Vietnamese-Style Cucumber Salad Recipe, Spotlight on Cucumbers, Keeping Diabetes in Check, Plus Exercise to Curb Appetite

With the year-round availability of cucumbers, it’s always time for cucumber salad! Fresh-pressed olive oil is a wonderful addition to Asian ingredients, as you’ll taste with this bountiful veggie bowl—it’s a great way to get healthier-eating plans off the ground. Need help curbing appetite? A study I’m sharing suggests exercise intensity can help. Plus here’s what you need to know about the negative effects of ultra-processed foods on blood sugar control.

Vietnamese-Style Cucumber Salad

• Vietnamese-Style Cucumber Salad

  Inspired by the ingredients in a traditional Vietnamese summer roll, this is a zesty salad that’s hearty enough for a meal any time of the year. To make the recipe your own, choose the types of cucumber and chiles you like best.

  Ingredients

  • 1 pound cucumbers 
  • 1/2 teaspoon sea salt
  • 2 tablespoons extra virgin olive oil
  • 2 tablespoons rice wine vinegar
  • 2 tablespoons sugar
  • 2 tablespoons lime juice
  • 2 tablespoons sweet chili sauce such as Mae Ploy (available at Asian markets)
  • 1/4 cup chopped red onion
  • 1 chile, such as jalapeño, serrano, or poblano, depending on heat preference, stemmed and chopped 
  • 1 carrot, peeled and cut into matchsticks
  • 2 scallions, trimmed and sliced on the diagonal into 2-inch pieces
  • 2 Hass avocados, ripe but still firm
  • 1 pound cooked jumbo shrimp 
  • 1/3 cup peanuts
  • 2 tablespoons chopped fresh mint leaves
  • 2 tablespoons chopped fresh cilantro leaves

  Directions

  Step 1

  If using thin English or Persian cucumbers, slice them into 1/4-inch discs; if using thicker cukes, cut them in half lengthwise, then into half-moon shapes about 1/4-inch thick. Place the slices in a large colander set over a large bowl or in the sink and sprinkle with the salt; toss well. Allow the cucumbers to sweat for about 15 minutes, then rinse to remove extra salt and shake well. 

  Step 2

  In a large glass bowl, mix the olive oil, vinegar, sugar, lime juice, and sweet chili sauce. Add in the cucumbers, red onion, chile, carrots, and scallions, and toss to combine. Cut the avocados into small cubes and halve each shrimp lengthwise from top to tail; fold both into the cucumber salad along with the peanuts and herbs. Allow the mixture to marinate for about 20 minutes, then serve at room temperature.

  Yields 4 servings

Healthy Ingredient Spotlight

Cukes!

Whether you choose the ubiquitous American garden cucumber or opt for a thinner variety, like short Persian or long English cucumbers, cukes are extremely versatile, often taking on the flavors of the other ingredients in a recipe. Very low in calories, cucumbers can fill you up and help you stayed hydrated, thanks to their high water content. They also make perfect dippers for salsa, guac, and more. Keep on the peel to get maximum nutrients, notably vitamin K, along with small amounts of vitamin C, potassium, calcium, and fiber.  

Commercially grown garden cucumbers are typically treated with an edible wax to keep them from drying out. It’s possible to scrub some of it off with a food brush, but if it keeps you from eating the nutrient-rich peel, buy unwaxed cukes at farmers’ markets or opt for one of the thin varieties, typically sold unwaxed but often shrink-wrapped to protect them. 

Quick Kitchen Nugget

Cucumber Prep

Cucumber seeds are rich in nutrients, so they should be eaten. But the larger the cucumber, the more bitter the seeds can taste. If you want to remove them for a recipe, the simplest tool to use is a spoon, preferably a grapefruit spoon. Slice the cucumber in half lengthwise, then run the tip of the spoon from one end to the other to remove the seeds in long strips. Rather than discard them, you can save them, refrigerated, to add to your next smoothie.  

For Your Best Health

Keeping Diabetes in Check

There’s no end to the warnings about the perils of a diet high in ultra-processed foods, from sodas and packaged snacks to even certain types of sugar-sweetened yogurt. Recent studies have found links to higher rates of cardiovascular disease, obesity, sleep disorders, anxiety, depression, and even early death. New research n ultra-pprocessed foods done at the University of Texas (UT) and published in the Journal of the Academy of Nutrition and Dietetics should be of particular concern to the millions of Americans managing type 2 diabetes.  

The study used baseline data from an ongoing clinical trial called Texas Strength Through Resilience in Diabetes Education (TX STRIDE), led by Mary Steinhardt in UT’s College of Education. Participants included 273 African American adults diagnosed with type 2 diabetes and recruited through Austin-area churches. Each participant provided two 24-hour diet recalls and a blood sample to measure HbA1C, a snapshot of blood sugar control over the past three months

“There are a lot of ways to look at and measure healthy eating,” said Marissa Burgermaster, PhD, assistant professor of nutritional sciences and senior author of the paper. “We set out to see which measurement was associated with blood sugar control in people with type 2 diabetes. We found that the more ultra-processed foods by weight in a person’s diet, the worse their blood sugar control was, and the more minimally processed or unprocessed foods in a person’s diet, the better their control was.” Also, eating more ultra-processed correleated to higher HbA1C levels while eating fewer ultra-processed correleated to lower HbA1C levels. Having an HbA1C below 7 is considered ideal for people with type 2 diabetes, and people who consumed, on average, 18% or fewer of their grams of food from ultra-processed foods were more likely to meet this mark.

Ultra-processed foods are typically higher in added sugars and sodium, but the researchers concluded that the HbA1C increases they saw were not about merely added sugar and sodium, or they would have correlated with the typical tools that measure overall nutritional quality in the diet. Synthetic flavors, added colors, emulsifiers, artificial sweeteners, and other artificial ingredients may be in part to blame, hypothesized Erin Hudson, a graduate student and co-author of the paper, and this would suggest that dietary guidelines may need to begin placing more emphasis on ultra-processed foods and its additives.

Fitness Flash

Exercise to Curb Appetite

A vigorous workout does more to suppress hunger levels in healthy adults than does moderate exercise, and women in particular may benefit from this response, according to a small study published in the Journal of the Endocrine Society that examined the effects of exercise intensity on ghrelin levels and appetite in men and women. Ghrelin is nicknamed “the hunger hormone” because it’s associated with perceptions of hunger. It’s also been shown to have wide-ranging biological effects in areas including energy balance, glucose homeostasis, immune function, sleep, and memory.

“We found that high-intensity exercise suppressed ghrelin levels more than moderate-intensity exercise,” said lead author Kara Anderson, PhD, of the University of Virginia and the University of Virginia Health System in Charlottesville. “In addition, we found that individuals felt ‘less hungry’ after high-intensity exercise compared to moderate-intensity exercise.”

Ghrelin circulates in acylated (AG) and deacylated (DAG) forms, which are known to affect appetite. Data on the impact of exercise intensity on AG and DAG levels, and their effects on appetite, is sparse and primarily limited to men, the study noted. To address this shortfall, the study examined eight men and six women. Participants fasted overnight, completed exercises of varying intensity levels that were determined by measurements of blood lactate, and then self-reported measurements of appetite. 

The women had higher levels of total ghrelin at baseline compared with the men, yet demonstrated “significantly reduced AG” following the intense exercise, according to the findings. The researchers found that “moderate intensity either did not change ghrelin levels or led to a net increase.” This suggests that exercise above the lactate threshold “may be necessary to elicit a suppression in ghrelin.”

“Exercise should be thought of as a ‘drug,’ where the ‘dose’ should be customized based on an individual’s personal goals,” Dr. Anderson said. “Our research suggests that high-intensity exercise may be important for appetite suppression, which can be particularly useful as part of a weight loss program.” The researchers also acknowledged that more work is needed to determine the extent to which the effects of exercise differ by gender. 

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Spinach-and-Cheese-Stuffed Shells Recipe, Spotlight on San Marzano Tomatoes, Grating Parmigiano-Reggiano, Reducing Type 2 Diabetes Risk, and A Motivation Reboot

As the nights get cooler, warm, nourishing meals become even more tempting palate-pleasers. My recipe for stuffed shells truly satisfies—it’s one of the new seasonal recipes in the latest edition of my online cookbook Savor the Season: Autumn 2024. Put together family style, it’s a great dish for large gatherings—everyone can dig in on their own. It’s also a very filling meatless option. You’ll read why that’s important in the diabetes-prevention research I’m sharing. Then, to get a motivation boost for healthier living, take a look at some top tips from a leading fitness expert to help you stay on track with your exercise goals.

Spinach-and-Cheese-Stuffed Shells

• Spinach-and-Cheese-Stuffed Shells

  This dish doesn’t just taste great; its pretty presentation will wow family and guests alike. You can make my fresh tomato sauce up to three days in advance, or use 3 cups of your favorite high-quality store-bought sauce for faster prep.

  Ingredients

  For the tomato sauce:

  • 3 tablespoons extra virgin olive oil
  • 4 large garlic cloves, minced
  • 1 cup grated yellow or Vidalia onions
  • One 6-ounce can tomato paste
  • 1/2 cup red wine
  • One 28-ounce can whole tomatoes, preferably San Marzano
  • 1/2 teaspoon dried oregano
  • Pinch of sea salt, more to taste

  For the shells:

  • 1 pound jumbo pasta shells
  • 2 teaspoons sea salt
  • 1 pound mozzarella
  • 1 pound ricotta cheese
  • 2 cups freshly grated Parmigiano-Reggiano cheese, divided use
  • 1 cup cooked spinach, well chopped
  • 2 tablespoons extra virgin olive oil, plus more for baking 
  • 1 egg, beaten
  • 1/2 teaspoon dried oregano
  • 1/4 teaspoon freshly grated nutmeg
  • 1/4 teaspoon freshly ground black pepper

  Directions

  Step 1

  Make the sauce: Heat a large saucepan. When hot, add the olive oil, garlic, and onions, and sauté until soft but not browned. Push the vegetables to the outside of the pan and add the tomato paste in the center. Sauté the paste until it browns, to release its flavors. Deglaze the pan with the red wine, then add the tomatoes, oregano, and salt. Use a potato masher to gently crush the tomatoes. Simmer for 20 minutes (or more) while you prepare the shells. 

  Step 2

  Make the stuffed shells: Bring a large pot of water to a rapid boil and add the shells and the salt. Cook according to package directions for al dente (don’t overcook, as the shells will soften more in the oven). 

  Step 3

  While the shells are boiling, line a rimmed sheet pan with parchment paper and set aside. Preheat your oven to 375°F. Cut the mozzarella into small cubes. Place the cubes in a large bowl along with the ricotta, 1 cup grated Parmigiano-Reggiano, spinach, olive oil, egg, oregano, nutmeg, and black pepper; mix thoroughly. 

  Step 4

  Drain the shells, place them on the prepared sheet pan, and use a small spoon to stuff them with the spinach-cheese mixture. Lightly coat a large round or rectangular baking dish with olive oil and add three-quarters of the sauce; use an offset spatula to spread it out evenly. 

  Step 5

  Place the filled shells in the baking dish in a festive pattern, brush the tops of the shells lightly with olive oil, and cover with the rest of the Parmigiano-Reggiano. Bake for 30 minutes or until the cheese topping is thoroughly melted and slightly browned. Serve with the rest of the tomato sauce on the side.

  Yields 4 to 6 servings

Healthy Ingredient Spotlight

San Marzano Tomatoes

These uniquely shaped Italian tomatoes have long been considered the ultimate in sweetness, but as we’ve seen with olive oil and balsamic vinegar, it’s important to know what’s real and what isn’t. True San Marzano tomatoes are grown in Sarnese-Nocerino, near still-active Mount Vesuvius in the Campania region of Italy. The volcanic soil is responsible for the tomato’s near-perfect balance of sweetness and acidity.  

In recent years, consumers in the US have sued companies whose labels imply that the cans contain San Marzano tomatoes when they don’t. This is not to say that other tomatoes aren’t tasty, but if you want the real thing, look for labels with two essential logos: the red-and-yellow DOP (denominazione d’origine protetta,ordesignation of protected origin) stamp from the EU and the colorful logo of the Agro Sarnese-Nocerino Consorzio, which is the local consortium that makes sure the tomatoes are grown according to its rules. Also, San Marzano tomatoes are always canned whole, peeled, and only in their own juice.

Quick Kitchen Nugget

Grating Parmigiano-Reggiano

If you’re a regular Newsletter reader, you know that only Parmigiano-Reggiano is true “Parmesan” cheese and it will have the word imprinted with a dot pattern all around the rind. How you grate it for a recipe, like my stuffed shells, or for a garnish on, say, Caesar salad, is more nuanced. It depends in part on whether the cheese is to seamlessly meld into a sauce, for instance, or stand out in the form of generous shavings. A sturdy vegetable peeler is a great way to get thin, narrow shavings: Run it along the edge of the wedge. For wide shavings, run a cheese plane over the surface of your wedge. Need a small amount of finely grated cheese? Pull out your microplane grater and shave the cheese right over your dish. For a larger amount, try a box grater—its four sides offer many options (place it over a large sheet of parchment paper to catch the gratings). If you want a very large amount, look to your food processor. Most steel blades will turn cubes into shreds. For a near-powder that will melt easily, Cuisinart has a very fine cheese grating blade that works in seconds—just cut off the rind, cut the cheese into pieces that will fit in the machine’s feed tube, and process. 

For Your Best Health

Reducing Type 2 Diabetes Risk

We know about the risks for heart disease and some forms of cancer associated with eating too much red and processed meat. Now an analysis of studies that included nearly two million people across 20 countries has also linked these foods to a higher risk for developing type 2 diabetes, a chronic condition that has reached epidemic proportions in the US, according to the National Institutes of Health. (Earlier studies made the association but had varying results.) This research, published in The Lancet Diabetes and Endocrinology, also looked at whether there’s a link between poultry and diabetes.

The team of scientists, led by researchers at the University of Cambridge in the UK, found that eating 50 grams of processed meat a day—that’s about 2 slices of ham—was associated with a 15 percent higher risk of developing type 2 diabetes in the next 10 years. Eating 100 grams of unprocessed red meat a day—that’s roughly a 3-ounce steak—was associated with a 10 percent higher risk. Eating 100 grams of poultry a day was associated with an 8 percent higher risk, but when further analyses were done to test the findings under different scenarios, the association for poultry consumption became weaker, whereas the associations with type 2 diabetes for both processed meat and unprocessed meat persisted.

Professor Nita Forouhi of the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge, a senior author on the paper, said, “Our research provides the most comprehensive evidence to date of an association between eating processed meat and unprocessed red meat and a higher future risk of type 2 diabetes. It supports recommendations to limit the consumption of processed meat and unprocessed red meat to reduce type 2 diabetes cases in the population. While our findings provide more comprehensive evidence on the association between poultry consumption and type 2 diabetes than was previously available, the link remains uncertain and needs to be investigated further.”

The team used theglobal InterConnect project for their work. It’s an approach that allows researchers to analyze individual participant data from diverse studies, rather than being limited to published results. This enabled the authors to include as many as 31 studies in this analysis, 18 of which had unpublished findings on the link between meat consumption and type 2 diabetes. By including this previously unpublished study data, the authors considerably expanded the evidence base and reduced the potential for bias from the exclusion of existing research, they explained.

Said Professor Nick Wareham, director of the MRC Epidemiology Unit and a senior author on the paper, “InterConnect enables us to study the risk factors for obesity and type 2 diabetes across populations in many different countries and continents around the world, helping include populations that are underrepresented in traditional meta-analyses…Using harmonized data and unified analytic methods across nearly two million participants allowed us to provide more concrete evidence of the link between consumption of different types of meat and type 2 diabetes than was previously possible.”

Fitness Flash

A Motivation Reboot

ACE Fitness, the leading organization for fitness professionals, recently published an inspiring blog on staying motivated, written by fitness expert Len Kravitz, PhD, coordinator of exercise science at the University of New Mexico, and students in his Introduction to Exercise Science course. Here are some of the ideas, abbreviated for space, that can help keep you on track with health and fitness goals, important because, as Dr. Kravitz pointed out, 80 percent of adults don’t meet current guidelines for aerobic exercise or resistance exercise. “These tips help target a person’s self-efficacy to adopt an exercise program and avoid dropping out,” he wrote. “As you read through this list, identify those strategies that resonate with you and fit best with your lifestyle, then incorporate those that will make the biggest impact.”

Set realistic health and fitness goals. Make sure they match your abilities, health, and lifestyle. Also break down even short-term three-month goals into smaller, more achievable segments of two to three weeks.

Create a weekly schedule that includes blocks of time for exercise. This helps with consistency.

Diversify. Mix up activities within each type of exercise—cardio, strength training, and flexibility. 

Track your progress. Seeing your achievements in black and white helps keep you enthusiastic. 

Create or join a network of fitness friends. Exercise loves company! 

Give yourself rewards. Treat yourself to new exercise clothes or gear, flowers, or something special you’ve been eyeing. 

Aim for consistency over intensity. Slow and steady wins the race. 

Set reminders. Use your smartphone to ping you 15 minutes before your scheduled workouts.

Create a vision board. This is a real or virtual poster composed of photos, drawings, and quotes that inspire you. 

Go small if needed. Some people find it easier to work out in 10-minute sessions—build up to three a day and you’ll meet daily recommendation of 30 minutes.

Get guidance. Consider hiring a personal trainer to provide expertise, guidance, education, and motivation tailored to you. This could be the smartest money you’ll ever spend on yourself and pay big dividends.

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Rainbow Slaw Recipe, Spotlight on Barley, Ancient Grains to Combat Diabetes, and Exercise + Greenscape = Bliss

There’s everything to love about a no-cook side dish that’s as tasty as it is visually appealing. My twist on traditional coleslaw brings together three different cruciferous veggies—all known for their high-level nutrients—and an olive-oil based dressing that adds in a healthy dose of polyphenols. It also includes barley, a whole grain with surprising health benefits. Finally, take advantage of the warm, sunny days to move your exercise activities to a greenspace—this change of venue can have physical and emotional benefits.

Rainbow Slaw

• Rainbow Slaw 

  Move over, mayo! A tangy vinaigrette is a great way to dress a slaw. And what a slaw this is—a colorful feast of fresh veggies enhanced with barley, an ancient grain that’s more versatile than you may think (see “Healthy Ingredient Spotlight” and “For Your Best Health” in this week’s newsletter).

  Ingredients

  • 3/4 cup uncooked hulled barley 
  • 3 tablespoons sherry vinegar
  • 1 tablespoon Dijon mustard
  • 1 tablespoon honey 
  • 1/4 cup chopped shallots
  • 4 tablespoons extra virgin olive oil
  • 1 pound head green cabbage, cored
  • 1/2 pound head red cabbage, cored
  • 1/2 pound Brussels sprouts, trimmed
  • 2 yellow or red bell peppers, stems and ribs removed
  • 1 red onion, trimmed
  • 3 large carrots, scrubbed and peeled, if needed
  • 1/4 cup fresh flat-leaf parsley, finely chopped
  • 1/4 cup fresh dill, finely chopped 
  • Coarse sea salt, to taste
  • Freshly ground black pepper to taste

  Directions

  Step 1

  Prepare the barley according to package directions and set aside to cool. Make the vinaigrette by whisking together the vinegar, mustard, honey, and shallots. Slowly drizzle in the olive oil, whisking until the vinaigrette has emulsified. 

  Step 2

  Grate all the vegetables by hand or machine and toss thoroughly in a very large glass mixing bowl along with the herbs. Add the vinaigrette and toss well again. Taste and add more vinegar, if desired, along with salt and pepper. Serve at room temperature but refrigerate any leftovers.

  Yields 10 servings

Healthy Ingredient Spotlight

Barley

If you only know barley from beef barley soup, you’re missing out on so many other ways to enjoy this whole grain—as a side dish with sautéed onions, as a breakfast cereal with fruit, or as a layered parfait with yogurt, to name just a few. A toothsome swap for white rice (which has almost no fiber and few nutrients because it’s refined), barley delivers on fiber, protein, and many vitamins and minerals. It also helps keep blood glucose steady, promotes a healthy gut biome, and fills you up. Though the cooking time is longer, hulled barley retains far more nutrients than pearl barley, so shop for that. Note: Barley does contain gluten, so it’s not for people with celiac disease or gluten sensitivity.

Quick Kitchen Nugget

Make a Weekly Barley Batch

Take some time one day a week to make enough barley for four or more servings, so that it’s ready when you are. Though package directions vary, you often need 3 or 4 cups of water per cup of uncooked barley. Keep an eye on it as it cooks, since the water may evaporate before the barley is done. It should retain its shape and be chewy, not mushy.

For Your Best Health

Ancient Grains Combat Diabetes 

According to the research review “Use of ancient grains for the management of diabetes mellitus: A systematic review and meta-analysis” published in the journal Nutrition, Metabolism and Cardiovascular Diseases, “there has been renewed interest in ancient grain varieties for their possible enhanced health benefits in [diabetes]. Ancient grains represent an important category of ancient cereals that have not undergone human breeding or genetic modification, thus preserving their inherent genetic features. The genetic diversity of these ancient crops not only offers a variety of food options but also represents a valuable genetic heritage to be preserved.” 

The report goes on to detail the phytochemicals in ancient grains, including phytosterols, phenolic compounds like ferulic acid and lignans, flavonoids, and carotenoids, all linked to a variety of health benefits thanks to their antioxidant and anti-inflammatory properties. Among the grains in the many studies the researchers reviewed with positive results are oats, brown rice, millet, buckwheat, and barley. Many are rich in beta-glucan, a type of soluble fiber that has been shown to improve insulin sensitivity.

Separate studies done at the University of Arizona found that the beta-glucan in barley surpassed other grains in terms of cholesterol reduction—it helps flush it out of your body. 

These and other research reports highlight the value of choosing these grains over refined ones—they take longer to cook but are more than worth the effort when it comes to feeling satisfied (they really fill you up!) and to improving heart health by mitigating two of its biggest risk factors: diabetes and high cholesterol. 

Fitness Flash

Exercise + Greenscape = Bliss

We know from past studies that being in nature brings physical and mental health benefits similar to those of physical activity and, of course, we know the benefits of exercise in general. So could exercising in greenspace boost the separate health benefits of each?

To answer this and other questions, Jay Maddock, PhD, Regents Professor with the School of Public Health at Texas A&M University and director of the university-led collaborative Center for Health & Nature, along with Howard Frumkin, MD, DrPH, Hagler Fellow and senior vice president and director of the Land and People Lab, assessed existing evidence regarding physical activity in natural settings and developed strategies for promoting these activities. Their study, published in the American Journal of Lifestyle Medicine, identified several factors that affect how often people visit parks and natural settings, the extent to which they engage in physical activities once there, and the benefits they get from this activity.

Dr. Maddock and Dr. Frumkin found that research suggests exercising in a park or other natural setting is more beneficial than exercising indoors. Because the studies they reviewed focused on short-term outcomes (less than one year), whether these benefits occur over the long term remains to be seen. “Despite this, the research is clear that natural settings could be an effective venue for promoting physical activity,” Dr. Maddock said. “People generally enjoy being outdoors, with parks, trails, and community gardens being the most popular venues.”

What makes the outdoors more enticing? Physical features, like community centers, playgrounds, lighting, and clear signage; natural features, such as a tree canopy and scenic bodies of water; and factors like classes, festivals, a welcoming environment, and a perception of safety, as well as visitors’ strong feeling of connectedness to nature and belief that spending time in these spaces, all contribute.

“Parks and trails are particularly important due to their accessibility and widespread availability, but access varies significantly by geography, and rural areas often have less access to natural spaces because they have more privately held land,” Dr. Maddock said. “For example, nearly 98 percent of Illinois residents live within half a mile of a park, compared to only 29 percent in Mississippi.”

Dr. Maddock and Dr. Frumkin also found that use of parks and greenspaces for physical activity varies across demographic groups, with men more likely than women to use these spaces for physical activity. In addition, a study of parks in Los Angeles found that Black adults are less likely than white adults to engage in physical activity in parks, while English-speaking Latinos are equally likely and Asian/Pacific Islanders are more likely.

“Some groups—Black, Indigenous, and other people of color, and immigrant and refugee populations, for example—often have experienced historic or current discrimination that hinders their use of natural spaces, and they routinely have less access to high-quality parks,” Dr. Frumkin said. “In addition, children, the elderly, and people with disabilities face challenges in accessing natural spaces. Ensuring that these spaces are safe and easy to navigate, with appropriate programming, could help increase their use of parks and other natural settings.”

With these complexities in mind, the researchers offered four options that health care professionals could implement to encourage the use of parks and other natural settings by their patients.

One is simply to “prescribe” nature contact to patients. “Recommending that patients spend more time in these settings is known as nature prescriptions, or ‘ParkRx,’ and while more research is needed, the studies to date suggest that this approach is effective,” Dr. Maddock said.

Another is for health professionals to model this behavior by engaging in it themselves—this is effective in promoting healthy behaviors while also enhancing the well-being of the health professionals.

A third approach is for health professionals to engage in community efforts that promote the use of outdoor spaces, such as Houston’s Be Well Communities initiative, which is supported by the M.D. Anderson Cancer Center.

Finally, health professionals could help create and maintain parks and greenspaces by steering funds into these efforts through Community Health Needs Assessments, Medicaid funds, and funds from health care conversion foundations.

“It is clear that the use of parks and natural settings for physical activities could be a potentially powerful tool for promoting two important health behaviors simultaneously,” Dr. Maddock said. “This could be especially important given that the majority of Americans do not get enough exercise or spend enough time outdoors.”

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