Organic gardening as horticultural therapy with older populations

1. Organic gardening as horticultural therapy with older populations Sin-Ae Park Department of Horticulture, Forestry and Recreation Resources

2. Introduction Saurce: U.S. Census Bureau, Decennial Data and Population Projects

3. 90% of 65 or older: one or multiple chronic health problems (Hoffman et al., 1996) • Health problems: Physical problems Aerobic capacity ￬ Pulmonary function ￬ Body fat ￪ Muscular strength ￬ Bone mass ￬ Movement and reaction time ￬ Psychological problems Depression ￪ Anxiety ￪ Stress related emotion￪ Sleep quality ￬

4. Major causes for health problems • Sedentary lifestyle ￫ lack of physical activity • Advancing age • Chronic illness • Poor nutrition habits

5. McGinnis and Foege (1993) 14% of all deaths in the United States ￫ insufficient activity ￫ inadequate nutrition

6. For healthy aging….. Regular physical activity is a very crucial factor (Institute of Medicine, 1990)

7. Russell et al., 1995

8. Regular physical activity • 30 min. • Three to five times per week ⇒ ￬ the risk of coronary heart disease ￬ chronic disease (diabetes, high cholesterol, high blood pressure) ￪ musculo-skeletal function (Chakravarthy et al., 2000; Galloway and Jokl, 2000)

9. Old people tend to avoid physical activity (USDHHS, 1996) Aged 65 to 74 Women 36.6% Men 33.22% Aged over 75 Women 50.5% Men 38.2% Percentage of no participation physical activity

10. Exercise programs … • Cannot maintainmotivation (inconvenient, boring and monotonous) (Patricia et al, 2002) • Not adaptable to those with special physical requirements • Equipment or fees are relatively expensive • Doesn’t involve all members of the family (Restuccio, 1992)

11. Horticultural therapy The use of plants by a trained professional as a medium through which certain clinically defined goals of the client may be met. (Dr. Shoemaker)

12. Relf and Dorn, 1995 As action-oriented activities, horticultural and gardening activities ￫￪mental, physical rehabilitation, social interaction, sensory stimulation, self-directed action

13. Why should organic gardening be a HT program ?

14. In the physical aspect 1. Gardening has been ranked as a moderate to high intensity physical activity(Brooks, 1988; Ford et al., 1991; Dannenberg et al., 1989)￬￬￬Change lifestyle from sedentary to active

15. 2. Applicable to those of all abilities levels (Mooney and Nicell, 1992) 3. Motivation: continuous activity(Restuccio, 1992) 4. Popular hobby(Charles, 1990) 5. Safe environment (pollution, crime, noise) (Restuccio, 1992)

16. In the nutritional aspect 6. Change eating habits, nutrition 7. A increased consumption of fruits and vegetables is associated with decrease in development of certain chronic disease (Terry et al., 2000) 8. Organic methods reduce pesticide exposure which associates with acute and chronic illness (Alavanja et al., 1996; Alavanja et al., 2003; Baldi et al., 2001; Calvert et al., 2003; Cooper et al., 1999; Eskenazi et al., 1999; Garry et al., 2002; Hardell and Ericsson 1999; Schreninemachers, 2003)

17. 9. Whole foods are natually higher in fiber and lower in fat,sodium, sugar, and additives compared to highly processed foods(Gussow, 2001) 10. Organic crops : more Vitamin C, iron, magnesium, phosphorous less nitrates less protein but higher quality lower amounts of some heavy metals (lead, cadmium,mercury, aluminum) (Worthington, 2001)

18. In the psychological aspect 11. Psychological well-being : release stress, mental relaxation (Ulrich, 1979; Ulrich et al., 1993; Ulrich and Parsons, 1992) 12. Quality of sleep 13. Responsibility(Relf, 1981) 14. Self-esteem

19. 15. Social cohesion : family, friends, neighbors (Restuccio, 1992) 16. Creativity(Relf, 1981) 17. Quality of life 18. Inexpensive activity, save money from harvest (Restuccio, 1992)

20. Objectives • To collect information about physical, psychological, and nutritional effects related to organic gardening by reviewing papers • To apply this information to my research

21. Methods

22. Review results from physical therapy research Review results from organic gardening research • Physical aspect • Psychological aspect • Nutritional aspect

23. Physical aspect Strength conditioning in older men:skeletal muscle hypertrophy and improved function(Walter et al., 1988) • Subjects:old men with the age of range 60 to 72 • Program:strength training program • Duration: 3 times in a week during 12 weeks • Results: ￪ strength of extensor 107.4% ￪ strength of flexor 226.7% ￪ total muscle area 11.4% ￪ quadriceps area 9.3% ￪ total thigh area 4.8%

24. Physical aspect High-Intensity Strength Training in Nonagenarians(Fiatarone et al., 1990) • Subjects:ten frail elderly aged 90 ± 1 years • Program: high-intensity resistance training • Duration: three times per week during 8 weeks • Results: muscle strength (knee) ￪averaged 174% ± 31% (mean ± SEM) midthigh muscle area ￪ 9.0% ± 4.5% tandem gait speed ￪ 48%

25. Physical aspect A Structured Resistive Training Program Improves Muscle Strength and Power in Elderly Persons with Dementia (Stephanie et al., 2003) • Subjects: 8 men and women aged range 63-88 years with a diagnosis of dementia • Program:a group resistive training program • Duration:held twice in a week for 12 weeks • Results: ⅹimprovements of functional abilities (balance, the timed chair stand, gait speed, the timed stair climb)

26. Physical aspect

27. Physical aspect Exercise Intensity of Horticulture as Physical Activity(Kweon et al., 2004) • Subjects: 6 healthy males aged 20’s • Program:making a flower-bed (1m ⅹ 3m) • Duration:approximately 20 mins. • Results: the mean range of horticultural activities of making a flower-bed was 2.8-7.4 metabolic equivalents (METs)

28. Physical aspect 1. Applying a farmyard 4. Planting seedlings fertilizer 5. Watering seedlings 2. Plowing 6. Putting tools in order 3. Arranging seedlings

29. Ainsworth et al. (1993)

31. Physical aspect Relf (1973) Specific activities in gardening ⇒improve muscle coordination train unused muscles e.g. transplanting of seedlings ⇒practice grasp release and flexion of the thumb and forefinger

32. Physical aspect Restuccio (1992) Hand weeding (sitting) / Digging holes Wrist Forearm Biceps Deltoids

33. Physical aspect Pruning Wrist Forearm Deltoids

34. Psychological aspect Emery and Gatz (1990) Subject:8 men, 40 women ( mean age of 72)Program: 1-hour fitness class Duration: three times in a week during 16 weeks Results:ⅹsignificant change in any pychological variables Toshima et al. (1990) Subject: 87 men, 32 women (mean age of 62.6 ) Program: progressive walking Duration: 2 day in a week for 8 weeks Results: ⅹimprove well-being, depression

35. Psychological aspect Blumenthal et al. (1989) Subject:50 men, 51 women (mean age of 67) Program:4 months program Duration:three times in a week Results:￬ depression for men ⅹdepression for women ⅹlife satisfaction

36. Psychological aspect Kaplan (1973) Hypothesis: Man has a basic psychological need for plants in the environment

37. Psychological aspect Midden and Barnicle (2004) Subject: 62 participationsin a long-term care facility Program: a one-hour indoor gardening activity Duration: once a week over the seven-week period Results: ￪psychological well-being in 31 gardening group ￬ psychological well-being in 31 control group

38. Nutritional aspect Baxter et al. (2001) Organic vegetable soup contained more salicylic acid than non-organic soup Carbonaro et al. (2002) Organic peaches had higher ascorbic and citric acids than conventional peaches and alphatocopherol was increased in the organic pear

39. Nutritional aspect Blair et al. (1991) Community gardeners have greater consumption of fresh vegetables and lower consumption of sweet foods and drinks Sugerman et al. (2003) Participants who garden to grow fruits and vegetables consumed 4.1 versus 2.9 servings

40. Nutritional aspect Brian et al. (1999) Subject: 1489 men,1900 women(aged 35-75) Program: The British Health and Lifestyle Survey (HALS1) Duration: 1984/85 -1991 Results: men: frequent winter salad vegetable consumption was more protective than that in summer for cancer fruit consumption showed no significant protection women: frequent salad vegetable consumption at any season was significantly protective of cardiovascular disease development, although cancer was not

41. Major findings

42. Organic gardening activity A kind of exercise Muscle strength ￪ (Body + Hand) Psychological well-being ￪ More nutrition ￪ Nutrition consumption ￪ Prevention of diseases Lack of tested data (physical, psychological aspects) Training Programs(strength training, resistance training, fitness, walking…)Muscle strength ￪ Muscle area ￪ Gait speed ￪(functional ability) No significance of data (psychological aspect)

43. Discussion

44. 1. Cannot maintain motivation 2. Don’t give applicable to those with special physical requirements 3. Psychological results are not clear 4. Difficult to find the relationship with nutrition The problems of training programs

45. The advantages of organic gardening activity Physical activity Keep motivation Organic gardening Organic food comsumption Basic psychological need Social cohesion Save money Quality of life

46. Conclusion Organic gardening has potential for horticultural therapy for elderly adults!

47. Muscle Strength (Body + Hand) ￪ • Muscle mass ￪ • Body fat ￬ • Bone mass ￪ • Flexibility ￪ • Balance ￪ • Cardiorespiratory fitness ￪ • Cardiovascular disease ￬ • The activities of daily living life ￪

48. Depression ￬ • Anxiety ￬ • Stress ￬ • Sleep quality ￪ • Satisfaction

49. HT Gardening