Fresh Air Medicine

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Fresh Air Medicine

Want to feel better and possibly improve your diabetes control, without trying very hard? Several studies indicate that spending one or more hours a day outside can have those benefits.

A recent British study of 502,000 people in the Journal of Affective Disorders found that each additional hour spent outdoors during the day was associated with:

  • Lower lifetime odds of developing major depression or needing antidepressant drugs
  • 45% greater self-reported happiness
  • 47% easier time getting up in the morning
  • About 20% less tiredness and 5% less insomnia

The researchers wrote that higher mental and physical energy in people who got outside were probably due to better sleep. “Circadian rhythms [natural, internal cycles] are known to affect mood and sleep. Dim light at night and bright light during the day are essential to strong circadian rhythms” and good sleep.

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Sunlight, sleep, and diabetes

As Diabetes Self-Management has reported before, insomnia increases the risk of type 2 diabetes. Subjects with insomnia under age 40 were 31% more likely than better sleepers to develop diabetes according to research, and those aged 41-65 were 24% more likely.

Elena Christofides, MD, FACE, chief operating officer of Endocrinology Associates in Columbus, Ohio, explained that not sleeping worsens the effects of stress. “Stress is a known contributor to the development and progression of obesity and diabetes, because it causes the body to not be ever able to go into repair and relaxation mode. It is always in reaction mode.” So, getting out in sunshine helps people sleep, and sleep reduces stress. But there are other benefits to being outdoors, too.

Vitamin D, sunshine, and diabetes

Sunlight is our bodies’ major source of vitamin D. In European studies, low vitamin D levels were associated with higher levels of type 1 and type 2 diabetes . People in the far north of Sweden and Finland, where the sun is low in the sky or absent much of the year, were much more likely to develop diabetes.

Sun exposure benefits in ways besides producing vitamin D. In 2014, Australian scientists writing in the journal Clinical Endocrinology noted that that oral supplementation of vitamin D had only “mixed results” in reducing diabetes rates.

These researchers studied fasting glucose, glucose tolerance, fasting insulin level, insulin sensitivity, and type 2 diabetes prevalence and found “moderate evidence to support a role of recreational sun exposure in reducing odds of T2DM incidence.”

Contact with nature

There’s more to the outdoors than sunlight. Trees and other living things may also have healing power. In 2018, scientists at the University of East Anglia in the UK reported that, “Exposure to greenspace reduces the risk of type II diabetes, cardiovascular disease, premature death, preterm birth, and high blood pressure.” The countries studied included Japan, where a practice called shinrin-yoku (“forest bathing” or “taking in the forest atmosphere”) is popular therapy. People go and spend hours in a forest either sitting or lying down, or walking around.

The East Anglia scientists gave several possible benefits of exposure to nature. Going to a park or open space gives opportunities for physical activity and socializing. “Meanwhile, exposure to a diverse variety of bacteria present in natural areas may have benefits for the immune system and reduce inflammation.” Inflammation is a major contributor to diabetes and its complications.

Trees and flowers breathe out oxygen and organic compounds called phytoncides, which Japanese researchers think may be beneficial to humans and explain some of the benefits of forest bathing. In my experience, just seeing the green plants, smelling the fresh air, listening to the birds, and feeling the sun are great stress reducers and energizers.

Where are your closest trees?

Sadly, not all people, especially those with less money, have access to greenspace or sunshine. In cities, we might live a long way from a forest or even a park. Tall buildings may keep sidewalks in shade even on sunny days. Trees might be a bus ride or even a car trip away, and some don’t have transportation to get there.

Wherever we live, we may not have much time for sun. Our daytimes may be spent working or studying indoors. In some neighborhoods, residents may feel unsafe to go out by themselves, or they may find the surroundings unpleasant. City streets may be too hot in summer or too cold in winter.

But even a small park or a garden can give us some of the benefits of outdoor time. Sitting in a chair on a sidewalk on a sunny day is better than not getting out at all. If you don’t want to go out alone, maybe there is someone (human or pet) who can go with you.

Some things to consider

  • Dress appropriately — sun on bare skin will generate more vitamin D, but don’t get too cold or sunburned. Be sure to stay hydrated on hot days.
  • Midday is the best time to get sun, because it’s higher in the sky. Unfortunately, it’s also most people’s work time. Try to get out and walk at lunchtime, if you possibly can.
  • If you live where it’s cloudy most of the time, as I do, don’t let sunny days go to waste! Try to get out in them at least for a bit.
  • Don’t watch your screen when you’re outside. It’s not only dangerous; it deprives you of most of the benefits of sight, sound, smell, and other people.
  • If people ask you why you’re outside doing not much, tell them it’s doctor’s orders. Enjoy it!

Want to learn about more ways to get outdoors? Read “The Health Benefits of Walking,” “Hiking for Health,” and “Biking for Health.”

David Spero, BSN, RN

David Spero, BSN, RN

David Spero, BSN, RN on social media

A nurse for 25 years at University of California San Francisco and Kaiser hospitals, and one of the first professional health coaches. Nurse Spero is author of Diabetes: Sugar-Coated Crisis and The Art of Getting Well: Maximizing Health When You Have a Chronic Illness, as well as co-author of Diabetes Heroes and the diabetes chapter in Where There is No Doctor. He writes for Diabetes Self-Management, Pain-Free Living, and Everyday Health.

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