Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients
Abstract Background The co-occurrence of diabetes and mental disorders is an exceedingly common comorbidity with poor prognosis. We aim to investigate the impact of green space, garden space, and the natural environment on the risk of mental disorders among the population living with diabetes. Metho...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-025-03864-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832585673469591552 |
|---|---|
| author | Erxu Xue Jianhui Zhao Jingyu Ye Jingjie Wu Dandan Chen Jing Shao Xue Li Zhihong Ye |
| author_facet | Erxu Xue Jianhui Zhao Jingyu Ye Jingjie Wu Dandan Chen Jing Shao Xue Li Zhihong Ye |
| author_sort | Erxu Xue |
| collection | DOAJ |
| description | Abstract Background The co-occurrence of diabetes and mental disorders is an exceedingly common comorbidity with poor prognosis. We aim to investigate the impact of green space, garden space, and the natural environment on the risk of mental disorders among the population living with diabetes. Methods We performed a longitudinal analysis based on 39,397 participants with diabetes from the UK Biobank. Residential green and garden space modeled from land use data and the natural environment from Land Cover Map were assigned to the residential address for each participant. Cox proportional hazards model was used to analyze the associations between nature exposures and mental disorders of diabetes. Casual mediation analysis was used to quantify indirect effect of air pollution. Results During a mean follow-up of 7.55 years, 4513 incident mental disorders cases were identified, including 2952 depressive disorders and 1209 anxiety disorders. Participants with natural environment at 300 m buffer in the second and third tertiles had 7% (HR = 0.93, 95%CI: 0.86–0.99) and 12% (HR = 0.88, 95%CI: 0.82–0.94) lower risks of incident mental disorders compared with those in the first tertile, respectively. The risk of mental disorders incidence among diabetes patients will decrease by 13% when exposed to the third tertile of garden space at 300 m buffer. The natural environment and garden space individually prevented 6.65% and 10.18% of mental disorders incidents among diabetes patients. The risk of incident mental disorders was statistically decreased when exposed to the third tertile of green space at 1000 m buffer (HR = 0.84, 95% CI: 0.78–0.90). Protective effects of three nature exposures against depressive and anxiety disorders in diabetes patients were also observed. Air pollution, particularly nitrogen dioxide, nitrogen oxides, and fine particulate matter, significantly contributed to the associations between nature exposures and mental disorders, mediating 48.3%, 29.2%, and 62.4% of the associations, respectively. Conclusions Residential green and garden space and the natural environment could mitigate mental disorders risk in diabetes patients, with air pollution playing a vital mediator. This highlights the potential for local governments to enhance the sustainability of such interventions, grounded in public health and urban planning, through strategic planning initiatives. Graphical Abstract |
| format | Article |
| id | doaj-art-db6e0c909856409880f9c5eba312b45d |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-db6e0c909856409880f9c5eba312b45d2025-01-26T12:37:27ZengBMCBMC Medicine1741-70152025-01-0123111510.1186/s12916-025-03864-yGreen sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patientsErxu Xue0Jianhui Zhao1Jingyu Ye2Jingjie Wu3Dandan Chen4Jing Shao5Xue Li6Zhihong Ye7Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Big Data in Health Science School of Public Health, The Second Affiliated Hospital and School of Public Health, Zhejiang University School of MedicineDepartment of Epidemiology, School of Public Health, Harbin Medical UniversityNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineDepartment of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang UniversityDepartment of Big Data in Health Science School of Public Health, The Second Affiliated Hospital and School of Public Health, Zhejiang University School of MedicineNursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of MedicineAbstract Background The co-occurrence of diabetes and mental disorders is an exceedingly common comorbidity with poor prognosis. We aim to investigate the impact of green space, garden space, and the natural environment on the risk of mental disorders among the population living with diabetes. Methods We performed a longitudinal analysis based on 39,397 participants with diabetes from the UK Biobank. Residential green and garden space modeled from land use data and the natural environment from Land Cover Map were assigned to the residential address for each participant. Cox proportional hazards model was used to analyze the associations between nature exposures and mental disorders of diabetes. Casual mediation analysis was used to quantify indirect effect of air pollution. Results During a mean follow-up of 7.55 years, 4513 incident mental disorders cases were identified, including 2952 depressive disorders and 1209 anxiety disorders. Participants with natural environment at 300 m buffer in the second and third tertiles had 7% (HR = 0.93, 95%CI: 0.86–0.99) and 12% (HR = 0.88, 95%CI: 0.82–0.94) lower risks of incident mental disorders compared with those in the first tertile, respectively. The risk of mental disorders incidence among diabetes patients will decrease by 13% when exposed to the third tertile of garden space at 300 m buffer. The natural environment and garden space individually prevented 6.65% and 10.18% of mental disorders incidents among diabetes patients. The risk of incident mental disorders was statistically decreased when exposed to the third tertile of green space at 1000 m buffer (HR = 0.84, 95% CI: 0.78–0.90). Protective effects of three nature exposures against depressive and anxiety disorders in diabetes patients were also observed. Air pollution, particularly nitrogen dioxide, nitrogen oxides, and fine particulate matter, significantly contributed to the associations between nature exposures and mental disorders, mediating 48.3%, 29.2%, and 62.4% of the associations, respectively. Conclusions Residential green and garden space and the natural environment could mitigate mental disorders risk in diabetes patients, with air pollution playing a vital mediator. This highlights the potential for local governments to enhance the sustainability of such interventions, grounded in public health and urban planning, through strategic planning initiatives. Graphical Abstracthttps://doi.org/10.1186/s12916-025-03864-yDiabetesGreen spaceGarden spaceNatural environmentMental disordersDepression disorders |
| spellingShingle | Erxu Xue Jianhui Zhao Jingyu Ye Jingjie Wu Dandan Chen Jing Shao Xue Li Zhihong Ye Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients BMC Medicine Diabetes Green space Garden space Natural environment Mental disorders Depression disorders |
| title | Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients |
| title_full | Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients |
| title_fullStr | Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients |
| title_full_unstemmed | Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients |
| title_short | Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients |
| title_sort | green sanctuaries residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients |
| topic | Diabetes Green space Garden space Natural environment Mental disorders Depression disorders |
| url | https://doi.org/10.1186/s12916-025-03864-y |
| work_keys_str_mv | AT erxuxue greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT jianhuizhao greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT jingyuye greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT jingjiewu greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT dandanchen greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT jingshao greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT xueli greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients AT zhihongye greensanctuariesresidentialgreenandgardenspaceandthenaturalenvironmentmitigatementaldisordersriskofdiabeticpatients |