Diabetes and Ecotherapy: Could a Walk in Nature ImproveYour Blood Sugar?

Research suggests spending time outside has measurable benefits for your mental and physical wellbeing. Learn more.


couple walking in nature on path between treesExperts and a growing body of research support the notion that spending time outside is good for your mental and physical wellbeing. So be sure to get a regular dose of nature therapy. (Photo: Unsplash, Shaojie)

Green spaces—including forests, rural areas, and parks—could help keep your diabetes under control. That’s because these places offer multiple health benefits,1 including stress reduction,2 boosting the immune system,3,4 and fighting mental fatigue.5, 6 Spending time in nature can also improve both thinking skills7 (including in people with depression),8 and mental health.9,10 And all these advantages can help you manage your diabetes.

Stress Reduction and Immune Function

“When you look out at a green landscape—even from indoors—your heart rate will go down, and you’ll change from sympathetic nervous activity over to parasympathetic nervous activity, which is basically going from what we call ‘fight or flight’ into ‘tend and befriend’ mode,” said Ming Kuo, PhD, associate professor in the Department of Natural Resources & Environmental Sciences, and Director of the Landscape and Human Health Lab at the University of Illinois at Urbana-Champaign on a recent episode of NPR’s Hidden Brain podcast.11 “So, it has these very systematic physiological impacts on us, which we also know have long-term health outcomes associated with them.” 12, 8, 13

“I can tell you anecdotally, everyone I’ve taken on forest walks has felt more relaxed,” offered Nancy H. Goldman, a psychiatric and mental health clinical nurse specialist in Jackson, Mississippi. Goldman is also an American Association of Nature & Forest Therapy member and certified guide who leads forest therapy walks on her farm outside of Jackson. Moreover, “the relaxation seems to hang around for a while.”14

Less Stress Equals Better Blood Sugar

Relaxation and stress management are crucial for diabetes patients: “Any stress on the body can lead to higher blood sugars, and long-term higher blood sugars leads to long-term complications,” OnTrack Diabetes editorial advisory board member Amy Hess Fischl, MS, RDN, LDN, BC-ADM, CDE explains.15 She is the Diabetes Education Manager, Teen Transition Program Coordinator, and Education Recognition Program Quality Coordinator at the University of Chicago Kovler Diabetes Center.

Immune system functioning also affects blood sugar control. It works like this: When your immune system is weakened, it’s easier to get sick. And while “people with diabetes are not at higher risk of getting the flu or a cold, when they do [get sick], it is much harder to fight it off and it may stick around longer,” Hess Fischl says. “The biggest problem when people with diabetes get sick is that it can cause blood sugars to rise a lot, which can then cause problems long-term.”

Fortunately, nature therapy—in this case, exposure to phytoncides, the woodsy-smelling essential oils we encounter in forests—can help with immune function. Phytoncides boost the activity of natural killer cells, which destroy tumor- and virus-infected cells.16, 17, 18

In fact, “A three-day weekend in a forest preserve… boosts natural killer cells on average by 50%,” Dr. Kuo says. On the other hand, “A three-day weekend in a nice urban area, it turns out, doesn’t do anything for your natural killer cells.” After 30 days, the effects of the weekend in the forest area are still measurable.19

Mood and Motivation

Nature’s ability to improve mood has a less direct effect on diabetes, but it can still help patients. “Depression, and subsequent mental fatigue [which is associated with problems with performance, attention, and motivation] is already more common in diabetes patients,” Hess Fischl observes. In fact, people with diabetes are about twice as likely to have depression as those without the condition.20 And “Both depression and mental fatigue can lead to someone to not really care about anything, including taking care of their diabetes. Mental fatigue can also affect sleep quality, which will then cause blood sugar disturbances and possible complications—it’s a vicious cycle,” Hess Fischl adds. So, a stroll in the woods might be just what you need to keep you committed to a healthy lifestyle.

Access to nature may also help people with diabetes maintain or increase activity levels: “We already know the benefits that 30 minutes of activity has on blood sugar levels—and the entire body,” Hess Fischl told OnTrack Diabetes. “But our biggest struggle is getting people to actually exercise. I think recommending forest preserves, botanical gardens, and other green space as locations to be active could be the incentive. If you are in a pretty environment, it is way easier to get lost, so to speak, and be out there longer and enjoy getting exercise.”

She adds, “I have five patients I can think of right now who spend time in nature or green spaces, and they all report feeling better.”

“Nature seems to be like a multivitamin,” Dr. Kuo concludes. “You can get different benefits from different kinds of exposures,” including looking at pictures in a lab. “But to get all of them, you have to be there.”


Updated on: June 20, 2019
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