Nature and Cardiometabolic Health. Why Maju and Gillman are an Easy Win for Singapore
Singapore has spent much of the past two months debating what to do with two patches of forest. Since July 2026, plans to build public housing at Gillman Barracks and Maju Forest have drawn parliamentary questions, petitions with tens of thousands of signatures, and rare public rallies, with the government subsequently agreeing to retain more greenery than originally proposed at both sites. Much of that debate has centred on biodiversity, heritage and housing supply.
Less discussed is a simpler question: what do these green spaces actually do for the health of the people living near them?
Published in BMC Medicine in November 2025, the review focused on longitudinal research, studies following people over time, rather than single-point snapshots. Researchers tracked continuous measures: blood pressure, fasting glucose, triglycerides, cholesterol and HbA1c. This matters because these measurements shift years before a diagnosed disease appears.
As ever, talk to your doctor before implementing any changes in diet, exercise or lifestyle, especially if you're under treatment. Links to all studies at bottom of page.
What is the "built environment"?
The built environment is the human-made world around us. The review focused on three features:
Green and open spaces (parks and vegetation)
Walkability (street connectivity and pedestrian-friendliness)
The food environment (access to healthier versus less healthy food).
These features may work through several pathways: encouraging physical activity, offering stress-buffering outdoor time, and making nutritious choices more practical. Researchers also note environmental conditions may influence biology directly, including chronic-stress pathways.
The key point is that these influences accumulate. Because cardiometabolic disease develops over years, looking only at eventual diagnosis can miss the smaller physiological changes happening along the way.
Green space stands out
Of the three features, green and open space produced the most consistent findings.
Nine of the 16 included studies examined it, and greater availability was consistently linked to smaller increases in blood pressure over time, with very strong evidence for systolic and strong evidence for diastolic blood pressure. Results for triglycerides, HDL cholesterol and fasting glucose were less consistent.
Why might this matter? Beyond enabling exercise, prior research cited in the review suggests "greenness" may buffer stressful life events and psychological distress. A park can offer somewhere to walk, spend time outdoors, and simply feel less stressed, pathways that likely interact rather than operate alone.
Walkability: promising, but more complicated
Walkability showed strong evidence for smaller increases in systolic blood pressure over time, plus evidence linking it to smaller HbA1c increases. But results were less consistent for diastolic pressure, fasting glucose and blood lipids, so the authors stop short of calling it a universal fix.
The relationship may also be shifting: the growth of food-delivery services could be changing how much physical proximity to shops and restaurants actually matters. A neighbourhood can be walkable, but modern habits determine whether people use that opportunity.
Your local food environment may matter too
Food availability was studied less, but findings were notable. Healthier food environments were linked to smaller increases in blood pressure, fasting glucose and HbA1c, while higher fast-food density and poorer access to healthy food tracked with greater increases in risk.
One study found greater healthy-food availability reduced the rate of HbA1c increase; another found similar negative associations with fasting glucose and HbA1c. The evidence base is small, though, so these findings warrant caution rather than certainty.
Why longitudinal research matters
This review's real value is its focus on change. Two neighbourhoods with identical hypertension rates could look similar on paper, yet one might have residents whose blood pressure is steadily climbing while still below diagnostic thresholds. The same logic applies to HbA1c: rising values signal movement toward metabolic risk even before a formal diagnosis. Continuous measures reveal what a simple disease-versus-no-disease comparison misses, which matters given how many years cardiometabolic disease takes to develop, a short study can easily miss the eventual consequences of an environmental exposure.
What can we do with these findings?
Two levels of action exist: what individuals can do now, and what policy can do longer-term.
Individually, the message is to make practical use of what's already available, folding a nearby park into your routine, walking for everyday journeys where it's safe, and making healthier food shops part of normal shopping habits.
But responsibility shouldn't rest on individuals alone. Someone without safe walking routes, green space or nutritious food access can't simply "choose" a better environment. That's why the authors emphasise public policy: improving green space, walkability and equitable food access as part of population-level prevention strategy.
The evidence has limitations
These findings are encouraging but not proof that changing a neighbourhood directly prevents disease. Only 16 studies met inclusion criteria, covering 43,967 participants across the US, Australia, China, Belgium, Brazil, the Netherlands and Luxembourg. Study quality was generally high, but uncertainties remain.
Self-selection is one issue, people who prioritise healthy living may simply choose greener, more walkable neighbourhoods, making it hard to separate environment from the people in it. Societal shifts like food delivery and rising medication use could also obscure these relationships. And neighbourhoods themselves change over time, so future research needs better tracking of relocation and environmental shifts alongside health data.
A healthier environment is a public-health issue
The biggest takeaway may be that healthy living isn't purely an individual responsibility. Our surroundings shape the choices available to us: greenery, walkable routes and healthy food options create opportunities, while unsupportive environments create barriers. The researchers call for closer collaboration between healthcare and urban planning, framing prevention as a community-level as well as medical issue.
In Singapore a debate is currently raging over the future of neighbourhood forests (that many believe are national health assets) and access to nature versus the need for new housing. Learn more...
Final Thoughts
This review makes a compelling case for looking beyond the individual in long-term cardiometabolic health. Green and open space was consistently tied to smaller blood pressure increases; walkability linked particularly to systolic blood pressure and HbA1c; and healthier food environments showed favourable, if less-studied, associations across several risk factors.
None of this settles the planning trade-offs at the heart of the Gillman and Maju Forest debate, which involve heritage, biodiversity and housing supply considerations well beyond the scope of this review. But it does add a data point often missing from that conversation: the forests and green corridors under discussion may be doing quiet, measurable work for residents' blood pressure and blood sugar long before anyone notices a health problem. If that's true, preserving accessible natural space isn't just an environmental or heritage question, it's a public health one, and in land-scarce Singapore, it may be one of the more genuinely low-cost wins available.
Practically, the message for individuals stays the same: use the green space and walkable routes already around you. For planners, the message this debate has already surfaced is broader: what gets built, and what gets left standing, shapes health outcomes for decades to come. And key human focused discussions not included here, urban cooling provided by forest and the forest's effects on mental and spiritual health, even fecundity.
As always, the best health strategy is one you can stick with - one that fits your personal lifestyle profile. Improving health is about finding motivation, prioritising self-care and taking action. If you want to take effective and targeted steps to that fit into your unique lifestyle, The Whole Health Practice is here to help. Whether you want to improve eating practices, beat chronic illness or enhance your overall well-being, our consultations and programs deliver results that are tailored to your needs.
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Studies and Resources
Feyissa, T.R., Beks, H., Tolossa, T. et al. Built environment and the evolution of cardiometabolic risk factors: a systematic review and meta-analysis of longitudinal studies. BMC Med 23, 638 (2025). https://doi.org/10.1186/s12916-025-04458-4
Other
Quintela Do Carmo et al. A systematic review of the impacts of nature exposure on the nervous system in children and youth: Implications for nature-based learning, Journal of Environmental Psychology, Volume 107, 2025, 102788, ISSN 0272-4944, https://doi.org/10.1016/j.jenvp.2025.102788
Struthers NA, Guluzade NA, Zecevic AA, Walton DM, Gunz A. Nature-based interventions for physical health conditions: A systematic review and meta-analysis. Environ Res. 2024 Oct 1;258:119421. doi: 10.1016/j.envres.2024.119421. Epub 2024 Jun 13. PMID: 38876421.
Tovan Lew, Kaitlyn J. Fleming, Phytoncides and immunity from forest to facility: A systematic review and meta-analysis, Pharmacological Research - Natural Products, Volume 4, 2024,100061, ISSN 2950-1997, https://doi.org/10.1016/j.prenap.2024.100061.
Noseworthy M, Peddie L, Buckler EJ, Park F, Pham M, Pratt S, Singh A, Puterman E, Liu-Ambrose T. The Effects of Outdoor versus Indoor Exercise on Psychological Health, Physical Health, and Physical Activity Behaviour: A Systematic Review of Longitudinal Trials. Int J Environ Res Public Health. 2023 Jan 17;20(3):1669. doi: 10.3390/ijerph20031669. PMID: 36767034; PMCID: PMC9914639.
Aik, Joel & Ang, Lina & Gunther, Samuel & Tang, Charissa & Lee, Jason & Seow, Wei Jie. (2023). Climate change and population health in Singapore: a systematic review. The Lancet Regional Health - Western Pacific. 40. 100947. 10.1016/j.lanwpc.2023.100947.
Liu Z, Chen X, Cui H, Ma Y, Gao N, Li X, Meng X, Lin H, Abudou H, Guo L, Liu Q. Green space exposure on depression and anxiety outcomes: A meta-analysis. Environ Res. 2023 Aug 15;231(Pt 3):116303. doi: 10.1016/j.envres.2023.116303. Epub 2023 Jun 1. PMID: 37268208.
Ho AFW, Hu Z, Woo TZC, Tan KBK, Lim JH, Woo M, Liu N, Morgan GG, Ong MEH, Aik J. Ambient Air Quality and Emergency Hospital Admissions in Singapore: A Time-Series Analysis. Int J Environ Res Public Health. 2022 Oct 16;19(20):13336. doi: 10.3390/ijerph192013336. PMID: 36293917; PMCID: PMC9603816.
Tan BA, Gaw LY-F, Masoudi M and Richards DR (2021) Nature-Based Solutions for Urban Sustainability: An Ecosystem Services Assessment of Plans for Singapore’s First “Forest Town”. Front. Environ. Sci. 9:610155. doi: 10.3389/fenvs.2021.610155
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