Association of Nature and Forest Therapy (ANFT)

Scientific Review: The Benefits of Forest Bathing

What can forest bathing do for your mental and physical health? Let’s look at the science to find out.

Spending time in nature offers a wealth of benefits that extend beyond mere enjoyment. 

Immersing oneself in natural environments can significantly enhance physical and mental wellbeing. Scientific studies have shown that nature exposure reduces stress, boosts moods and improves cognitive function. The fresh air, sunlight and natural landscapes stimulate the senses and supports us in being present, an effective antidote to stress. We have organized the studies and research by topic. 

Reviews - Metaanalysis

Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review
In this metaanalysis from 2017,  127 papers that were using the phrases: “Shinrin-yoku” AND/OR “forest bathing” AND/OR “nature therapy” were analyzed. Out of those, 64 studies met the inclusion criteria and were considered for the summary review. They divide the benefits into “physiological,” “psychological,” “sensory metrics” and “frameworks” sub-groups. They found that human health benefits associated with the immersion in nature continue to be currently researched. Longitudinal research, conducted worldwide, is needed to produce new evidence of the relationships associated with Shinrin-Yoku and clinical therapeutic effects. Nature therapy as a health-promotion method and potential universal health model is implicated for the reduction of reported modern-day “stress-state” and “technostress.”.

Hansen MM, Jones R, Tocchini K. Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. Int J Environ Res Public Health. 2017;14(8):851. doi: 10.3390/ijerph14080851. 

The Psychological and Physical Effects of Forests on Human Health: A Systematic Review of Systematic Reviews and Meta-Analyses
11 systematic reviews covering 131 different primary intervention studies, mostly from Asian countries, three of which included supplementary meta-analyses were reviewed. The quality assessment resulted in moderate confidence in the results of two reviews, low confidence in six, and critically low confidence in three.
The results of the eight moderate and low-rated reviews indicated that forest-based interventions are beneficial to the cardiovascular system, immune system, and mental health (in the areas of stress, depression, anxiety, and negative emotions). Evidence for the effectiveness of forest-based interventions on metabolic parameters in adults, the severity of atopic dermatitis in children and adolescents, and social skills and sociality in healthy primary school children was weak.

Stier-Jarmer M, Throner V, Kirschneck M, Immich G, Frisch D, Schuh A. The Psychological and Physical Effects of Forests on Human Health: A Systematic Review of Systematic Reviews and Meta-Analyses. Int J Environ Res Public Health. 2021;18(4):1770. doi: 10.3390/ijerph18041770.

Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
This study from 2022, comprised a systematic review and meta-analysis to determine how forest therapy affects the physiological and psychological health of adults.

The effect size was calculated by dividing blood pressure as a physiological indicator and depression as a psychological indicator.

Of the 16,980 retrieved studies, 17 were selected based on the inclusion criteria. Of these, eight

studies were included in the meta-analysis. The effect size of forest therapy on improving systolic

and diastolic blood pressure was not significant; however, it significantly reduced depression. While

the results have limited generalizability due to the inclusion of few studies, the effects of forest

therapy on reducing depression have been confirmed.

Yi Y, Seo E, An J. Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2022;19(17):10512. doi: 10.3390/ijerph191710512.

Effects of Forest-Based Interventions on Mental Health: A Meta-Analysis of Randomized Controlled Trials

This study from 2022 investigated the effects of forest therapy on anxiety, depression, and

negative and positive mental condition through a meta-analysis of recent randomized controlled

trials. Of 825 articles retrieved from databases, 6 met the inclusion criteria. The results of this study

showed that forest-based interventions improved the mental health of participants in the intervention

groups when compared to those in the control groups. Thirty-four outcome variables were analyzed

from six studies. The overall effect size of the forest therapy programs was 1.25 (95% CI = 0.93–1.57,

p < 0.001), which was large and statistically significant. These findings imply that forest-based

interventions can improve mental health as a nonpharmacological intervention.

Kang MJ, Kim HS, Kim JY. Effects of Forest-Based Interventions on Mental Health: A Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2022 17;19(8):4884. doi: 10.3390/ijerph19084884.

Mapping of Research in the Field of Forest Therapy-Related Issues: A Bibliometric Analysis for 2007-2021

Based on 290 original articles, this study focuses on mapping the research in the field of Forest Therapy. The findings showed that the knowledge foundation of forest therapy was multidisciplinary with most published in the fields of environmental sciences and ecology but lacking input from social disciplines.

The research hotspots evolved from the early focus on individual benefits obtained from nature to increasing attention on human well-being at the social-ecological scale. More rigorous experiments with strict randomized controlled trials and blinding are needed to accommodate the trend of forest therapy toward non-pharmacological treatments.

According to Shneider’s four-stage theory, forest therapy research is in the third stage of the scientific research process. More future studies utilizing novel technologies and decision-making frameworks to solve practical issues are needed to introduce health into policies and promote human well-being.

 Wang X, Gong XF, Xiong KX, Guo DS, Liu LJ, Lin CM, Chang WY. Mapping of Research in the Field of Forest Therapy-Related Issues: A Bibliometric Analysis for 2007-2021. Front Psychol. 2022 Jul 11;13:930713. doi: 10.3389/fpsyg.2022.930713. PMID: 35898977; PMCID: PMC9309728.

Effects of forest bathing (shinrin-yoku) on levels of cortisol as a stress biomarker: a systematic review and meta-analysis.

This review aims to investigate the effects of forest bathing on levels of salivary or serum cortisol as a stress biomarker to understand whether forest bathing can reduce stress. 

A total of 971 articles were screened; 22 were included in the systematic review and 8 in the meta-analysis. In all but two included studies, cortisol levels were significantly lower after intervention in forest groups if compared with control/comparison groups, or a significant pre-post reduction of cortisol levels was reported in the forest groups. The main results of the meta-analysis showed that salivary cortisol levels were significantly lower in the forest groups compared with the urban groups both before and after intervention

Overall, forest bathing can significantly influence cortisol levels on the short term in such a way as to reduce stress, and anticipated placebo effects can play an important role in it. Further research is advised because of the limited available data.

Antonelli M, Barbieri G, Donelli D. Effects of forest bathing (shinrin-yoku) on levels of cortisol as a stress biomarker: a systematic review and meta-analysis. Int J Biometeorol. 2019;63(8):1117-1134. doi: 10.1007/s00484-019-01717-x. 

Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to summarize the effects of forest therapy on depression and anxiety using data obtained from randomized controlled trials (RCTs) and quasi-

experimental studies. The findings showed that forest therapy is preventive management and

non-pharmacologic treatment to improve depression and anxiety. However, the included studies

lacked methodological rigor and required more comprehensive geographic application. Future

research needs to determine optimal forest characteristics and systematic activities that can maximize

the improvement of depression and anxiety.

Yeon PS, Jeon JY, Jung MS, Min GM, Kim GY, Han KM, Shin MJ, Jo SH, Kim JG, Shin WS. Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(23):12685. doi: 10.3390/ijerph182312685. 

General Wellbeing

Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention -the Establishment of “Forest Medicine”.

Dr QIng Li’s research team has established a new medical science called Forest Medicine. The Forest Medicine is a new interdisciplinary science, belonging to the categories of alternative medicine, environmental medicine and preventive medicine, which studies the effects of forest environments (Forest bathing/Shinrin-yoku) on human health. It has been reported that Forest bathing/Shinrin-yoku has the following beneficial effects on human health:

  1. Shinrin-yoku increases human natural killer (NK) activity, the number of NK cells, and the intracellular levels of anti-cancer proteins, suggesting a preventive effect on cancers.
  2. Shinrin-yoku reduces blood pressure and heart rate showing preventive effect on hypertension and heart diseases.
  3. Shinrin-yoku reduces stress hormones, such as urinary adrenaline and noradrenaline and salivary/serum cortisol contributing to
    stress management.
  4. Shinrin-yoku increases the activity of parasympathetic nerves and reduces the activity of sympathetic nerves to stabilize the
    balance of autonomic nervous system.
  5. Shinrin-yoku improve sleep.
  6. Shinrin-yoku increases the levels of serum adiponectin and dehydroepiandrosterone sulfate.
  7. In the Profile of Mood States (POMS) test, Shinrin-yoku reduces the scores for anxiety, depression, anger, fatigue, and confusion, and increases the score for vigor, showing preventive effects on depression.
  8. Shinrin-yoku may apply to rehabilitation medicine
  9. Shinrin-yoku in city parks also has benefits on human health.
  10. Shinrin-yoku may have a preventive effect on COVID-19 by boosting immune function and by reducing mental stress.

Taken together, these findings suggest that Shinrin-yoku may have potential preventive effects on non-communicable diseases.

Li Q. Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention -the Establishment of “Forest Medicine”. Environ Health Prev Med. 2022;27:43. doi: 10.1265/ehpm.22-00160. PMID: 36328581; PMCID: PMC9665958.

Spending Time in the Forest or the Field: Investigations on Stress Perception and Psychological Well-Being-A Randomized Cross-Over Trial in Highly Sensitive Persons

Research suggests that staying in a forest promotes relaxation and reduces stress compared to spending time in a city. The aim of this study was to compare stays in a forest with another natural environment, a cultivated field. Healthy, highly sensitive persons aged between 18 and 70 years spent one hour in the forest and in the field at intervals of one week. The primary outcome was measured using the Change in Subjective Self-Perception questionnaire. Secondary outcomes were measured using the Profile Of Mood States (POMS) questionnaire and by analyzing salivary cortisol. We randomized 43 participants. Thirty-nine were allocated and included in the intention-to-treat analysis (90% female, mean age 45 years).A short-term stay in a forest in summer caused a greater improvement in mood and well-being in HSP than in a field. This effect was not detectable during bad weather in the fall.

Oomen-Welke K, Schlachter E, Hilbich T, Naumann J, Müller A, Hinterberger T, Huber R. Spending Time in the Forest or the Field: Investigations on Stress Perception and Psychological Well-Being-A Randomized Cross-Over Trial in Highly Sensitive Persons. Int J Environ Res Public Health. 2022 Nov 19;19(22):15322. doi: 10.3390/ijerph192215322. PMID: 36430041; PMCID: PMC9690301.

The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan.

This paper reviews previous research on the physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing), and presents new results from field experiments conducted in 24 forests across Japan. The term Shinrin-yoku was coined by the Japanese Ministry of Agriculture, Forestry, and Fisheries in 1982, and can be defined as making contact with and taking in the atmosphere of the forest. In order to clarify the physiological effects of Shinrin-yoku, we conducted field experiments in 24 forests across Japan. In each experiment, 12 subjects (280 total; ages 21.7 ± 1.5 year) walked in and viewed a forest or city area.

On the first day, six subjects were sent to a forest area, and the others to a city area. On the second day, each group was sent to the other area as a cross-check. Salivary cortisol, blood pressure, pulse rate, and heart rate variability were used as indices. These indices were measured in the morning at the accommodation facility before breakfast and also both before and after the walking (for 16 ± 5 min) and viewing (for 14 ± 2 min). The R–R interval was also measured during the walking and viewing periods. The results show that forest environments promote lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity, and lower sympathetic nerve activity than do city environments. These results will contribute to the development of a research field dedicated to forest medicine, which may be used as a strategy for preventive medicine.

Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environ Health Prev Med. 2010 Jan;15(1):18-26. doi: 10.1007/s12199-009-0086-9. PMID: 19568835; PMCID: PMC2793346.

Disease-specific research: Cancer

The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies

Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. For both pathologies, factors such as poverty, lack of physical activity (PA), poor dietary intake, and climate change increase risk of adverse outcomes. Prior research has shown that greenspaces and other nature-based interventions (NBIs) contribute to improved health outcomes and climate change resilience. Of 2565 articles retrieved, 31 articles were considered. (26 articles studied cardiovascular related outcomes and 5 studied cancer-related outcomes.) Interventions were coded into 4 categories: forest bathing, green exercise, gardening, and nature viewing. Outcomes included blood pressure (BP), cancer-related quality of life (QoL) and (more infrequently) biomarkers of CVD risk. (1) Clinical implication: Healthcare providers should consider the promotion of nature-based programs to improve health outcomes. (2) Policy implication: There is a need for investment in equitable greenspaces to improve health outcomes and build climate resilientneighborhoods. (3) Research or academic implication: Research partnerships with community-based organizations for a comprehensive study of benefits associated with NBIs should be encouraged to reduce health disparities and ensure intergenerational health equity. There is a need for investigation of the mechanisms by which NBIs impact CVD and exploration of the role of CVD biological markers of inflammation among cancer survivors.

Bikomeye JC, Balza JS, Kwarteng JL, Beyer AM, Beyer KMM. The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies. PLoS One. 2022;17(11):e0276517. doi: 10.1371/journal.pone.0276517. 

The effect of nature as positive distractibility on the Healing Process of Patients with cancer in therapeutic settings. 

Environmental design has a positive effect on patient health. The aim of this study was to examine the effect of nature on positive distraction on the Healing Process of Patients with Cancer.

This research is a descriptive-correlational study which conducted on 80 cancer patients in an educational center with two different outlooks (natural view and no natural view) in Hamadan, Iran from March to May 2017. Patients were selected by convenience sampling method based on inclusion criteria. Two kinds of questionnaires were distributed among who view natural landscapes (nature group) and who don’t view natural landscapes (no nature group). Two groups compared in terms of pain and anxiety.

Findings of the study indicate that admitted patients viewing natural scenery had less anxiety and painthan admitted patients viewing no natural scenes.

Conclusion: Natural scenes caused to reduce the pain and anxiety, so using this healing power of nature leads to positive distraction.
Emami E, Amini R, Motalebi G. The effect of nature as positive distractibility on the Healing Process of Patients with cancer in therapeutic settings. Complement Ther Clin Pract. 2018 Aug;32:70-73. doi: 10.1016/j.ctcp.2018.05.005. Epub 2018 May 24. PMID: 30057062.

Cardiovascular

The Effects of Forest Therapy on the Blood Pressure and Salivary Cortisol Levels of Urban Residents: A Meta-Analysis.

Urban residents have a higher risk of hypertension and psychological stress than rural residents. Aside from medical interventions, understanding how to control hypertension and alleviate the stress of urban populations has become a public concern. As an alternative medical measure, forest therapy has shown the effects of normalizing blood pressure (BP) and reducing stress increasingly in recent literature, but this is still inconclusive. In order to systematically verify forest therapy’s effects on the BP and mental stress of urban residents, we conducted meta-analyses to assess the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and salivary cortisol concentration (SCC; a stress biomarker) between the forest therapy group and urban control group. 21 studies on BP involving 2270 participants and 13 studies on SCC involving 1786 participants were included. Through the meta-analysis, the mean difference and confidence interval (CI) estimates indicated that forest therapy significantly reduced participants’ SBP, DBP and SCC as compared with urban control. After forest therapy, older participants

and those with higher baseline SBP levels had greater SBP-lowering effects. In subgroup analyses, we discovered that longer-term forest therapy programs (≥20 min) resulted in a greater reduction in BP and SCC than shorter-term forest therapy programs (<20 min). Additionally, seated viewing, walking, or multi-session programs in forests were observed to have similar effects on reducing BP and SCC. Overall, we conclude that forest therapy programs have beneficial therapeutic effects on urban residents’ physio-psychological health through lowering BP and relieving stress (reducing SCC). This finding provides solid evidence of the contribution of forest therapy to urban residents’ health and wellbeing.

Qiu Q, Yang L, He M, Gao W, Mar H, Li J, Wang G. The Effects of Forest Therapy on the Blood Pressure and Salivary Cortisol Levels of Urban Residents: A Meta-Analysis. Int J Environ Res Public Health. 2022;20(1):458. doi: 10.3390/ijerph20010458.

Forest Bathing Always Makes Sense: Blood Pressure-Lowering and Immune System-Balancing Effects in Late Spring and Winter in Central Europe

Various formats of forest bathing have been receiving increasing attention owing to their perspectives in health promotion and the treatment of chronic lifestyle diseases. The majority of field studies are still being conducted in the Far Eastern region, and they often make psychological assessments mainly in the green season. In our pretest-posttest field experiment, twelve healthy, working-age volunteers participated in a 2-h leisurely forest walking program, first in the green season (May) and then in the winter season (January), in the Mecsek Hills, next to Pécs, Hungary.

Systolic blood pressure decreased after the trips both in late spring and in the winter. We detected the stimulation of NKbright cells and activation of all examined immune cell subsets in the green season. In the winter, a slight activating and an interesting balancing effect regarding TIM-3 could be observed considering our finding that basal (pretest) TIM-3 expression by NK cells was significantly lower in the winter. Our work expands the knowledge of and potential of forest medicine.

Peterfalvi A, Meggyes M, Makszin L, Farkas N, Miko E, Miseta A, Szereday L. Forest Bathing Always Makes Sense: Blood Pressure-Lowering and Immune System-Balancing Effects in Late Spring and Winter in Central Europe. Int J Environ Res Public Health. 2021 Feb 20;18(4):2067. doi: 10.3390/ijerph18042067. PMID: 33672536; PMCID: PMC7923773.

Forest Bathing Is Better than Walking in Urban Park: Comparison of Cardiac and Vascular Function between Urban and Forest Parks.

Forest bathing is beneficial for human health. To investigate whether walking in forest or urban parks affects cardiovascular functions (CVFs), the present study was conducted in five forest trails in the Xitou Experimental Forest and in five urban parks in Taipei city. We recruited 25 adult volunteers for an observational pilot study in forest parks and urban parks. CVFs were assessed by measuring the arterial pressure waveform. The baseline and paired differences of systolic BP (SBP), central end SBP, heart rate, left ventricle (LV) dP/dt max and cardiac output in participants were lower before and after walking in a forest park than those in an urban park. In addition, the systemic vascular compliance and brachial artery compliance of those who walked in a forest park were significantly higher compared with those in an urban park. This study provides evidence of the potential beneficial effects of walking exercise in forest parks on CVFs.

Tsao TM, Hwang JS, Lin ST, Wu C, Tsai MJ, Su TC. Forest Bathing Is Better than Walking in Urban Park: Comparison of Cardiac and Vascular Function between Urban and Forest Parks. Int J Environ Res Public Health. 2022 Mar 15;19(6):3451. doi: 10.3390/ijerph19063451. PMID: 35329139; PMCID: PMC8949865.

Effects of forest bathing on pre-hypertensive and hypertensive adults: a review of the literature.

The aim in this literature review was to explore the physiologically and psychologically therapeutic benefits of forest bathing on adults suffering from pre-hypertension or hypertension, and to identify the type, duration, and frequency of an effective forest bathing intervention in the management of pre-hypertension and hypertension, so as to provide directions for future interventions or research. Of the 364 articles that were identified, 14 met the criteria for inclusion in this review. The synthesis of the findings in the included studies revealed that forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants. Forest walking and forest therapy programs were the two most effective forest bathing interventions. Studies reported that practicing a single forest walking or forest therapy program can produce short-term physiological and psychological benefits.

It is concluded that forest bathing, particularly forest walking and therapy, has physiologically and psychologically relaxing effects on middle-aged and elderly people with pre-hypertension and hypertension.

Yau KK, Loke AY. Effects of forest bathing on pre-hypertensive and hypertensive adults: a review of the literature. Environ Health Prev Med. 2020 Jun 22;25(1):23. doi: 10.1186/s12199-020-00856-7. PMID: 32571202; PMCID: PMC7310560.

Mental Health

Effects of Plant-Emitted Monoterpenes on Anxiety Symptoms: A Propensity-Matched Observational Cohort Study.

Immersive experiences in green areas, particularly in forests, have long been known to produce beneficial effects for human health. However, the exact determinants and mechanisms leading to healthy outcomes remain to be elucidated. The purpose of this observational cohort study was to investigate whether inhaling plant-emitted biogenic volatile compounds, namely monoterpenes (MTs), can produce specific effects on anxiety symptoms. Data from 505 subjects participating in 39 structured forest therapy sessions at different Italian sites were collected. The air concentration of monoterpenes was measured at each site. STAI state questionnaires were administered before and after the sessions as a measure of anxiety. A propensity score matching analysis was then performed, considering an above-average exposure to inhalable air MTs as the treatment. The estimated effect was −1.28 STAI-S points (95% C.I. −2.51 to −0.06, p = 0.04), indicating that the average effect of exposure to high MT air concentrations during forest therapy sessions was to decrease anxiety symptoms.

Donelli D, Meneguzzo F, Antonelli M, et al. Effects of Plant-Emitted Monoterpenes on Anxiety Symptoms: A Propensity-Matched Observational Cohort Study. Int J Environ Res Public Health. 2023;20(4):2773. Published 2023 Feb 4. doi:10.3390/ijerph20042773

An integrative review of the evidence for Shinrin-Yoku (Forest Bathing) in the management of depression and its potential clinical application in evidence-based osteopathy

There is growing interest in the idea of integrating Nature Therapies into the multidisciplinary management of complex conditions such as depression. Shinrin-Yoku (Forest Bathing), a practice involving spending time in a forested environment while paying attention to multi-sensory stimuli has been proposed as one such modality.

The objectives of this review were to critically analyse the current evidence base on the efficacy of Shinrin-Yoku for the treatment of depression, and to examine how the findings may reflect and/or inform osteopathic principles and clinical practice. An integrative review of the evidence for Shinrin-Yoku in the management of depression published between 2009 and 2019 was conducted resulting in n = 13 peer-reviewed studies meeting inclusion criteria. Two themes emerged from the literature, the positive effect of Shinrin-Yoku on self-reported mood scores, and physiological changes arising from forest exposure. However, the methodological quality of the evidence is poor and experiments may not be generalisable. Suggestions were made for improving the research base via mixed-method studies in a biopsychosocial framework, and aspects of the research which may be applicable to evidence-based osteopathy were noted.

Doran-Sherlock R, Devitt S, Sood P. An integrative review of the evidence for Shinrin-Yoku (Forest Bathing) in the management of depression and its potential clinical application in evidence-based osteopathy. J Bodyw Mov Ther. 2023;35:244-255. doi: 10.1016/j.jbmt.2023.04.038. 

Effects of forest bathing (shinrin-yoku) on serotonin in serum, depressive symptoms and subjective sleep

We previously found that a forest bathing (shinrin-yoku) program significantly reduced the scores for depression, anxiety, anger, fatigue, and confusion and increased the score for vigor in the profile of mood states (POMS) test and showed a potential preventive effect on the depressive status in both males and females. In the present study, we investigated the effects of a forest bathing program on the level of serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males.

Twenty healthy male subjects aged 57.3 « 8.4 years were selected after obtaining informed consent. These subjects took day trips to a forest park, the birthplace of forest bathing in Japan named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture, and to an urban area of Nagano Prefecture as a control in June 2019. On both trips, they walked 2.5km for 2

hours each in the morning and afternoon on Saturday and Sunday, respectively. Blood was sampled in the afternoon before and after each trip. Concentrations of serotonin and lactic acid in serum were measured. The POMS test and a questionnaire for subjective sleep quality were conducted before and after the trips. Ambient temperature and humidity were monitoring during the trips.

The forest bathing program significantly increased level of serotonin in serum, and significantly increased the score for vigor and decreased the score for fatigue in the POMS test. The forest bathing program also improved the sleepiness on rising and feeling refreshed (recovery from fatigue) in the Oguri-Shirakawa-Azumi sleep inventory MA version (OSA-MA).

Taken together, the present study suggests that forest bathing may have potential preventive effects on depression (depressive status).

Li Q, Ochiai H, Ochiai T, Takayama N, Kumeda S, Miura T, Aoyagi Y, Imai M. Effects of forest bathing (shinrin-yoku) on serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males. Environ Health Prev Med. 2022;27:44. doi: 10.1265/ehpm.22-00136. PMID: 36328588; PMCID: PMC9665960.

The influence of forest therapy camp on depression in alcoholics.

The objective of this study is to evaluate the effect of a forest experience on the levels of depression of alcoholics. Prior to the study, 92 alcoholics were divided into treatment and control groups. During the summer of 2009, the treatment group participated in a series of forest therapy programs, while the control group followed their normal daily routines. Both groups were re-tested upon completion of the program by the treatment group and the depression levels compared. There was a significant improvement in the depression level of alcoholics who had participated in the forest camp program (treatment group). Those participants in their 40s who had severe levels of depression at the beginning of the program showed the most significant improvement during the program experience. The forest therapy camp experience can considerably reduce and ameliorate the depression levels of alcoholics.

Shin WS, Shin CS, Yeoun PS. The influence of forest therapy camp on depression in alcoholics. Environ Health Prev Med. 2012 Jan;17(1):73-6. doi: 10.1007/s12199-011-0215-0. Epub 2011 Apr 19. PMID: 21503628; PMCID: PMC3258312.

Effects of Urban Forest Therapy Program on Depression Patients

Depression is a common serious mental health condition that can have negative personal and social consequences, and managing it is critical for treating depression patients. Forest therapy is emerging as a promising non-pharmacological intervention to improve mental health. However, although the effectiveness of forest therapy programs using forests far from the city has been proven, it is not well known that urban forests can be easily accessed in daily life. Therefore, this study aimed to examine the effects of an urban forest therapy program on depression symptoms, sleep quality, and somatization symptoms of depression patients.

A total of 47 depression patients participated in this study (22 in the urban forest therapy program group and 25 in the control group). The Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HRSD), the Pittsburgh Sleep Quality Index (PSQI), and the Patient Health Questionnaire-15 (PHQ-15) were administered to each participant to assess the effects of the urban forest therapy program. The results of this study revealed that depression patients in the urban forest therapy program had significantly alleviated depression symptoms and improved sleep quality and somatization symptoms compared to the control group. In conclusion, this study demonstrates the possibility that the urban forest therapy program could be used as an effective non-pharmacological treatment to alleviate depression disorder. 

Yeon PS, Kim IO, Kang SN, Lee NE, Kim GY, Min GM, Chung CY, Lee JS, Kim JG, Shin WS. Effects of Urban Forest Therapy Program on Depression Patients. Int J Environ Res Public Health. 2022;20(1):507. doi: 10.3390/ijerph20010507.

Spirituality

Spirituality and Well-Being: Theory, Science, and the Nature Connection

The links between spirituality and eudaimonic well-being are examined, beginning with a look at theoretical issues as to whether spirituality is best construed as part of well-being, or as a possible influence on well-being. A brief review of scientific findings from the MIDUS study linking religion and spirituality to well-being and other outcomes is then provided to show recent empirical work on these topics. Suggestions for future work are also provided. The third section is forward-thinking and addresses the power of nature to nurture spirituality and well-being, beginning with a look at how current research has linked nature to human flourishing. Issues of spirituality are rarely mentioned in this literature, despite evidence that nature has long been a source of inspiration in poetry, literature, art, and music. These works reveal that the natural world speaks to the human soul. To explore such ideas, parts of Jungian psychology are revisited: the soul’s longing for poetry, myth, and metaphor; the importance of animism, which sees nature as a field inhabited by spirit; and the devaluing of ancient cultures. The final section considers the wisdom of the indigenous peoples who saw spirit in everything. Their inputs, exemplified with “Two-Eyed Seeing”, offer new visions for thinking about the interplay of spirituality, well-being, and the natural world.

Spirituality and Well-Being: Theory, Science, and the Nature Connection Carol D. Ryff Citation: Ryff, Carol D. 2021. Spirituality and Well-Being: Theory, Science, and the Nature Connection. Religions 12: 914. https://doi.org/ 10.3390/rel12110914 Academic Editor: Pninit Russo-Netzer Received: 15 September 2021 Accepted: 14 October 2021 Published: 21 October 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2021 by the author. Licensee MDPI, Basel, Switzerland. Institute on Aging, Department of Psychology, University of Wisconsin-Madison, Madison, WI 53706, USA; [email protected]

The Interrelationship of Shinrin-Yoku and Spirituality: A Scoping Review

Shinrin-yoku (SY; Forest Bathing) is an integrative practice known to improve humans’ physiologic and psychologic health and well-being by mindfully using the five human senses while relaxing in natural environments. In addition, it may be effective in enhancing or revealing human spirituality. The World Health Organization defines an individual’s well-being as an awareness of one’s fullest possible physical, psychologic, social, spiritual, and economic self. Recent evidence suggests that nature promotes spiritual well-being. Hence, the authors performed a scoping review of the literature with regard to the evidence of the interrelationship of SY/nature and spirituality with an aim to identify gaps in knowledge and assist with furthering empirical research. Of 30 publications, 13 met the eligibility criteria and were included in the synthesis. The authors discovered that, despite the different research methodologies and publications, nature may have a positive effect on human spirituality and, therefore, enriching individuals’ well-being. SY is an integrative practice that may enhance or actualize human spirituality. More research is needed to determine the interrelationship of SY and human spirituality in achieving one’s fullest possible self.

Hansen MM, Jones R. The Interrelationship of Shinrin-Yoku and Spirituality: A Scoping Review. J Altern Complement Med. 2020;26(12):1093-1104. doi: 10.1089/acm.2020.0193. 

The Interrelationship of Shinrin-Yoku and Spirituality: A Scoping Review

Hansen MM, Jones R. The Interrelationship of Shinrin-Yoku and Spirituality: A Scoping Review. J Altern Complement Med. 2020;26(12):1093-1104. doi: 10.1089/acm.2020.0193

Virtual Forest Bathing

Physiological Benefits of Viewing Nature: A Systematic Review of Indoor Experiments
In this systematic review, from 2019 current peer-reviewed articles regarding the physiological effects of visual stimulation from elements or representations of nature in an indoor setting were examined . The articles were analyzed for their stimulation method, physiological measures applied, groups of participants, and outcomes. Thirty-seven articles presenting evidence of the physiological effects of viewing nature were selected. The majority of the studies that used display stimuli, such as photos, 3D images, virtual reality, and videos of natural landscapes, confirmed that viewing natural scenery led to more relaxed body responses than viewing the control. Studies that used real nature stimuli reported that visual contact with flowers, green plants, and wooden materials had positive effects on cerebral and autonomic nervous activities compared with the control. Accumulation of scientific evidence of the physiological relaxation associated with viewing elements of nature would be useful for preventive medicine, specifically nature therapy.

Jo H, Song C, Miyazaki Y. Physiological Benefits of Viewing Nature: A Systematic Review of Indoor Experiments. Int J Environ Res Public Health. 2019;16(23):4739. Published 2019 Nov 27. doi:10.3390/ijerph16234739

The Effect of Forest Video Using Virtual Reality on the Stress Reduction of University Students Focused on C University in Korea.

The purpose of this study from 2021 is to study the effect of forest videos using virtual reality (VR) on the stress of college students. The study subjects were 60 college students who watched two-dimensional (2D) and VR videos, and we compared their control heart rate variability (HRV) and electroencephalogram (EEG). As a result of the above, it was investigated that forest videos using VR had a positive effect on the physiological stress on college students. Therefore, it is expected that a positive effect will occur if VR is used as an alternative to stress management for college students.

Jo SH, Park JS, Yeon PS. The Effect of Forest Video Using Virtual Reality on the Stress Reduction of University Students Focused on C University in Korea. Int J Environ Res Public Health. 2021;18(23):12805. Published 2021 Dec 4. doi:10.3390/ijerph182312805

Effect of Viewing Video Representation of the Urban Environment and Forest Environment on Mood and Level of Procrastination.

To measure the impact of the forest environment on the level of procrastination of the subjects, a randomized experiment was carried out, in which the subjects watched in random order (on different days) one of two 15-min videos: one showing a walk in the forest area and one showing a walk in an urban environment (control). We measured the level of so-called ‘fluid procrastination’ including three aspects: ‘lack of energy to do the work’, ‘inability to get to work’ and ’pessimistic attitude to do the work’ with a set of questions the respondents completed before and after the experiment. The results showed that one aspect of fluid procrastination (‘pessimistic attitude to do the work’) can be effectively lowered by watching a video showing the forest environment. In contrast, watching a video of an urban environment increased the procrastination levels for two other aspects of procrastination (‘lack of energy to do the work’, ‘inability to get to work’). We also measured three other parameters before and after the experiment: mood state, restoration and vitality. Watching the video from forest area raised mood and restoration and watching the video from urban area, decreased mood, vitality and restoration.The study suggests that watching a video showing forest landscapes could be used as an effective remedy for problems related to procrastination among students.

Bielinis E, Simkin J, Puttonen P, Tyrväinen L. Effect of Viewing Video Representation of the Urban Environment and Forest Environment on Mood and Level of Procrastination. Int J Environ Res Public Health. 2020;17(14):5109. Published 2020 Jul 15. doi:10.3390/ijerph17145109

Physiological and Psychological Effects of Watching Videos of Different Durations Showing Urban Bamboo Forests with Varied Structures

This study from 2021 illustrated the physiological and psychological effects of watching videos of different durations showing  bamboo forests with varied structures. Physiological indicators, including EEG (electroencephalogram), blood pressure, skin conductance, and pulse, were monitored in 180 Chinese university students (mean age: 20.72 ± 2.56 years) while they were watching bamboo videos. Before and after watching the videos, their psychological indicators, including positive and negative moods, were measured using the Profile of Mood States questionnaire. After watching the bamboo videos of different durations, all of the physiological indicators responded to the stimulation after only 1 min.

Wang Y, Jiang M, Huang Y, et al. Physiological and Psychological Effects of Watching Videos of Different Durations Showing Urban Bamboo Forests with Varied Structures. Int J Environ Res Public Health. 2020;17(10):3434. Published 2020 May 14. doi:10.3390/ijerph17103434

Immune System

Studies will follow.

Pain

Studies will follow.

Pulmonary Disease

Studies will follow.

Sleep Disorders

Studies will follow.

Stress Burnout

Studies will follow.

Increased Environmental Consciousness

Nature Connection as Spirituality, Wellbeing Practice, and Subjective Activism

Nature connection is promoted as a way to increase personal wellbeing and as a solution to the ecological crisis. At the same time, however, the practice may be characterized as a new way of consuming nature and of training to become more skilled consumers of natural landscapes. The practices consist to a large degree of exercises of sensory attention and of ritual-like activities that enhance and redirect practitioners’ attention to the landscape, which lead to an experience of being a subject among other subjects. In this article, I will analyse what I heuristically refer to as the nature connection movement as a practice at the junction between personal wellbeing and social activism and ask how its practice alters practitioners’ experience of nature and what the social implications of that alteration may be. Against the backdrop of what has been called the subjective turn, a turn towards inner experience as the main point of reference, we may also speak of subjective activism, i.e., activism with an inward direction but with social ambitions.

Nature Connection as Spirituality, Wellbeing Practice, and Subjective Activism

Ohlsson, HenrikSödertörn University, School of Historical and Contemporary Studies, The Study of Religions. ORCID iD: 0000-0002-2335-0471 2022 (English) In: New Spiritualties and the Cultures of Well-being / [ed] Géraldine Mossière, Cham: Springer Nature, 2022, p. 153-168

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