Review finds nature prescriptions benefit physical and mental health

A new Australian systemic review and meta-analysis suggests that nature prescriptions provide both physical and mental health benefits.
 
Conducted by University of NSW researchers and published in The Lancet Planetary Health, the research indicates that recipients of nature prescriptions have reduced blood pressure, a higher daily step count, and lower depression and anxiety scores.
 
GP Associate Professor Carolyn Ee reviewed the study and said the ‘rigorous’ meta-analysis of randomised controlled trials shows that benefits were particularly apparent when the prescriptions were issued by health or social professionals with an existing connection to patients.
 
‘There are some limitations to this study, as sample sizes were small, populations were varied, and it was impossible to blind the participants,’ she told newsGP.
 
‘However, given that nature prescriptions have multiple benefits and are a low-risk and low-cost intervention, GPs should consider incorporating them into their practice.’
 
Associate Professor Ee said examples of nature prescriptions include time spent in parks and forests, gardens or farms, and blue space such as lakes or oceans.
 
‘Many of the interventions also included physical activity, such as walking and gardening, and relaxation strategies such as meditation,’ she said.
 
‘Therefore, GPs can consider including these components in their prescriptions and can also consider recommending that patients choose their own activities.’  
 
Compared with control conditions, nature-based interventions were found to have a ‘moderate effect’ on depression scores, and a moderate-to-large effect on anxiety scores. They also resulted in a greater reduction in systolic blood pressure (mean difference -4.82 mm Hg) and diastolic blood pressure (mean difference -3.82 mm Hg), and a greater increase in daily step counts (mean difference 900 steps).
 
The study’s lead author Professor Xiaoqi Feng said the results indicate that nature prescriptions can help to ‘restore and build capacities’ for better physical and mental health.
 
‘This study is built upon a long-term program of research that we are doing, where we show contact with nature – and trees especially – is really good for strengthening mental and physical health across our lives,’ she said.
 
‘What we need now is to work out how to make nature prescriptions happen in a sustained way for those people with high potential to benefit, but who currently spend little time in nature.’
 
While the UK recently invested £5.77 million (AU$10.33 million) in a pilot program for ‘green social prescribing’ and Canada has a national nature prescription program, there are no large-scale nature prescription programs in Australia.
 
A previous review of observational studies suggests that people who spent 120 minutes a week in nature settings had higher wellbeing compared to people who spent less time in nature.
 
But Professor Feng says more research is needed to understand how nature prescriptions could be implemented in our local context.
 
‘Even if you have a high-quality green space like a park nearby, it doesn’t mean that everyone will visit and benefit from it … that’s where the idea of a nature prescription comes in,’ she said.
 
‘[But] how long should the nature prescription be for? What should be in the prescription? How should we deliver it, and by whom? These questions don’t have firm answers yet.
 
‘If we want nature prescriptions to become a national scheme, we really need to provide the evidence.’
 
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