Fostering human health through ocean sustainability in the 21st century

This is the final version. Available on open access from Wiley via the DOI in this recordThe approach of the Decade of the Ocean for Sustainable Development (2021–2030) provides a time to reflect on what we know about the complex interactions between the seas, oceans, and human health and well‐being. In the past, these interactions have been seen primarily within a risk framework, for example, adverse impacts of extreme weather, chemical pollution and increasingly, climate change. However, new research is expanding our concept of the ‘health’ of the ‘Global Ocean’, with a broader recognition of its essential and beneficial contribution to the current and future health and well‐being of humans. The seas and coasts not only provide an essential source of food, opportunities for trade and access to sustainable energy, but also the chance for people to interact with high‐quality marine environments which can lead to improvements in mental and physical health and well‐being, particularly of socio‐economically deprived individuals. By going beyond this risk framework and a purely extractive anthropocentric point of view, we can capture the true benefits, value and importance of these resources. Articulating a vision of how humans might better interact with marine ecosystems in the future, is a key first step in identifying a range of policy and management actions that can deliver our goals of fostering health and well‐being through the establishment of more sustainable interconnections with the Global Ocean.European Union Horizon 2020Natural Environment Research Council (NERC)UKRI Global Challenges Research FundNational Institute for Health Research (NIHR

Coastal proximity and mental health among urban adults in England: The moderating effect of household income

This is the final version. Available on open access from Elsevier via the DOI in this recordAfter adjusting for covariates, self-reported general health in England is higher among populations living closer to the coast, and the association is strongest amongst more deprived groups. We explored whether similar findings were present for mental health using cross-sectional data for urban adults in the Health Survey for England (2008-2012, N ≥25,963). For urban adults, living ≤1 km from the coast, in comparison to >50 km, was associated with better mental health as measured by the GHQ12. Stratification by household income revealed this was only amongst the lowest-earning households, and extended to ≤5 km. Our findings support the contention that, for urban adults, coastal settings may help to reduce health inequalities in England.National Institute for Health Research (NIHR)European Union Horizon 202

Associations between pro-environmental behaviour and neighbourhood nature, nature visit frequency and nature appreciation: Evidence from a nationally representative survey in England

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Mechanical loading of tissue engineered skeletal muscle prevents dexamethasone induced myotube atrophy

Skeletal muscle atrophy as a consequence of acute and chronic illness, immobilisation, muscular dystrophies and aging, leads to severe muscle weakness, inactivity and increased mortality. Mechanical loading is thought to be the primary driver for skeletal muscle hypertrophy, however the extent to which mechanical loading can offset muscle catabolism has not been thoroughly explored. In vitro 3D-models of skeletal muscle provide a controllable, high throughput environment and mitigating many of the ethical and methodological constraints present during in vivo experimentation. This work aimed to determine if mechanical loading would offset dexamethasone (DEX) induced skeletal muscle atrophy, in muscle engineered using the C2C12 murine cell line. Mechanical loading successfully offset myotube atrophy and functional degeneration associated with DEX regardless of whether the loading occurred before or after 24 h of DEX treatment. Furthermore, mechanical load prevented increases in MuRF-1 and MAFbx mRNA expression, critical regulators of muscle atrophy. Overall, we demonstrate the application of tissue engineered muscle to study skeletal muscle health and disease, offering great potential for future use to better understand treatment modalities for skeletal muscle atrophy

The effects of meteorological conditions and daylight on nature-based recreational physical activity in England

This is the final version. Available on open access from Elsevier via the DOI in this recordMeteorological conditions affect people’s outdoor physical activity. However, we know of no previous research into how these conditions affect physical activity in different types of natural environments – key settings for recreational physical activity, but ones which are particularly impacted by meteorological conditions. Using responses from four waves (2009–2013) of a survey of leisure visits to natural environments in England (n = 47,613), visit dates and locations were ascribed estimates of energy expenditure (MET-minutes) and assigned meteorological data. We explored relationships between MET-minutes in natural environments (in particular, parks, woodlands, inland waters, and coasts) and the hourly maxima of air temperature and wind speed, levels of rainfall, and daylight hours using generalised additive models. Overall, we found a positive linear relationship between MET-minutes and air temperature; a negative linear relationship with wind speed; no relation with categories of rainfall; and a positive, but non-linear relationship with daylight hours. These same trends were observed for park-based energy expenditure, but differed for visits to other natural environments: only daylight hours were related to energy expenditure at woodlands; wind speed and daylight hours affected energy expenditure at inland waters; and only air temperature was related to energy expenditure at coasts. Natural environments support recreational physical activity under a range of meteorological conditions. However, distinct conditions do differentially affect the amount of energy expenditure accumulated in a range of natural environments. The findings have implications for reducing commonly-reported meteorological barriers to both recreational physical activity and visiting natural environments for leisure, and begin to indicate how recreational energy expenditure in these environments could be affected by future climate change.National Institute for Health Research (NIHR)European Commissio

Urban nature and physical activity: Investigating associations using self-reported and accelerometer data and the role of household income

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordBackground Physical inactivity is a major public health concern. Natural, or semi-natural, environments may encourage physical activity, but the influences of socio-economic factors have been under-researched. Methods We explored the associations between meeting physical activity (PA) guidelines and both neighbourhood green (area coverage) and blue (freshwater coverage and coastal proximity) environments for urban adults using data from the Health Survey for England [HSE] (2008/2012). We considered different domains of self-reported PA: walking (n = 18,391), sports and other exercise (n = 18,438), non-recreational (domestic/gardening/occupational; n = 18,446) and all three domains combined (n = 18,447); as well as accelerometer-derived PA data using a subsample (n = 1,774). Relationships were stratified by equivalised household income as an indicator of socio-economic status. Results After adjusting for covariates, living 20 km, adjusted odds ratio (ORadj) = 1.26; 95% confidence interval (CI) = 1.15–1.39) but unrelated to sports and exercise. Greater neighbourhood greenspace, however, was only associated with significantly higher odds of meeting guidelines through non-recreational PA alone (e.g. 80–100% vs. <20% ORadj = 1.32; 95% CI = 1.12–1.56). Although associations were most consistent in the lowest income quintile, income-related results were mixed. Relationships were not replicated in the smaller accelerometry subsample. Conclusion Our self-report findings for the differing domains of PA as a function of neighbourhood green and blue space broadly replicated previous research, yet the reasons for the observed differences between PA domains and environments remain unclear. We did not observe any associations between environmental variables and accelerometer-measured PA; further research with larger samples is needed.European CommissionNational Institute for Health Research (NIHR

Natural environments and subjective wellbeing: Different types of exposure are associated with different aspects of wellbeing

publisher: Elsevier articletitle: Natural environments and subjective wellbeing: Different types of exposure are associated with different aspects of wellbeing journaltitle: Health & Place articlelink: http://dx.doi.org/10.1016/j.healthplace.2017.03.008 content_type: article copyright: © 2017 Elsevier Ltd. All rights reserved

Redesigning walking brochures using behaviour change theory: implications for walking intentions in natural environments

Summary Natural environments can be used to promote health through facilitating recreational walking. However, efforts to encourage this often neglect messages identified in psychological research that are effective at influencing intentions to walk. This is despite the National Institute for Health and Care Excellence stating that promotional efforts should utilize theoretical frameworks of behaviour change and be targeted towards less active adults. As an illustrative example, this experiment compared a prototypical recreational walking brochure with an “enhanced” version including such persuasive messages on people’s intentions to walk for recreation in natural environments. The enhanced brochure heightened intentions for inexperienced recreational walkers through our hypothesized mechanisms, but appeared to dissuade already-experienced walkers. Optimal messaging strategies in recreational walking brochures require tailoring to more and less active readerships. Guidelines are provided for authors of recreational walking brochures, though the principles and techniques could easily be extended to other means of outdoor walking promotion.</jats:p

Recreational visits to marine and coastal environments in England: Where, what, who, why, and when?

Health and economic benefits may accrue from marine and coastal recreation. In England, few national-level descriptive analyses exist which examine predictors of recreation in these environments. Data from seven waves (2009–2016) of a representative survey of the English population (n = 326,756) were analysed to investigate how many recreational visits were made annually to coastal environments in England, which activities were undertaken on these visits, and which demographic, motivational, temporal, and regional factors predict them. Inland environments are presented for comparison. Approximately 271 million recreational visits were made to coastal environments in England annually, the majority involving land-based activities such as walking. Separately, there were around 59 million instances of water-based recreation undertaken on recreational visits (e.g. swimming, water sports). Visits to the coast involving walking were undertaken by a wide spectrum of the population: compared to woodland walks, for instance, coastal walks were more likely to be made by females, older adults, and individuals from lower socioeconomic classifications, suggesting the coast may support reducing activity inequalities. Motivational and temporal variables showed distinct patterns between visits to coastal and inland comparator environments. Regional variations existed too with more visits to coastal environments made by people living in the south-west and north-east compared to London, where more visits were made to urban open spaces. The results provide a reference for current patterns of coastal recreation in England, and could be considered when making policy-level decisions with regard to coastal accessibility and marine plans. Implications for future public health and marine plans are discussed

BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces

This is the final version of the article. Available from BMJ Publishing Group via the DOI in this record.INTRODUCTION: Proximity and access to water have long been central to human culture and accordingly deliver countless societal benefits. Over 200 million people live on Europe's coastline, and aquatic environments are the top recreational destination in the region. In terms of public health, interactions with 'blue space' (eg, coasts, rivers, lakes) are often considered solely in terms of risk (eg, drowning, microbial pollution). Exposure to blue space can, however, promote health and well-being and prevent disease, although underlying mechanisms are poorly understood. AIMS AND METHODS: The BlueHealth project aims to understand the relationships between exposure to blue space and health and well-being, to map and quantify the public health impacts of changes to both natural blue spaces and associated urban infrastructure in Europe, and to provide evidence-based information to policymakers on how to maximise health benefits associated with interventions in and around aquatic environments. To achieve these aims, an evidence base will be created through systematic reviews, analyses of secondary data sets and analyses of new data collected through a bespoke international survey and a wide range of community-level interventions. We will also explore how to deliver the benefits associated with blue spaces to those without direct access through the use of virtual reality. Scenarios will be developed that allow the evaluation of health impacts in plausible future societal contexts and changing environments. BlueHealth will develop key inputs into policymaking and land/water-use planning towards more salutogenic and sustainable uses of blue space, particularly in urban areas. ETHICS AND DISSEMINATION: Throughout the BlueHealth project, ethics review and approval are obtained for all relevant aspects of the study by the local ethics committees prior to any work being initiated and an ethics expert has been appointed to the project advisory board. So far, ethical approval has been obtained for the BlueHealth International Survey and for community-level interventions taking place in Spain, Italy and the UK. Engagement of stakeholders, including the public, involves citizens in many aspects of the project. Results of all individual studies within the BlueHealth project will be published with open access. After full anonymisation and application of any measures necessary to prevent disclosure, data generated in the project will be deposited into open data repositories of the partner institutions, in line with a formal data management plan. Other knowledge and tools developed in the project will be made available via the project website (www.bluehealth2020.eu). Project results will ultimately provide key inputs to planning and policy relating to blue space, further stimulating the integration of environmental and health considerations into decision-making, such that blue infrastructure is developed across Europe with both public health and the environment in mind.This work was supported by funding received from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 666773