Recently, I put to myself a simple question: Are there any benefits of undertaking physical activity in the outdoors environment as compared to indoors, whatever the latter entails?

This chain of thought came about since the COVID-19 pandemic necessitated a shift to the outdoors for many who usually undertook their physical activity inside. There was also a plethora of individuals who picked up regular exercise for the first time during this time, and outdoors was the most natural location.

My gut instinct told me, yes, for sure, there must be mental and physical advantages in partaking one’s physical activity outdoors. But then, you see social media plastered with multiple instances where individuals complain on the reduced safety and accessibility of our roads for pedestrians and cyclists, and that countryside access has become more of a hazard rather than an enjoyment, due to the, legal or not, land grabbing of our coastal areas and countryside in general. So is it worth this extra hassle?

For clarification’s sake, I walk outdoors regularly and am often baffled at how our countryside has been overridden with interesting signage on where I can and cannot go. This definitely needs to be regularised for the sake of the people who actually own the land in question and also for those who pass along. I also was an ardent cyclist; however, on my return to Malta from a prolonged working stint abroad, I just didn’t feel safe again on two wheels to venture on our roads. A real pity as I love cycling.

So going back to my initial query, outdoor or indoor exercise? Well, being a scientist, I decided to read up on the subject and yes, there is growing evidence of the benefits for being and exercising in nature or at least having contact with the natural environment. Interestingly, or maybe logically, the main benefits were mental and psychological, with studies indicating that compared to indoor exercise, the outdoors was associated with greater feelings of revitalisation and a decrease in tension, confusion, anger and depression. However, from a purely fitness and physical perspective, the difference was not so evident. So where does this leave us?

Outdoor exercise can contribute to mental and social health benefits.

The World Health Organisation defines ‘health’ as a state of complete physical, mental and social well-being, and not as the mere absence of disease or infirmity. Hence, outdoor exercise can definitely contribute to mental and social health benefits, even though the physical benefits do not appear to be superior to exercising in an indoor environment. 

The creation of environmentally-sensitive outdoor fitness areas carries merit and should be explored and encouraged further

Aaron Farrugia, the minister responsible for the environment, has been rather prominent when it comes to the development of more user-friendly park and play areas. I personally appreciate that he genuinely appears to undertake regular outdoor physical activity. Leading by example if you want. Do I agree with all the decisions taken by the government when it comes to the environment? Obviously not, in fact far from it! However, I am encouraged by the fact that the environment ministry seems to have finally taken a more active role in this important aspect of our life. Not since the times of former PN parliamentary secretary Stanley Zammit have we had such a hands on approach.

In Malta we lack friluftsliv, the ‘free-air life’ Scandinavian philosophy of outdoor recreation. This has led to a significant amount of our natural environment being lost forever. A recent Canadian position statement states that “access to active play in nature and outdoors… is essential for healthy child development”. We owe it to our children to preserve and promote what we can.

So where do we go from here? Besides the obvious preservation of the environment, I came across two very interesting concepts that I was not aware of, namely, the Park Prescription Study, and the importance of the availability, accessibility and placement of outdoor exercise equipment.

The former is a study undertaken in Singapore where a community-based physical activity intervention clearly showed multiple health (physical, mental and social) benefits of prescribing exercise within the outdoor environment, in this case a park. The latter concept indicated that the successful use of outdoor exercise equipment, be it obstacle-course style or plain exercise machines, depended also on the ease of accessibility and the placement within the outdoor environment. In fact, the creation of a specific outdoor fitness zone seemed to lead to the increase in physical activity levels of park users.

In Malta, exercise prescription is unfortunately still in its infancy. We prescribe drugs by the ton, but maybe we should start prescribing more natural health solutions.

The creation of environmentally-sensitive outdoor fitness areas carries merit and should be explored and encouraged further. Maybe another challenge for Minister Farrugia to take up?

The Maltese physical inactivity epidemic is very real. The loss of our natural environment is alarmingly real. Maybe combining exercise and the outdoors is a way of tackling both problems.

There are no easy solutions but I strongly believe that if we respect the environment and promote an outdoor mentality, a Maltese friluftsliv, we all stand to benefit, but especially our future generations.

Dr Kirill Micallef Stafrace is a sport and exercise medicine consultant who loves the outdoors.