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J. Barton, M. Griffin and J. Pretty. Exercise, Nature and Socially Interactive Based Initiatives Improve Mood and Self-esteem in the Clinical Population. Perspectives in Public Health, 2011; DOI:  10.1021/1757913910393862

Aims: This study evaluated two existing group-based health promotion initiatives (a social club and a swimming group) and compared these to a new green exercise programme (weekly countryside and urban park walks). Methods: Participants represented a clinical population (N = 53) and were all experiencing a range of mental health problems. They only attended one of the three programmes and sessions were held once a week for six weeks in all initiatives. Composite questionnaires incorporating two standardized measures to analyse changes in self-esteem and mood were completed before and after all sessions. Results: A significant main effect for self-esteem and mood pre and post activity (p < 0.001) was reported after participating in a single session. The change in self-esteem was significantly greater in the green exercise group compared with the social activities club (p < 0.001). Dose responses showed that both self-esteem and mood levels improved over the six-week period and improvements were related to attendance in the green exercise group. Conclusions: Green exercise as a health-promoting initiative for people experiencing mental ill health is equally as effective as existing programmes. Combining exercise, nature and social components in future initiatives may play a key role in managing and supporting recovery from mental ill health, suggesting a potential ‘green’ approach to mental healthcare and promotion.

 

J. Thompson Coon, K. Boddy, K. Stein, R. Whear, J. Barton, M. H. Depledge. Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review. Environmental Science & Technology, 2011; : 110203115102046 DOI: 10.1021/es102947t

Our objective was to compare the effects on mental and physical wellbeing, health related quality of life and long-term adherence to physical activity, of participation in physical activity in natural environments compared with physical activity indoors. We conducted a systematic review using the following data sources: Medline, Embase, Psychinfo, GreenFILE, SportDISCUS, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, Arts and Humanities Citation Index, Conference Proceedings Citation Index - Science and BIOSIS from inception to June 2010. Internet searches of relevant Web sites, hand searches of relevant journals, and the reference lists of included papers and other review papers identified in the search were also searched for relevant information. Controlled trials (randomized and nonrandomized) were included. To be eligible trials had to compare the effects of outdoor exercise initiatives with those conducted indoors and report on at least one physical or mental wellbeing outcome in adults or children. Screening of articles for inclusion, data extraction, and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Due to the heterogeneity of identified studies a narrative synthesis was performed. Eleven trials (833 adults) were included. Most participants (6 trials; 523 adults) were young students. Study entry criteria and methods were sparsely reported. All interventions consisted of a single episode of walking or running indoors with the same activity at a similar level conducted outdoors on a separate occasion. A total of 13 different outcome measures were used to evaluate the effects of exercise on mental wellbeing, and 4 outcome measures were used to assess attitude to exercise. Most trials (n = 9) showed some improvement in mental wellbeing on one or other of the outcome measures. Compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalization and positive engagement, decreases in tension, confusion, anger, and depression, and increased energy. However, the results suggested that feelings of calmness may be decreased following outdoor exercise. Participants reported greater enjoyment and satisfaction with outdoor activity and declared a greater intent to repeat the activity at a later date. None of the identified studies measured the effects of physical activity on physical wellbeing or the effect of natural environments on exercise adherence. The hypothesis that there are added beneficial effects to be gained from performing physical activity outdoors in natural environments is very appealing and has generated considerable interest. This review has shown some promising effects on self-reported mental wellbeing immediately following exercise in nature which are not seen following the same exercise indoors. However, the interpretation and extrapolation of these findings is hampered by the poor methodological quality of the available evidence and the heterogeneity of outcome measures employed. The review demonstrates the paucity of high quality evidence on which to base recommendations and reveals an undoubted need for further research in this area. Large, well designed, longer term trials in populations who might benefit most from the potential advantages of outdoor exercise are needed to fully elucidate the effects on mental and physical wellbeing. The influence of these effects on the sustainability of physical activity initiatives also awaits investigation.

Barton J and Pretty J. 2010. What is the Best Dose of Nature and Green Exercise for Improving Mental Health? A Multi-Study Analysis. Environmental Science and Technology 44(10):3947-55

 

Green exercise is activity in the presence of nature. Evidence shows it leads to positive short and long-term health outcomes. This multi-study analysis assessed the best regime of dose(s) of acute exposure to green exercise required to improve self-esteem and mood (indicators of mental health). The research used meta-analysis methodology to analyse ten UK studies involving 1252 participants. Outcomes were identified through a priori sub-group analyses, and dose-responses were assessed for exercise intensity and exposure duration. Other sub-group analyses included gender; age group; starting health status and type of habitat. The overall effect size for improved self-esteem was d=0.46 (CI 0.34-0.59, p<0.00001) and for mood d=0.54 (CI 0.38-0.69, p<0.00001). Dose responses for both intensity and duration showed large benefits from short engagements in green exercise, and then diminishing but still positive returns. Every green environment improved both self-esteem and mood; the presence of water generated greater effects. Both men and women had similar improvements in self-esteem after green exercise, though men showed a difference for mood. Age groups: for self-esteem, the greatest change was in the youngest, with diminishing effects with age; for mood, the least change was in the young and old. The mentally-ill had one of the greatest self-esteem improvements. This study confirms that the environment provides an important health service.

Haubenhofer DK, Elings M, Hassink J and Hine RE. 2010. The Development of Green Care in Western European Countries. Explore 6(2) 106-111 

This article represents a review of green care across Western European countries. The following questions are addressed: What is green care, and what are its basic goals? What are the most commonly known types of green care interventions, and how are they connected to each other? There are different sectors of green care intervention that vary from each other regarding their structure, specific goals, and purpose. These traits will be investigated in this review. And lastly, how these interventions are designed and their approach to promote and provide health will be examined. Key words: Care farming, animal-assisted interventions, social and therapeutic horticulture, healing gardens, green exercise, wilderness therapy.

Sandercock G, Angus C and Barton J. 2010. Physical activity levels of children living in different built environments. Preventive Medicine http://www.sciencedirect.com/scidirimg/clear.gifDOI:10.1016/j.ypmed.2010.01.005

Objective. To review the available literature assessing differences in physical activity levels of children living in different built environments classified according to land use within developed countries.

Methods. A systematic review of published literature up to March 2009. Online searches of five databases yielded 18 studies which met inclusion criteria. Studies provided data on n=129446, 5-18 years old 21 (n=117544 from the United States).

Results. From 13 assessments of differences in physical activity between rural and urban children one showed that rural children were significantly more active than urban children. In studies where the built environment was sub-divided further, suburban and small town children showed the highest levels of physical activity, followed by rural, then urban children. Differences in types of physical activity undertaken were evident, showing that rural children spent more time outdoors, involved in unstructured play compared with urban children. These findings were mainly restricted to children <13 years old.

Conclusions. The literature does not show major differences in the physical activity levels between

children from rural or urban areas. Where studied, the suburban built environment appears most conducive to promoting physical activity. Further research should use at least a trilateral division of the built environment and should also account for socioeconomic status, racial factors and seasonal effects.

Barton J, Hine R and Pretty J. 2009. The health benefits of walking in greenspaces of high natural and heritage value. Journal of Integrative Environmental Sciences 6(4) 1-18

Lifestyles are increasingly characterised by sedentary behaviour, obesity problems, stress, mental ill-health and disconnection from nature. However, contact with nature has been shown to improve psychological health by reducing stress, enhancing mood and replenishing mental fatigue. In addition to providing a range of environmental services, greenspaces provide opportunities and

incentives for ‘green exercise’ such as walking, cycling or horse riding. Visitor numbers indicate that many people already benefit from spending time in greenspaces, but little is known about the immediate impact of an acute exposure on their health and wellbeing. This study focuses on evaluating changes in self-esteem and mood after walking in four different National Trust sites of natural and heritage value in the East of England. The standardised measures of both

self-esteem and mood were administered immediately pre- and post-activity. Self-esteem

scores for visitors leaving the sites were significantly higher than those just arriving and overall mood also significantly improved. Feelings of anger, depression, tension and confusion all significantly reduced and vigour increased. Thus, the environment plays an important role in facilitating physical activities and helping to address sedentary behaviours. Walking, in particular, can serve many purposes including exercise, recreation, travel, companionship, relaxation and restoration. However, walking in greenspaces may offer a more sustainable option, as the primary reward is enhanced emotional wellbeing through both exposure to nature and participation in exercise. Keywords: greenspaces; natural environments; self-esteem; mood; walking;

physical activity.

Hine R. 2008. Care farming: Bringing together agriculture and health. ECOS 29(2), 42-51

A recent study carried out by the University of Essex examined the range and extent of care farming in the UK and also conducted an in-depth case study analysis involving clients of different types of care farm, to provide some empirical data addressing psychological health and well-being effects of spending time on a care farm. The aim of both studies being to help build up a body of evidence to inform health and social care providers (amongst others) and to support the promotion and spread of care farming in the UK. There is great potential for the use of farms (as well as forests, canals, and nature reserves), to provide programmes of green care, which could bring greater connections between people and the land (both farmed and non-farmed), and thus greater understanding of the environment. Care faming and other green care approaches could link policy priorities for farming, conservation, countryside and health agencies, and help create healthy places for the general public.

Hine R, Peacock J and Pretty J. 2008. Care farming in the UK: Contexts, benefits and links with therapeutic communities. Int. Journal of Therapeutic Communities 29(3)

There is increasing evidence for the positive role of nature in human health, particularly in the light of the increase in sedentary lifestyles and the emergence of growing health concerns over obesity, coronary heart disease (CHD) and mental illness. This paper addresses the links between contact with nature and improved health and well-being, introduces the concept of various green care approaches and examines the links between care farming and therapeutic communities. Two studies outlining care farming in the UK are described. The first is a scoping exercise to discover the current extent and diversity of care farming in the UK, in order to form baseline data on which to build future research needs and to help support care farmers. The second study is an in-depth analysis of clients from different types of care farm, and provides empirical data on psychological health and well-being outcomes. The aim of this study is to help build up a body of robust scientific evidence to inform health and social care providers (amongst others) of the benefits of time spent on a care farm. We conclude by setting care farming in a wider context by looking at the potential impact that an expansion of care farming could have on emergent health and social issues and policy in the UK.

Pilgrim S E, Cullen L, Smith D J and Pretty J. 2008. Ecological knowledge is lost in wealthier communities and countries. Environmental Sci & Tech 42(4), 1004-09

Accumulated knowledge about nature is an important part of people’s capacity to manage and conserve the environment. But this ecological knowledge is now being increasingly lost. There have been few cross-cultural and quantitative studies to describe the phenomenon of its loss. Here we show a strong inverse correlation between ecological knowledge and income levels in and among India, Indonesia, and the UK (n) 1095 interviews). Knowledge acquisition and subsequent saturation occurs at an early age in the most resource-dependent communities, but not in the UK, where knowledge levels are low and acquisition is slow. Knowledge variance within communities increases in association with ecological knowledge decline and a scale of progressive knowledge loss was revealed with the most rapid rates of loss in industrialized regions. Various studies have described the mutually exclusive relationship between economic growth and environmental

conservation; however this is the first to consider the association between economic growth and social capacity to manage the environment. Understanding ecological knowledge loss is important to understanding the declining capacities of communities undergoing economic development to manage their natural resources and the future of ecosystem diversity in the light of current patterns of economic growth.

Cullen L, Smith, D J, Pretty J & Pilgrim S E. 2007. The links between local ecological knowledge and wealth in indigenous communities. International Journal of Social Sci 2(1): 289-299

Accumulated knowledge about nature is an important part of people’s capacity to manage and conserve the environment. Local ecological knowledge is vital if natural habitats are to receive sufficient public support for their conservation and if local capacity for self-management is to be maintained. Loss of traditional knowledge is a worldwide phenomenon, resulting in reduced environmental awareness and diminished local capacity for sustainable use and conservation of natural resources. Economic development leading to environmental disconnection through reduced local resource dependence and interaction is causing local knowledge to be hybridised and lost or replaced with modern knowledge systems. Simultaneously, globalisation and increased opportunities to trade can result in severe overexploitation. To date, there have been few cross-cultural and quantitative studies to describe this knowledge loss. This study illustrates the loss of local knowledge using an Indonesian case study, the Kaledupa sub-district of Wakatobi Marine National Park. Kaledupa has a population of around 17,000 comprised of two distinct cultural groups, Kaledupan Islanders (Pulo) and traditionally nomadic boat people (Bajo) now living in permanent houses on stilts over the sea. Marine resources are heavily exploited for income, food, building materials and waste disposal by both groups. Marine ecological knowledge differed significantly between Bajo and Pulo communities (U = 1305.000; p < 0.001). An inverse relationship was shown between marine ecological knowledge and wealth (Rs = -0.395; p < 0.001), and a positive relationship between marine ecological knowledge and support for traditional management practices (Rs = 0.396; p < 0.001). This has implications for the future management of marine and coastal systems in the area and in similar small island communities worldwide.

Pilgrim S, Cullen L, Smith D J and Pretty J. 2007. Hidden harvest or hidden revenue. Indian Journal of Traditional Knowledge 6(1), 150-159

In the 5-7 million years we spent as hunter-gatherers, our knowledge base evolved with the ecosystems within which it existed and has further developed as a result of historical continuity of local resource dependence. Knowing which wild animals and plants are palatable and have nutritious content has long been a survival strategy for the rural poor, indigenous peoples and tribal communities, particularly those living in harsh environmental conditions. This information is essential to supplementing diets when harvests fail due to insect blights, disease or adverse weather conditions, hence wild nutritional resources are often termed the “hidden harvest”. This study used ethnobotanical and ethnozoological surveys to assess the relationship between wealth and use of local resources in a remote region of Indonesia. Contrary to the results of previous studies, this study found that poorer households are more likely to use local resources to generate income than wealthier households, who are more likely to use local species for consumption and rely on other sources of income. It also found that individuals or communities with higher income levels are less likely to support traditional ecosystem practices. The shift in resource collection incentives (from subsistence to income) as a result is likely to threaten ecosystems, management practices and the human populations that will have to rely on them in the future. Therefore, it may be essential to externally-manage systems of resource management in the future as economic development encroaches on traditional communities. The findings of this study also have implications for the future of less wealthy communities in resource-rich regions. If access to natural resources is ever reduced or removed, for instance through ecosystem degradation or management regulations limiting extracted yields, in addition to ensuring that alternative food sources are available, state authorities must ensure that alternative income streams are found for these communities, particularly in the light of future economic development. Therefore, both wild and human populations inhabiting an ecosystem come under threat when economic development and market pressures force the local view of natural resources to shift from one of hidden harvest opportunities to hidden revenue.

Pilgrim S, Smith D J and Pretty J. 2007. A cross-regional quantitative assessment of the factors affecting ecoliteracy: implications for conservation policy and practice. Ecological Applications 17(6), 1742-51

The value of accumulated ecological knowledge, termed ecoliteracy, is vital to both human and ecosystem health. Maintenance of this knowledge is essential for continued support of local conservation efforts and the capacity of communities to self- or co-manage their local resources sustainably. Most previous studies have been qualitative and small scale, documenting ecoliteracy in geographically isolated locations. In this study, we take a different approach, focusing on (1) the primary factors affecting individual levels of ecoliteracy, (2) whether these factors shift with economic development, and (3) if different knowledge protection strategies are required for the future. We compared non-resource-dependent communities in the United Kingdom with resource-dependent communities in India and Indonesia (n ¼ 1250 interviews). We found that UK residents with the highest levels of ecoliteracy visited the countryside frequently, lived and grew up in rural areas, and acquired their knowledge from informal word-of-mouth sources, such as parents and friends, rather than television and schooling. The ecoliteracy of resource-dependent community members, however, varied with wealth status and gender. The least wealthy families depended most on local resources for their livelihoods and had the highest levels of ecoliteracy. Gender roles

affected both the level and content of an individual’s ecoliteracy. The importance of reciprocal oral transfer of this knowledge in addition to direct experience to the maintenance of ecoliteracy was apparent at all sites. Lessons learned may contribute to new local resource management strategies for combined ecoliteracy conservation. Without novel policies, local community management capacity is likely to be depleted in the future. Key words: ecoliteracy; India; Indonesia; knowledge; natural resource; oral traditions; resource management; sustainable management; United Kingdom

Pretty J, Peacock J, Hine R, Sellens M, South N and Griffin M. 2007. Green Exercise in the UK Countryside: Effects on Health and Psychological Well-Being, and Implications for Policy and Planning. Journal of Environmental Planning and Management. 50 (2) 211-231 

There is evidence that contact with the natural environment and green space promotes good health. It is also well known that participation in regular physical activity generates physical and psychological health benefits. The authors have hypothesised that ‘green exercise’ will improve health and psychological well-being, yet few studies have quantified these effects. This study measured the effects of 10 green exercise case studies (including walking, cycling, horse-riding, fishing, canal-boating and conservation activities) in four regions of the UK on 263 participants. Even though these participants were generally an active and healthy group, it was found that green exercise led to a significant improvement in self-esteem and total mood disturbance (with anger-hostility, confusion-bewilderment, depression-dejection and tension-anxiety all improving post-activity). Self-esteem and mood were found not to be affected by the type, intensity or duration of the green exercise, as the results were similar for all 10 case studies. Thus all these activities generated mental health benefits, indicating the potential for a wider health and well-being dividend from green exercise. Green exercise thus has important implications for public and environmental health, and for a wide range of policy sectors.

Pretty J. 2006. Physical activity in modern society: is there also an environmental benefit? Environmental Conservation 33 (2), 87-88

Higgins (2005) has shown that increased human physical activity in the USA could lead to both improvements in physical health and reductions in oil consumption by motor vehicles, thereby also reducing carbon emissions. It is an intriguing idea and, as the health costs of obesity are so high, the potential health and environmental savings could be vast. These questions deserve wider attention, as all the trends suggest that consumption of both fossil fuels and food calories (combined with more sedentary lifestyles) will continue to rise in the coming years.

Pretty J, Hine R and Peacock J. 2006. Green Exercise: The benefits of activities in green places. The Biologist 53(3), 143-148

Samson C and Pretty J. 2006. Environmental and health benefits of hunting lifestyles and diets for the Innu of Labrador. Food Policy 31(6), p 528-553

The Innu of Northern Labrador, Canada have undergone profound transitions in recent decades with important implications for conservation and health policy. The change from permanent nomadic hunting, gathering and trapping in `the country’ (nutshimit) to sedentary village life (known as‘sedentarisation’) has been associated with a marked decline in physical and mental health. The overarching response of the national government has been to emphasize village-based and institutional solutions. We show that changing the balance back to country-based activities would address both the primary causes of the crisis and improve the health and well-being of the Innu. Drawing on ethnographic fieldwork, interviews with Innu older people (Tshenut), empirical data on nutrition and activity, and comparative data from the experiences of other indigenous peoples, we identify pertinent biological and environmental transitions of significance to the current plight of the Innu. We show that nutrition and physical activity transitions have had major negative impacts on individual and community health. However, hunting and its associated social and cultural forms is still a viable option as part of a mixed livelihood and economy in the environmentally-significant boreal forests and tundra of Northern Labrador. Cultural continuity through Innu hunting activities is a means to decelerate, and possibly reverse, their decline. We suggest four new policy areas to help restore country-based activities: i) a food policy for country food; ii) an outpost programme; iii) ecotourism; and iv) an amended school calendar. Finally, we indicate the implications of our analysis for people in other countries.

Pretty J, Peacock J, Sellens M and Griffin M. 2005. The Mental and Physical Health Outcomes of Green Exercise. International Journal of Environmental Health Research 15(5), 319-337

Both physical activity and exposure to nature are known separately to have positive effects on physical and mental health. We have investigated whether there is a synergistic benefit in adopting physical activities whilst being directly exposed to nature (‘green exercise’). Five groups of 20 subjects were exposed to a sequence of 30 scenes projected on a wall whilst exercising on a treadmill. Four categories of scenes were tested: rural pleasant, rural unpleasant, urban pleasant and urban unpleasant. The control was running without exposure to images. Blood pressure and two psychological measures (self-esteem and mood) were measured before and after the intervention. There was a clear effect of both exercise and different scenes on blood pressure, self-esteem and mood. Exercise alone significantly reduced blood pressure, increased self-esteem, and had a positive significant effect on 4 of 6 mood measures. Both rural and urban pleasant scenes produced a significantly greater positive effect on self-esteem than the exercise-only control. This shows the synergistic effect of green exercise in both rural and urban environments. By contrast, both rural and urban unpleasant scenes reduced the positive effects of exercise on self-esteem. The rural unpleasant scenes had the most dramatic effect, depressing the beneficial effects of exercise on three different measures of mood. It appears that threats to the countryside depicted in rural unpleasant scenes have a greater negative effect on mood than already urban unpleasant scenes. We conclude that green exercise has important public and environmental health consequences. Keywords: Green exercise, physical activity, mental health, self-esteem, mood, environmental health

 

 

 

 

 

 

University of EssexInterdisciplinary Centre for Environment and Society