The Healing Power of Nature | Dr. Melissa Lem

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Many are familiar with the age-old wisdom that emphasizes the positive impact of nature on one’s well-being. Those who have immersed themselves in the tranquility of forests, mountains, oceanfronts, or other natural settings can attest to the profound sense of wellness they impart.

Beyond the intuitive understanding that nature feels good, there is actually also an extensive amount of research spanning over a decade that substantiates the remarkable impact it has on both our physical and mental health.

To delve in-depth into this topic, I invited, as a guest of our show, Dr. Melissa Lem—a family physician who is an internationally recognized proponent of nature and health, and who is also the Director of PaRx. An initiative of the BC Parks Foundation, PaRx is driven by healthcare professionals who want to improve patients’ health by connecting them to nature.

Yes. Dr. Lem is indeed one of the many doctors registered at PaRx who prescribes nature to her patients. It sounds, funny enough, revolutionary. Be that as it may, it is certainly exciting to see healthcare professionals embracing the power of nature, and in this way, patients—and people in general—will also view nature as not just something marvelous but also essential for physical and mental health.

Warning: After you are done listening to this episode, there might be a high chance you’ll be in the mood for a walk outdoors… 🙂

Websites:

  • PaRx: A Prescription for Nature (2 hours a week, 20+ minutes each time. That’s all it takes. We’re breaking ground as Canada’s first national, evidence-based nature prescription program.)
  • BC Parks Foundation (Our mission is to inspire and empower you to enjoy, protect, and expand parks and indigenous protected areas in BC. Help keep BC beautiful, full of life, and resilient for now, forever, and for everybody.)
  • David Suzuki Foundation (Founded in 1990, the David Suzuki Foundation is a national, bilingual non-profit organization headquartered in Vancouver, with offices in Toronto and Montreal.)


Mentioned Research:


Mentioned People:

  • Dr. David Suzuki (David Takayoshi Suzuki, CC, OBC, FRSC, is a Canadian academic, science broadcaster, and environmental activist. Dr. Suzuki earned a PhD in zoology from the University of Chicago in 1961 and was a professor in the genetics department at the University of British Columbia from 1963 until his retirement in 2001.)
  • Dr. Cecil Konijnendijk (Dr. Konijnendijk is an internationally recognized scholar within the fields of urban forestry and nature-based solutions.)
  • Dr. Richard Louv (Richard Louv is an American non-fiction author and journalist. He is best known for his seventh book, Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder, which investigates the relationship of children and the natural world in current and historical contexts.)
  • Dr. Anna Gunz (Dr. Gunz is a paediatric intensive care doctor at Children’s Hospital, London Health Sciences Center and Associate Professor at Schulich School of Medicine & Dentistry, Western University. )
  • – Dr. Matthew White
  • – Dr. Komedi Abaitang

     

Mentioned Books:

  • Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder (Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder is a 2005 book by author Richard Louv that documents decreased exposure of children to nature in American society and how this “nature-deficit disorder” harms children and society. The author also suggests solutions to the problems he describes.)

The transcription is, for the most part, AI-transcribed and is currently 85% accurate. We are still weeding out some minor errors.

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Dr. Melissa Lem
I think a better question is what health condition isn’t nature good for? There have been these big meta-analyses looking at a huge variety of health conditions, from high blood pressure to cholesterol issues to pregnancy outcomes, cancer care, anxiety, depression, and almost across every single health condition. Spending time in nature and having access to nearby nature is an evidence-based benefit.

Jellis Vaes
What’s up there everyone? Welcome here to another episode on The IPS podcasts. I’m Jellis Vaes, the founder of The IPS project and your host here on the podcast. I was looking forward to this episode quite a lot and I am really, really excited to release it out. And with that, I’m also super excited that you are tuning in to listen to this episode. In this episode, we’re going to talk about nature. I mean, personally, I’ve always had a love for nature and for the great outdoors. As a child, I used to play a lot in nature. And honestly, as an adult, that love for nature and the outdoors grew even more. I mean, I’ve had the chance to travel to many places in the world. I went on many multi-day hikes. I’ve climbed many of the highest mountains around the world. I mean, there is something about just being in nature that just feels right, doesn’t it? And honestly, almost. I mean, so many people would say the same, that there is something about nature that just feels good. It feels good to be in nature. And you know what? There’s actually just a whole bunch of studies spanning from a decade ago showing just how incredibly good it is to be in nature, both for our physical health, but also for our mental health. To dig into that topic, to zoom even more into know about what is it about nature that makes it so good for us?

I went out to look for a qualified expert, and that’s where I stumbled upon Dr. Melissa Lem. She’s a Vancouver family physician an internationally recognized leader in nature and health and the director of PaRx, an initiative of the BC Parks Foundation. Now, this initiative, driven by healthcare professionals, aims to improve patient health by connecting them with nature. So yes, Dr. Lem, along with other doctors who are registered at PaRx, prescribes nature to her patients. And this sounds funny enough, revolutionary. Therefore, I am just so excited to have you here join me in this episode to learn in depth about all the benefits nature has for our mental and physical health, because it’s honestly quite a list. Now, to find any of the resources mentioned by Dr. Lem in the interview, do check out the show notes, which you can find in the description of this episode. Or you can also go directly to theipsproject.com/podcast and search for Dr. Lem and the episode will pop up. Oh, and one last thing before we dive into the episode, if you will come to find this episode helpful and insightful, or if there were any other episodes that you really liked and that you really felt like you learned something from, if you could just take a moment, 1 second to leave a rating, you have no idea how much it would mean to me. But also, you have no idea how much you would actually be helping information like this to be spread out into the world so other people can discover the podcast and with that, learn about topics like this. So if you would take a moment. Thank you so much, truly, for taking that time. If you don’t care about it at all, that’s fine too, right? Still happy to have you here. All right, with that, let’s now dig into the interview with Dr. Melissa Lem.

Jellis Vaes
Dr. Lem, a warm welcome here to The IPS Podcast. I’ve been honestly looking forward to this episode for quite a few days, so I’m really thrilled to finally have you here on the show.

Dr. Melissa Lem
Thanks. Jellis. It’s amazing to be talking to someone from across the ocean.

Jellis Vaes
When I was actually preparing for this interview, and when people were asking me like, who’s going to be the new guest on the show? And I told them like, well, it’s this doctor from Canada who prescribes nature to their patients, honestly, everyone immediately said like, that’s amazing. More doctors should do this. Is there something coming to your mind why so many people seem to have such an almost innate and instinctual response to say that, that it’s amazing that doctors actually, or that there is a doctor who does that?

Dr. Melissa Lem
I think one of the reasons is people are looking for non-medication ways to manage their health issues, whether it’s mental health concerns or physical health concerns. We’re always looking for evidence-based interventions. And I think the fact that a doctor might be prescribing nature, which is something that, for example, I don’t get any money to do, I really do it just because I know and I’ve seen it improve my patient’s health, is kind of revolutionary. But the funny thing is, it’s really something that’s back to basics when it comes to health. In Canada in particular, we talk a lot about preventative health care and how it’s important to have a healthy diet, exercise regularly and get good quality sleep for a healthy lifestyle. But we like to call nature time the fourth pillar of health in our program, because the evidence behind the health benefits of nature is so overwhelming. And I think it’s really my job as someone who wants healthier people on a healthy planet, knowing this information and having the platform that I do and the skills that I do to communicate this to the public and decision-makers, so we can get more nature in our cities, so we can get more people outside into those green spaces to improve health.

Jellis Vaes
Yeah. And we’re definitely going to talk about parks, of course, in the interview. But first, I actually saw not too long ago, like about a month, I think, on your LinkedIn page, that one of your childhood heroes, Dr. David Suzuki, invited you for a. Actually, because he’s quite a famous person in Canada. Right? I did not know about him. So actually, also, thank you for kind of introducing me to him, because he seems like such an incredible human being. So, a few questions on this. Who is Dr. David Suzuki? For those who don’t know who he is, and what makes him one of your childhood heroes? And plus also, why did you meet?

Dr. Melissa Lem
Dr. David Suzuki is probably one of Canada’s best-known environmentalists and best-known communicators. I think he really came to prominence in kind of the middle to late 20th century when he started appearing on CBC, the Canadian Broadcasting Corporation, which is our national public broadcaster, on television and on the radio, to educate people about different aspects about the environment and nature, and also to inspire them to want to protect it. So he’s one of the first. He’s one of the OG environmentalists in Canada. He also founded the David Suzuki Foundation, which does amazing work on nature conservation and work on climate action. And he’s still, I would say, even though he’s now 87, one of Canada’s best-known fathers of the environment. And I remember growing up in Toronto and watching the nature of things, which was his show on the CBC, on television. And I think also the fact that he was a racialized Canadian, his background is Japanese, and the fact that someone who kind of looked like me could be on television and be talking about these things that I really cared about as a child as well, was incredible. And this was in fact the third time that I’ve met Dr.

Dr. Melissa Lem
Suzuki, but the first invited me. Yeah, he probably doesn’t remember, to be honest. I was just part of one of his crowd of adoring fans or whatever. But I met him once in Toronto, when I used to live in Toronto. He was talking with Dr. Richard Louv, who’s the author of The Last Child in the Woods, an amazing book about nature deficit disorder and how it’s impairing children’s health. And they were talking at the Art Gallery of Ontario, and I’d written a blog entry for the David Suzuki foundation about the health benefits of nature and how it reduced stress. And so the foundation invited me to this event. And I remember there was this vip reception, this is over a decade ago, where Dr. Suzuki was there, and I remember thinking, ok, this is my chance. I can tell him how much he means to me. And so I kind of scuttled up to him and blurted out this verbal diarrhea about how he was my hero, about how I followed his work my whole career. And you can just imagine what it’s like for someone like that to be approached by members of the public all the time.

Dr. Melissa Lem
And he was very gracious, he was very lovely and kind of nodded his head and smiled benevolently. The second time was in fact, more wrapped into the environmental work that I do. We invited him to help open up an event where we were talking about the health impacts of fossil fuel extraction within.

Jellis Vaes
Okay.

Dr. Melissa Lem
And I, in fact, did a prolonged interview with him about his views on that. But I think it was really after kind of. He has great interest, in fact, in human health and the environment. After doing some intersecting work on that with the Canadian association of Physicians for the Environment, which I’m president of right now, and the David Suzuki Foundation, that he decided to reach out and say, we should go for coffee. And it was a great conversation. It was an amazing moment, a watershed moment for me.

Jellis Vaes
Yeah. And so why did you meet each other? Why did he invited you for a coffee? Like what you do that day?

Dr. Melissa Lem
He, in fact, was invited to give a keynote at the Canadian Association of Physicians for the Environments, or CAPE’s annual general meeting. And then in conversations afterwards, the past president and I. It’s kind of a dry story anyway. It’s all about email connections. This is how we communicate these days. Said, hey, we should meet up when I’m in Vancouver. And then David said, oh, well, why don’t you invite Melissa as well to this meetup? And then we arranged our own meetup outside of that. But it was really a long time in coming because we had another conversation prior about potentially meeting up. But so that was what catalyzed it was an online Zoom meeting where he keynoted our AGM.

Jellis Vaes
How amazing is it to meet your hero in real life and then also actually, now actually working with him? It sounds like quite an amazing thing, actually.

Dr. Melissa Lem
I think that’s one of the coolest things about working in this space, about working in the environment and health and nature space is the incredible people you meet. People often ask me what’s the best thing about it. And not only is hearing my patients, the stories from my patients about how nature time has improved their health in tangible ways, that’s very rewarding. But meeting really cool people is also a great aspect of this work for sure.

Jellis Vaes
Definitely enriches your life as well, right? Yeah. Okay, so you launched in 2020 PaRx, and please correct me on anything that I’m getting wrong, right? In collaboration with…

Dr. Melissa Lem
It’s pronounced P-A-R-X. Just so you know.

Jellis Vaes
P-A-R-X. Sorry.

Dr. Melissa Lem
That’s okay. Well, the thing is, I don’t know if in the Netherlands you have if Rx means prescription, but in English, like in North America, Rx stands for prescription.

Jellis Vaes
Okay. Because I was actually looking on YouTube for other people how to pronounce it, and some people said PaRx, and others I thought said PaRx, but okay, it got me a little bit confused. So, PaRx. So you launched it in 2020, right. In collaboration with the BC Parks. Now, in short, PaRx is an initiative of the BC Parks Foundation that is driven by healthcare professionals who want to improve their patients health by connecting them to nature. Now, what I’m curious about is what was the turning point for you as a physician who likely, well, as many physicians, probably did not learn a lot about the benefits of nature in med school, what was the turning point for you to decide, this is what people need. This is what I have to start.

Dr. Melissa Lem
It was really a personal experience with nature deficit that spurred me to start advocating at this intersection. My first job was as a rural family doctor in northern BC. I went straight from training to in Victoria, British Columbia, up to the north, and suddenly was a full-service rural family doctor where I had to do a lot of pretty stressful things. If you’re objective about it, delivering babies in the middle of the night running the emergency department. We were only family doctors in a hospital where a lot of sick people came in. And if you imagine this person in their mid-20s, who just went from a learner to staff, it was an objectively stressful experience. But in fact, I loved the work an incredible amount. And when I moved from northern BC to downtown Toronto, which is, in fact, where I was born, suddenly I moved from a place where there were mountains and ocean and bears walking across my driveway. Actually, there wasn’t ocean. Sorry. That’s where I live now, in Vancouver. Mountains and the amazing Skeena river and forest and bears. To concrete and glass. Exactly. And bears, which I loved, by the way, and deer.

Dr. Melissa Lem
Suddenly, I felt a lot more stressed, even though the work itself was objectively easier. I was doing outpatient student health without patients of car accidents coming in or moms in labor, anything that required immediate attention. It was pretty low acuity work, and I felt a lot more edgy. And I still remember one day standing at my window and looking out and listening to the noise of the street, of the streetcars rattling by and looking at all the people and thinking, do you know what I think I’m missing? And do you know why I think I’m feeling so stressed? Is because I’m missing nature. And this was just this intuitive sense that I had because I was still going to do rural locums as a doctor. So I would both work in the city, but also go to other places in northern Ontario or in, for example, the Northwest Territories, or even in BC and work. And I could feel the difference in myself, even though, again, I would go do more stressful rural work, I felt more relaxed despite that. And I thought, do you know what it is? I think I’m missing nature. And as a good evidence-based doctor who doesn’t believe anything unless it’s backed up by randomized controlled trials and papers and research, I thought, okay, well, this intuitive sense can’t be real unless it’s backed up by the evidence.

And so I did this big lit review. This is close to 15 years ago now, looking for search terms like nature, health, medicine, health benefits. And hundreds of studies popped up about the health benefits of nature. And this is something, as you mentioned, I’d never learned out about in medical school. I really was not hearing anyone talking about it at this point. And I thought, you know what? This is a big gap in our healthcare system. This is a big knowledge gap among my colleagues, and I want to do my best to make sure that everyone knows, public decision makers, my colleagues, about these evidence-based health benefits of nature. So that was my turning point. A personal nature deficit experience leading to my discovery of this evidence base and then wanting to work to make sure everyone knew about it. It’s kind of a bit of a nerdy story that involves a lit review, but that’s the.

Jellis Vaes
And. And when did you then decide to actually take steps on this, to actually make PaRx?

Dr. Melissa Lem
It was when I connected with the BC Park Foundation after moving back to British Columbia that I found that they were looking to launch a nature prescription program. They had a lot of foresight, I would say, because a lot of nature foundations focus on conservation, but they really, really wanted to zero in on human health, because that’s really a big motivator. And this is also backed up by the research, for people to support policies and for people to support initiatives. When they can feel the benefits of nature themselves, they will fall in love with nature and want to protect it, because you want to protect what you love. And so they wanted to launch a nature prescription program. I’d been thinking about it for years at this point, but I thought, I’m one doctor. There really aren’t a lot of people like me in Canada. How am I supposed to launch a nature prescription program around my practice and everything else that I do? And so it was really having access to staff and resources and a credible name with the BC Park Foundation that allowed us to make it happen. And I became director of PaRx in 2019 and then worked steadily to launch nature prescriptions by November 2020.

Jellis Vaes
For people listening, now… How does it work? Because most people know, okay, when you go to a doctor, you might get a prescription for medication. You go to the pharmacy, you take the medication for x amount of time. But what about nature? How do you get a prescription for that? So maybe, first of all, for who is this? When a patient comes in, what can nature treat? What are the things that nature can treat? And then, if this patient could benefit from it, how does it look in practice?

Dr. Melissa Lem
I think a better question is, what health condition isn’t nature good for? There have been these big meta-analyses looking at a huge variety of health conditions, from high blood pressure to cholesterol issues, to pregnancy outcomes, cancer care anxiety, depression, and almost across every single health condition. Spending time in nature and having access to nearby nature is an evidence-based benefit. So you could really prescribe nature to anyone. That said, I would say the majority of nature prescriptions of prescribers in our program tend to be for mental health issues like anxiety and depression, because I think that feels the most intuitive. Even though the evidence is there for chronic diseases like diabetes and high blood pressure, people think about that less because you can’t feel your blood pressure going down, you can’t feel your sugar going down when you step into nature, but you can feel a sense of calm and better focus when you walk into nature. So, yes, I would say through our program, the majority of mental health prescriptions, but it could be for really any other condition.

Jellis Vaes
And why does it work, actually, what is it about nature that it does to the mind or brain and body that makes it so effective for so many different conditions?

Dr. Melissa Lem
There are a couple of major psychological theories about why nature is really good for our brains and gives our brains a break. And the first one is called attention restoration theory. And when we spend time in busy city environments that have so many different stimuli competing for our attention, like traffic lights, crowds, noises, sure, that tires out our powers of conscious attention, which we only have a finite amount of. There’s only so much attention in the bucket. And once you pass it, it starts to overflow and make us more irritable and tired and lose focus. But when you step into nature, a park or a forest or by the water, it’s a source of soft fascination. That’s interesting, but doesn’t require that focused attention that navigating around a sidewalk and across a crosswalk through traffic requires, and that restores that power of conscious attention and reduces our fatigue and irritability. There’s another major theory called stress reduction theory that says that when we spend time in nature during periods of stress and after immediately after periods of stress, that nature helps our brains recover faster because it’s naturally restorative. And this can go back to, when you think about it, human evolution.

So if you think about areas with high biodiversity, they tend to have lots of sources of food, of things that you can use to build shelter, of water, of, say, trees that you can climb up to get away from predators from. So having this biophilia or preference for nature is really an evolutionary benefit. Yeah, makes sense. Passed on these nature-loving genes to future generations. And then because of this reduction in stress, when you step into nature, your primary stress hormone, or cortisol, levels drop. And we know that cortisol is bad for all kinds of different health conditions, from high blood pressure to diabetes to cancer. And then also it’s what we touch and what we smell in nature that also improve our health. There are these volatile organic compounds called phytoncides. That plants and trees release. If you think about a cedar or a pine forest and that nice smell that you get when you walk into that forest, you’re breathing in these chemicals that, in fact, boost your levels of natural killer cells and immunoproteins. And then when you touch nature, you get your hands in the soil or touch the trees, you are getting healthy bacteria on your skin that help your immune system move in healthy ways towards being defensive against viruses and bacteria, as opposed to more allergies.

So there’s so many different ways from our brains to our noses, to our digestive tract and to our stress system, that nature is improving our health.

Jellis Vaes
And then, of course, you have the physical part to it, too, right? When you are in nature, you might be walking around, which is good for everyone to just move. I actually moved from Antwerp, so one of the cities in Belgium, to my hometown again, which is just a lot more green. And I can honestly feel so much. I sleep so much better, so many less noises at night. And, yeah, it’s so good to just walk again in a forest a bit more. It feels amazing because there’s also noises in a forest, right. But they’re more calming noises compared to the noises of cars and. I don’t know, and all the machine thing. Yeah. Any drills that you hear somewhere in the distance or something, and when you.

Dr. Melissa Lem
Hear those animal noises and you hear the sounds of nature, they tell your brain, hey, there might be a source of food here, or, hey, there’s something here that I can use to eat or use to build a shelter. They are signals that are positive for our health, as opposed to drills and traffic that are generally negative for our health.

Jellis Vaes
Yeah, I actually read, when I was preparing for this interview, a whole bunch of studies also about the benefits of nature for our mental health and our physical health. And there was one that actually, I thought was just mind-blowing to read, and it has been shown multiple times, apparently, in other studies, but that patients who are in the hospital and who have a window with just green, with trees, healed on average. Let me see that I get it right. Healed on average a day faster, needed significantly less pain medication, and had fewer post-surgical complications than patients who just saw a brick wall, which, I mean, that’s insane that nature can have such an impact on our mental and our physical health, actually. Are there any other interesting findings, such as this one about the impact of nature on our physical and mental health that, you know, that you often feel other people don’t fully know or understand? Are there any other studies coming to mind or anything coming to mind on this question.

Dr. Melissa Lem
I want to add something to the study you just mentioned. And these patients not only got discharged earlier, used less pain medication, but their healthcare providers also found them less bothersome when they were able to look out to nature out their window. So it makes us happier too. Not only that our patients are healthier, but that they interact in more positive.

Jellis Vaes
Yeah, it makes work easier for you, too.

Dr. Melissa Lem
Exactly. In terms of other neat studies, I would point to the fact that there are studies showing that you don’t necessarily have to move when you’re in nature to get those health benefits. And you mentioned the exercise component. That’s definitely one pathway by which we can improve our health when we spend time in nature. Because we know there’s a huge amount of evidence behind the health benefits of exercise. But you don’t even have to move. There are studies showing that if you just sit in nature for 15 minutes in a forest versus on a city street, that your cortisol levels drop, that your blood pressure goes down, that your heart rate variability improves, these are all markers of stress. So taking a break, even if you don’t feel like exercising. I personally love to exercise and hike and do all those things, but there are people that can’t, that have mobility issues or just don’t have energy to do. So. If you just sit on that park bench or sit by the river or ocean or look out your window, even if you’re stuck inside at nature for 15 minutes, that can improve your health also.

So it’s not just that exercise benefit that improves people’s health, it’s the stress reduction in many ways that being around nature helps with.

Jellis Vaes
Which actually reminds me also, just when you, for example, would give a prescription to a patient that could need or could use the benefit of being in nature, how long? This might vary depending on the patient, right? But what is the general rule that works best? How long do they have to be in nature? Do they have to be every day in it for hours or every week? What in general works on average best?

Dr. Melissa Lem
Do you know what the really cool thing is? At the time when we were coming up with our nature prescription program recommendations around dosing, nature dosing were starting to come up in the literature. And there was a paper released in 2019 that looked at recreational time in nature in adults in the UK, close to 20,000 adults, and self-reports of health and well-being. And they found that when their time in nature hit at least 2 hours per week, that they reported significantly greater health, well being. And this health and well-being. And this was controlled for a number of other factors, like income and preexisting health status and proximity to nature, because you think, okay, often people who live in healthier environments have more exposure to nature tend to be wealthier. Of course they’re going to Report greater Health and well-being if they spend more time in Nature, but they controlled for a lot of those different Confounders, which is really neat. There was a second study that came out again in 2019 that looked at how much each Nature pill has to be. How much time should you spend in nature each time to get the biggest bang for your buck?

And it turns out that the biggest drop in cortisol, that stress hormone, was between the 20 to 30-minute mark, the steepest drop. And I know a lot of us are really busy people, and sometimes we only have so much time to get a health benefit, like get an rxercise in or something that’s good for a health in. And it’s really that 20 to 30 minutes is the sweet spot. Now, when it comes to at least 2 hours a week, at least 20 minutes each time. No one’s saying you get your 2 hours, you get your 20 minutes. Stop, you’re done. More. Nature does tend to be better up to a certain point. So, of course, if you’re feeling great, if you’re enjoying that hike with friends, stay out for longer, because the Health benefits do improve over time as you stay out up to the studies say about 5 hours. I want to mention something, actually a Personal Experience that has to do with this 2 hours in nature per week benefit. I’m an international advisor for an international trial research project called Resonate, which is looking at nature based therapies and health outcomes.

And I was at the first annual kickoff meeting in Vienna in September of 2023, and I met the principal investigator in person for the first time. And I was presenting to the group, these are these esteemed researchers from mainly Europe who are all looking into nature based therapies. And, you know, I felt like a bit of an imposter. I’m like, this family doctors does this nature prescription program. I’m not this esteemed researcher. And I was presenting on our guidelines what we recommend for nature dosing. And then the principal investigator, his name’s Dr. Matthew White, he actually said, I wrote that paper on the two hour per week nature recommendation. I’m the first author, and we deliberately wrote that paper to speak to health professionals who were asking for dosing information. And it’s incredible that here we are in this room together now, leaning on each other’s work and inspired by each other’s work. So this was really a full circle moment. They spoke, the researchers spoke, and I listened. And the rest is history, right?

Jellis Vaes
Yeah. Wow. But 2 hours a week, that’s honestly not long for quite some good positive impacts on your mental and physical health, right? Because like you said, some people listening might be like, oh, cool being in nature. But I already have so many things to check off. Got my work, got to work out. Now I also have to be in nature. So yeah, just having maybe a walk for ten or 15 minutes a day could already be huge.

Dr. Melissa Lem
Or you can incorporate nature time into what you already do. If your work commute involves, you can try to ride your bike or walk along a treeline street or through a park if you can. If you are socializing with a friend, grabbing coffee, take the coffee to go and walk in a park, you can do your workout, do your cardio in particular. In nature, it doesn’t have to be an instead of it can be incorporated into what you do.

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Jellis Vaes
And by the way, maybe it sounds a bit sad for me to ask this, but I was looking not too long ago actually, at photos from my hometown of like 50 years ago. There were a lot more fields and trees compared to now. I mean, there’s a lot more buildings where those fields and trees were. But how much nature do you need for it to actually work? Because you said a park, but compared to a national park, just a city park work just as good as well? Or does even like a tiny garden, because some people might just have only a tiny garden, and not so many city parks either. Does that also work? When do you have enough nature? When is it effective?

Dr. Melissa Lem
Actually, what the research does show is when you feel like you’ve had a meaningful nature experience, is when you’re going to get those health benefits. So the objective biodiversity, number of trees, that sort of thing, number of birds, doesn’t necessarily matter as much as when you feel like you’ve had that experience. So if you feel like you’ve connected to nature when you’re in your garden, or if you’re in a city park or elsewhere, you’ll see those health benefits. And I will point to this 3300 rule that one of my colleagues, Dr. Cecil Konijnendijk came up with, and he was originally based at the University of British Columbia, where I’m a clinical assistant professor. But he now works in the EU. And this rule, and it’s backed up by evidence, says that we’ll know that our cities are healthy from an infrastructure perspective, when everyone in every neighborhood, not just the rich ones, can see at least three mature trees from their windows, when every neighborhood has at least 30% tree canopy, and when everyone is within a 300 meters walk from a high-quality green space…

Jellis Vaes
It would be amazing.

Dr. Melissa Lem
And this is backed up by… Wouldn’t it be? This is backed up by research, for example, from some of my colleagues in Australia. I’m also participating in another research project with them that looks at that lowest quartile of nature and tree canopy within city neighborhoods, and then anything over 30%, and they find that conditions, from sleep issues to loneliness, to heart disease and high blood pressure, are significantly lower once you hit that…

Jellis Vaes
Loneliness?

Dr. Melissa Lem
…Tree canopy level. Exactly. Yeah, it’s really interesting.

Jellis Vaes
How would loneliness, because you get out and meet people, maybe, or how would it impact?

Dr. Melissa Lem
That’s one of the mechanisms. That’s a great question, and they would be great people to interview for another podcast. But nature, I think because it relaxes us, like, we feel calmer when we’re outside in nature, it facilitates those social connections. And I think you really see this in kids, in the research in children, when they play in green playgrounds versus playgrounds that have jungle gyms and plastic and metal structures, they play more cooperatively and there’s less conflict. And I think it’s a function of it being kind of an equal space for everyone to interact. And we see that in other research where it shows that health disparities reduce in neighborhoods that have more nature in them. Between people who earn low income versus high income. It’s really this great equalizer for all of us.

Jellis Vaes
Yeah, it is, right? And wait, it was 3300 or what was it?

Dr. Melissa Lem
It’s the 3300 rule. And what’s interesting, too, is that there are different cities that are in fact, taking up this guideline. The city of Victoria, which is where I, in fact, did my family medicine training, has added this in policy, and they’re aiming for their city to fit the three 3300 rule. And I think it’d be amazing if more and more cities everywhere in the world started taking this up because we would see real benefits for human health and benefits for the city as well. Like when you have more trees, it reduces the urban heat island effect. It filters the air, also reduces flooding when there’s heavy rainfall. So there’s so many different wins for health and infrastructure when you add more nature into cities.

Jellis Vaes
Yeah. And it makes people happier and healthier, like you also said. So only more reasons to make parks right in cities. And actually, what about. Because you mentioned people with disabilities, right. For people who do have a disability or for some other reason can’t leave their apartment, how could a nature prescription actually look like for them? Is there some way to still benefit from nature even though that you’re indoors?

Dr. Melissa Lem
Any way that you can connect to nature is in some way going to improve your health. And I want to lean on some of the work that my colleagues in Ontario are doing. There’s a pediatrician, her name is Dr. Anna Gunz, and one of her residents, Dr. Komedi Abaitang. And they, in fact, brought a nature for healing program into their children’s hospital. And they recognize that not a lot of these kids can go outside because they’re sick, they’re hooked up to different equipment and it’s hard to go out. So they’ve created a program where they can bring nature to their patients indoors. And this involves having more plants indoors. This involves having more nature imagery and nature sounds around. And so if, say, someone is inside their home, and I think a lot of us saw this during the lockdowns of Covid-19 when a lot of people didn’t necessarily feel safe to go outside into green spaces because we didn’t quite know how the virus transmitted. If you can have house plants, if you can play nature sounds, the smells of nature videos of nature, there is research showing that that can improve mental health outcomes in particular.

So just as much as you can bring into your home, the better. And I think we who are in positions where we can speak to decision makers and influence public discourse. It’s important for us to emphasize that governments have to step up and make sure people have green space and trees and plants outside their windows too, so they can enjoy the health benefits of nature too, even if they can’t get outside all the time.

Jellis Vaes
Yeah. And what you also said, I actually also did read it, that actually seeing a documentary on nature does also have positive effects on your physical and mental health, apparently. So that’s actually quite. Just seeing any kind of nature, even a documentary could already do quite amazing things on a person.

Dr. Melissa Lem
I really love those documentaries. And I think one of the big reasons is they inspire a lot of awe. You look at them and you think, wow. I mean, I have this zoomed in microscopic view of this insect that I would never see in real life, or just I’m watching the migrations and movements of these groups of animals in another country that I probably won’t ever have the chance to see in my lifetime. It’s amazing. And in fact, that sense of awe is something else that improves our health when it comes to nature, because you see your place in the universe a bit better and you understand what’s important. It puts things in perspective and it gives your brain a break while you’re doing that. So nature is really good for inspiring that sense of awe. And I think documentaries are really good for that in particular.

Jellis Vaes
So for someone listening right now, who, after everything that you’ve shared about nature, who feels inspired or curious to actually incorporate nature more in their day or in their week, do you have any other, just general suggestions for anyone listening to make, in a way, the most out of nature when they’re out there, or to feel the most benefits out of nature? Is there anything more of something that you could share to someone listening who wants to incorporate nature more in their life?

Dr. Melissa Lem
First of all, I would say, remember our standard guidelines. To spend at least 2 hours in nature a week, at least 20 minutes each time, and try to make it a meaningful experience. Be as present as you can and as mindful as you can about your surroundings. Another way, I think, to enhance your experience is to engage family and friends. We know that the social aspect of connecting outdoors is really good for our health too. And if you can do it in nature, all the better. Not only that, but they’ll keep you honest. If you tell them. If you tell people I plan to spend at least 2 hours in nature each week, then they’ll hold you to it and they’ll get healthier at the same time. And I think finding something that you enjoy as well. And this is important for any new habit that we pick up, whether it’s exercise or diet. This is a prescription for life. This is not a prescription for a few weeks or a month. You want to make sure that you do this forever. And so finding something that you like that you can keep up and that you can do with others, I think these are all important.

Jellis Vaes
Yeah. And also if you can combine it, like you also mentioned, for example, if you could have every, I don’t know, every two weeks, maybe a fixed day and time to go for a hike with some friends, which kind of checks off multiple things. Right. You’re in nature, you spend time with friends or family, so you’re social as well. You’re maybe also seeing new things. I actually used to do that, that I went on a hike with friends every month and yeah, I should probably start doing that again. But it was a really awesome way for me to check off, in a way, multiple things.

Dr. Melissa Lem
That’s right. And we can think about this pyramid of nature experiences, like the everyday nature experiences, the 20 minutes bursts, maybe in your nearby nature, but then maybe once a month go on a hike or a nature experience somewhere further afields that has more biodiversity and is a bigger nature spot. And then maybe once a year, like take a prolonged camping trip or a vacation somewhere surrounded by nature.

Jellis Vaes
Yeah, that’s good. It’s maybe a bit of an analogy of like, everyone needs to eat every day and you cook every day, maybe for yourself, but maybe once every month go on a really nice restaurant and let someone else cook for you. But to have also a whole different experience. It’s nice, dude. Yeah, that’s a good suggestion. Actually, when a patient comes back to you, one that you prescribe medication. Sorry, not medication, nature. To how do you assess actually the effectiveness that the nature treatment worked for them? Are there any specific metrics or tools that you use to see if it was effective? And also for people listening, what could they do to see if nature is actually being beneficial to them?

Dr. Melissa Lem
Well, the first thing I do when I follow up with a patient I prescribe nature to is ask them if they’re indeed spending time in nature to see if they’ve picked up a nature habit. The vast majority of the time they say yes. And I do have to say that I’m very lucky to live in a neighborhood in Vancouver, British Columbia, that is filled with nature. So we have pretty easy access to beautiful second growth forest, trails and ocean and all kinds of parks. So it’s not hard for them to fill their nature prescription. So most of the time they come back saying yes, and then it depends on the condition. I would say, just like most of my colleagues, I prescribe the majority of nature prescriptions to patients with mental health issues. And I can’t think of one patient I’ve prescribed nature to who hasn’t gotten better in some way. And there’s some different scales that we use, for example, to assess people’s mood, depression, and anxiety scales, and they almost invariably improve. And I can’t say for certain, being completely honest here, that it’s the nature prescription that did it all. Sometimes I will prescribe counseling in addition, or sometimes medication in addition.

It’s not one or the other, but it’s really part of an overall treatment plan that improves patients health. And it’s evidence based in terms of patients, other people, not just people listening to this podcast about how they can tell if nature is improving their health. If you feel like it is, it is, essentially. And I know that sounds kind of like a hedge or something, but it’s based on the research that tells us if you feel like you’ve had a meaningful experience in nature, your health is improving. You can track your own blood pressure, you can see what your stress levels feel like. You can go to your doctor and get your blood sugar. Exactly. I think if you take the time to spend time in nature and then look to see how you’re feeling, both mentally and physically, and measure what you can, I think you will see some benefits.

Jellis Vaes
This notion that nature can actually be used as an effective treatment is becoming more common knowledge. I’m not saying we’re there yet, right? Not at all. But it seems like slowly things are changing. Right. And it’s truly thanks to the work of people like you that this is happening. But what I’m curious about is why now? Why does it seem now that people are taking nature more serious, even though there are years and years of. I mean, years ago, already, there were studies about the benefits of it, but only now, it seems doctors are slowly accepting nature as treatment. Any thoughts on why that’s the case?

Dr. Melissa Lem
There are a few ways I could answer this question, and I think one is the world was ready in 2019. Nature prescriptions were, in fact, named one of the top eight global wellness trends. This is 2019. And then I think the Covid-19 pandemic as well, really drove a lot of people outside, because all the indoor places where they used to destress and socialize were closed. And so they got to experience firsthand the benefits of nature. And it was the right message at the right time. It’s like we’re looking for something to improve our health, reduce our stress. That’s evidence-based based and that’s safe. And so it’s the right message at the right time. And then, honestly, I think it takes individuals who really have a passion for a cause, really have a passion for spreading evidence-based health interventions out there. And I’m not the only one. I mean, there’s an amazing American physician. His name is Dr. Robert Zar, who heads at Park Rex America. He helped launch the first national nature prescription program in the world, in the US in 2017, I believe it was. And it took one person who built a team and found the resources and made it happen.

So I think more and more leaders are stepping up now that they’re aware of the evidence base and also now that we’re seeing the effects of climate change and biodiversity, nature loss in our own cities and in our own lives, I think that’s making more healthcare professionals aware of the effects of the environment on their health.

Jellis Vaes
Yeah, it’s always crazy, even though, I mean, there’s other things, right, that we know is good, but that we’re not implementing yet into just in the medical world. So it does take sometimes a perfect storm for it to be applied. Like you said, COVID might definitely have something to do with it, and just the awareness of nature, of climate change. So there’s probably multiple factors why it’s becoming more used now, today, which is good. Really happy about that. Is there actually any ongoing research that you’re aware of or that you’re even involved in that you’re actually very excited about? On the topic of nature and its benefits for physical and mental health, I’m.

Dr. Melissa Lem
Really excited about this Canadian National Household Survey, the results which are going to come out this spring, and I think it’s okay to give you a little preview of it. But I was involved in publishing a paper in Australia looking at what percentage of Australian adults would spend more time in nature if their doctor recommended it. And in Australia, the number was over 75%. Even though many of them hadn’t heard about nature prescriptions. They said if my doctor recommended it, I would spend more time in nature for my health. We ran a similar survey here in Canada over the last couple of months and we found pretty similar results, which is really interesting that again, the vast majority of Canadian adults would spend more time in nature if their doctor recommended it. So I think it’s really important for more and more health professionals to sign up. And then in terms of other research. I am involved in a couple other big international research projects looking specifically at nature prescriptions and nature-based therapies and how they can improve health. And the really exciting part of one in particular that’s headquartered in Europe is they’re also looking at ways to most effectively scale up these therapies around the world, not just increasing the knowledge base, but also implementing these interventions everywhere. So I’m really excited about these two projects. They’re called the Resonate Project, based in the EU, and the Panda Project in Australia. So I’d encourage your listeners to look up those projects and see what we’re up to.

Jellis Vaes
Yeah, I will link it up in the show notes for everyone listening so you can find it there. And as just the last question, where do you see the future of Nature as a treatment actually going to?

Dr. Melissa Lem
I see more and more health professionals adopting nature prescriptions as an evidence-based intervention into their practice. And I will say that we’ve been around in Canada for about three years, our nature prescription program. We have registered over 12,000 regulated health professionals across Canada in our program. In my home province of British Columbia, about 15% of doctors are prescribing nature for their patients health. They’re registered in our program and we’ve had endorsements from over 60 major health organizations within the country, including the Canadian Medical Association, which represents every single doctor in the country.

Jellis Vaes
Yeah.

Dr. Melissa Lem
And so I see more and more and more health professionals adopting nature prescribing within Canada and elsewhere. And something else I see is more linkages between the healthcare system and outdoor experience providers. Because when you prescribe nature, sometimes patients want to know, well, what can I do and who can I do it with? And so I think it’s important to connect also with the people and the places that provide those Nature experiences to make sure that patients are filling their prescriptions in an effective way.

Jellis Vaes
Yeah. Well, I’m very excited only about the future, and I am so thankful and grateful that we have you in this world because it’s really thanks to people like you, right, that this is becoming more common knowledge and is being taken serious and that it’s only being pushed more towards that direction. So thank you, honestly, for all the work that you have done, for all the work that you are doing and just for bringing this awareness and of course, for PaRx, for starting that initiative. Yeah. So thanks.

Dr. Melissa Lem
It’s my pleasure. I get to speak with people like you, and then I get to help inspire new nature and health colleagues also across the country and elsewhere in the world. I do have to say that a lot of people have stepped out of the woodwork, a lot of other doctors and nurses and health professionals saying, I want to be part of this movement. How can I help? And they’ve really been responsible for a lot of the spread of our initiative across the country. So if one person leads, often many people will follow and become leaders themselves. So it’s great to be part of this movement.

Jellis Vaes
So there’s one last end question that I have for you that I ask all my guests, that I would also love to ask you. But before I will do that, what is the best place for listeners to check out your work or to connect with you, or where would you want to send people to?

Dr. Melissa Lem
I would get you to check out our website,parkprescriptions.ca. It’s at www.parkprescriptions.ca. We actually have a French language sister program based in Quebec. If you’d rather read in French, www.prescri-nature.ca. And read all about the health benefits of nature and all the media stories about what our program is up to, we get a lot of coverage by the media, which is probably how you heard about our program.

Jellis Vaes
Yeah. Well… I was actually explicitly looking for a doctor who was doing work around nature, and that’s how I actually came to find you. And you’re also on Instagram, right? And on LinkedIn. I don’t know if you also want me to link that up in the show notes.

Dr. Melissa Lem
Sure. Happy for you to add, I think Instagram, LinkedIn and X, or Twitter if you happen to be on that platform.

Jellis Vaes
So for everyone listening, I will link that all up in the show notes. So the final question, the end question that I have for you, Dr. Lem, and you can take your time with this, right? It can be super short. It can be quite extensive. From everything that you have seen, experienced. Lived and learned in your life, what’s the one thing you know to be true?

Dr. Melissa Lem
I know that spending time in nature is good for our health from both an intuitive sense and also from a research-based sense. And this is something that I’ve known since I was a kid, growing up in the suburbs of Toronto and feeling like an outsider and finding belonging in nature. And I would say I’ve really found my calling within this space. I’ve found amazing colleagues who can help push this work forward. So I know that when you feel something to be true and it’s good for you and it’s good for the rest of society and the planet at the same time, this is something that you should really pursue because it can result in great things like a national nature prescription program and like inspiring these conversations around the world. And I want to add one more thing.

Jellis Vaes
Sure.

Dr. Melissa Lem
Which is that there is research showing that when people are more connected to nature, that they’re more likely to protect it. And it makes a lot of sense because you protect what you love. But they also engage in behaviors and adopt values above and beyond conservation. They tend to recycle more and save more energy and vote for climate advocates. So from a little kid who would give speeches about the disappearing rainforest and be called a tree hugger by my family, to an adult who’s heading up a big physicians environmental organization and running a national nature prescription program, I think that really holds true for myself. I really felt connected to nature when I was a kid, and it’s become beautiful things as an adult.

Jellis Vaes
Dr. Lem, thank you for taking your time and for being here on the show.

Dr. Melissa Lem
My pleasure. Jellis, thank you so much for inviting me. I had a great time talking with you.

Jellis Vaes
All right, and that concludes this episode with Dr. Melissa Lem. I hope that you learned something here in this interview. You know, about the physical and mental health benefits of nature, and that in addition to all that, that it also inspired you, maybe to seek out nature even more in your life. Now, if you want to find any of the resources mentioned by Dr. Lem, then check out the show notes, which are, as always, located in the description of this episode. Or you can also go directly to theipsproject.com/podcast and search for Dr. Lem and the episode will pop up. Oh, and one last thing, as I also said in the intro, if you could just take a second of your time to leave a rating that would truly mean so much to me. I mean truly. And you also have to know that you are also directly impacting or allowing this information, as we covered here on the podcast, to be spread out more into the world. So if you also feel that more people should know about stuff like this topic and other things, life education that we cover here on the podcast, then leaving a rating will allow that information to be spread more out there in the world. Alright, with that, thank you for being here once again. And who knows, maybe I get to welcome you again soon on another episode here on the IPS podcast. Until then, this is your host, Vas, signing off.

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