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Small Doses of Nature Can Lead to Big Health Benefits

Many people believe that being outdoors in nature is good for them, and research backs that up. But what “dosage” of nature is needed for good health?

Two recent studies show that just ten minutes of exposure to nature, two to three times per week, provides real health benefits. And you don’t have to visit the wilderness to get the good effects; short nature “time-outs” can happen in small, urban green spaces or even your backyard.

The studies were conducted by Mary Carol Hunter at the University of Michigan and Marc Berman of the University of Chicago. The studies are part of a larger body of research supported by the TKF Foundation, which funds projects across the country integrating the design of urban green spaces with research on user benefits. TKF has funded the creation of more than 130 publicly accessible, urban green spaces, and seeks to prove that green spaces provide health benefits through contemplation and restoration, with the goal of influencing city planning and design.

Hunter’s study had subjects immerse themselves in nature and answer questions before and after about their mental well-being on a mobile app. The digital entries were correlated with participants’ cortisol levels in saliva, an indicator of stress. After being exposed to nature for just ten minutes, two to three times a week, participants reported having significantly less stress, improved ability to focus, and increased satisfaction with their mood and energy levels. Also, benefits were greater in residential landscapes or small parks.

In Berman’s study, subjects were asked to take a 2.5 mile, 50-minute walk through either a dense urban environment or an arboretum. Afterward, they were given memory tests to measure their ability to concentrate or focus. Those who walked through the arboretum had a 20 percent improvement in working memory over the other group.

The two researchers are still working to answer questions such as how senses other than sight might influence health benefits, and which features of nature create a sense of well-being and improve one’s ability to concentrate. However, their studies make a strong case that exposure to nature, even in small doses and in urban settings, makes you feel better. And that’s an important part of good health.



Garth Ashbeck, M.D.Dr. Ashbeck is an MPCP partner and sees patients in the Pasadena office. Certified by the American Board of Family Medicine, he received his medical degree from Georgetown University School of Medicine and completed his residency program in Family Practice at Memorial Medical Center.

Can We Boost Our Immune System?

by Garth Ashbeck, M.D.

immune3The latest science on staying healthy.
Visit your local pharmacy, page through a magazine, or browse online and you’re sure to see products promising to boost your body’s immune system. Everything from echinacea, ginseng, probiotics to mega-dose vitamins – claim to help prevent or cure disease. But is there enough science to prove we should hop on the immune-supplement bandwagon?

“There is no simple answer for now,” says Dr. Garth Ashbeck of MPCP’s Pasadena practice. “While there are studies that show benefits to antioxidants, probiotics and some supplements, there needs to be more research into whether we can truly alter- or boost- our immune system. Regulatory statements cannot then be made to currently support or refute these supplements, he adds.

The main problem is that our immune system is just that: a complicated, biological system. There are many different kinds of immune cells that respond to various threats on the body in different ways. So, if you want to boost your immune system, which part should you boost, and by how much?

On the whole, our immune system does a remarkable job of protecting against harmful microorganisms. But, sometimes it fails and you get sick. Researchers are trying to find out how we can alter this path, and in addition to studying the effects of supplements and other agents, they are looking closely at the link between lifestyle and better immune function.

“We can’t underestimate how a proper diet and enough sleep, for example, affect our health, so we feel the best way to currently keep our immune system strong is by controlling key lifestyle habits, “ says Dr. Ashbeck.
Here are some general guidelines for helping your immune system based on the latest science:

Eat a varied, healthy diet
There is lots of research about the diet-immunity link. While some dietary supplements have been found to alter components of immune function, there is no firm evidence that they actually bolster immunity to the point where you are better protected against infection or disease than by eating a varied, healthy diet.

For example, scientists have found that too much dietary sugar may curb immune system cells that help control bacteria, and cause inflammation in the body. Again, this is just one small part of a complicated system, but cutting down on sugary drinks and other sugary, or processed foods, is definitely recommended.

Eating a variety of fruits and vegetables, which are rich in nutrients like vitamins C and E, plus beta-carotene and zinc, is a good choice as well. Go for a wide array of brightly colored fruits and vegetables, including berries, citrus fruits, kiwi, apples, red grapes, kale, spinach, sweet potatoes, and carrots.

“Even though we don’t know exactly how diet affects immunity, there are clearly benefits to eating healthy. For example, eating cruciferous vegetables can boost the liver’s ability to flush toxins from the body,” says Dr. Ashbeck. “And some researchers are studying how the bacteria in our stomach’s and digestive system can affect immunity and health, so there is much on the horizon.”

If you have questions about taking certain vitamins or dietary supplements, talk to your doctor first.

Get Enough Sleep
You may have noticed you’re more likely to catch a cold or other infection when you’re not getting enough sleep. While some consider it an old wive’s tale that lack of sleep will make us sick, some data is showing that sleep does help immune function. People with sleep disorders or extreme lack of sleep have shown a decrease in adequate development of protective T-cells and higher levels of certain stress hormones in recent studies. Although researchers don’t yet understand the exact link, it’s clear that our brains and bodies perform better with adequate sleep – usually seven to nine hours for an adult.

Exercise and Control Weight
Try to get regular, moderate exercise on a daily- or at least 5 times a week- basis. Even a 20-minute daily walk can improve your fitness and may help your immune system fight infection. “It makes sense that a strong body and effective circulatory system will help you fight illness and disease,” says Dr. Ashbeck. “We also know that exercise can boost your body’s feel-good chemicals and help you sleep, both of which are good for immunity.”
Exercise can also help you control or lose weight. There is direct evidence linking obesity to disease, including diabetes, heart disease, cancer and other illness. If you are overweight, even losing a few pounds puts less stress on your body’s organs and function, which includes your immune system.

Everyone has some stress; it’s part of life. But if stress drags on for a long time, it seems to make you more vulnerable to illness, from colds to serious diseases. Chronic stress exposes your body to a steady stream of stress hormones that could suppress the immune system. You may not be able to get rid of your stress, but you can get better at managing it:

  • Learn to meditate.
  • Slow down.
  • Plan for some “You” time in your day.
  • Connect with other people.
  • Work out to blow off steam.

Other lifestyle choices that may have a direct impact immunity include quitting smoking, controlling your blood pressure, drinking alcohol only in moderation, and taking steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.

While there may not be a magic pill to prevent disease, you can start making practical lifestyle changes now. They will not only improve your overall health, but will also help keep your immune system strong and working hard to protect you. Also, talk with your doctor about screenings, vaccines, the right medications, and other ways to stay on the road to health.



Garth Ashbeck, M.D.Dr. Ashbeck is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. He received his medical degree from Georgetown University School of Medicine in 1995 and completed his residency program in Family Practice at Memorial Medical Center in 1998. Dr. Ashbeck sees patients in MPCP’s Pasadena office.

Womens Guide to Guys’ Health

– Key tips for his 30s-70s

We first thought of this article as a “Men’s Guide to Good Health.” But, as primary care doctors we know that many of our male patients would never even see us for a check-up if it weren’t for their wives, mothers or girlfriends. “Men notoriously underestimate their level of disease risk or sickness,” says MPCP physician, Dr. Garth Ashbeck. “They tend to ignore scheduling regular health exams, perhaps because they’re not as used to seeing the doctor on a regular basis as are women. However, it is through those regular check-ups and screenings that we can catch health problems early, often when they’re most treatable,” he adds.

That’s why we’re directing these health tips to women, (but we hope you men will read on…..)

In his 30’s– Men at this age should see the doctor for a baseline check-up and then at least every other year until age 40. A baseline gives the doctor a picture of where your health is now, and some important information about blood pressure, weight, disease risk and family history. Some guys don’t know their family history, so try to find out if cardiovascular disease, cancer, diabetes or other disease runs in the family. While most screenings are done in a man’s 40s, some may need to be done early if he’s at high-risk. “Establishing a good relationship with a doctor early helps form a partnership in keeping the patient healthier throughout their life,” says Dr. Jonathan Forman of MPCP, “The focus can be on prevention versus treating disease after it’s already arisen.”

In his 40s– Men may start to feel their age more in their 40s, particularly if they’ve been ignoring their health up to now. “Often the 40s are the decade where men begin to see weight gain, high blood pressure or other problems creep up,” says Dr. Forman. The good news is that it’s a great time to turn your health around. Key screenings that should be done in men’s 40’s are for: high blood pressure, cholesterol levels, blood glucose for diabetes, PSA (prostate-specific antigen), and a skin cancer check. Dr. Ashbeck adds that staying active is crucial in this decade and beyond. “Many men have hectic work and family lives, but regular exercise is a key to staying heart healthy, keeping the weight off, and reducing stress,” he notes.

In his 50’s– The main screening to add at age 50 (for men & women) is for colorectal cancer. Men should also see an ophthalmologist for an eye exam to detect early signs for glaucoma or other vision issues. “This is a time to tell your man not to ignore any warning signs,” says Dr. Forman. “What might seem to be indigestion, can actually be early signs of a heart attack, or those frequent trips to the bathroom at night might indicate an enlarged prostate.” By now men should be getting a full yearly work-up that includes blood tests to check cholesterol and triglyceride levels. Some doctors may even suggest an echocardiogram or stress test if there are any cardiovascular disease symptoms.

In his 60s & Beyond– Research shows that people in their 60s and 70s are markedly happier than at other points in their lives. “If men have stayed on top of their health, these decades are usually very active and rewarding,” says Dr. Ashbeck. “Also, since it’s never too late to get healthier, proper diet, exercise and staying engaged socially are important habits to maintain.” Mixing in some strength training with regular aerobic exercise will help- remember senior does not mean sedentary. Men should also feel comfortable talking to their doctor about sexual function and health “below the belt.” Keeping on top of vision and hearing screenings is also important to staying active and social. Talk with your doctor about other important screenings, vitamin supplements, and recommended vaccinations, including an annual flu shot.

Jonathan Forman, M.D. Dr. Jonathan Forman, an MPCP partner who practices in our Glen Burnie office, is certified by the American Board of Family Medicine. He received his medical degree from Temple University School of Medicine and completed a residency program in Family Practice at University of Maryland Medical Center.
Garth Ashbeck, M.D.Dr. Garth Ashbeck is also an MPCP partner and he practices in the Pasadena office. Certified by the American Board of Family Medicine, he received his medical degree from Georgetown University School of Medicine and completed a residency in Family Practice at Memorial Medical Center.