Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered podcast. I am Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine.

All of us are familiar with the term “screen time,” which is the amount of time spent using a device such as a phone, computer, television, or video game console. For many parents, screen time is something we are concerned about, something we monitor and wonder about the impact this has on our child’s health, development, and social and emotional lives.

What about “green time?” Green time refers to spending time playing, relaxing, or adventuring outside, anything from team sports to spending time in a local park or a national park. 

Today, I’ll sit down with two experts and co-authors of the book Digging Into Nature: Outdoor Adventures for Happier and Healthier Kids to discuss how small doses of nature can build resilience, reduce stress, and foster developmental milestones in ways that may surprise us. 

We’ll explore actionable tips to incorporate nature into everyday life for busy families who may be pressed for time or face obstacles from lack of access to safe outdoor spaces to screen time distractions. From rethinking playdates to leveraging schoolyards and local resources, they discuss creative ways to make nature accessible and fun for our kids. They’ll also share insights from their own practice and personal experiences on why maximizing “green time” is just as important as minimizing screen time. Listen in to learn how a few simple steps toward embracing nature can foster healthier, happier kids.

First, let me introduce my guests, Dr Pooja Tandon and Dr Danette Glassy. 

Dr Tandon is a general pediatrician and researcher at the Seattle Children’s Hospital, an associate professor at the University of Washington School of Medicine, and the director of health at the Trust for Public Land. She has published widely on the importance of physical activity, outdoor time, and nature contact for health. 

Dr Glassy is a primary care pediatrician and child advocate. She is the co-founder and board president of the nonprofit BestStart Washington and leads its Project Nature initiative—a program to support pediatric medical professionals as they encourage children to spend time in nature. She is the co-editor of Caring for Our Children.

Welcome to the WebMD Health Discovered podcast.

Danette Swanson Glassy, MD, FAAP: Thank you so much.

Pooja S. Tandon, MD: Thanks for having us.

Pathak: So before we jump into what you have written about and your advice and tips for parents like me, we'd love to start off with just asking about your own personal aha moment, your own health discovery around children's mental health, physical health, and nature.

Glassy: I was in primary care practice for 30 years, and over that long arc of time and, of course, raising my own children, it became very clear that childhood was becoming very different. Children weren't spending time outside, and they were busy with lots of scheduled activities. At the same time, we were seeing, as a profession, pediatricians, seeing the obesity epidemic and mental health crisis. This was long before the pandemic, and the rising rates. Lots of new issues bubbling up through our practice. 

One day, I had this kindergartner come in for her six-year-old well visit. I asked her, like I usually did, what do you like to do outside? And this six-year-old rolled her eyes and said, Oh, Dr Glassy, I'm not an outdoor girl, and everybody in the room laughed and, and her parents said, Oh, we're so proud of her. She loves the computer, and she's already writing code, and they were clearly very proud of her and not at all worried about no time outside.

It got me thinking, how did we get here? What can we do? I started reading about the idea of nature prescriptions that some physicians were writing about. I was reading in the literature about spending time in nature being linked to good physical health, and good mental health, and I talked with my fellow pediatricians on the Best Start Washington board, and we started to pull together some ideas that would pull together the resources to talk to families about that.

In fact, that's how I met Dr Tandon, and she became involved in that project and really helped us create a very effective model for talking to families about nature.

Tandon: In addition to sort of a clinical experience as a pediatrician to what Danette described. I was early in my career, a physical activity researcher, and interested in getting children moving. And one day, I was on a beach with my own 2 little boys and I realized how active they were just running back and forth and digging and how well everyone got along, how much better I felt being out there, how parenting felt easier in that moment. It was this kind of aha moment. At the same time, I actually also was reading a book Last Child in the Woods by Richard Louv about this idea of how children today are less connected with nature than ever before.

I think all of those things as a pediatrician, a researcher, and a mom came together and made me really curious, and eventually passionate about this idea that children, all children need nature in childhood.

Pathak: I would love if we could start off with just talking about what are some of the ways that we know nature nurtures our health. And both physical and mental health. I know we sometimes have this false dichotomy, but how do you both approach it? So I'd love to start with you, Dr Tandon, and then pass it on to Dr Glassy.

Tandon: I love that you made that point that we often dichotomize this physical and mental health, but they're all health. They're all connected to children's health and wellbeing, and development. And the research is strong. I was part of a team where we did a systematic review where we tried to look for all of the literature, the scientific evidence on nature contact and children's health and found some areas of particularly strong evidence around physical activity, movement, and around mental health, symptoms of depression, anxiety, stress, just general well-being supported by time in nature for children of all ages.

How does that happen? There are a few different pathways that have been put out there. Some of it is because of what we can do when we're in nature, when we're in a park or in a forest, and that is things like moving our bodies, which is good for our health, developing our relationships, being with peers, family members, and community members. And then some of it is the actual characteristics of the nature itself. There's this idea that when we're in nature, our stress comes down, there may be awe inspiring aspects of nature. There are substances the plants themselves give off, that are, thought to bring down our stress and boost our immune system. And the protection against things like air pollution or noise pollution or excessive heat. Those are all good for our health too. So, I'll pass it off to Danette. I love how you always talk about the developmental benefits for children.

Glassy: One of the things that the research is finding is how important nature and being outside are to developmental milestones. And, obviously, the gross motor skills that you have to develop as a toddler, walking on uneven ground, maybe the preschooler who's picking up loose parts and using them, and then in the creative way of pretend play and the importance of free play for children to manage their own curiosity, pursue their ideas, manage their own boredom, and come up with something new, and get frustrated and solve their own problems, which is all building blocks of resilience.

You add that to your family enjoying this awe-inspiring, inspirational setting that the outdoors is compared to indoors and you're really building relational health. As we kind of pivot and talk more about mental health in pediatrics, we are so committed, of course, to treating diseases and managing symptoms that come up for people, but really feel our primary aim is to in prevention and really helping families and their children find that health and well-being that their children will grow into. So relational health and its relationship to resilience to managing stress and bad things that are going to happen in the future is something that we all need to pay attention to as we raise our kids, not just their gross motor skills and fine motor skills and language skills.

Tandon: I might jump in with the studies have found positive relationships between both living near nature and spending time in nature for things like prenatal outcomes. So even before children are born, there are studies that have looked at thousands of ,pregnant people and living near nature or parks is associated with healthier birth weight babies and less premature births, for example, and later in childhood and adolescence, associated with healthier weight status and cardiometabolic outcomes, and then just healthy behaviors. We mentioned physical activity, but also things like, sleep, which is so critical for so many aspects of our health. And even things like when children, especially young children, get to experience like gardening in their schools or preschools, they're more likely to try different vegetables or different foods. All of the things as pediatricians, we want to promote their movement and their sleep and healthy eating, just evidence that all of those things can be really supported by time and nature. 

Pathak: So I'm curious. What do you hear? And what do you see as some of the obstacles to finding time in nature?

Glassy: I'm so glad you brought that up because, as we started to look at some of the nature prescriptions, the programs, and you know, this from your primary care practice, simply telling someone that they should do it for their good health is not helpful. In fact, in our very stressed-out parents, just giving them another task to do to raise their healthy kids is quite stressful for them.

The framework of motivational interviewing, where you step back, you say, what do you like to do outside? How often do you get to do that? Is there anything help holding you back?

And what can we do to help you overcome that? 

What we found as we've spread this message across the state of Washington is every practice and probably every family has different barriers and challenges that keep them from nature. So depending on the time of year, we hear weather. “Oh, do we want to go out in that drizzly rain again?”

Well, it turns out, usually, the children do. They're not bothered by it at all. And the parents have to find some comfortable clothes, and, certainly, the gear that it takes, especially as it gets even colder, can be cost prohibitive for kids who every two weeks need a different size. So, being ready to talk to families about that and where they can get resources. 

Most of our families that are really invested in making sure their kids are growing up with everything they need are right now kind of overscheduling them and feeling stressed out by the sports they have to sign them up for, the enrichment classes, and their own stress of work and, home and family and maybe grandparent care or other community commitments. Then, there's the idea of feeling comfortable in that space. Pooja, do you want to talk a little bit about the barriers and challenges that we learned about?

Tandon: Yeah. That last one you mentioned is something that really resonated with me and it's something that I've been thinking a lot about in terms of what does that mean? There's the sort of physical access, and physical safety in a space, which is really important and a huge barrier for many. And then there's the psychological access and that feeling of belonging. I think one key thing for me is that it can look very different for each family, each person, each community, and for some people, being in nature by yourself, kind of that lone hiker in the wilderness, is sort of what either resonates with them or is fulfilling to them. For others, like me, that's terrifying. I don't want to be by myself in the wilderness. I think my family too, we always went in groups and we brought the food and we brought the noise. I think that that's okay too. It's like finding your people and if you need running water and electricity to experience nature, that is also possible.

And, or organized events. For some communities and people, it doesn't feel safe. It's not safe to be in some places, whether it's because of people or animals or, just the circumstances in their community and thinking about after school programs, summer camps, places where there are park rangers, lighting. All of those types of things, programming, and amenities can make that. 

The other thing we talk about sometimes is this idea of nature allies and nature mentors. There are probably people out there that have done what maybe you want to be able to do, or you aspire to do or hope to have your children be part of. You've never gone skiing, but, all your children's friends are doing it, and you don't want them to grow up without that experience or hiking or whatever. I found that in my life, just trying to tie up with others who've maybe done this and can encourage and guide us in those experiences can be really useful.

Glassy: I was just going to say, we've learned so much from the families we've talked to as this is rolled out these resources and from the pediatricians. So kind of taking all of these great solutions and bridges to getting families out in nature is kind of really part of the inspiration for the book that we wrote, Digging Into Nature. So, we collected everything we heard and put it in there.

Pathak: Amazing. So I'm really excited to dig into some of the solutions that you focus on. But before we get to that, is there a difference with regard to the mental health impacts and well-being impacts if we are talking about nature prescribing in natural spaces of parks, national parks, wooded areas versus more man-made greenscapes. For example, a traditional urban park or something like that. Is there a difference, or do you see that the mental health benefits extend to prescribing both of those things?

Tandon: There are not really studies that have very clearly answered that specific question but I'll say that the mental health benefits that we've seen in the research come from a range of different types of nature exposures, if you will. So, the how much you need is difficult to answer, but even the nearby small nature, the plants in a classroom, even, there have been studies that have found that those can have an impact on our mental health and our behavior, on our ability to focus.

So, from a practical standpoint, that to me means that nature and in sort of even small doses, even micro experiences can be beneficial to our health, to our well being and probably the awe-inspiring, the big nature has more impact, but I don't think like from a scientific standpoint, that's been answered.

Glassy: This idea that nature, in whatever form, the plant in the classroom versus the tree outside your apartment versus the beautiful natural setting in a park, it just inspires so much curiosity in your mind. If you have the space and time to let that happen, whether you're a two-year-old or you're a 16-year-old, is just good for your brain. If you share that with others, your family, you're building that relationship. And again, those microdoses just don't happen inside, and especially not if you're being distracted by your screen.

Tandon: There's this book by Florence Williams called The Nature Fix. And I think from that book, there's this kind of pyramid idea of nature exposure. That really resonated with me, this idea that at the base of the pyramid are your daily experiences in your daily doses. And for children, we believe and want children to have daily experiences in nature, and that's likely not going to happen in a national park for most children.

So, where are those places in and around your home or in and around your school, your schoolyard, the neighborhood park, the trees on a street, if those are available? That's what we want to get to, daily little doses of nature. And then, maybe on the weekends, there's something you could go to a state park or something that's a little bit more immersive, and you can kind of build your way up and maybe at the top of the pyramid where a couple of times a year, on a vacation, on a school trip, on an overnight environmental education center, you get something that's truly deep and immersive and and probably at every level there's some some benefit and value that's cumulative.

Pathak: I would be really interested in your viewpoint on digital access, and that cutting both ways. You talked about noise pollution, how nature protects us from that. I talk to my kids about ding pollution. Because when we go to natural parks, I don't want that phone ding to ruin my experience. So we have to leave all phones and electronics in the car if we go. 

So I'm really curious, one, about how you see this sort of digital addiction or connection that a lot of our kids have to their devices. How is that an obstacle? And then conversely, should we turn on bird song in the background or put on an image on our televisions of just a nature scape? Is there any benefit?

Glassy: Well, there's no doubt that screens are gobbling up the time that children have, their free time and maybe even stealing their school time, right? And definitely their social time as groups of kids you see all just sitting together, but all on their phones separately. So, it's a distinct problem and we all need to work on that. And as parents, the advice is, you've just got to rein it in. You've got to turn it off, manage the time, make it inaccessible in whatever way you can. And, you know, there's lots and lots written about tools that families can use for that or empowering families to get to that point. 

For our purposes, we were talking about green time versus screen time and how a family decides they're going to allocate the time that they have and kind of sticking to it, making contracts with older kids and certainly, more hands-on management with the younger kids. I think it's very important. Not only does screen time rob you of green time because that's how you're spending your after-school time or whatever, but it also is bad for you, right? There's no creativity. It's addicting. You're sedentary. You might be seeing images that are disturbing or harmful to your developmental stage.

There's all those bad things that we know about screens and it's been hard for this generation of parents to run to catch up and learn how to parent through that. But, definitely worth swapping out your screen time for your green time. However, your family finds the tools to be able to do that. And it's a big job.

Tandon: I'll jump in on the second part. The reality is that the screens are also here to stay. They're not going away. How do we think about the role that, in some cases, screens can help facilitate nature contact that could be maybe a reluctant teenager who's just like, I'm not a nature person. But would they be interested in nature photography? Could they use their phone to take pictures and post them on social media? There are apps that parents can use. We came across some interesting ones, a thousand hours and ones that parents can track their outdoor time, and it can be a motivator to doing that as a family. Or use the ones where you can identify plants, flowers, and bugs just by bringing them into your kind of phone camera and connecting to nature in that way.

So, we think that there are ways that digital technology, which is literally in our hands and pockets most of the time, could be used to facilitate nature. And then to your question of virtual nature or digital nature, are views of nature or sounds of nature health promoting the way that real nature is?

People are studying that. I have not seen many studies in children, but in adults, I think there is a case to be made that it's probably not the same as real nature, but there could be benefits to listening to nature sounds, especially when you use sort of virtual reality type images. There's a researcher who is working with adults with physical limitations and disabilities where there are just places in nature they could not access. She used VR technology to bring them virtually to nature places that they connected with from their childhood years. And they reported feeling emotional and mental health benefits that they experienced even through that VR nature.

I think there may be cases where virtual reality or images or bird song could be health-promoting, but probably not a substitute for for the real thing.

Glassy: Thinking back about that pyramid, a little bit every day would be great. How much better is that than maybe listening to the dings from your phone? But trying to get the real nature because it's not just the sounds or the sites. It's the smell. It's the phytoncides that the trees are giving off.

It's the feel of the wind on your skin. It's all of your senses. Now, there's this idea that we have more than five senses. And definitely, real nature is probably tingling all of them. So, I want to try for that real nature as well.

Pathak: How do you think about helping children and their friends so that they're getting that social connection piece as well, find this unstructured time in nature? 

Glassy: You know, when I talk to families, I just ask them to think about it. You can get so busy as a parent running your life that you might not notice that you're a little bit out of balance, that maybe your child isn't getting any free play. And the answer to adding more free play, of course, depends on their age.

So, the under-one-year-old who needs constant supervision is probably mostly doing free play. You're probably interacting with them a little bit, or if they're at childcare, there's circle time, and then there's free play. So, you know, just take a moment to reflect on that. Can you take that outside and safely be in a natural setting while your under-one-year-old is having free play? Try for that every day. 

Your toddler and preschooler enjoy playing with their friends, and as you said, they're starting to go from that parallel play into interactive play and making sure that whatever setting they have some of that and making it outside so the kids can be more creative in that and not just the teacher or the parents running a game for them to play, which is also very important, but not always, right? Having that free play and free time. 

As your kids get older, again, the idea of managing their boredom, making them put in the effort to do that without their screens, is going to be one of the most essential life skills, I think of this 21st century because it's so easy to just fill your mind with your screen and not ever manage that and know what to do about that.

I think having families just reflect on how does the day unfold for my child and is there any opportunity for them to just make it up as they are going and can it be outside.

Tandon: There's this concept in behavioral parent training that often is recommended for families with children with ADHD is special time, scheduling a special time, but the child determines what you're going to do. And it's sort of this special, sacred, protected time.

It's not completely unstructured with peers, but it's this idea that there's not an adult telling a child what they have to do. So, to the extent that families can kind of carve that in their schedule in a way, but a time where the child, their outdoors, outdoor special time, the child chooses what they're going to do and they're going to go with it and, and it's not, there's not a coach, teacher or parent telling them what to do.

Pathak: Are there any other specific solutions that you really wanted to point out from your book that you think might be helpful to that busy family to ensure that they're getting the time in nature?

Glassy: I'd like to circle back a little bit to the idea of “I just don't have time to go outside.” One of the things that we found inspirational was taking your usual action. We all learned a little bit about this during the pandemic. For many of the months, you could suddenly be with other people, but only outside.

How about when you can, eat outside. Take your meals outside for a picnic or under an awning. The idea of instead of driving, walking, or biking, of course, is important, but again, for a busy family, maybe that's not going to be doable. So, roll down your windows in the car and ask everybody to name what they are smelling or what their favorite nature thing that they're watching, or if it's a route you're going to take over and over throughout the year, talk about the changing of the season and how that landscape is changing and using all your senses when you are outside. Gravitating more towards sports that are outside than inside, maybe doing your music practice outside or concerts, reading outside, and making your play dates outside. In whatever way you can, take what you're doing, your normal activity, and move it outside, and you get a little more nature that day.

Tandon: I'll add two things to it. On the topic of reading, choose books that include nature and nature elements. That's something you could do even indoors, and there are so many books about animals and nature and adventures that are outdoors. Our book actually highlights some of those. We worked with a children's librarian to curate that list. The final strategy is the schoolyards. We have to think about where children are spending their time. Often, they're not home during like the peak daylight hours, or they live in a neighborhood where It doesn't feel safe to be outdoors, but our schools are preschools or child cares should be right.

We should make those places safe and accessible. And so, to the extent that they're not asphalt and plastic, could we make those schoolyards more nature-rich? Could we advocate for that if we are in a position to do so and support recess and daily outdoor time and, if possible, linger in those schoolyards when families are picking up children or ask if those could be open hour after hours to go back to? But really, can those schoolyards become places where children and community members can get those daily experiences with nature?

Glassy: Again, this is not a way to make parents feel like they're inadequate or that this is another thing on their list of 750 things to do in a day. We hope that they're able to reflect on ways to increase it for their children and themselves; they're going to benefit from that time as well and just lean into the unstructuredness that we know is so powerful as well. If you can find the time, if you find the place, it's just be there and experience what you're seeing, hearing, smelling, and feeling.

Tandon: I think that idea of the five senses, meditation in nature or teaching children, even from a very young age, and I think they can learn that is just how to be present. It's a type of mindfulness that we know is going to help children and adults bolster their resilience and their ability to just kind of find that moment of calm when things around us feel a little bit out of control.

Pathak: I couldn't agree more, and I would say I feel like when you are in nature with children, it's actually something that makes it so much more magical for the adult. You go, and you're seeing maybe different things or feeling different things, and you watch your child or their friends and what they're observing and experiencing nature, and it completely transforms my own experience.

Glassy: Seeking joy and awe is probably the best thing you can put in your parent toolkit.

Pathak: I want to thank Dr. Tandon and Dr. Glassy for joining us today. 

Some of my key takeaways are it’s not just about minimizing screen time but really intentionally thinking about green time. Even small interactions with nature—whether it's a neighborhood park, a few trees, or an indoor plant—can have a meaningful impact on our children’s well-being. 

I also found it really interesting how nature can support essential developmental milestones and can improve things that we know are important, from physical activity, sleep, and even mood, to help our kids grow healthier and happier. They shared a lot of practical, accessible strategies to make nature a part of daily life without adding stress to an already overburdened to-do list. 

They also reminded us that nature doesn’t have to be a distant forest or a national park. We can leverage nearby green spaces that can offer real benefits, and even virtual nature sounds or images can play a supportive role. 

So, I’m hoping we can all make an effort to bring a bit more of the outdoors into our kids’ lives for their health and also ours!

To find out more information about their work, we’ll have the information linked in our show notes. Thank you for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you’d like to send me an email about topics you are interested in or questions for future guests, please send me a note at [email protected]. This is Dr. Neha Pathak for the WebMD Health Discovered Podcast