Clinicians find it difficult to persuade patients that exercise is more effective than medication for any number of conditions, including stroke recovery, diabetes prevention, and treatment of low back pain.^[3] Regular exercise reduces the risk for recurrent breast cancer by approximately 50%.^[4]

Given all these reasons, it’s easy to see why fitness prescriptions are seldom more than an afterthought. Yet even without formally prescribing the frequency, intensity, time, and type of exercise, clinicians can speak with patients and families about fitness in inspiring, life-changing ways.

Because clinicians have a secret weapon to use that most people don’t even know about—location. Exercising in nature (in sight of and preferably near water or greenery, whether a deserted beach or an urban park) is better.

Why Location?

Walking city streets and the office itself can be harder on your health than you think. In both environments, your attention is demanded and directed—sometimes by digital interruptions, sometimes by vehicles, toxins, or duties. In nature, your attention is drawn, not pushed, to a variety of often unexpected but not unpleasant sounds, colors, aromas, textures, and form.

A recent Stanford study^[5] of nature therapy showed significantly reduced rumination after a 90-minute walk in nature, compared with a 90-minute walk through an urban environment. On MRI, “nature walkers” showed lower activity in an area of the brain linked to risk for mental illness, the subgenual prefrontal cortex, compared with “urban walkers.”

In other words, nature offers a sense of something bigger than ourselves on which to focus. MRIs show the way the brain changes when that sense occurs to us.

Exercising in nature may improve a person’s immune system by enriching the diversity in the microbiota. Microbiota buffer the immune system against chronic stress-related disease.^[6] They appear to act as a hormone-producing organ, not simply a collection of beneficial bacteria. Microbiota are sensitive and responsive to physical environmental changes as well as dietary ones. So, exercise in nature may favorably boost microbiota.

Just 5 Minutes!

A Chinese study^[8] showed higher energy levels, and lower levels of interleukin-6 and tumor necrosis factor (both markers of inflammation), in a forest walking group compared with an urban exercising group. A British study^[9] showed significantly improved mood and self-esteem with “green” exercise, with the largest benefits from 5-minute engagements. Five minutes!

Dr La Puma is based in Santa Barbara, California. His most recent book is Refuel: A 24-Day Eating Plan to Shed Fat, Boost Testosterone and Pump Up Strength and Stamina (Harmony, 2014). Visit him at his websiteand follow him on Twitter @johnlapuma.