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Special Issue "Effects of Alpine Natural Health Resources on Human Health and Wellbeing"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 March 2023 | Viewed by 13315

Special Issue Editors

Dr. Arnulf Josef Hartl
E-Mail Website
Chief Guest Editor
Institute of Ecomedicine, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria
Interests: ecomedicine, microbial biodiversity and immunology; evidence-based health tourism; public health in alpine regions
Institute of Ecomedicine, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria
Interests: green and white exercise in alpine space; allergy and asthma; microbiome and immunology, prevention; rehabilitation
Institute of Ecomedicine, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria
Interests: green and white exercise in alpine space; musculoskeletal physiotherapy; prevention; rehabilitation

Special Issue Information

Dear Colleagues,

A Special Issue of the International Journal of Environmental Research and Public Health on “Effects of Alpine Natural Health Resources on Human Health and Wellbeing” is being organized. For detailed information on the journal, we refer you to the following webpage: https://www.mdpi.com/journal/ijerph.

The Alpine region, with its unique nature, terrain, climate, and cultural heritage, offers numerous opportunities to promote human health and wellbeing. A growing number of scientific studies have highlighted the crucial link between the loss of nature and poor physiological, psychological, and social health. Scientific evidence increasingly shows that contact with nature provides a wide range of health benefits.

Traditional alpine health resources, as well as the alpine terrain, show a huge potential with respect to research on evidence-based health supporting activities. The potential of Alpine health resources and associated activities, such as green and white exercise, balneotherapy, or special inhalation therapies—to name just a few examples—may offer new opportunities in health maintenance, prevention, treatment, and rehabilitation of certain diseases.

Thus, for this Special Issue, we welcome contributions related to “Effects of Alpine Natural Health Resources on Human Health and Wellbeing”. The keywords below provide an overview of some of the possible areas of interest.

Dr. Arnulf Josef Hartl
Dr. Johanna Freidl
Dr. Daniela Huber
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ecomedicine
  • alpine health resources
  • green and white exercise in alpine space
  • health maintenance, prevention, treatment, and rehabilitation in alpine space
  • alpine microbiome
  • evidence-based health tourism
  • climate change and public health in alpine regions
  • nature relatedness, nature connection

Published Papers (8 papers)

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Research

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Article
Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2023, 20(2), 1469; https://doi.org/10.3390/ijerph20021469 - 13 Jan 2023
Cited by 1 | Viewed by 1010
Abstract
Background: Lifelong physical activity is related to longer health span, which is reflected at an individual level, and is of substantial socioeconomic relevance. Sedentary lifestyles, on the other hand, pose an increasingly major public health problem. In addition, the COVID-19 pandemic had a [...] Read more.
Background: Lifelong physical activity is related to longer health span, which is reflected at an individual level, and is of substantial socioeconomic relevance. Sedentary lifestyles, on the other hand, pose an increasingly major public health problem. In addition, the COVID-19 pandemic had a negative impact on activity levels and well-being. Previous research indicates that contact with nature might improve exercise levels as well as well-being. Methods: This randomized, controlled clinical trial (ANKER-study) investigated the effects of two types of nature-based therapies (forest therapy and mountain hiking) in couples (FTG: n = 23; HG: n = 22;) with a sedentary or inactive lifestyle on health-related quality of life, relationship quality and other psychological and physiological parameters. Results: The results of this study displayed that healthy and highly functioning women and men with sedentary lifestyles mentally benefit from contact with nature (quality of life, satisfaction with life, mood, internal and external health-related control beliefs). The gender-specific effect on women is most visible in the physiological outcomes (hemopoietic system, aerobic capacity, skeletal muscle mass and hydration) of mountain hiking. Men and women showed small improvements in blood pressure as a result of the interventions. Conclusions: The ANKER-study provides a method for valid comparison of forest therapy interventions for the first time. Regarding the COVID-19 pandemic, the nature-based intervention presented could offer a multimodal contribution to maintaining a more active lifestyle, further contact with nature that affects peoples physical as well as mental health, and an improvement in social interaction. Full article
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Article
Assessment of Exercise Intensity for Uphill Walking in Healthy Adults Performed Indoors and Outdoors
Int. J. Environ. Res. Public Health 2022, 19(24), 16662; https://doi.org/10.3390/ijerph192416662 - 12 Dec 2022
Viewed by 874
Abstract
Background: Borg’s rating of perceived exertion (BRPE) scale is a simple, but subjective tool to grade physical strain during exercise. As a result, it is widely used for the prescription of exercise intensity, especially for cardiovascular disease prevention. The purpose of this study [...] Read more.
Background: Borg’s rating of perceived exertion (BRPE) scale is a simple, but subjective tool to grade physical strain during exercise. As a result, it is widely used for the prescription of exercise intensity, especially for cardiovascular disease prevention. The purpose of this study was to assess and compare relationships between BRPE and physiological measures of exercise intensity during uphill walking indoors and outdoors. Methods: 134 healthy participants [median age: 56 years (IQR 52–63)] completed a maximal graded walking test indoors on a treadmill using the modified Bruce protocol, and a submaximal 1 km outdoor uphill cardio-trekking test (1 km CTT). Heart rate (HR) and oxygen consumption (V̇O2) were continuously measured throughout both tests. BRPE was simultaneously assessed at the end of each increment on the treadmill, while the maximal BRPE value was noted at the end of the 1 km CTT. Results: On the treadmill, BRPE correlated very high with relative HR (%HRmax) (ρ = 0.88, p < 0.001) and V̇O2 (%V̇O2max) (ρ = 0.89, p < 0.001). During the 1 km CTT, a small correlation between BRPE and %HRmax (ρ = 0.24, p < 0.05), respectively %V̇O2max was found (ρ = 0.24, p < 0.05). Conclusions: Criterion validity of BRPE during uphill walking depends on the environment and is higher during a treadmill test compared to a natural environment. Adding sensor-based, objective exercise-intensity parameters such as HR holds promise to improve intensity prescription and health safety during uphill walking in a natural environment. Full article
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Article
Sustainability of Hiking in Combination with Coaching in Cardiorespiratory Fitness and Quality of Life
Int. J. Environ. Res. Public Health 2022, 19(7), 3848; https://doi.org/10.3390/ijerph19073848 - 24 Mar 2022
Cited by 2 | Viewed by 1499
Abstract
Although strong evidence shows that physical inactivity and sedentary behavior are associated with many negative health outcomes, inactive lifestyles are still increasing. Consequently, new approaches must be developed to increase adherence to an active lifestyle and hence a longer life. Green exercise and [...] Read more.
Although strong evidence shows that physical inactivity and sedentary behavior are associated with many negative health outcomes, inactive lifestyles are still increasing. Consequently, new approaches must be developed to increase adherence to an active lifestyle and hence a longer life. Green exercise and health coaching could be effective ways to induce long-lasting lifestyle changes geared towards more physical activity. In this randomized controlled trial, we investigated the effects of mountain hiking and psychological coaching on adults with a sedentary lifestyle. The coaching group (n = 26) participated in a 7-day guided hiking program with three personal coaching sessions, whereas the hiking group (n = 32) received no coaching. The effects on aerobic capacity, spirometry and quality of life were assessed at baseline (day 0), after the intervention week (day 7) and after 80 days. Fully nonparametric statistical analysis revealed a gender-based effect for aerobic capacity—the female participants of the coaching group showed a greater improvement (p = 0.03) than the hiking group. No significant effects were found for spirometry. Quality of life parameters improved in both groups. In conclusion, both green exercise and health coaching are capable of inducing improvements in health-related quality of life and cardiorespiratory fitness. No superior effects of health coaching were found. Full article
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Article
Geography Matters, But… Evolving Success Factors for Nature-Oriented Health Tourism within Selected Alpine Destinations
Int. J. Environ. Res. Public Health 2021, 18(10), 5389; https://doi.org/10.3390/ijerph18105389 - 18 May 2021
Cited by 3 | Viewed by 1964
Abstract
This paper analyzes the success factors of health tourism based on natural attractions in selected European spa and health destinations. The natural resources included in the offers, such as water, salt, and air, play a central role in this context, as their evidence-based [...] Read more.
This paper analyzes the success factors of health tourism based on natural attractions in selected European spa and health destinations. The natural resources included in the offers, such as water, salt, and air, play a central role in this context, as their evidence-based effects have a high relevance for the health and wellbeing of tourists. Due to its specific geographical location and considering the threat of climate change, however, this offer is facing increasing challenges which make adaptation strategies necessary. In addition to a conceptional introduction to the topic, this paper contains a descriptive analysis of tourism statistics and the results from self-administered questionnaires with six selected representatives from alpine health destinations (DE, FR, IT, AT, CH, SI). The results show varying forms of health tourism based on natural attractions, which are also reflected in online marketing, with potential for optimization. The web research and the responses to the questionnaire revealed that evidence-based studies hardly play a role in promoting health touristic offers. Furthermore, climate change effects on natural attractions are considered extremely small and tend to prompt the development of new offers. Health destinations are advised to generate a clearer focus on the risks of climate change regarding natural resources. Full article
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Article
Health Promotion as a Motivational Factor in Alpine Cycling
Int. J. Environ. Res. Public Health 2021, 18(5), 2321; https://doi.org/10.3390/ijerph18052321 - 26 Feb 2021
Cited by 1 | Viewed by 1558
Abstract
The present study examines motives for cycling in the alpine region and focuses on the relative importance of health promotion with respect to other motives. Furthermore, the influences of person-specific characteristics on the rank of the motives are examined, and possibilities for advertising [...] Read more.
The present study examines motives for cycling in the alpine region and focuses on the relative importance of health promotion with respect to other motives. Furthermore, the influences of person-specific characteristics on the rank of the motives are examined, and possibilities for advertising bike tourism based on these motives and characteristics are derived. By applying a quantitative approach, a total of 175 cyclists were surveyed using questionnaires on person-specific characteristics, motives, and their relevance for alpine cycling. Data analysis revealed that health promotion is the most important motive for alpine cycling after fun and action as well as nature experience. Further health-related motives such as stress reduction are also perceived as important. The social component, on the other hand, was given the least priority. The results also showed that person-specific characteristics influence the relative importance of motives. For example, elderly persons and people with children perceive the motive of health promotion as the most important. The study shows that the health-promoting effect of alpine cycling is noticed and may be further encouraged. This study demonstrates that alpine cyclists are a heterogeneous group and that health benefits are perceived by various sub-groups therein. Therefore, any marketing for alpine cycling needs to reflect the diversity of cyclists, and approaches need to be adapted according to the respective target group. Full article
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Article
Sudden Cardiac Death Risk in Downhill Skiers and Mountain Hikers and Specific Prevention Strategies
Int. J. Environ. Res. Public Health 2021, 18(4), 1621; https://doi.org/10.3390/ijerph18041621 - 08 Feb 2021
Cited by 5 | Viewed by 1800
Abstract
Sudden cardiac death (SCD) still represents an unanticipated and catastrophic event eliciting from cardiac causes. SCD is the leading cause of non-traumatic deaths during downhill skiing and mountain hiking, related to the fact that these sports are very popular among elderly people. Annually, [...] Read more.
Sudden cardiac death (SCD) still represents an unanticipated and catastrophic event eliciting from cardiac causes. SCD is the leading cause of non-traumatic deaths during downhill skiing and mountain hiking, related to the fact that these sports are very popular among elderly people. Annually, more than 40 million downhill skiers and mountain hikers/climbers visit mountainous regions of the Alps, including an increasing number of individuals with pre-existing chronic diseases. Data sets from two previously published case-control studies have been used to draw comparisons between the SCD risk of skiers and hikers. Data of interest included demographic variables, cardiovascular risk factors, medical history, physical activity, and additional symptoms and circumstances of sudden death for cases. To establish a potential connection between the SCD risk and sport-specific physical strain, data on cardiorespiratory responses to downhill skiing and mountain hiking, assessed in middle-aged men and women, have been included. It was demonstrated that previous myocardial infarction (MI) (odds ratio; 95% CI: 92.8; 22.8–379.1; p < 0.001) and systemic hypertension (9.0; 4.0–20.6; p < 0.001) were predominant risk factors for SCD in skiers, but previous MI (10.9; 3.8–30.9; p < 0.001) and metabolic disorders like hypercholesterolemia (3.4; 2.2–5.2; p < 0.001) and diabetes (7.4; 1.6–34.3; p < 0.001) in hikers. More weekly high-intensity exercise was protective in skiers (0.17; 0.04–0.74; p = 0.02), while larger amounts of mountain sports activities per year were protective in hikers (0.23; 0.1–0.4; <0.001). In conclusion, previous MI history represents the most important risk factor for SCD in recreational skiers and hikers as well, and adaptation to high-intensity exercise is especially important to prevent SCD in skiers. Moreover, the presented differences in risk factor patterns for SCDs and discussed requirements for physical fitness in skiers and hikers will help physicians to provide specifically targeted advice. Full article
Article
Psychological Variables Related to Developmental Changes during Adolescence—A Comparison between Alpine and Non-Alpine Sport Participants
Int. J. Environ. Res. Public Health 2020, 17(21), 7879; https://doi.org/10.3390/ijerph17217879 - 27 Oct 2020
Viewed by 1297
Abstract
Alpine sport is a popular form of exercise and provides several skills that are potentially relevant for positive development during adolescence. However, empirical data on differences between alpine and non-alpine sport participants in variables related to developmental changes are lacking. Therefore, the primary [...] Read more.
Alpine sport is a popular form of exercise and provides several skills that are potentially relevant for positive development during adolescence. However, empirical data on differences between alpine and non-alpine sport participants in variables related to developmental changes are lacking. Therefore, the primary aim of the present study was to analyze differences in self-esteem and additional variables between adolescent alpine and non-alpine sport participants. A comparison to non-regular exercisers was conducted for self-esteem. In a cross-sectional design, information on self-esteem, sensation seeking, agency, and emotion regulation was collected in 183 adolescents [(mean age: 15.4 (SD: 2.3) years, 71.0% female)]. Alpine sport participants reported significantly higher self-esteem compared to non-regular exercisers, p = 0.003, d = 0.95, but not compared to non-alpine sport participants, p = 0.774, d = 0.06. When controlling for sex and high-risk sport engagement, alpine sport participants showed a significantly higher experience of agency compared to non-alpine sport participants, p = 0.016, d = 0.46. We conclude that alpine sport participation is less relevant with regard to self-esteem compared to regular exercise. However, the characteristics of alpine sport might provide a trigger for higher experience of agency during sport participation, potentially helping to satisfy the increased need for autonomy and independence in adolescence. Full article

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Study Protocol
Mountain Hiking vs. Forest Therapy: A Study Protocol of Novel Types of Nature-Based Intervention
Int. J. Environ. Res. Public Health 2022, 19(7), 3888; https://doi.org/10.3390/ijerph19073888 - 24 Mar 2022
Cited by 3 | Viewed by 2167
Abstract
Introduction: The global rise of urbanization has much triggered scientific interest in how nature impacts on human health. Natural environments, such as alpine landscapes, forests, or urban green spaces, are potential high-impact health resources. While there is a growing body of evidence to [...] Read more.
Introduction: The global rise of urbanization has much triggered scientific interest in how nature impacts on human health. Natural environments, such as alpine landscapes, forests, or urban green spaces, are potential high-impact health resources. While there is a growing body of evidence to reveal a positive influence of these natural environments on human health and well-being, further investigations guided by rigorous evidence-based medical research are very much needed. Objective: The present study protocol aims at testing research methodologies in the context of a prospective clinical trial on nature-based interventions. This shall improve the standards of medical research in human–nature interactions. Methods: The ANKER Study investigates the influence of two novel types of nature-based therapy—mountain hiking and forest therapy—on physiological, psychological, and immunological parameters of couples with a sedentary lifestyle. Two intervention groups were formed and spent a seven-day holiday in Algund, Italy. The “forest therapy group” participated in daily guided low-power nature connection activities. The “hiking group”, by contrast, joined in a daily moderate hiking program. Health-related quality of life and relationship quality are defined as primary outcomes. Secondary outcomes include nature connection, balance, cardio-respiratory fitness, fractional exhaled nitric oxide, body composition and skin hydration. Furthermore, a new approach to measure health-related quality of life is validated. The so-called “intercultural quality of life” comic assesses the health-related quality of life with a digitally animated comic-based tool. Full article
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Authors: Wolfgang Schobesberger and Cornelia Blank

Affiliation: Institute for Sports Medicine, Alpine Medicine and Health Tourism; University for Health Sciences, Medical Informatics and Technology, Hall/Tirol & Tirol Kliniken GmbH, Innsbruck, Austria

Title: Can multiple short vacations boost the positive effects on health and sleep quality? A experimental study

 

Authors: Daniela Huber, Johanna Freidl, Arnulf Josef Hartl, et al.

Affiliation: Institut for Ecomedicine, Paracelus Privatmedizinische Universität, 5020 Salzburg, Austria

Title: Long-term effects of mountain hiking versus Forest Therapy – the ANKER-Study: A randomized controlled trial

 

Authors: Johanna Freidl, Daniela Huber, Arnulf Josef Hartl, et al.

Affiliation: Institut for Ecomedicine, Paracelus Privatmedizinische Universität, 5020 Salzburg, Austria

Title: Short-term effects of mountain hiking versus Forest Therapy – the ANKER-Study: A randomized controlled trial

 

Authors: Christina Pichler, Renate Weisböck-Erdheim, Arnulf Josef Hartl, et al.

Affiliation:Institut for Ecomedicine, Paracelus Privatmedizinische Universität, 5020 Salzburg, Austria

Title: Nature interventions: The role of health-related quality of life as assessment criterion

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