Research

Gardening is Good for You: the Evidence

Gardens and gardening do great things for our health and wellbeing, and the evidence of these effects is now significant. The mental health benefits are probably best known: gardening reduces feelings of anxiety, stress, fear, anger and pain, and you can get these effects even by just looking at plants or gardens. Gardening helps reduce depression scores, improve cognitive health in people with dementia, and reduce blood pressure, heart rate and fatigue levels. 

Did you know gardening and garden views also help speed recovery after surgery, cancer and heart disease? Gardening programmes have been used successfully to help people overcome traumatic experiences, aid addiction recovery, weight control and as an effective way for people with learning disabilities to learn literacy and numeracy skills. 

We have collected studies of therapeutic gardening into a Research Library. This resource is not exhaustive but aims to be a source of evidence to support practice development and funding applications. As further evidence relevant to the benefits of gardening come to our attention we will list them in the Research Library and highlight some of them on this page. 

Research Digest

In July 2016, a visit to the Trellis office from Maxel Ng of the National Parks Board , Singapore and currently a member of the Visiting Staff at Royal Botanic Garden Edinburgh, brought us news of studies being carried out there, including The Effects of Horticultural Therapy on Asian Elderly’s Mental Health https://www.nparks.gov.sg/~/media/nparks-real-content/news/2016/launch-of-therapeutic-garden-at-hortpark/media-factsheet-b-research-programmes-on-benefits-of-greenery.pdf . So far the results are significantly positive - we’ll link to the full research paper, when it’s published. Singapore has adopted a strategic approach to therapeutic gardening, with direct government investment in gardening projects across the country, see the wealth of gardening and greenspace in Singapore’s culture at https://www.nparks.gov.sg/gardening

 

Gardening and well being

Therapeutic Gardening: theory and evidence
A summary of the main studies relevant to gardening therapy Word | pdf

Trellis Annual Conference 11th March 2016 : Dr Rachel Bragg, Development Coordinator, Care Farming UK, delivered an animated and enlightening overview of therapeutic gardening, its place within green care and evidence of how it supports health and wellbeing. To open the presentation please right click on the link and select 'open in new window' . This is the accompanying research paper.  

AIPH International Green City Conference: Growing Green & Healthy Places
Sir Richard Thompson KCVO, DM, President of the Royal College of Physicians in his conference paper  Why and How Green Environments are Better for Your Health   (please right click on the link and select  'open in new window') at the AIPH International Green City Conference,  1st April 2014

Gardens and health: Implications for policy and practice
A useful new publication, 2016,  making the case for increased use of gardening in health services, and rounding up some good research references about the health benefits of gardens and gardening. http://www.ngs.org.uk/Upload/What-we-do/News/King%27s%20Fund%20Report%20...
 

Forward to Nature: Why a Walk in the Woods Could Calm ADHD, Make Your Family Happier and Deliver Your Kid to Harvard. Research shows getting kids in nature can increase intelligence, creativity, and well-being, as well as solving a host of other psychological and physical illnessess.
http://www.parentmap.com/article/a-walk-in-the-woods-calm-adhd-make-your-family-happier-and-deliver-your-kid-to-harvard

Longitudinal study of older people in Sweden highlighting the importance of non sport based physical activity in cardio vascular health.
The importance of non-exercise physical activity for cardiovascular health and longevity, Ekblom-Bak, E. et al.,Br J Sports Med: 28th October 2013
Abstract: http://bjsm.bmj.com/content/early/2013/10/08/bjsports-2012-092038

Green spaces deliver lasting mental health benefits. Analysing data that followed people over a five year period, the research has found that moving to a greener area not only improves people’s mental health, but that the effect continues long after they have moved. Article:.http://www.exeter.ac.uk/news/featurednews/title_349054_en.html

PubMed: Healing gardens and cognitive behavioral units in the management of Alzheimer's disease patients: the Nancy experience.http://www.ncbi.nlm.nih.gov/pubmed/23207487
Healing gardens: recommendations and criteria for design.http://www.ncbi.nlm.nih.gov/pubmed/23015232
What Is the Evidence to Support the Use of Therapeutic Gardens for the Elderly?.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372556/

 

Physical Activity and the Prevention of Depression: A Systematic Review of Prospective Studies
George Mammen and  Guy Faulkner, PhD shows evidence that any level of physical activity including low levels (e.g., walking or  gardening  <150 minutes/weeks), can prevent future depression. From a population health perspective, promoting physical activity  may serve as a valuable mental health promotion strategy in reducing the risk of developing depression. Published in the
American Journal of Preventive Medicine Volume 45, Issue 5 , Pages 649-657, November 2013
Abstract: http://www.ajpmonline.org/article/PIIS0749379713004510/abstract

The Growing Healthy Older People in Wales (GHOP) research programme reveals that allotment and community gardening reduces stress, boosts self-esteem and enhances feelings of happiness and well-being, particularly for women see the report at
http://www3.uwic.ac.uk/English/health/research/psyr/HeaPsy/GHOP/Documents/Results%20Summary%20Document%20[web].pdf
 

ecotherapy benefits for mental health and wellbeing
Mind (the mental health support charity in England and Wales) recently released Feel Better Outside, Feel Better Inside - a report showing the many benefits of ecotherapy for mental wellbeing. Ecotherapy involves activities such as gardening, food growing and conservation work in natural environments. The report demonstrates that ecotherapy improves mental health, boosts self-esteem, helps people with mental health problems return to work, improves physical health and reduces social isolation. It also calculates the savings to the public purse from engaging people in ecotherapy activities.see report at www.mind.or.uk  
also see Mind's report Ecominds effects on mental wellbeing: an evaluation for mind at
http://www.mind.org.uk/media/354166/Ecominds-effects-on-mental-wellbeing-evaluation-report.pdf

Allotment gardening and health: a comparative survey among allotment gardeners and their
neighbors without an allotment,  van den Berg et al. Environmental Health 2010, http://www.ehjournal.net/content/9/1/74
 

Di Blackmore PhD postgraduate student at the University of Stirling gives an update on her research into the health effects of therapeutic gardening.

The main application of the research will be to raise awareness and convince service managers, funders and policy makers in organisations such as national government, local authorities, health and environmental agencies, of the value delivered by such projects.
 

Green space and Health

Ground-breaking research into the impacts of greenspace, blue space and urban environments on individual and population health was reported at the GreenHealth conference in Edinburgh in March. The conference, organised by greenspace scotland on behalf of the GreenHealth research partnership heard from speakers including Prof George Morris, Prof Richard Mitchell of Glasgow University, Prof Catharine Ward Thompson of the OPENspace Research Centre and Prof David Miller of the James Hutton Institute. In the final session delegates proposed key recommendations for policy, practice and further research. The recommendations, together with the presentations are now available at greenspace scotland

 

Trellis Research Work

We aim to collate new research relevant to therapeutic gardening so that it's accessible to practitioners in one central place. We also work in partnership with researchers to encourage more studies that will help build the evidence base that demonstrates the benefits of therapeutic horticulture initiatives.

 


Latest Research

  • Social and Therapeutic Horticulture as a Palliative Care Intervention

    Elisabeth Pilgrem
    2023
    BMJ Supportive & Palliative Care Journal: Online First

    Abstract:

    Abstract Objectives Social and therapeutic horticulture (STH) is little known in palliative care. This evaluation sets out to explore the effectiveness of STH in relieving distress, managing symptoms and supporting people with advanced and terminal illness to live well throughout each stage of the disease trajectory. Methods STH was provided for 218 patients in an indoor hospice setting during a 2-year period (April 2018 to March 2020). Nature-based interventions, such as potting up plants, floristry and creating miniature gardens, were adapted for all participants to create a nature connection experience while indoors. The Distress Thermometer (DT) was used to measure perceived distress before and after each session, and patients’ reports of their subjective experience were recorded verbatim. Results Results showed a statistically significant reduction in DT scores of between 54% and 60%. Patients also self-reported an improvement in quality of life and well-being and in management of symptoms including a reduction in pain. Conclusions This evaluation shows that STH is effective in relieving distress in palliative care and may be considered a valued therapeutic intervention. The findings can inform planning within hospices and palliative care settings to enhance the care of patients and their family members. http://dx.doi.org/10.1136/spcare-2021-003503

  • Elizabeth R. Messer Diehl
    2017
  • Vitamin D Deficiency and Leisure Time Activities in the Elderly: Are All Pastimes the Same?

    Marina De Rui, Elena Debora Toffanello, Nicola Veronese, Sabina Zambon, Francesco Bolzetta, Leonardo Sartori, Estella Musacchio, Maria Chiara Corti, Giovannella Baggio, Gaetano Crepaldi, Egle Perissinotto, Enzo Manzato, Giuseppe Sergi
    2014
    PLOS ONE | www.plosone.org
    April 2014 | Volume 9 | Issue 4 | e94805

    Abstract:

    Abstract Background: Optimal vitamin D status is important for overall health and well-being, particularly in the elderly. Although vitamin D synthesis in the skin declines with age, exposure to sunlight still seems to help older-aged adults to achieve adequate serum 25-hydroxyvitamin D (25OHD) levels. Elderly people would therefore benefit from outdoor leisure activities, but the effects of different types of pastime on serum 25OHD levels have yet to be thoroughly investigated. Aims: To assess the association of different pastimes with 25OHD deficiency in elderly subjects. Methods: A sample of 2,349 community-dwelling elderly individuals (1,389 females and 960 males) enrolled in the Progetto Veneto Anziani was analyzed. Brisk walking, cycling, gardening and fishing were classed as outdoor activities, and dancing and gym workouts as indoor pastimes. Any activities undertaken for at least 1 hour/week during the previous month were considered as being practiced regularly. Logistic regression models were used to estimate the association between different pastimes and 25OHD deficiency. Results: Serum 25OHD levels were significantly higher in individuals who engaged in outdoor pastimes (+25% in women, + 27.7% in men) compared to those who did not. In particular, subjects regularly practicing gardening or cycling had higher serum 25OHD levels than those who did not, whereas 25OHD levels differed little between subjects who did or did not undertake indoor activities. Among the outdoor pastimes considered, logistic regression analysis confirmed a lower likelihood of vitamin D deficiency (25OHD,50 nmol/L) for cyclists (OR 0.51, 95% CI 0.37–0.69 in women; OR 0.50, 95% CI 0.29–0.87 in men) and gardeners (OR 0.62, 95% CI 0.47–0.83 in women; OR 0.46, 95% CI 0.26–0.80), but not for brisk walkers. Conclusions: Regular cycling and gardening reduce the likelihood of inadequate vitamin D status in Caucasian elderly people, irrespective of their age, BMI and comorbidities, and of the season of the year.

  • Is gardening associated with greater happiness of urban residents? A multiactivity, dynamic assessment in the Twin-Cities region, USA

    Graham Ambrosea,, Kirti Dasb,, Yingling Fanb,, Yingling Fanb,
    2020
    Elsevier
    Volume 198, June 2020, 103776

    Abstract:

    As cities seek to become more livable and environment-friendly, activities like bicycling, walking, and urban gardening (household and community-gardening) are receiving much attention. However, few field studies have measured well-being of urban gardening, particularly during household gardening. Our study develops protocols to measure emotional well-being (EWB) reported during household gardening, comparing it with other leisure and day-to-day activities. We also explore how gardening EWB varies across gardener type (vegetable vs ornamental), demographics, neighborhood type, and companionship during gardening. Using a recently developed app-based Day Reconstruction Method, EWB was measured across 370 participants in the Minneapolis-St. Paul Area, USA, wherein 118 (32%) reported engaging in household gardening. Innovatively, five measures of EWB were computed for each participant for each activity type: average net affect, average happiness, average meaningfulness, the frequency of experiencing peak positive emotions (happiness and meaningfulness). Among all three average EWB measures, gardening is among the top 5 out of 15 activities assessed, and, is not statistically different from biking, walking and eating out. All four of these activities fall behind other leisure/recreation activities, which ranks first. For frequency of experiencing peak happiness, only other leisure/recreation activities were statistically higher than all the remaining (14) activities. Average net affect of gardening was significantly higher for vegetable gardeners (vs ornamental), for low-income gardeners (vs higher income) and for women. Companionship while gardening at home, race/ethnicity and urban versus suburban location showed no significant difference. Livability and equity considerations based on these EWB findings, and their impacts on urban food plans, are discussed.

  • What is the evidence for the impact of gardens and gardening on health and well-being: a scoping review and evidence-based logic model to guide healthcare strategy decision making on the use of gardening approaches as a social prescription

    Michelle Howarth, Alison Brettle, Michael Hardman , Michelle Maden
    2020
    BMJ Open

    Abstract:

    Abstract Objective To systematically identify and describe studies that have evaluated the impact of gardens and gardening on health and well-being. A secondary objective was to use this evidence to build evidence-based logic models to guide health strategy decision making about gardens and gardening as a non-medical, social prescription. Design Scoping review of the impact of gardens and gardening on health and well-being. Gardens include private spaces and those open to the public or part of hospitals, care homes, hospices or third sector organisations. Data sources A range of biomedical and health management journals was searched including Medline, CINAHL, Psychinfo, Web of Knowledge, ASSIA, Cochrane, Joanna Briggs, Greenfile, Environment Complete and a number of indicative websites were searched to locate context-specific data and grey literature. We searched from 1990 to November 2019. Eligibility criteria We included research studies (including systematic reviews) that assessed the effect, value or impact of any garden that met the gardening definition. Data extraction and synthesis Three reviewers jointly screened 50 records by titles and abstracts to ensure calibration. Each record title was screened independently by 2 out of 3 members of the project team and each abstract was screened by 1 member of a team of 3. Random checks on abstract and full-text screening were conducted by a fourth member of the team and any discrepancies were resolved through double-checking and discussion. Results From the 8896 papers located, a total of 77* studies was included. Over 35 validated health, well-being and functional biometric outcome measures were reported. Interventions ranged from viewing gardens, taking part in gardening or undertaking therapeutic activities. The findings demonstrated links between gardens and improved mental well-being, increased physical activity and a reduction in social isolation enabling the development of 2 logic models. Conclusions Gardens and gardening can improve the health and well-being for people with a range of health and social needs. The benefits of gardens and gardening could be used as a ‘social prescription’ globally, for people with long-term conditions (LTCs). Our logic models provide an evidence-based illustration that can guide health strategy decision making about the referral of people with LTCs to socially prescribed, non-medical interventions involving gardens and gardening.

Year Published by Where Abstract Link Pages Notes Pages
Elisabeth Pilgrem Social and Therapeutic Horticulture as a Palliative Care Intervention 2023 BMJ Supportive & Palliative Care Journal: Online First Abstract Objectives Social and therapeutic horticulture (STH) is little known in palliative care. This evaluation sets out to explore the effectiveness of STH in relieving distress, managing symptoms and supporting people with advanced and terminal illness to live well throughout each stage of the disease trajectory. Methods STH was provided for 218 patients in an indoor hospice setting during a 2-year period (April 2018 to March 2020). Nature-based interventions, such as potting up plants, floristry and creating miniature gardens, were adapted for all participants to create a nature connection experience while indoors.
Elizabeth R. Messer Diehl 2017
Prof Alistair Griffiths, How to Make Your Garden Good for You Dorling Kindersley
Marina De Rui, Elena Debora Toffanello, Nicola Veronese, Sabina Zambon, Francesco Bolzetta, Leonardo Sartori, Estella Musacchio, Maria Chiara Corti, Giovannella Baggio, Gaetano Crepaldi, Egle Perissinotto, Enzo Manzato, Giuseppe Sergi Vitamin D Deficiency and Leisure Time Activities in the Elderly: Are All Pastimes the Same? 2014 PLOS ONE | www.plosone.org Abstract Background: Optimal vitamin D status is important for overall health and well-being, particularly in the elderly. Although vitamin D synthesis in the skin declines with age, exposure to sunlight still seems to help older-aged adults to achieve adequate serum 25-hydroxyvitamin D (25OHD) levels. Elderly people would therefore benefit from outdoor leisure activities, but the effects of different types of pastime on serum 25OHD levels have yet to be thoroughly investigated. Aims: To assess the association of different pastimes with 25OHD deficiency in elderly subjects. Methods: A sample of 2,349 community-dwelling elderly individuals (1,389 females and 960 males) enrolled in the Progetto Veneto Anziani was analyzed.
Graham Ambrosea,, Kirti Dasb,, Yingling Fanb,, Yingling Fanb, Is gardening associated with greater happiness of urban residents? A multiactivity, dynamic assessment in the Twin-Cities region, USA 2020 Elsevier As cities seek to become more livable and environment-friendly, activities like bicycling, walking, and urban gardening (household and community-gardening) are receiving much attention. However, few field studies have measured well-being of urban gardening, particularly during household gardening. Our study develops protocols to measure emotional well-being (EWB) reported during household gardening, comparing it with other leisure and day-to-day activities. We also explore how gardening EWB varies across gardener type (vegetable vs ornamental), demographics, neighborhood type, and companionship during gardening. Using a recently developed app-based Day Reconstruction Method, EWB was measured across 370 participants in the Minneapolis-St.
Professor Murphy, Dr Holmes The Eating and Drinking Well with Dementia Toolkit 2021 Bournemouth University Based on their findings, Professor Murphy, Dr Holmes and the team developed the toolkit to provide freely available resources (a film, workbook, leaflet and guide) to deliver person-centred nutritional care in the area of dementia. The toolkit has been used all over the UK and overseas, as far afield as Australia and is the winner of the 2019 CN Award for Nutrition Resource of the Year! For more information about the CN Awards, visit: nutrition2me.com/cn-awards
Michelle Howarth, Alison Brettle, Michael Hardman , Michelle Maden What is the evidence for the impact of gardens and gardening on health and well-being: a scoping review and evidence-based logic model to guide healthcare strategy decision making on the use of gardening approaches as a social prescription 2020 BMJ Open Abstract Objective To systematically identify and describe studies that have evaluated the impact of gardens and gardening on health and well-being. A secondary objective was to use this evidence to build evidence-based logic models to guide health strategy decision making about gardens and gardening as a non-medical, social prescription. Design Scoping review of the impact of gardens and gardening on health and well-being.
RIVASSEAU-JONVEAUX Thérese (et al) Healing gardens: recommendations and criteria for design 2012 Gériatrie et Psychologie Neuropsychiatrie du vieillissement The French Alzheimer plan anticipates new specialized structures for cognitive rehabilitation and psycho-behavioural therapy of Alzheimer's patients: the cognitive-behavioural units as follow-care units, the units of reinforced hospitalization inside the long term care units and the adapted activities units. this plan indicates the need to make healing gardens integral parts of these units. The benefits of green space in urban environments has been demonstrated with regards to physical, psychological and sociological effects and similarly studies in hospitals have revealed objective and measurable improvements of patients well being. 245-253 245-253
PRINGUEY Dominique, PRINGUEY-CRIOU France The healing garden, therapeutic resource: Psychopathological and phenomenological aspects, therapeutic implications 2015 L’Encéphale 197-201 197-201
PRINGUEY-CRIOU France Healing garden: Primary concept 2015 L’Encéphale 41 Since ancient times the relationship between mankind and plants occupies medicine and philosophy. From the first tablets of herbal medicine to Asclepius gardens, those of cloisters and bimaristans to cosmological gardens in Asia, from the largest public park to asylum institutions of the nineteenth century, the garden is proposed as a place of care, a promoter of restoration of the human being. If the advent of technology and drugs have for a time relegated it to the level of empirical care, results in neuroscience ultimately provide it on a scientific basis. 454-459 454-459
POMMIER Romain (et al.) Approche qualitative de l’éprouvé au Jardin de Soins. Une étude exploratoire en Psychiatrie de l’Adulte 2018 Annales Médico-Psychologiques In Adult Psychiatry, the Healing Garden seems today an innovative therapeutic mediation aimed likely take part in the recovery of severe patients. The therapeutic effect would depend on several bound mechanisms, in keeping with our fundamental relation with the natural environment and socio-relational purposes supported by a nonintrusive support of low complexity. Formal scientific clinical studies began in psychiatry in reactive disorders. We want to consolidate the clinical impressions accumulated in practice care in the suffering hospitalized adult of a severe pathology, through a pilot study of a qualitative type using the content analysis of interviews in a short form. 150-156 150-156
Sin-Ae Park, Ki-Cheol Son, Weon-Keun Cho Practice of Horticultural Therapy in South Korea 2012 Acta Horticulturae 954 Horticultural therapy (HT) in Korea has seen rapid growth over the past 15 years. The Korean HT and Well-Being Association has been playing a crucial role in developing Korean HT. There are four levels of HT certification including Advanced HT, HT Level 1, HT Level 2, and Horticultural Well-being provided by the Korean HT and Well-Being Association. At present, the number of qualified horticultural therapists stands at approximately 2,000 and HT is offered at about 1,700 facilities such as social welfare organizations, job rehabilitation facilities, hospitals, public health centers, schools, etc. for various people. The practice of HT includes four phases: diagnosis and preparation, planning, implementation, and evaluation. 179-185 179-185
Van Den Berg AE, Custers MH Gardening promotes neuroendocrine and affective restoration from stress 2015 Epub 2010 Jun 3. Journal of Health Psychology Stress-relieving effects of gardening were hypothesized and tested in a field experiment. Thirty allotment gardeners performed a stressful Stroop task and were then randomly assigned to 30 minutes of outdoor gardening or indoor reading on their own allotment plot. Salivary cortisol levels and self-reported mood were repeatedly measured. Gardening and reading each led to decreases in cortisol during the recovery period, but decreases were significantly stronger in the gardening group. Positive mood was fully restored after gardening, but further deteriorated during reading. These findings provide the first experimental evidence that gardening can promote relief from acute stress. 3-11 3-11
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McClellan J Benefits of a gardening project for people with dementia in nursing homes 2018 Nursing Times [online] Gardening and garden-related activities can be a fun way of getting nursing home residents more physically active and engaged. For residents with dementia, they can provide opportunities to be involved, express themselves and interact with others. Gardening can also be a way of getting all members of the nursing home community involved in a common project. This article describes a gardening project undertaken at two nursing homes in Scotland, where it was found to have numerous benefits for all involved. 38-40 Jeanette McClellan is a retired nurse helping to deliver on the Standards of Care for Dementia in Scotland in residential care settings. 38-40