This Hospital Prescribes Fresh Food From Its Own Organic Farm
By Liza Bayless
Five years ago, when Lankenau Medical Center was confronted with evidence that it was serving the unhealthiest county in Pennsylvania, the hospital decided to embrace the findings with an unconventional approach: building a half-acre organic farm on its campus to provide fresh produce to patients.
The Deaver Wellness Farm at Lankenau Medical Center. Lankenau Medical Center
The teaching and research hospital just outside Philadelphia was in the midst of its own patient health needs assessment in 2011 when the Robert Wood Johnson Foundation released findings about health outcomes in Pennsylvania counties. Lankenau is officially located within Montgomery County, one of the state's healthiest, taking into account factors including obesity rates and access to reliable sources of food. But the campus is adjacent to and receives many patients from Philadelphia County, ranked the least healthy of all 67 counties.
"That was really telling because it showed that we were serving a really diverse patient population," said Chinwe Onyekere, associate administrator at Lankenau, of the study's revelations. The findings showed that the hospital's patients had widely varying access to healthy food and nutritional knowledge.
With more than 1.5 million people, Philadelphia is one of the largest cities in the country and consistently named one of the unhealthiest. In 2010, 32 percent of its adults and about 25 percent of its children were obese. The same year, 13 percent of the city's adults had diabetes, and Philadelphia County ranked highest among the country's largest counties for chronic illnesses like cardiovascular disease and hypertension.
Across the nation, about half of Americans are estimated to have some kind of chronic disease stemming from health risks including lack of exercise, obesity, smoking and unhealthy eating. Treatment for these illnesses, which include asthma, heart disease or diabetes, has accounted for more than 75 percent of hospital admissions and physician visits in recent years.
This has caused some hospitals to look for ways to address health needs before a patient's condition has deteriorated so much that a hospital visit is necessary. At Lankenau, that meant providing its patients with a source of healthy food.
Students learn about fresh produce at the Deaver Wellness Farm. Lankenau Medical Center
Because the doctors, nurses and other staff were not farming experts, the hospital paired with Greener Partners, a nonprofit advocate for local food systems in Pennsylvania, to build and maintain what would become the Deaver Wellness Farm. Onyekere, who heads community needs programs for the hospital, oversees the project.
Since the farm's launch in 2015, it has provided more than 4,000 pounds of organic food to hospital patients at no cost. The produce is used for educational demonstrations and served in the hospital cafeteria. From its community needs assessment, Lankenau's staff learned that many of its patients, especially from West Philadelphia, lacked access to and nutritional knowledge of fruits and vegetables. So Lankenau now facilitates pop-up markets in internal medicine and the OBGYN practice wards.
While patients wait for appointments, medical assistants bring in fresh kale, broccoli, tomatoes, eggplant, arugula and other produce for them to select. The hospital also provides recipes, and, during an appointment, physicians use the produce to show how a patient can make healthier lifestyle choices.
In the Lankenau waiting rooms, hospital employees lead nutrition courses and food demonstrations. An employee might bring in the materials for a carrot salad, discuss the nutritional significance of each of its ingredients and then chop and assemble the salad in front of patients. Afterward, patients are given the ingredients and a recipe to try at home.
A young visitor gets a taste of what we do at the #DeaverWellnessFarm at #LankenauMedicalCenter. https://t.co/jTSbIAs4B3— ilana_grubin (@ilana_grubin)1480014835.0
For years before the farm, health educators employed by the hospital ran roughly 14 programs in a health education center with two classrooms in the middle of Lankenau's facilities. Seven thousand to 10,000 students from kindergarten through 12th grade took courses each year in physical health, like nutrition, as well as social health issues, like bullying and harassment.
Now, part of the mission of the farm is to serve as what Onyekere calls a "learning laboratory" for classes about healthy eating, and to create a hands-on experience for students to learn about nutrition, gardening and building healthy behaviors.
Outside the hospital, Lankenau—in partnership with The Food Trust and the Philadelphia Department of Public Health—incentivizes healthy food buying by providing coupons called Philly Food Bucks. These coupons for fresh fruits and vegetables are valid at more than 30 farmers markets and are given to patients who express the desire for better access to healthy foods.
"From the moment the patient walks into the door to the moment they leave the office, that whole experience is focused on improving their health," Onyekere said.
Drew Harris, director of health policy and population health at Thomas Jefferson University's College of Population Health, said that only recently have health providers begun to take accountability for addressing food insecurity among their patients. A former practicing doctor with a specialty in diabetes, he remembers having a very different philosophy about chronic diseases and overall patient health.
"Like many doctors, I probably blamed the patients for not getting well," he said. "I didn't really ask the question: Did they have the ability to follow the diet they were supposed to follow as a diabetic?"
Harris eventually became interested in the wider issues that led to chronic illness. While some patients are never taught health literacy, he said, for others "challenges in life can intervene."
"Not having food security—not knowing where your next meal is going to come from or whether you can purchase everything you need to purchase when you need to—is a major challenge," he said.
What's more, the tools for patient treatment taught in the medical profession have been so focused on prescriptions and procedures, Harris said, that doctors do not always learn the importance of stressing to their patients things like how to create a balanced diet and where to access those foods—knowledge that could keep people out of the hospital in the first place.
Though food insecurity is not a new issue, he thinks medical education is just starting to take a more holistic approach.
"There's a much stronger incentive to worry about why patients are not getting better and what we can do to avoid them getting sick in the first place, and a lot of it has to do with their social environment, their access to healthy food," he said.
Still, Harris stresses the need to pressure health providers. "Holding the medical profession more accountable for results—the quality of the care they provide—is going to make a difference," he said.
Onyekere estimates that Lankenau has provided farm produce to about 400 patients so far, and the hospital is about to launch a survey of patients to better understand the program's impact. Although she said patients have expressed that the farm is making a difference and raising awareness of how to incorporate healthy choices into daily life, the research survey will be a valuable resource for other health providers considering similar initiatives.
Going forward, Lankenau plans to grow the farm with four additional raised beds. Though this year's yield far exceeded initial expectations, staff took that as a sign that it can further increase production. Onyekere said Lankenau is also looking to donate its food to additional community partners, like local food banks.
Lankenau is not the nation's only hospital-run farm. Others include St. Joseph Mercy Ann Arbor and Henry Ford West Bloomfield Hospital, both in Michigan; and St. Luke's University Health Network in Pennsylvania. But Onyekere is aware of none that have so extensively incorporated their own organic food into hospital life.
If America is to confront its growing chronic health epidemic, that integration is key, and, as these hospitals show, is already happening. "We're beginning to move from the patient outward to look more at the neighborhood and the larger environment in which that patient lives," Harris said.
Reposted with permission from our media associate YES! Magazine.
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Since even moderate-intensity workouts offer a slew of benefits, walking is a good choice for people looking to stay healthy.
How to Rock Your Walk<p>Walking isn't just fun and healthy. It's accessible.</p><p>"Walking is cheap," says Dr. John Paul H. Rue, a sports medicine doctor at <a href="https://mdmercy.com/" target="_blank">Mercy Medical Center in Baltimore</a>. "You can do it anywhere at any time; [it] requires little to no special equipment and has many of the same cardio benefits as running or other more intense workouts."</p><p>Want to up your walking game? Try the tips below.</p>
Use Hand Weights<p>Cardio and strength training can go hand-in-hand when you add weights to your walk.</p><p>A <a href="https://journals.lww.com/acsm-msse/Fulltext/2019/03000/Associations_of_Resistance_Exercise_with.14.aspx" target="_blank">2019 study</a> found that weight training is good for your heart, and <a href="https://www.mayoclinicproceedings.org/article/S0025-6196(17)30167-2/abstract" target="_blank">research</a> shows it reduces the risk of developing a <a href="https://www.healthline.com/health/nutrition-metabolism-disorders" target="_blank">metabolic disorder</a> by 17 percent. People with metabolic disorders have a higher chance of being diagnosed with high cholesterol, high blood pressure, and diabetes.</p><p>Rue suggests not carrying weights for your entire walk.</p><p>"Hand weights can give you an added level of energy burning, but you have to be careful with these because carrying [them] over a long period of time or while walking could actually lead to some overuse injuries," he says.</p>
Make It a Circuit<p>As another option, consider doing a circuit. First, put a pair of dumbbells on your lawn or somewhere in your home. Walk around the block once, then stop and do some bicep curls and tricep lifts before walking around the block again.</p><p>Rue recommends <a href="https://www.healthline.com/health/exercise-fitness/running-with-weights" target="_blank">avoiding ankle weights</a> during cardio workouts, as they force you to use your quadriceps rather than hamstrings. They can also cause muscle imbalance, according to the <a href="https://www.health.harvard.edu/staying-healthy/wearable-weights-how-they-can-help-or-hurt" target="_blank">Harvard Health Letter</a>.</p>
Find a Fitness Trail<p>Strength training isn't limited to weights. You can get stronger by <a href="https://www.healthline.com/health/bodyweight-workout" target="_blank">simply using your body</a>.</p><p>Often found at parks, fitness trails are obstacle courses with equipment for pullups, pushups, rowing, and stretches to build upper and lower body strength.</p><p>Try searching "fitness trails near me" online, checking out your local parks and recreation website, or calling the municipal office to <a href="https://calisthenics-parks.com/" target="_blank">find one</a>.</p>
Recruit a Friend<p>People who workout together stay healthy together.</p><p><a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-017-0584-3" target="_blank">One study</a> showed that older adults who exercised with a group improved or maintained their functional health and enjoyed their lives more.</p><p>Enlist the help of a walking buddy with a regimen you aspire to have. If you don't know anyone in your area, apps like <a href="https://www.strava.com/" target="_blank">Strava</a> have social networking features so you can get support from fellow exercisers.</p>
Try Meditation<p>According to the <a href="https://www.nccih.nih.gov/research/statistics/nhis/2017" target="_blank">2017 National Health Interview Survey</a>, published by the National Institutes of Health, meditation is on the rise, and for good reason.</p><p>Researchers <a href="https://pubmed.ncbi.nlm.nih.gov/29616846/" target="_blank">found</a> that mind-body relaxation practices can regulate inflammation, <a href="https://www.healthline.com/health/biological-rhythms" target="_blank">circadian rhythms</a>, and <a href="https://www.healthline.com/health/glucose" target="_blank">glucose</a> metabolism, as well as lower <a href="https://www.healthline.com/health/high-blood-pressure-hypertension" target="_blank">blood pressure</a>.</p><p>"Any form of exercise can be turned into a meditation of some type, either by the surroundings you are walking in, like a park or trail, or by blocking out the outside world with music on your headphones," Rue says.</p><p>You can also play a podcast or download an app like <a href="https://www.headspace.com/headspace-meditation-app" target="_blank">Headspace</a> that has a library of guided meditations to practice while you walk.</p>
Do Fartlek Walks<p>Typically used in running, fartlek intervals alternate periods of increased and decreased speed. These are <a href="https://www.healthline.com/nutrition/benefits-of-hiit" target="_blank">high-intensity interval training (HIIT)</a> workouts, which allow exercisers to accomplish more in less time.</p><p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154075" target="_blank">One study</a> showed that 10-minute interval training improved <a href="https://www.healthline.com/health/metabolic-syndrome" target="_blank">cardiometabolic</a> health, or lowered the risk of heart disease, stroke, and diabetes, just as well as working out at a continuous pace for 50 minutes.</p><p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111489" target="_blank">Research</a> also shows that HIIT workouts increase muscle <a href="https://www.healthline.com/health/fast-twitch-muscles" target="_blank">oxidative</a> capacity, or the ability to use oxygen. To do a fartlek walk, try walking at an increased pace for 3 minutes, slow down for 2 minutes, and repeat.</p>
Gradually Increase Pace<p>A faster walking pace is associated with a lower risk of <a href="https://www.healthline.com/health/copd" target="_blank">chronic obstructive pulmonary disease (COPD)</a> and respiratory diseases, according to a <a href="https://pubmed.ncbi.nlm.nih.gov/30303933/" target="_blank">2019 study</a>.</p><p>Still, it's best not to go from a stroll to an Olympic-worthy power walk in a day. Instead, increase your pace gradually to prevent injury.</p><p>"Start by walking at a brisk pace for about 10 minutes per day, 3 to 5 days per week," Rue says. "Once you've done this for a few weeks, increase your time by 5 to 10 minutes per day until you get to 30 minutes."</p>
Add Stairs<p>You've likely heard that taking the stairs instead of an elevator is a way to add more movement into your daily routine. It's also a way to step up your walking. Stair climbing has been shown to <a href="https://www.sciencedirect.com/science/article/pii/S2211335519301123?via%3Dihub" target="_blank">decrease the risk of mortality</a> and can easily add a bit more challenge to your walk.</p><p>If you don't have stairs in your home, you can often find them outside a local municipal building, train station, or at a high school stadium.</p>
Is Your Walk a True Cardio Workout?<p>Not all walks are equal. A walk that's too leisurely may not provide enough burn to qualify as cardio. To see if you're getting a good workout, try to <a href="https://www.healthline.com/health/how-to-check-heart-rate" target="_blank">measure your heart rate</a> using a monitor.</p><p>"A target goal for a good walking workout heart rate is about 50 to 70 percent of your maximum heart rate," Rue says, adding that maximum heart rate is <a href="https://www.healthline.com/health/fitness-exercise/fat-burning-heart-rate" target="_blank">typically calculated</a> by 220 beats per minute minus your age.</p><p>You can also monitor how easily you can carry on a conversation while you walk to gauge your heart rate.</p><p>"If you can walk and carry on a normal conversation, that's probably a lower intensity walk," says Rue. "If you are slightly breathless but can still have a conversation, that's probably a moderate workout. If you are out of breath and can't talk normally, that's a vigorous workout."</p>
Takeaway<p>By shaking up your routine, you can add excitement to your workout and reap even more rewards than a basic walk provides. Increasing the pace and intensity of a workout will make it more effective.</p><p>Simply pick your favorite variation to add some spice to your next walk.</p>
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