The Effectiveness of MIND Diet and Forest Bathing on Reducing Psychological Stress Among Older Chinese: A Pilot Randomized Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Emotional states
Study Overview
Brief Summary
This clinical trial aims to explore the effectiveness of the Mediterranean DASH Intervention for Neurodegenerative Delay (MIND) diet and Forest Bathing (FB) in reducing psychological stress among older Chinese individuals. The main questions it aims to answer are:
- what is the effect of FB on stress reduction
- what is the effect of MIND on stress reduction
Participants of the MIND-FB group will participate will receive
- FB: a two-hour FB session on four consecutive weekends in a country park,
- MIND: four nutrition sessions, and adhere to the MIND diet for 12 weeks
Researchers will compare the FB and routine care groups to compare the effectiveness of MIND and FB in reducing psychological stress.
Detailed Description
This project is a pilot study to examine the effectiveness of Mediterranean DASH Intervention for Neurodegenerative Delay (MIND) Diet and Forest Bathing (FB) on reducing psychological stress. In recent years, mental health has become an increasingly important issue in Hong Kong. More people in Hong Kong are seeking help for mental health issues such as anxiety, depression, and stress. A 2020-2022 survey found that 1.2% of individuals aged 15 or above reported depression and 0.9% reported anxiety. Females had higher prevalence rates than males, and individuals aged 55-64 had the highest rates of depression (1.7%) and anxiety (15%). Conventional treatments have not been sufficient in managing or addressing chronic stress in individuals. Several factors including dietary intake and forest visits have been reported to be associated with psychological health. Research suggested that the MIND diets anti-inflammatory and pro-inflammatory components may reduce anxiety and depression, and forest bathing (FB) can reduce physiological and psychological stress by decreasing sympathetic nervous system activity and having a restorative effect. However, it is unclear if these approaches are effective for older adults with mild to moderate levels of psychological stress, particularly in the Chinese population. Additionally, there is a gap in the literature regarding the relationship between the MIND diet and psychological stress among the Chinese population. Therefore, it is important to investigate the potential impact of the MIND diet and forest bathing on psychological stress among older Chinese individuals.
The objectives of this study will be to:
- examine and compare the therapeutic effects of the MIND-FB, FB and routine care on psychological stress (emotional states) and physiological stress (blood pressure and salivary cortisol level) at 4 weeks.
- examine and compare the sustained effects of the MIND-FB, FB and routine care on these psychological and physiological stress at 12 weeks.
- examine the therapeutic effect of the MIND-FB, FB and routine care by controlling for other individual characteristics (demographic and lifestyle characteristics, health history and current medication use).
In the short term, the study will benefit participants by providing them with either the MIND diet and forest bathing intervention or routine care, which is expected to reduce the level of psychological stress. The study results will be published in international peer-reviewed journals and presented at conferences. In the medium term, the project will offer evidence for local healthcare providers on the use of similar therapies for adults with psychological stress.
Introduction
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 50 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Chinese ethnicity, and
- •able to speak and understand Cantonese, and
- •the Chinese version of the DASS-21 stress subscale score larger than or equal to 8, and smaller than or equal to 12; or
- •the Chinese version of the DASS-21 anxiety subscale score larger than or equal to 4, and smaller than or equal to 7, or
- •the Chinese version of the DASS-21 depression subscale score larger than or equal to 5, and smaller than or equal to 10.
Exclusion Criteria
- •kidney disease and chronic obstructive pulmonary disease that is poorly controlled
- •known allergies to berries, nuts, fish or olive oil
- •known to mental health services
- •those who participated in any relaxation or dietary programme in the past 3 months and those who anticipate joining such a programme shortly
- •those who are unable to walk independently
Arms & Interventions
MIND Diet and Forest Bathing (MIND-FB)
In this arm, participants will receive both the MIND diet and Forest Bathing (FB) intervention.
Intervention: Forest Bathing (FB) (Behavioral)
MIND Diet and Forest Bathing (MIND-FB)
In this arm, participants will receive both the MIND diet and Forest Bathing (FB) intervention.
Intervention: MIND diet (Behavioral)
Forest bathing (FB)
In this arm, participants will receive Forest Bathing intervention only.
Intervention: Forest Bathing (FB) (Behavioral)
routine care group
The routine care group will be instructed to perform daily activities as usual and will receive a health talk and be given pamphlets about tips on maintaining mental well-being.
Outcomes
Primary Outcomes
Emotional states
Time Frame: The outcome measures will be evaluated at three time points: baseline assessment (T0), immediately after the fourth session (T1), and 12 weeks following the intervention (T2) at the participating community center.
Emotional states are measured using self-reported Chinese questionaries of depression, anxiety and stress scale -21 items (DASS-21) with alpha coefficient ranging from 0.79 to 0.83 (Cao et al., 2023).
Secondary Outcomes
- Systolic Blood Pressure (SBP)(The outcome measures will be evaluated at three time points: baseline assessment (T0), immediately after the fourth session (T1), and 12 weeks following the intervention (T2) at the participating community center.)
- Salivary Cortisol(The outcome measures will be evaluated at three time points: baseline assessment (T0), immediately after the fourth session (T1), and 12 weeks following the intervention (T2) at the participating community center.)