Kent Nature Partnership The Natural Health Servicekentnature.org.uk/.../files/Resources/Kent-Nature-Partnership-BIRD.pdf · Nature and the Unborn Child High Blood Pressure in pregnant

Dr William Bird MRCGP MBE

28th June 2016

Kent Nature Partnership The Natural Health Service

© 2015 Intelligent Health

We were

designed to

be

connected

to nature

The Story

Yet 54% of the world’s population live in cities Is this disconnection the underlying cause of the epidemics of obesity and other chronic diseases? Do we need healthy landscapes?


• Our genes make up 1.5% of the

Genome.

• Almost 50% of our Genome is from

viruses.

• We depend on contact with ancient

bacteria in the soil to regulate our

immune system

Our energy

is supplied

by an old

sea

bacterium

What are we?

Only 10% of

cells in our

body belong

to us


If we take an hour to equal 1,000 years, then four days is 100,000 years – the time from the origin of mankind to today

4 days ago

100,000 years ago

hunter gatherers

10 hours ago

10,000 years ago agriculture

4 hours ago

4,000 years ago civilisation

10 hours ago

10,000 years ago agriculture

4 hours ago

4,000 years ago civilisation

technology industrialisation industrialisation

9 minutes ago

9 minutes ago

80 seconds ago


Sociable Green Valued

Our factory setting is to be in a sociable group, supportive environment and

have a purpose

People Place Purpose


Loneliness Hostile Rejection


Fear and Chronic Stress


How does nature benefit health?

(a) Less stressed,

(b) More exercise,

(c) More positive social interactions and

(d) Better quality environment for health promotion (i.e. has lower levels of air pollution)

Hartig T., Mitchell R., De Vries S.

and Frumkin H. (2014) Nature and

health. Annual Review of Public

Health 35, 207–228.




The Effect of Trees on Cognitive Performance

–3

–2

–1

0

1

2

3

4

5

6

7

No Tree Min Awareness Mod Awareness Heightened Awareness

Lin, Ying-Hsuan, et al. "Does awareness effect the restorative function and

perception of street trees?“ Cognitive Science 5 (2014): 906.

Digit Span Backward Test


Exposure to Neighbourhood Green Space and Mental Health

Beyer, Kirsten MM, et al. Int.J of environmental research and public health 11.3 (2014): 3453-3472


Association Between Trees, Vegetation, Depression and Stress

–1.6

–1.4

–1.2

–1.0

–0.8

–0.6

–0.4

–0.2

0.0

25% more Tree Cover 25% Higher NDVI 25% more Greenspace

Depression Stress

Normalized Difference Vegetation Index (NDVI)

Beyer, Kirsten MM, et al. Int.J of environmental research and public health 11.3 (2014): 3453-3472


Green Space reduces Health Inequalities

1.0

1.2

1.4

1.6

1.8

2.0

2.2

No green Little green Some green More green Very green

Exposure to green

HighestIncome

MiddleIncome

LowestIncome

Linear (HighestIncome)

Linear (MiddleIncome)

Linear (LowestIncome)

Mitchell, R. and Popham, F. (2008) Effect of exposure to natural environment on health inequalities:

an observational population study. The Lancet 372(9650):pp. 1655-1660.

Incidence Rate Ration


Nature and the Unborn Child

High Blood Pressure

in pregnant women increased by 14% for every 300 meters away

from green space

Birth weight and baby’s head

size were larger within the 500

metres of green space

1. Grazuleviciene R et al Int J Environ Res Public Health 2014 11 2958-2972

2. Dadvand P Env Health Perspectives 120 10


Chronic

Stress

Anxiety and

depression

Physical

Inactivity

Poor diet


Chronic Stress

Stress

Hormones

Physical

Inactivity

And other

poor health

behaviours

Chronic Inflammation

Mitochondria as a key component of the stress response. Manoli et al. Trends in Endocrinology and Metabolism Vol 18 No 5 2007


Chronic

Inflammation Immune system

is constantly

switched on


Inflammation: ‘the cause of causes’

Chronic

Inflammation

Starts in children

as young as

6 years old

Arthritis Arthritis

Cancers Cancers

Diabetes Diabetes

Obesity Obesity

Dementia Dementia

Cardiovascular

disease

Anxiety and

Depression


Inactivity causes inflammation

1.

Increases

visceral fat

3.

Damages

healthy cells

2.

Reduces anti-

inflammatories


Inactivity: trilogy of inflammation

1.

Increases

visceral fat

3.

Damages

healthy cells

2.

Reduces anti-

inflammatories


Reducing inflammation – fat

Visceral fat = 0.5 L Visceral fat = 1.1 L

Visceral fat = 1.3 L Visceral fat = 1.7 L

Visceral fat = 4.3 L Visceral fat = 4.2 L Visceral fat = 1.8 L

Visceral fat = 1.2 L

Variation in visceral fat

content in men with the

same waist circumference


Visceral fat reduction with exercise

–25

–20

–15

–10

–5

0

Lean Obese Type 2 Diabetes

Subcutaneous Fat Visceral Fat

Lee S et al. J Appl Physiol 2005;99:1220-1225

Fat loss after 13 weeks of walking 60 mins a day and no weight loss

% Loss of Fat



1.

Increases

visceral fat

3.

Damages

healthy cells

2.

Reduces anti-

inflammatories


Reducing inflammation – muscles

Contracting

muscles

release powerful

anti-inflammatories

called Myokines

These

Myokines

Circulate

around the

whole body

calming every

cell



1.

Increases

visceral fat

3.

Damages

healthy cells

2.

Reduces anti-

inflammatories


Chromosomes

keep dividing

Immune

system is

switched off

until needed

Mitochondria,

healthy

and active.

Providing lots

of energy

Inside a healthy cell


‘The mitochondria is like a dynamo, it has to keep moving ...

... and in the body they

weigh as much as a car battery’

Prof Mike Murphy,

MRC Mitochondrial Biology Unit Cambridge University


Sedentary, high fat diet and stress

Mitochondria

Anti-

Oxidants Reactive

Oxidative

Species

Mitochondrial DNA

Oxidative Phosphorylation


Physically active, low fat and not stressed

Mitochondria

Oxidative Phosphorylation

Reactive

Oxidative

Species

Mitochondrial DNA

Anti-

Oxidants


Telomeres get shorter

Epel, Elissa, et al. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres.

Annals of the New York Academy of Sciences 1172.1 (2009): 34-53


Senescence: the end of the cell

Hezel, Aram F., Nabeel Bardeesy and

Richard S. Maser. ‘Telomere induced

senescence: end game signaling.’ Current

molecular medicine 5.2 (2005): 145-152.


Loneliness Hostile Rejection


Fear and Chronic Stress


Chronic Stress

Stress

Hormones

Physical

Inactivity

And other

poor health

behaviours

leads to inflammation Mitochondrial damage and telomere shortening

Depression

Mitochondria as a key component of the stress response. Manoli et al. Trends in Endocrinology and Metabolism Vol 18 No 5 2007

Cancers Diabetes Dementia Cardiovascular


Physical Activity clears all CVD risk from patients with Diabetes

1

2.81

0.89 0.78

0

1

2

3

Less than 3 hours a week no Diabetes

Less than 3 hours a week with Diabetes

More than 3 hours a week no Diabetes

More than 3 hour a week

with Diabetes

Moe B et al Diabetes Care March 2013 vol. 36 no. 3 690-695

Follow up of 53,973 Norwegian Men (recruited 1995). Adjusted for weight, 1,750

deaths from CVD in 2008. Less than 3 hours vs more than 3 hours a week of Physical

Activity

CVD Risk (1.93 – 4.07)

(0.48 – 1.63) (0.63 – 0.96)


Brain Derived Neuro-trophic Factor

• Opposes Neuro-generative processes

• Reduces Type 2 Diabetes in Mice

• Increases Connectivity between Neurones

• Improves Mitochondrial function in the

brain

Noakes T Spedding M: Olympics: Run for

Your Life Nature 487, 295–296 (19 July

2012)

PA is Fundamental to Human Survival


Physical Activity increases

Hippocampus by 20% in

children and stabilises it in

those elderly at risk of

Alzheimers

Smith, J. Carson, et al. "Physical activity reduces

hippocampal atrophy in elders at genetic risk for

Alzheimer's disease." Frontiers in aging neuroscience

6 (2014): 61.


After 20 minutes of sitting quietly After 20 minutes of walking

Hillman et al. (2009). Neuroscience,159, 1044-1054

Single Sessions of Physical Activity can enhance Attention and Memory


Boosts Natural

Killer Cells


Durand CP, Andalib M, Dunton

GF, Wolch J Pentz MA.

A Systematic review of built

environment factors related to

physical activity and obesity risk:

Implications for smart growth

urban planning. Obesity Reviews

(2011) 12 173-182

A Therapeutic Environment


Foster distinctive, attractive

communities with a strong sense of

place


Belfast Connswater Greenway 9 km linear park, a wildlife corridor

124 Ha of open space

43 new bridges

19 km of foot and cycle paths

5 km of clean rivers

A civic square

Serving 40,000 people and 26

schools

Create Walkable

Environments




Key attributes to increased use of green space

● Perceived quality and safety of local green space.

● Good access to green space and lack of antisocial behaviour on the way.

● Improvement of quality and access can increase overall physical activity levels

Ward Thompson C, Aspinall P; Natural Environments and their

Impact on Activity, Health, and Quality of Life. Applied

Psychology: Health and Wellbeing, 2011, 3 (3), 230–260


Adding Quality of Green Space

Measures of Quality:

● Accessibility,

● maintenance,

● variation,

● naturalness,

● colourfulness,

● clear arrangement,

● shelter,

● absence of litter,

● general impression.

Dillen, S.M.E. van, Vries, S. de,

Groenewegen, P.P., Spreeuwenberg,

P. Greenspace in urban

neighbourhoods and residents’ health:

adding quality to quantity. Journal of

Epidemiology & Community Health:

2012, 66(6)

Green or Blue Willingness to visit 0-10

0

10

9

8

7

6

5

4

3

2

1

0

5.96 Urban Blue Space p= <0.01

4.89 Urban Green Space P= <0.01

3.66 Urban No Nature

5.83 Woodland

7.68 coast

7.40 open water

White M.P., Smith A., Humphryes K., Pahl S., Snelling D. and Depledge M. (2010) Blue space: the importance of water for preference, affect and restorativeness ratings of natural and built scenes. Journal of Environmental Psychology 30, 482–493.

http://www.intelligenthealth.co.uk/



Green Gym Vs Aerobics

Comparison of heart-rate response

during two sessions of activity

0

50

100

150

200

Time Minutes

Heart Rate

Green Gym

Step aerobicsV Reynolds 1999

OCHRAD


To make a step change in activity levels we need to be bold

Let’s

remove

boundaries

and turn a whole

town into a

playground!


Step change across a community


Beat the Street East London

Beat the Street in Annan

Exploring the local area (66%) Getting fit (54%) Having fun (54%) Spending time with friends or family (53%) and feeling more healthy (52%) Winning Prizes (13%)


Beat Box in a Park


https://vimeo.com/119756210

Teams and individuals who use Beat Box 22

https://vimeo.com/119756210


Beat the Street Reading

35%

45% 36%

45% 46%

56%

40%

47%

0%

10%

20%

30%

40%

50%

60%

2014 registration 2014 registration3 months after

2015 registration 2015 registration3 months after

Took part in 2014 only Took part both years Took part 2015 only

Over two years in Reading there has been a 20% increase in the number of people

reaching the Government recommended activity levels of 150 minutes a week


• Disconnection from nature causes

chronic stress

• We eat badly and exercise less

• More visceral fat, inflammation and

telomere shortening.

• Result: an epidemic of chronic disease

e.g. diabetes , heart disease

• Being healthy is about friends, family,

nature and feeling good about

ourselves.

• Nature reduces stress connects

people, increases activity and is

generally more healthy

We are

designed to

be Hunter

Gatherers

The Story


Building Active Communities

[email protected]

Documents

Kent Nature Partnership The Natural Health Servicekentnature.org.uk/.../files/Resources/Kent-Nature-Partnership-BIRD.pdf · Nature and the Unborn Child High Blood Pressure in pregnant