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Gardening for Health

December 3, 2009 Written by JP    [Font too small?]

My wife and I had a rather interesting experience over this past holiday. We had the good fortune of being invited to the home of a famous restaurateur. While there we toured his personal and fully sustainable garden and farm. Two things struck me about this unique encounter. The first was the obvious joy that this gentleman exhibited while giving us a tour of his own private paradise. It reminded me, in the best possible way, of the enthusiasm that children display when they’re genuinely excited about something that’s important to them. The other thing that captured my attention was that his young children were keenly aware of the fate that would ultimately befall the chicken, pigs and other animals that live on their farm. They clearly understood that their food was not coming from a package in the refrigerated section of a supermarket, but rather from the land itself. I understand that some people may find the last few sentences objectionable. However I firmly believe that if we decide to eat an omnivorous diet, then we must come to terms with all that it encompasses. This family not only understands that point of view, they live it.

If I had to choose just one philosophical point that most directly impacts health it would be this: Wherever and whenever practical, we should “get back to our roots”. I’m not suggesting that we abandon the comfort and convenience of all modern technology. But I do think it’s important to understand what has sustained us in our relatively brief history on this planet: the air we breathe, the food and water that nature provides and the sunshine that lights our days. I find it nearly impossible to believe that technology can ever replace the essentials of biological existence with advancements made in laboratories and test tubes. At our core we are natural beings and we require exposure to nature in order to thrive.

One of the best examples of this philosophy in practice is a form of “treatment” known as horticulture therapy – the use of a garden environment to promote mental and physical wellness. Much like many other natural therapies, gardening seems deceptively simple. However, scientists are finding that exposure to fresh air, green surroundings, a peaceful environment and the wildlife that inhabits it can profoundly improve medical outcomes, reduce patient suffering and health care spending. What’s more, some of the benefits of horticulture therapy also appears to extend to the “healers” that care for those in need. (1,2,3,4,5,6,7,8)

Today’s column focuses on the two most vulnerable segments of the population – children and seniors. Please note that the information presented here also applies to people living somewhere between the dawn and twilight of life. Before I begin I want to dispel the notion that gardening and horticulture therapy are primarily helpful because they encourage individuals to be more active. Not only do I personally disagree with this position but, more importantly, the results of a recent study from The Netherlands refute this as well. The trial I’m referring to was published in June 2008 in the journal BMC Public Health. The conclusion of that inquiry pretty much says it all, “the amount of physical activity undertaken in greener living environments does not explain the relationship between green space and health”. (9)

What if I told you that I had developed a supplement that was clinically proven to make kids want to eat more fruits and vegetables? Would you believe me? Probably not. I wouldn’t believe that claim either. But the findings of several studies do, in fact, show that exposing children to a “garden-based education” can accomplish that seemingly impossible feat.

One scientific review and four studies in 2009 alone prove that time spent in a garden setting not only increases vegetable intake, but it also changes the attitude of children toward fruits and vegetables. In addition, it tends to promote a greater willingness to try new foods. But the education that is received during such training goes far beyond expanding one’s palate and improving nutrition. It’s also an effective way to teach respect for the environment, scientific principles and a unique set of social skills. In general, children who participate in these types of programs report “high levels of enjoyment in the intervention activities” and often express more interest in learning how to prepare the food that they help grow. Establishing these kinds of taste preferences and life skills will likely support better health for a lifetime to come. A group of scientists from Auburn University recently remarked that “school gardens as a component of nutrition education can increase fruit and vegetable knowledge and cause behavior change among children” and that “educators should implement school gardens as a way to positively influence dietary habits at an early age”. (10,11,12,13)

It’s unrealistic to expect most schools to establish garden based educational programs in a time of rampant economic hardship. But there are many private and public organizations that already offer horticulture therapy projects outside of the confines of school grounds. Information about these sorts of programs can be found online through non-profit organizations such as The American Horticultural Therapy Association. (14)

Perceived Benefits of Gardening
Source: Edmonton Community Garden Network (link)

In the course of studying today’s topic, I came across a relatively new therapeutic modality referred to as a “wander garden” – a specially created natural habitat that affords seniors with special medical needs a safe way to spend time outdoors communing with nature. These gardens are intended to provide a soothing environment that includes carefully “designed paths” that are enriched with pleasing, fragrant flowers and visual stimuli. To date, there have been three peer-reviewed, published studies evaluating the effects of this type of treatment setting. Thus far, it appears as though wander gardens can:

  • Reduce the need for antipsychotic medications, decrease the frequency of falls and lower the rate of fall related morbidity in patients with dementia.
  • Lower the degree of staff reported agitation and inappropriate behavior in dementia patients, while improving mood and quality of life.
  • Act as a useful tool in supporting post-stroke rehabilitation, according to a case study from the Veterans Affairs Medical Center, Salem, Virginia. (15,16,17)

I feel that it’s important to note that these findings are coming from research facilities throughout the world. This does not seem to be culturally or geographically influenced in any way. One example is a pilot study that was performed at the Department of Nursing at Woosuk University in Korea. In that trial, 23 “institutionalized dementia patients” suffering from agitation and poor sleep took part in a 5 week gardening program. Post study evaluations (Modified Cohen-Mansfield Agitation Inventory and Hasegawa Dementia Scale) determined that this form of therapy “was found to be effective for sleep, agitation and cognition of dementia patients”. Another recent Australian experiment specifically pointed to gardening as an effective way to ameliorate loneliness in seniors. This is particularly relevant because numerous scientific studies have identified loneliness as a major contributor to poor health outcomes in this population. To tie this all together, it has recently been discovered that spending more time in “green spaces”, such as gardens, helps to promote a greater sense of social connectedness and discourages feelings of loneliness. (18,19,20,21,22)

I came across a quote from Thomas Jefferson that summarizes today’s column more eloquently and succinctly than I ever could. “Though an old man, I am but a young gardener”. The more I explore the human condition in relation to medicine, the more I become convinced of the similarities between those of advanced age and those just starting out in life. Beyond that, the very things that nurture us in sickness are generally the things that help keep us well in the first place. Along the way many of us become distracted from what the body, mind and spirit truly require. The sooner we remember those things and reintroduce them into our lives, the more likely we are to invite back good health.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Alternative Therapies, Food and Drink, Nutrition

13 Comments & Updates to “Gardening for Health”

  1. Bill Rawls Says:

    A very “Michael Pollan” style article… Fantastic!

    This reminds me of a program in NC called “SEEDS.” Years ago a group took a plot of abandoned land in a high-crime area and employed local teenagers to build a garden. The program has been unbelievably successful and teens/kids of all ages now sell their organic produce at local farmers markets, cook meals weekly from their garden for guests, and more! It teaches children from low-income families the value of composting, cooking, eating healthy, respecting the earth, etc. From what I hear it is a magnificent program and I would love to see more programs like it sprout up (no pun intended!). http://www.seedsnc.org

  2. JP Says:

    Thanks, Bill!

    SEEDS sounds like a wonderful organization! That’s exactly the type of charity that I like best. People helping other people to help themselves and the community/world around them. Beautiful! 🙂

    Be well!

  3. Nina K. Says:

    Morning 😉

    ot: what a wonderful pic!

    these studies are very interessting. those residential homes for elderly should be interessted in having such a garden and the healthier elderly could work there.

    i read about a study done with rats and little children (they where in the kindergarten. the researcher testet if theres a difference between organic fruits and veggies and non-organic and which one will the rats / children choose.

    you will know the end :-)! the rats sniffed the non-organic and went straight towards the organic carrots. the same did the children but it takes a little more time. within a few days the children chose the organic fruits and veggies. the reseacher concluded that little children have a very fine natural sense of taste which is destroyed by all the artifical junk food around in supermarkets. that gives hope 🙂

    Be well!
    Nina K.

  4. JP Says:

    Good day, Nina!

    Those are hopeful findings indeed!

    Speaking of hope … I hope more of the hospitals and rehabilitation centers of the future will feature a natural setting. Beyond that, I hope they’ll care for their gardens in the safest possible way – with conservative/limited measures to control pests, etc. Dare to dream! 🙂

    Be well!


  5. Hyun Koo Kim Says:

    I love green life!

  6. JP Says:

    Me too, Hyun! 🙂

    Be well!


  7. JP Says:

    Update 10/15/15:


    Scand J Occup Ther. 2015 Sep 16:1-6.

    Gardening is beneficial for adult mental health: Scottish Health Survey, 2012-2013.

    BACKGROUND: Gardening has been reported as being beneficial for mental well-being for vulnerable populations since 2000. However, little is known concerning its role in the general population. Therefore, the aim of the present study was to investigate the relationship of gardening and mental health in adults in a countrywide and population-based setting.

    METHODS: Data was retrieved from and analysed in the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, gardening engagement, and adult mental health by General Health Questionnaire was obtained by household interview. Statistical analyses including chi-square test, t-test and survey-weighted logistic and multi-nominal regression modelling were performed.

    RESULTS: Of 9709 Scottish adults aged 16-99, 5 531 (57.0%) people did not do any gardening or building work in the last four weeks. A total of 888 (9.2%) people reported poor self-rated health. Gardening was associated with adult mental health in people both with or without heart conditions including ability to concentrate, feeling playing a useful part in things, feeling capable of making decisions, thinking of self as worthless, feeling reasonably happy, etc.

    CONCLUSION: General adults with or without heart conditions could benefit from engaging with gardening or building work. Future public health programmes promoting such activity should be encouraged in order to optimise adult mental health.

    Be well!


  8. JP Says:

    Updated 04/14/16:


    Environ Health Perspect. 2016 Apr 14.

    Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women.

    BACKGROUND: Green, natural environments may ameliorate adverse environmental exposures (e.g. air pollution, noise, and extreme heat), increase physical activity and social engagement, and lower stress.

    OBJECTIVES: We aimed to examine the prospective association between residential greenness and mortality.

    METHODS: Using data from the US-based Nurses’ Health Study prospective cohort, we defined cumulative average time-varying seasonal greenness surrounding each participant’s address using satellite imagery (Normalized Difference Vegetation Index (NDVI)). We followed 108,630 women and observed 8,604 deaths between 2000-2008.

    RESULTS: In models adjusted for mortality risk factors (age, race/ethnicity, smoking, and individual- and area-level socioeconomic status), women living in the highest quintile of cumulative average greenness (accounting for changes in residence during follow-up) in the 250m area around their home had a 12% lower rate of all-cause non-accidental mortality (95% CI 0.82, 0.94) compared to those in the lowest quintile. Results were consistent for the 1,250m area, although the relationship was slightly attenuated. These associations were strongest for respiratory and cancer mortality. Findings from a mediation analysis suggest that the association between greenness and mortality may be at least partly mediated by physical activity, particulate matter less than 2.5 micrometers, social engagement, and depression.

    CONCLUSIONS: Higher levels of green vegetation were associated with decreased mortality. Policies to increase vegetation may provide opportunities for physical activity, reduce harmful exposures, increase social engagement, and improve mental health. While planting vegetation may mitigate effects of climate change, evidence of an association between vegetation and lower mortality rates suggests it also might be used to improve health.

    Be well!


  9. JP Says:

    Updated 10/08/16:


    Qual Life Res. 2016 Oct 1.

    Effects of horticulture therapy on nursing home older adults in southern Taiwan.

    PURPOSE: This study aimed to test the effects of horticulture therapy on activities of daily living, happiness, meaning of life, and interpersonal intimacy of nursing home older adults in southern Taiwan.

    METHODS: A quasi-experimental study was applied. Eighty-five older adults aged 65 or older who lived in nursing homes in southern Taiwan were recruited conveniently. All participants completed the study: experimental group (n = 41) and control group (n = 44). The experimental group received horticulture therapy for 1 h once a week for 8 weeks, while the control group continued their routine daily activities. The following questionnaires were administered before and after the intervention period: (1) Barthel Index (BI), (2) Chinese Happiness Inventory short version (CHI), (3) Meaning of Life Scale (MLS), and (4) Interpersonal Intimacy Scale (IIS).

    RESULTS: The BI, CHI, MLS, and IIS scores significantly improved in the experimental group (p < .05). After 8 weeks of horticulture therapy, the BI, CHI, and IIS scores of experimental group participants were significantly better than the scores of control group participants (p < .05); however, the MLS scores of two groups showed no significant differences (p = .738). CONCLUSIONS: Horticulture therapy improved activities of daily living, happiness, and interpersonal intimacy of older adults in nursing homes. We recommend that nursing homes recruit and train personnel to lead horticultural therapy and to incorporate the therapy as routine daily activities in the facilities. Be well! JP

  10. JP Says:

    Updated 12/16/16:


    J Acad Nutr Diet. 2016 Dec 7.

    Increasing Fruit and Vegetable Intake among Children and Youth through Gardening-Based Interventions: A Systematic Review.

    Although there are numerous health benefits associated with eating fruit and vegetables (F/V), few children are consuming recommended amounts. Gardening interventions have been implemented in various settings in an effort to increase children’s F/V consumption by expanding knowledge, exposure, and preferences for a variety of F/V. The purpose of this review was to identify the effectiveness of gardening interventions that have been implemented to increase F/V consumption among children. A systematic review was conducted using four electronic databases: Web of Science, PubMed, Scopus, and the Cumulative Index to Nursing and Allied Health Literature. English language studies conducted in developed countries between January 2005 and October 2015 were included in this review. Included studies measured F/V consumption among children aged 2 to 15 years before and after implementation of a gardening intervention in a school, community, or afterschool setting. All study designs were included in this review. A total of 891 articles were identified through database searching and cross-referencing. After removing duplicates, 650 articles remained and were screened using inclusion and exclusion criteria. Twenty-seven full-text articles were analyzed and 14 articles were included in this review. Of the 14 articles reviewed, 10 articles found statistically significant increases in fruit or vegetable consumption among participants after implementation of a gardening intervention. However, many studies were limited by the use of convenience samples, small sample sizes, and self-reported measurements of F/V consumption. Although the evidence is mixed and fraught with limitations, most studies suggest a small but positive influence of gardening interventions on children’s F/V intake. Future studies that include control groups, randomized designs, and assessments of F/V consumption over at least 1 year are needed to advance the literature on this topic.

    Be well!


  11. JP Says:

    Updated 01/18/17:


    Int J Environ Res Public Health. 2017 Jan 12;14(1).

    Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration.

    With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare.

    Be well!


  12. JP Says:

    Updated 10/02/17:


    J Phys Act Health. 2017 Sep 14:1-6.

    Effects of School Gardening Lessons on Elementary School Children’s Physical Activity and Sedentary Time.

    BACKGROUND: Recess and physical education time continue to diminish, creating a need for additional physical activity opportunities within the school environment. The use of school gardens as a teaching tool in elementary science and math classes has the potential to increase the proportion of time spent active throughout the school day.

    METHODS: Teachers from 4 elementary schools agreed to teach 1 math or science lesson per week in the school garden. Student physical activity time was measured with ActiGraph GT3X accelerometers on 3 garden days and 3 no-garden days at each school. Direct observation was used to quantify the specific garden-related tasks during class. The proportion of time spent active and sedentary was compared on garden and no-garden days.

    RESULTS: Seventy-four children wore accelerometers, and 75 were observed (86% participation). Children spent a significantly larger proportion of time active on garden days than no-garden days at 3 of the 4 schools. The proportion of time spent sedentary and active differed significantly across the 4 schools.

    CONCLUSIONS: Teaching lessons in the school garden may increase children’s physical activity and decrease sedentary time throughout the school day and may be a strategy to promote both health and learning.

    Be well!


  13. JP Says:

    Updated 03/17/19:


    Int J Environ Res Public Health. 2019 Mar 2;16(5).

    Benefits of Gardening Activities for Cognitive Function According to Measurement of Brain Nerve Growth Factor Levels.

    The objective of this study was to determine the effects of gardening activities in senior individuals on brain nerve growth factors related to cognitive function. Forty-one senior individuals (age 76.6 ± 6.0 years) were recruited from the local community in Gwangjin-gu, Seoul, South Korea. A 20-min low-to-moderate intensity gardening activity intervention, making a vegetable garden, was performed by the subjects in a garden plot located on the Konkuk University (Seoul, South Korea) campus. The gardening involved six activities including cleaning a garden plot, digging, fertilizing, raking, planting/transplanting, and watering. To determine the effects of the gardening activities on brain nerve growth factors related to memory, blood samples were drawn twice from each subject before and after the gardening activity by professional nurses. The levels of brain nerve growth factors, including brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF), were analyzed. Levels of BDNF and PDGF were significantly increased after the gardening activity. This study revealed a potential benefit of gardening activities for cognitive function in senior individuals.

    Be well!


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