The Healing Power of Nature

“Classical music provides another way of bringing spiritual benefits and may actually also contribute to overall mental and physical health.”

In the current issue of the American Journal of Lifestyle Medicine, we are delighted to publish an article and an editorial related to health benefits of physical activity in nature.

The article by Moore, “The Interweaving Trails of Lifestyle and Wilderness Medicine” in this issue of AJLM makes the case that participation in wilderness environments can yield multiple health benefits and should be considered a legitimate part of lifestyle medicine. ¹ Moore reports that there are over 803 wilderness areas in the 50 States of the United States. He also provides a robust discussion of theories and research as to why participation in wilderness activities exerts positive effects on humans’ health. These theories include the Stress Reduction Therapy (SRT), the Attention Restoration Therapy (ART), and the “Biophilia” Hypothesis which links modern humans to our ancient ancestors who relied on the environment for survival in the wilderness. These concepts will be of great interest to practitioners of lifestyle medicine.

The linkage between nature and health benefits has a long and storied history in the United States, particularly in the area of landscape architecture. Frederick Law Olmstead, who is considered the Father of American Landscape Architecture, felt strongly that natural landscapes should benefit the psychological and physical health of individuals. He saw the magnificent landscapes he designed as an antidote to the stresses and strains of city living. Olmstead executed numerous, magnificent landscape projects including Central Park in New York City, the Emerald Necklace surrounding Boston, the Arnold Arboretum of Harvard University, the Stanford University Campus, Yosemite National Park, and Yellowstone National Park. In all of these settings, he designed the landscape with the vision to create a sublime experience which would fill visitors with renewed energy and spiritual enlightenment.

The editorial by Dr. John La Puma, entitled “Nature-Based Medicine,” also in this issue of AJLM, ² puts wilderness medicine in the larger context of “nature medicine” and documents that there are multiple health related benefits from activities not only in wilderness, but in other outdoor areas. Practitioners of lifestyle medicine will recognize Dr. La Puma largely through his work in culinary medicine. Indeed, he is often given the credit for introducing culinary medicine into mainstream medical practice. Dr. La Puma is also one of the leaders in the emerging field of nature-based medicine and is the Founder of EcoMedicine.org (https://www.drjohnlapuma.com/ecomedicine/).

I have been personally interested, for many years, in the health benefits of outdoor physical activity both from a research standpoint and also in my personal life. Early in research studies that were conducted in my laboratory (Rippe Lifestyle Institute), when we looked at psychological benefits of walking exercise, we quickly learned that pre and post experiments had to be done either all indoors or all outdoors. When we compared indoor exercise to outdoor exercise, the outdoor exercise always yielded much more significant psychological benefits and, thus, served as a confounding variable when it came to looking at psychological benefits of simply walking.

In my own life, I experience the benefits of outdoor exercise on a daily basis. My wife and I are blessed to have two, large properties in Massachusetts, one of them right outside of Boston and the other in the Berkshire Mountains in the Western part of the State. I typically walk outdoors two or three times a day at either property, often as a way of taking breaks from other aspects of my work life.

When I am at our property outside of Boston, I also have the pleasure of walking with my two, big Labrador Retrievers who spend a lot of the time sniffing around the trails or chasing training dummies, which I throw in our two-acre pond.

When we are out in the Berkshires, we are blessed to have several ponds and a mountain stream running through our property. These features compound the pleasure of being outdoors with the sound of running water. In fact, I selected the Berkshire property many years ago based on an experience that I had in medical school. During the only vacation that I took during medical school, I traveled to the South of Spain. This area, which is called Andalusia, was conquered hundreds of years ago by the Moors from North Africa. The Moors believed that wise decisions could only take place within the sound of running water. They built their magnificent castles, including the Alhambra, high up in the hills of the towns that they conquered, and accomplished incredible engineering feats to bring running water to each of these castles. I was determined, when I had the opportunity to purchase a property in the Berkshires, to make sure that there was the sound of running water in all of the rooms of the house.

I also have some personal experience with the wilderness aspects that Dr. Moore discusses. My wife and I learned long ago that our vacations are best conducted in beautiful settings where we can be physically active, but also enjoy fabulous scenery. We have been fortunate to ski at Vail and windsurf in Maui. While I certainly enjoy the physical exertion, we sometimes will just pause to take in the magnificent nature in both places.

I hope that by bringing the concepts of the emerging field of “nature medicine” into discussions of lifestyle medicine it will offer another modality for lifestyle medicine practitioners to benefit all of our patients. Since recommending physical activity is a key component of the practice of lifestyle medicine, why not expand this to recommend to our patients that they try to take some of their physical activity sessions in the outdoors? The emerging science of the benefits of doing this will add another component to the ongoing and ever-expanding research into the multiple benefits of lifestyle medicine.

The health benefits of outdoor activities have become increasingly prominent during the COVID epidemic. Of course, the COVID pandemic caused many people to sequester indoors and may have contributed to the psychological deterioration that many people experienced despite the fact that the recommendation for exercise in outdoor environments persisted even through the depth of the epidemic. In addition to the reduced likelihood of transmitting COVID in the outdoor environment, there are psychological benefits offering other reasons for outdoor physical activity.

Recently, a number of psychologists have articulated an alarm that the overwhelming amount of time that many people spend indoors on their computers may have left people with some potential psychological harm. There is even a suggestion of a new medical condition called “Nature Deficit Disorder.” While the internet has been a great boon in many ways, it is important to recognize that excessive time spent indoors may actually result in psychological and physical adverse consequences.

Some beginnings have emerged suggesting that more people are becoming aware of the importance of nature for psychological and spiritual well-being. For example, the acclaimed cellist Yo-Yo Ma has also started giving pop up concerts in various wilderness settings in our magnificent national parks. This is part of his initiative which he calls “Our Common Nature.” Yo-Yo Ma has recently given concerts during times of national mourning or national celebrations such as at Presidential Inaugurations. He hopes that his campaign of “Our Common Nature” will create more people “thinking and feeling and knowing that we are part of nature, instead of just thinking: What can we use it for?”

Incidentally, I have been a long-time lover of classical music and play it non-stop when I am working in my study. Perhaps my favorite classical piece is Yo-Yo Ma playing Dvorak’s cello concerto. If you have not ever experienced this magnificent piece, I would highly recommend it to you. Classical music provides another way of bringing spiritual benefits and may actually also contribute to overall mental and physical health.

I hope lifestyle medicine practitioners will consider “nature medicine” as an expanded modality in our ongoing goal of practicing the most comprehensive and beneficial recommendations for our daily habits and actions impact on not only short- and long-term health, but also quality of life.

James M. Rippe, MD Editor in Chief, American Journal of Lifestyle Medicine

Rippe Lifestyle Institute, Shrewsbury, MA UMass Chan Medical School, Worcester, MA