutrition on mental health and wellbeing – Cambridge University Press

#mentalhealth #COVID19

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You are what you eat…body and mind

Last week, I wrote about the importance of when you eat… but what you eat is also important to your health. A ranking of popular diets for 2020 ranked the traditional Mediterranean diet as #1. This rating was based on how nutritious and safe the diet is; how effective it is for weight loss; how easy it is to follow and stick with; and how well it protects against diabetes and heart disease. The Mediterranean diet is also recognized by the Mayo Clinic and World Health Organization as a healthy and sustainable dietary pattern.

Advantages of the Mediterranean diet

The Mediterranean diet is a traditional way of eating that people living in counties in the Mediterranean area have followed for generations, rather than a constructed diet based on manipulating components of food. This diet has attracted attention because of the lower rates of heart disease and cancer in populations who follow it.

While other diets are better at losing weight more quickly, the Mediterranean diet helps maintain a healthy weight without severely limiting or removing entire food groups from your plate. This can make it much easier to follow long-term. Of course, weight loss or gain depends on how much of the recommended food you eat.

This diet includes a wide variety of foods, making it enjoyable and easy to follow, with just a few basic “rules” on what foods to choose most often.

And, with this diet, a glass or two of red wine along with your meal is acceptable and possibly even advantageous but, of course, not necessary if that’s your taste. For me, that’s a plus… a nice glass of red wine makes a meal more special!

What is the Mediterranean diet?

The Mediterranean diet is more of an eating pattern than a structured diet. It is a plant-based diet that emphasizes eating fruit, vegetables, whole grains, beans, nuts, legumes (lentils, peas, chickpeas, beans, soybeans, peanuts), olive oil and plenty of tasty herbs and spices (lessening the need for salt); and seafood at least twice a week; and poultry, eggs, cheese and yogurt in moderation. Sweets and red meat are saved for special occasions. And a splash of red wine if that’s to your taste—the recommended amount is one glass a day for women and two for men. (I have often questioned why men are thought to be able to cope with twice what women can, given the often-small difference in body weight… but that’s a subject for another blog!)

Here is how the Mayo Clinic website describes the diet:

· Daily consumption of vegetables, fruits, whole grains and healthy fats (mainly olive oil)

· Weekly intake of fish, poultry, beans and eggs

· Moderate portions of dairy products

· Limited intake of red meat

Find it tough to change the way you eat?

McMaster University’s Optimal Aging Portal suggests starting with these 5 steps (Guess what? They recommend the Mediterranean diet too!):

1. Please pass (up) the salt—reducing sodium (in salt) will help lower blood pressure which, in turn, will decrease your risk of heart disease. Try using herbs and spices for flavour instead. Note that many processed foods are high in salt.

2. Nothing fishy about this advice—eat more salmon, mackerel, tuna and other fish high in omega-3 fatty acids. Don’t like fish? Try a fish oil supplement instead.

3. Cut the (saturated) fat—red meat and dairy are generally higher in this type of fat. Reducing these and replacing with healthier unsaturated fats (found in plants and fish) can lower risk of heart disease.

4. Choose a smaller plate—the size of your plate, food package, or portion you are offered (at home or in a restaurant) can influence how much you eat. Using a smaller plate and avoiding “super size” portions in restaurants can help avoid health risks associated with weight gain.

5. Go Mediterranean—as discussed above, learn about the Mediterranean diet, where you are encouraged to eat more vegetables, fruit, fish, whole grains and unsaturated fats like olive oil. There is evidence that this diet can improve blood sugar, insulin and blood pressure as well as help you lose weight.

Diet can also affect mental health

What you eat can also influence your mental health. Nutritional psychiatry, the study of how food is connected to mental function and mood, is a new but interesting field that is working to determine the connections between our diet and our mental health.

What you eat directly affects the structure and function of your brain and, ultimately, your mood. For example, we know that the brain chemical, serotonin, affects mood and many drugs work by increasing this neurochemical. It is also linked to diseases like irritable bowel syndrome, cardiovascular disease (heart disease and stroke), and osteoporosis. And it helps regulate sleep and appetite, and inhibits pain. But 90-95% of serotonin is produced in the gut, not the brain!

We also know that what you eat influences the “good” bacteria in your intestines, your microbiome, and these bacteria activate nerve pathways directly between the gut and the brain, along with their many other effects on health that scientists are currently identifying. Studies show that taking probiotic supplements can lower anxiety levels and perception of stress, and improve mental outlook, when compared to those not taking the supplements. Many traditional diets contain fermented foods, which act to improve the microbiome in the same manner as probiotic supplements.

As well, diets high in refined sugars and processed foods, like the typical Western diet, worsen symptoms of mood disorders, such as depression, promote inflammation and oxidative stress causing harm to the brain and other parts of the body.

So, consider trying a traditional diet like the Mediterranean diet for 2 or 3 weeks. Think about adding a few fermented foods—experts suggest 5 servings a week of 3 different kinds—and see how it makes you feel.

The field of nutritional psychiatry is relatively new, but it makes sense that what we eat can affect how we feel as well as our overall health. Remember, you are what you eat!

References:

Best Diets Overall—US News

Nutrition and healthy eating—Mayo Clinic

Gut microbes important for serotonin production—Medical News Today

Adopt a Mediterranean diet now for better health later—Harvard Health Publishing

5 Diet changes supported by evidence—McMaster University’s Optimal Aging Portal

Does diet influence mental health? Assessing the evidence–Medical News Today

#Mediterraneandiet #mentalhealth #bestdiet