Inside Is Making Us Sick

For Dr. John La Puma, “stop and smell the roses,” “get some fresh air,” and “touch grass” are not merely suggestions. They’re prescriptions. 

We’re all susceptible to the Indoor Epidemic — the title of his new book — or the idea that being indoors makes us sick. 

To illustrate, La Puma — a mix between trained physician, professional chef, best-selling author, and organic farmer — invited journalists to tour his small farm on the Mesa. 

We were immediately greeted by vibrant colors and aromas, and a sweet cattle dog named Rocky. At the entrance was an orchard of rare and unusual citrus and buzzing bee boxes. Songbirds played tag across the mountain-lined horizon. Native plants, olive trees, passionfruit, and herbs bloomed around the property. 

La Puma bought the farm 15 years ago and soon realized he never wanted to leave. Even when he was going to New York to be on The Dr. Oz Show, he was compelled to return to his farm — at that time in its infancy — as soon as possible. 

“I had to figure out why I wanted to come back here,” he said. He began to research the draw of the outdoors, reviewing more than 2,000 studies on how spending time outside affects the brain and body.

Beyond that, he noticed the effect the farm had on his visitors: their shoulders dropped, their pulses slowed, and their moods brightened. 

We’re not burned out, he realized. We’re just indoors. It’s a likely culprit behind brain fog, stress, depression, poor sleep, and high blood pressure.

“You’re living like a zoo animal — no horizon, stale air, in a box,” he said. “That’s not burnout. It’s captivity biology.”

We now spend 93 percent of our lives indoors, La Puma says. It’s draining our energy, accelerating aging, and disrupting metabolic repair — putting us at higher risk for chronic illnesses.

Luckily, there is a cure: Go outside. But it’s not as simple as walking out your front door. 

Light and Awe 

Next to tunnels of passionfruit on a sunny hill, La Puma spoke of morning light. Sunlight should hit your retinas within 90 minutes of waking, he said.

The first step is to step outside, with “no sunglasses, no screen, no glass in the way,” he noted. “Ten minutes of morning light resets your circadian rhythm, jumpstarts dopamine, and preps your brain for focus. It’s free, it’s fast, and it works better than your second cup of coffee.”

At the end of the day, he suggested taking time to watch the sunset. Those red and orange hues help the body’s temperature drop and tell the brain it’s time to wind down. They are the only wavelengths that don’t suppress melatonin, the sleep hormone.

The wrong type of light exposure, on the other hand, can be a big risk factor, La Puma said. Around 40 percent of Americans fall asleep with lamps or the television on. That exposes us to blue light, which keeps our minds awake and hinders us from getting restful sleep. Reducing screen time at night, he stressed, is key to sleeping well.

Staring at the horizon — and the accompanying feeling of awe — also reverses screen fatigue and helps us shed some of the pixels weighing us down. It counteracts what La Puma calls “digital obesity,” or biological overload from screen-centric indoor life. 

Screen fatigue can explain why people feel “so wigged out or work, or like they just can’t take much anymore,” La Puma explained.

“Like too much sugar burns out your metabolism, too many pixels burn out your brain,” he said.

Forest Bathing   

La Puma then led us to a small grassy patch shaded by 100-year-old oak trees. We closed our eyes and listened to the world around us; crunched allspice leaves between our fingers and smelled their cinnamony aroma; and stuck our hands in the dirt.  

Too often, “we just walk by the roses,” La Puma suggested.

Using our senses to stop and experience the outside world — or “forest bathing” — allows the rest of the brain to rest. While stale indoor air can drain our cognitive performance, forest air boosts immune cells by 56 percent and drops cortisol by 21 percent, according to La Puma. 

Studies show that inhaling the defense chemicals produced by trees — called phytoncides — reduces neuroinflammation and increases natural white blood cell counts. 

And you don’t need a forest to forest bathe — just a few trees overhead, a patch of grass, and a clear view of the sky will do the trick. 

Spending time in nature is also great for social connection. Loneliness is about as deadly as smoking a pack a day, La Puma said. 

“When you’re outside in a park or at a beach, you’re usually around other people,” he said. “Engaging with them allows your world to be larger — and break outside of the indoors, where you’re kept to be small and confined.”

From there, he guided us down a dirt pathway to his small orchard, containing Buddha hands and yellow limes. As we walked, he explained the benefits of movement in nature. “Green exercise” takes about 20 percent less perceived activity than doing the same thing inside, even though you’re expending more energy. 

La Puma encourages a variety of activities, especially walking through nature, which can improve your health and longevity. 

Gardening helps get your hands dirty and your head clear, too, and lowers your blood sugar, he said. And you don’t need a full orchard of weird citrus. You can start with just a house plant.

The Outdoor Rx

To reap the benefits of the outdoors,  you don’t need hours every day, just intentional minutes. 

“Morning light, midday outdoor movement, and short fresh-air recalibrate metabolism, immunity, and focus,” he said. “These microdoses act like time-released medicine, building toward greater health-span and long-term resilience.” 

Many of us may be treating a nature-deficiency with antidepressants, GLP-1s, or stimulants. But it’s not our bodies that are broken, La Puma stressed. It’s our environment. 

He says that 80 percent of cardiovascular disease is preventable, as well as 50 percent of depression and anxiety, and 40 percent of cancers. 

“You have more control than you thought,” he said.

La Puma’s “Outdoor Rx” is at least two hours of intentional time outside per week — about 17 minutes per day — but the ideal amount is 5 hours. “We can repurpose minutes outside as medicine,” he said. 

And lastly, take care of your sleep hygiene. That means sleeping in a dark room, no screens before bed, and maintaining a cool bedroom temperature. 

“The book gives you the exact doses, timing, and protocols — like a prescription, but for your outdoor time,” La Puma said. “That’s the Outdoor Rx.”

La Puma’s new book, Indoor Epidemic, comes out on March 17. Learn more here.