Gardening activity and its relationship to mental health: Understudied and untapped in low-and middle-income countries.

There is increasing awareness among researchers and health practitioners from high income countries about the potential mental health benefits of participating in gardening activities and spending substantial time in green spaces. However, this phenomenon is not well established in low- and middle-income countries. In this commentary, we discuss the evidence base surrounding the potential mental health benefits of participating in gardening activity and spending substantial time in a green space. We hope to stimulate discourse about incorporating these activities into mental health prevention in low- and middle-income countries.

Fruit and vegetable intake and mental health among family caregivers of people with dementia in Uganda.

Consumption of fruits and vegetables is correlated with improved mental wellbeing. Although this growing body of research has been recognized by researchers and clinicians in high-income countries, fewer studies examining this relationship have been conducted in low- and middle-income settings. In this study, we sought to estimate the association between fruit and vegetable intake and symptoms of depression and anxiety. We conducted a cross-sectional study among 242 family caregivers of people with dementia in southwestern Uganda. Fruit and vegetable intake in the past week was measured with a food frequency questionnaire. Depression and anxiety were assessed using the depression and anxiety subscales of the 42-item Depression, Anxiety and Stress Scales. Multivariable regression models were used to estimate the associations between fruits and vegetable consumption and depression and anxiety, adjusting for caregiving burden and other potential confounders. Depression symptom severity was negatively associated with consumption of jackfruits (b =-4.68; 95% confidence interval [CI], -8.96 to -0.39), green leafy vegetables (b =-14.1; 95% CI, -18.0 to -10.1), root vegetables (b =-14.0; 95% CI, -19.5 to -8.63), and other vegetables (b =-14.8; 95% CI, -19.3 to -10.3), and frequent consumption of vegetables (b =-1.91; 95% CI, -3.77 to -0.04). Anxiety symptom severity was negatively associated with consumption of green leafy vegetables (b =-12.2; 95% CI, -16.0 to -8.46), root vegetables (b=-12.6; 95% CI, -17.5 to -7.58), and other vegetables (b =-12.7; 95% CI, -17.0 to -8.40), and frequent consumption of vegetables (b =-2.07; 95% CI, -3.84 to -0.29). Our results suggest that fruit and vegetable consumption is associated with reduced depression and anxiety symptoms.

Participation in gardening activity and its association with improved mental health among family caregivers of people with dementia in rural Uganda.

Evidence from high-income settings suggests that gardening is associated with reductions in depression, anxiety, and stress. The benefits of gardening are less well understood by mental health practitioners and researchers from low- and middle-income countries. Our study estimated the association between participation in gardening and symptoms of depression, anxiety, and stress among caregivers of people living with dementia in rural, southwestern Uganda. In a cross-sectional study, we interviewed 242 family caregivers of people with dementia to elicit their gardening activities; symptoms of depression, anxiety, and stress (Depression Anxiety Stress Scales); and caregiving burden (Zarit Burden Interview). Linear multivariable regression models estimated the association between participation in gardening and symptoms of depression, anxiety, and stress. Out of 242 participants, 131 (54%) caregivers were involved in gardening. Severe to extremely severe symptoms of depression were less prevalent among those who were involved in gardening compared with those who were not (0 [0%] vs. 105 [95%], P < 0.001), as were severe to extremely severe symptoms of anxiety (36 [27%] vs. 110 [99%], P < 0.001) and stress (2 [2%] vs. 94 [85%], P < 0.001). In regression models adjusting for covariates,we found statistically significant associations between participation in gardening and symptoms of depression (b = -18.4; 95% CI, 20.5 to -16.3), anxiety (b = -16.6; 95% CI, -18.6 to -14.6), and stress (b = -18.6; 95% CI, -20.6 to -16.6). Caregivers of people with dementia who participate in gardening have lower symptoms of depression, anxiety, and stress. Gardening interventions in this at-risk population may ameliorate symptoms of depression, anxiety, and stress.