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Lin PJ, Lee TLI, Hershey MS, Shih CW, Tausi S, Sosene V, Maani PP, Tupulaga M, Wu SM, López-Gil JF, Lo YH, Shiau SC, Hsu YT, Chang CR, Wei CF. Exploring the link between home garden use and severe obesity: Insights from a nationwide survey in Tuvalu. J Glob Health 2023; 13:04097. [PMID: 37655368 PMCID: PMC10472202 DOI: 10.7189/jogh.13.04097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Obesity is prevalent and increasing but understudied across Pacific Islanders. Tuvalu is a South Pacific country with a high obesity rate and faces multiple threats of food insecurity. Home garden serves as a sustainable food source and can be a possible intervention for the obesity pandemic in Tuvalu. This study investigated Tuvaluans' home garden use and obesity, and explored factors associated with increased use of home gardens. Methods We conducted a nationwide, cross-sectional study in Tuvalu during 2022. Structured questionnaires were administered during the in-person interviews, and trained interviewers measured the height and weight of each participant. The association between home garden use, obesity and severe obesity were tested with univariate and multivariable logistic regression. We also applied overlapping weights to balance the distribution of baseline demographic factors. Results The average body mass index was 34.87 kilogrammes (kg) / square metre (m2) among the study population of 1024 adults (630 from Funafuti and 394 from other islands in Tuvalu). Overall, people having home gardens was associated lower odds for severe obesity compared to those without a home garden in overlap weighting models (odds ratio (OR) = 0.946, 95% CI = 0.897-0.997, P = 0.039) and the association was stronger in Funafuti (OR = 0.927, 95% CI = 0.866-0.991, P = 0.027) than in the outlying islands (OR = 0.967, 95% CI = 0.889-1.052, P = 0.435). Furthermore, increased age was positively associated with having a home garden in Funafuti, and smoking showed an inverse association. Conclusions Having a home garden is associated with lower odds of severe obesity in Tuvalu, and the association is stronger in Funafuti. Smokers are less likely to have home gardens, and increased age is positively associated with having home gardens. These findings promote more home garden utilisation and provide evidence for targeted interventions in Tuvalu.
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Affiliation(s)
- Po-Jen Lin
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Department of Medicine, Nuvance Health Danbury Hospital, Danbury, Connecticut, USA
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tai-Lin I Lee
- Division of Medical Imaging, Department of Radiology, Far Eastern Memorial Hospital, New Taipei city, Taiwan
| | - Maria Soledad Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chih-Wei Shih
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Selotia Tausi
- Department of Agriculture, Tuvalu Ministry of Local Government and Agriculture, Funafuti, Tuvalu
| | - Vine Sosene
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Pauke P Maani
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Malo Tupulaga
- Department of Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu
| | - Stephanie M Wu
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - José Francisco López-Gil
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, IdiSNA, Pamplona, Navarra, Spain
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Yuan-Hung Lo
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Shi-Chian Shiau
- Taiwan International Cooperation and Development Fund (ICDF), Taipei, Taiwan
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
| | - Yu-Tien Hsu
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chia-Rui Chang
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chih-Fu Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Taiwan Technical Mission to Tuvalu, Funafuti, Tuvalu
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Nguyen PY, Astell-Burt T, Rahimi-Ardabili H, Feng X. Effect of nature prescriptions on cardiometabolic and mental health, and physical activity: a systematic review. Lancet Planet Health 2023; 7:e313-e328. [PMID: 37019572 DOI: 10.1016/s2542-5196(23)00025-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/19/2023]
Abstract
Nature prescriptions are gaining popularity as a form of social prescribing in support of sustainable health care. This systematic review and meta-analysis aims to synthesise evidence on the effectiveness of nature prescriptions and determine the factors important for their success. We searched five databases from inception up to July 25, 2021. Randomised and non-randomised controlled studies featuring a nature prescription (ie, a referral or an organised programme, by a health or social professional, to encourage spending time in nature) were included. Two reviewers independently conducted all steps of study selection; one reviewer collected summary data from published reports and conducted the risk of bias assessment. Random-effect DerSimonian-Laird meta-analyses were conducted for five key outcomes. We identified 92 unique studies (122 reports), of which 28 studies contributed data to meta-analyses. Compared with control conditions, nature prescription programmes resulted in a greater reduction in systolic blood pressure (mean difference -4·82 mm Hg [-8·92 to -0·72]) and diastolic blood pressure (mean difference -3·82 mm Hg [-6·47 to -1·16). Nature prescriptions also had a moderate to large effect on depression scores (post-intervention standardised mean difference -0·50 [-0·84 to -0·16]; change from baseline standardised mean difference -0·42 [-0·82 to -0·03]) and anxiety scores (post-intervention standardised mean difference -0·57 [-1·12 to -0·03]; change from baseline standardised mean difference -1·27 [-2·20 to -0·33]). Nature prescriptions resulted in a greater increase in daily step counts than control conditions (mean difference 900 steps [790 to 1010]) but did not improve weekly time of moderate physical activity (mean difference 25·90 min [-10·26 to 62·06]). A subgroup analysis restricted to studies featuring a referring institution showed stronger effects on depression scores, daily step counts, and weekly time of moderate physical activity than the general analysis. Beneficial effects on anxiety and depression scores were mainly provided by interventions involving social professionals whereas beneficial effects on blood pressures and daily step counts were provided mainly by interventions involving health professionals. Most studies have a moderate to high risk of bias. Nature prescription programmes showed evidence of cardiometabolic and mental health benefits and increases in walking. Effective nature prescription programmes can involve a range of natural settings and activities and can be implemented via social and community channels, in addition to health professionals.
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Affiliation(s)
- Phi-Yen Nguyen
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Hania Rahimi-Ardabili
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Xiaoqi Feng
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; The George Institute of Global Health, Sydnet, NSW, Australia.
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Amenyah SD, Waters D, Tang W, Fenge LA, Murphy JL. Systematic realist synthesis of health-related and lifestyle interventions designed to decrease overweight, obesity and unemployment in adults. BMC Public Health 2022; 22:2100. [PMCID: PMC9668709 DOI: 10.1186/s12889-022-14518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Obesity and unemployment are complex social and health issues with underlying causes that are interconnected. While a clear link has been established, there is lack of evidence on the underlying causal pathways and how health-related interventions could reduce obesity and unemployment using a holistic approach.
Objectives
The aim of this realist synthesis was to identify the common strategies used by health-related interventions to reduce obesity, overweight and unemployment and to determine for whom and under what circumstances these interventions were successful or unsuccessful and why.
Methods
A realist synthesis approach was used. Systematic literature searches were conducted in Cochrane library, Medline, SocIndex, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PsychInfo. The evidence from included studies were synthesised into Context-Mechanism-Outcome configurations (CMOcs) to better understand when and how programmes work, for which participants and to refine the final programme theory.
Results
A total of 83 articles met the inclusion criteria. 8 CMOcs elucidating the contexts of the health-related interventions, underlying mechanisms and outcomes were identified. Interventions that were tailored to the target population using multiple strategies, addressing different aspects of individual and external environments led to positive outcomes for reemployment and reduction of obesity.
Conclusion
This realist synthesis presents a broad array of contexts, mechanisms underlying the success of health-related interventions to reduce obesity and unemployment. It provides novel insights and key factors that influence the success of such interventions and highlights a need for participatory and holistic approaches to maximise the effectiveness of programmes designed to reduce obesity and unemployment.
Trial registration
PROSPERO 2020 CRD42020219897.
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Yang Y, Ro E, Lee TJ, An BC, Hong KP, Yun HJ, Park EY, Cho HR, Yun SY, Park M, Yun YJ, Lee AR, Jeon JI, Jung S, Ahn TH, Jin HY, Lee KJ, Choi KH. The Multi-Sites Trial on the Effects of Therapeutic Gardening on Mental Health and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138046. [PMID: 35805706 PMCID: PMC9266122 DOI: 10.3390/ijerph19138046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 01/11/2023]
Abstract
Although many people affected by COVID-19 suffer from some form of psychological distress, access to proper treatment or psychosocial interventions has been limited. This study aimed to examine the feasibility and preliminary effects of a therapeutic gardening program conducted during the COVID-19 pandemic. The program consisted of 30 sessions and was conducted at 10 nationwide sites in Korea from June to November 2021. Mental health and well-being were assessed using the Mental Health Screening Tool for Depressive Disorders, Mental Health Screening Tool for Anxiety Disorders, Engagement in Daily Activity Scale, brief version of World Health Organization Quality of Life, and Mindful Attention Awareness Scale. Cohen’s d value was calculated for the effect size, and a multilevel analysis was used to determine the longitudinal effects of therapeutic gardening. The effect sizes for depression, anxiety, daily activities, quality of life, and mindfulness were 0.84, 0.72, 0.61, 0.64, and 0.40, respectively. Multilevel analyses showed that all five mental health variables improved significantly over time as the therapeutic gardening program progressed. Therapeutic gardening is promising and applicable as a nature-based intervention to improve the mental health of individuals experiencing psychological distress especially in the COVID-19 pandemic.
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Affiliation(s)
- Yeji Yang
- School of Psychology, Korea University, Seoul 02841, Korea; (Y.Y.); (E.R.)
- KU Mind Health Institute, Korea University, Seoul 02841, Korea
| | - Eunbin Ro
- School of Psychology, Korea University, Seoul 02841, Korea; (Y.Y.); (E.R.)
- KU Mind Health Institute, Korea University, Seoul 02841, Korea
| | | | - Byung-Chul An
- Division of Forest & Landscape Architecture, Wonkwang University, Iksan 54538, Korea;
| | | | | | - Eun-Yeong Park
- Department of Environmental Landscape Architecture, Joongbu University, Geumsan 32713, Korea;
| | | | - Suk-Young Yun
- Department of Landscape Architecture, Daegu Catholic University, Gyeongsan 38430, Korea;
| | - Miok Park
- Department of Smart Green City Industry Convergence, Korea Nazarene University, Cheonan 31172, Korea;
| | - Young-Jo Yun
- Department of Ecological Landscape Architecture Design, Kangwon National University, Chuncheon 24341, Korea;
| | - Ai-Ran Lee
- Department of Human Environment Design, Cheongju University, Cheongju 28503, Korea;
| | - Jeong-Ill Jeon
- Shingu Botanic Garden, Shingu College, Seongnam 13443, Korea;
| | - Songhie Jung
- Gardens and Education Research Division, Korea National Arboretum, Pocheon 11186, Korea; (S.J.); (T.-H.A.)
| | - Tai-Hyeon Ahn
- Gardens and Education Research Division, Korea National Arboretum, Pocheon 11186, Korea; (S.J.); (T.-H.A.)
| | - Hye-Young Jin
- Gardens and Education Research Division, Korea National Arboretum, Pocheon 11186, Korea; (S.J.); (T.-H.A.)
- Correspondence: (H.-Y.J.); (K.J.L.); (K.-H.C.); Tel.: +82-31-540-1031 (H.-Y.J.); +82-10-9745-2145 (K.J.L.); +82-2-3290-2867 (K.-H.C.)
| | - Kyung Ju Lee
- Integrative Obstetrics & Gynecology, Institute for Occupational & Environmental Health, Korea University, Seoul 02841, Korea
- Correspondence: (H.-Y.J.); (K.J.L.); (K.-H.C.); Tel.: +82-31-540-1031 (H.-Y.J.); +82-10-9745-2145 (K.J.L.); +82-2-3290-2867 (K.-H.C.)
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul 02841, Korea; (Y.Y.); (E.R.)
- KU Mind Health Institute, Korea University, Seoul 02841, Korea
- Correspondence: (H.-Y.J.); (K.J.L.); (K.-H.C.); Tel.: +82-31-540-1031 (H.-Y.J.); +82-10-9745-2145 (K.J.L.); +82-2-3290-2867 (K.-H.C.)
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Weight Management Interventions for Adults With Overweight or Obesity: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1855-1865. [PMID: 33069660 DOI: 10.1016/j.jand.2020.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/30/2020] [Accepted: 07/21/2020] [Indexed: 12/26/2022]
Abstract
The objectives of this evidence scoping review were to identify and characterize studies investigating weight management interventions provided by a registered dietitian nutritionist or international equivalent (RDN) among adults with overweight or obesity. A medical librarian conducted an electronic literature search in 6 databases-MEDLINE (Ovid), Embase (Ovid), PyscINFO (Ovid), Cochrane CENTRAL (Ovid), Cochrane Database of Systematic Reviews (Ovid), and CINAHL (Ebsco). Except for narrative review, gray literature, and case study or report, all types of peer-reviewed articles published between January 2008 and April 26, 2019 were eligible. Two content advisors, who are experts in adult weight management, guided the process and reviewed the search plan and findings. The literature search resulted in 30,551 records with 16 additional records identified through other sources. A total of 29,756 records were excluded during the first round of screening due to duplication or irrelevancy. Of the 811 full-text articles that were screened, 139 met the criteria and were included. Approximately 51% and 43% of the studies were conducted in the community setting and in the United States or Canada, respectively. Over 97% of the studies were clinical or quasi-experimental trials. A total of 6 different intervention delivery modes were reported, which resulted in 22 combinations of the modes of delivery. RDNs delivered the weight management intervention (especially the nutrition component) in all studies, but some (61%) also involved an interdisciplinary team to deliver other components of the intervention. The average length of the intervention was about 10 months with a follow-up that ranged from 0 to 9 years. The commonly reported outcomes were anthropometrics, endocrine, and cardiovascular measures; dietary intake; and physical activity. Based on the scoping review, there were systematic reviews and evidence-based practice guidelines on weight management interventions but none of them met the a priori inclusion or exclusion criteria. Therefore, it would be beneficial to conduct a systematic review and develop an evidence-based practice guideline on adult weight management interventions provided by an RDN to guide practitioners and to evaluate their effects on health and nutrition-related outcomes.
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