Nature Therapy: The Physiological Effects of Nature on Humans

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Foods foods	4.7	7.4	2012	14.5 Days	CHF 2900
Forests forests	2.4	4.4	2010	16.2 Days	CHF 2600
International Journal of Environmental Research and Public Health ijerph	-	7.3	2004	25.8 Days	CHF 2500
Sustainability sustainability	3.3	6.8	2009	19.7 Days	CHF 2400
Urban Science urbansci	2.1	4.3	2017	20.7 Days	CHF 1600

12 pages, 526 KiB

Open AccessArticle

The Inverse Association between the Frequency of Forest Walking (Shinrin-yoku) and the Prevalence of Insomnia Symptoms in the General Japanese Population: A Japan Multi-Institutional Collaborative Cohort Daiko Study

by Emi Morita, Hiroshi Kadotani, Naoto Yamada, Tae Sasakabe, Sayo Kawai, Mariko Naito, Takashi Tamura and Kenji Wakai

Int. J. Environ. Res. Public Health 2024, 21(3), 350; https://doi.org/10.3390/ijerph21030350 - 15 Mar 2024

Cited by 2 | Viewed by 2843

Abstract

Since a single forest walk (Shinrin-yoku or forest bathing) session is reported to improve sleep temporarily, occasional forest walks may have a positive effect on daily sleep. Therefore, this study aimed to examine whether more frequent forest walking is associated with better daily [...] Read more.

Since a single forest walk (Shinrin-yoku or forest bathing) session is reported to improve sleep temporarily, occasional forest walks may have a positive effect on daily sleep. Therefore, this study aimed to examine whether more frequent forest walking is associated with better daily sleep conditions. Data from the second survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Daiko Study conducted among residents of Nagoya City, Japan, were used. The study design was a cross-sectional study. In total, 2044 participants (529 men and 1515 women; age, mean ± standard deviation: 58.8 ± 9.9 years) were included in the analysis. Frequent forest walks were associated with a low percentage of insomnia symptoms (Insomnia Severity Index ≥10) in women, but not in men. The adjusted odds ratio for the group that rarely took forest walks with reference to the group that engaged in the activity once a month or more often was 2.04 (95% confidence interval: 1.29–3.23) in women. Forest walk frequency was not significantly associated with sleep duration or sleep efficiency as measured by actigraphy in either men or women. In conclusion, the results suggested that increasing the frequency of forest walks or Shinrin-yoku may be effective in preventing insomnia in women. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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19 pages, 1059 KiB

Open AccessReview

The Impact of Forest Therapy Programs on Stress Reduction: A Systematic Review

by Yawei Zhang, Lu Feng and Wenjie Duan

Forests 2023, 14(9), 1851; https://doi.org/10.3390/f14091851 - 12 Sep 2023

Cited by 4 | Viewed by 7135

Abstract

This systematic review aims to examine key findings of previous studies in order to explore how forest therapy programs impact stress reduction on physiological and psychological levels. It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). [...] Read more.

This systematic review aims to examine key findings of previous studies in order to explore how forest therapy programs impact stress reduction on physiological and psychological levels. It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Quantitative studies that compared forest therapy program interventions with urban exposure were searched in February 2023 in six databases: CINAHL, EMBASE, Medline, PsycINfo, PubMed, and Web of Science (core collection). This review included 17 relevant articles selected from a total of 495 individual studies, in accordance with the set inclusion and exclusion criteria. The results of this review indicated that forest therapy programs were effective at relieving stress, particularly on a psychological level. Forest therapy programs could be used as a part of stress reduction projects. However, results regarding physiological effects have yet to be confirmed, and in the future, more in-depth and well-designed research will be required. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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20 pages, 547 KiB

Open AccessArticle

Restorative Environmental Perception’s Influence on Post-Tour Behavior of Desert Off-Road Self-Driving Tourists: The Mediating Role of Flow Experience

by Cai Li and Jingyi He

Sustainability 2023, 15(17), 12934; https://doi.org/10.3390/su151712934 - 28 Aug 2023

Cited by 7 | Viewed by 2271

Abstract

Desert tourism has always been one of the main types of adventure tourism in the world. Restorative environmental perception and flow experience are closely related concepts in adventure activities, but few studies have examined the mechanisms of their effects on tourists’ post-tour behaviors. [...] Read more.

Desert tourism has always been one of the main types of adventure tourism in the world. Restorative environmental perception and flow experience are closely related concepts in adventure activities, but few studies have examined the mechanisms of their effects on tourists’ post-tour behaviors. Desert off-road self-driving tours, as a typical adventure tourism project, are suitable for studying the relationships among three factors. We chose the Kumutag Desert as our study area, as it attracts many off-road self-driving tourists every year. Based on SOR theory, data were collected through questionnaires, and partial least squares structural equation models were constructed using SmartPLS 3.0 software. It was found that (1) restorative environmental perception has a direct positive impact on visitors’ flow experiences; (2) flow experience has a direct positive influence on tourists’ revisit behaviors and recommendation behaviors; (3) novelty, escape, fascination, and compatibility in restorative environmental perception have a direct positive influence on tourists’ post-tour behaviors; (4) flow experience partially mediates the relationships among novelty, escape, fascination, compatibility, and post-tour behavior. This article deepens the understanding of the mechanism by which restorative environmental perception and flow experience affect tourists’ post-tour behaviors while expanding the scope through three studies and providing theoretical support for subsequent research on adventure tourism. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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13 pages, 1314 KiB

Open AccessArticle

Additional Health Benefits Observed following a Nature Walk Compared to a Green Urban Walk in Healthy Females

by Yvanna Todorova, Izzy Wellings, Holly Thompson, Asya Barutcu, Lewis James, Nicolette Bishop, Emma O’Donnell, Colin Shaw and Daniel P. Longman

Urban Sci. 2023, 7(3), 85; https://doi.org/10.3390/urbansci7030085 - 15 Aug 2023

Cited by 4 | Viewed by 4764

Abstract

Chronic stress and obesity are major public health concerns and represent significant risk factors for a plethora of non-communicable diseases. Physical exercise represents a valuable health intervention in both cases, providing benefits for mental and physical health, as well as appetite regulation. While [...] Read more.

Chronic stress and obesity are major public health concerns and represent significant risk factors for a plethora of non-communicable diseases. Physical exercise represents a valuable health intervention in both cases, providing benefits for mental and physical health, as well as appetite regulation. While the emerging field of ‘green exercise’ suggests that the presence of nature may amplify the benefits of exercise, the quality of evidence has been questioned. To address this, we recruited 22 healthy females to complete a crossover randomised trial comprising a 75 min walk in both a forest and urban area, separated by 2–7 days. Markers of mood (Profile of Mood States), stress (sympathetic-adreno-medullar [resting heart rate, blood pressure] and hypothalamic–pituitary axis activation [salivary cortisol]) and eating behaviour (energy intake and salivary ghrelin) were measured before and after each walk. While both walking interventions improved mood and reduced physiological stress, the nature intervention (but not the urban intervention) also led to further improvements in total mood disturbance, depression, confusion and esteem-related affect (F_(1,21)

\geq

4.98, p

\leq

0.037). Salivary ghrelin (F₍₂₀₎ = 0.229, p = 0.637) and energy intake (t₍₂₀₎ = −0.54, p = 0.60) did not respond differently in the two environments. Overall, while walking improved mood and physiological stress in both environments, walking in a forested environment provided additional benefits for mood not seen following the urban walk. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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16 pages, 1172 KiB

Open AccessArticle

Nature Photographs as Complementary Care in Chemotherapy: A Randomized Clinical Trial

by Giulia Catissi, Leticia Bernardes de Oliveira, Elivane da Silva Victor, Roberta Maria Savieto, Gustavo Benvenutti Borba, Erika Hingst-Zaher, Luciano Moreira Lima, Sabrina Bortolossi Bomfim and Eliseth Ribeiro Leão

Int. J. Environ. Res. Public Health 2023, 20(16), 6555; https://doi.org/10.3390/ijerph20166555 - 10 Aug 2023

Cited by 3 | Viewed by 2828

Abstract

The incidence of cancer cases is increasing worldwide, and chemotherapy is often necessary as part of the treatment for many of these cases. Nature-based interventions have been shown to offer potential benefits for human well-being. Objective: This study aims to investigate the outcome [...] Read more.

The incidence of cancer cases is increasing worldwide, and chemotherapy is often necessary as part of the treatment for many of these cases. Nature-based interventions have been shown to offer potential benefits for human well-being. Objective: This study aims to investigate the outcome of nature images on clinical symptom management related to chemotherapy. Methods: A randomized clinical trial was conducted in an outpatient cancer unit of a private hospital in Brazil, with 173 participants over the age of 18 who were undergoing chemotherapy and had signed an informed consent form. The intervention consisted of the presentation of a 12-min video featuring nature images categorized under the themes of Tranquility, Beauty, Emotions Up, or Miscellany. Images were sourced from the e-Nature Positive Emotions Photography Database (e-NatPOEM), a publicly available collection of affectively rated images. Sociodemographic and clinical data, as well as the participants’ connection to nature, were investigated. The Positive Affect/Negative Affect Scale (PANAS) and the Edmonton Symptom Assessment System (ESAS) were applied pre- and post-intervention. Results: Data showed very strong evidence of a reduction in negative affect for the intervention group (p < 0.001) and moderate evidence for the control group (p = 0.034). There was also a significant reduction in the intervention group for pain (p < 0.001), tiredness (p = 0.002), sadness (p < 0.001), anxiety (p < 0.001), and appetite (p = 0.001). The Beauty video had the best performance, while the Tranquility video showed no significant improvement in any of the symptoms evaluated. These findings suggest that images of nature may be a valuable tool to help control clinical and psychological symptoms in cancer patients undergoing chemotherapy. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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13 pages, 964 KiB

Open AccessArticle

Social Return on Investment of Nature-Based Activities for Adults with Mental Wellbeing Challenges

by Ned Hartfiel, Heli Gittins, Val Morrison, Sophie Wynne-Jones, Norman Dandy and Rhiannon Tudor Edwards

Int. J. Environ. Res. Public Health 2023, 20(15), 6500; https://doi.org/10.3390/ijerph20156500 - 2 Aug 2023

Cited by 5 | Viewed by 2721

Abstract

Increased time spent in nature can enhance physical health and mental wellbeing. The UK Government’s ‘25 Year Environment Plan’ recommends extending the health benefits of contact with nature to a wider group of people, including those with mental health challenges. This study investigated [...] Read more.

Increased time spent in nature can enhance physical health and mental wellbeing. The UK Government’s ‘25 Year Environment Plan’ recommends extending the health benefits of contact with nature to a wider group of people, including those with mental health challenges. This study investigated whether nature-based interventions (NBIs) for people with mild mental health challenges could generate a positive social return on investment (SROI). Between May 2017 and January 2019, 120 participants at six outdoor sites in Wales participated in a 6 to 12-week NBI, which consisted of a weekly 2- to 4-h session. Quantitative data were collected from baseline and follow-up questionnaires identifying participant demographics and measuring mental wellbeing, physical activity, self-efficacy, and social trust. Wellbeing valuation generated a range of social value ratios by applying the Housing Association Charitable Trust (HACT) Social Value Calculator (SVC 4.0) and HACT Mental Health Social Value Calculator (MHSVC 1.0). Seventy-four participants (62%) completed follow-up questionnaires at 6 months. SROI ratios were calculated using the SVC for physical activity, self-efficacy, and social trust. The MHSVC generated social value ratios for mental wellbeing. The base case results revealed a positive social value ratio for participants, ranging from British Pound Sterling (GBP) 2.57 to GBP 4.67 for every GBP 1 invested, indicating favourable outcomes in terms of value generated. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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13 pages, 2933 KiB

Open AccessArticle

Physiological Effects of Visual Stimulation by a Japanese Low Wooden Table: A Crossover Field Experiment

by Harumi Ikei, Hyunju Jo and Yoshifumi Miyazaki

Int. J. Environ. Res. Public Health 2023, 20(14), 6351; https://doi.org/10.3390/ijerph20146351 - 12 Jul 2023

Cited by 1 | Viewed by 2663

Abstract

The purpose of this study was to evaluate the physiological effects of visual stimulation by a unique Japanese low wooden table on the prefrontal cortex and autonomic nervous activities. A within-participants experiment with 26 male university students was conducted in a Japanese-style room. [...] Read more.

The purpose of this study was to evaluate the physiological effects of visual stimulation by a unique Japanese low wooden table on the prefrontal cortex and autonomic nervous activities. A within-participants experiment with 26 male university students was conducted in a Japanese-style room. The visual stimuli were a low wooden table (WT) made of Japanese cypress and a low cloth-covered table (control) for an exposure time of 90 s. Near-infrared spectroscopy was used to measure the prefrontal cortex activity in the left and right prefrontal cortices as an indicator of oxyhemoglobin (oxy-Hb) concentration. Autonomic nervous activity was measured as an indicator of sympathetic (low-frequency/high-frequency component ratio, LF/HF), and parasympathetic (high-frequency components, HF) nervous activities were assessed by heart rate variability. Furthermore, the modified semantic differential method and the Profile of Mood States 2nd edition were used to measure psychological responses. Physiologically, the oxy-Hb concentration in the left prefrontal cortex and ln (LF/HF) were significantly lower during visual exposure to the WT than to the control. Psychologically, more comfortable, relaxed, and natural impressions, as well as improved mood states, were reported during visual stimulation to the WT than to the control. This study demonstrated that viewing a WT led to physiological relaxation and had a positive psychological effect on the participants. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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19 pages, 8600 KiB

Open AccessArticle

Do All Types of Restorative Environments in the Urban Park Provide the Same Level of Benefits for Young Adults? A Field Experiment in Nanjing, China

by Yuanbi Li, Jinguang Zhang, Bijun Jiang, Hongyi Li and Bing Zhao

Forests 2023, 14(7), 1400; https://doi.org/10.3390/f14071400 - 9 Jul 2023

Cited by 14 | Viewed by 3468

Abstract

Previous research has consistently shown that exposure to natural environments provides a variety of health benefits. The purpose of this study is to investigate the restorative benefits of non-virtual environments in field experiments as well as the differences in physiological and psychological effects [...] Read more.

Previous research has consistently shown that exposure to natural environments provides a variety of health benefits. The purpose of this study is to investigate the restorative benefits of non-virtual environments in field experiments as well as the differences in physiological and psychological effects between different types of restorative sites for stressed young adults. This controlled study design used the Positive and Negative Affect Schedule (PANAS), electroencephalogram (EEG), and heart rate variability (HRV) as psychophysiological indicators of individual affect and stress. We used a “stress imposition-greenspace recovery” pre- and post-test mode to simulate the most realistic short-term recovery experience in the park (Grassplots, Square, Forest, and Lakeside) under relatively free conditions. The experimental results show that all four natural spaces in the park have some degree of recovery. However, there were discernible differences in the restorative effects of four selected natural sites. Lakeside and Forest demonstrated the most robust restorative properties in terms of both negative emotion reduction and positive emotion enhancement. In contrast, Square showed the weakest facilitation of recovery, while Grassplots promoted moderate resilience. Physiologically, we found that the EEG-α% of the Square was significantly lower than the EEG-α% of the Forest (t = −3.56, p = 0.015). This means that stressed young adults were much more relaxed in the forest than in the paved square. The study answers which types of natural spaces, when considered together, would provide greater restorative benefits to stressed young people participating in natural therapies in urban parks. The study’s policy implications include the need to create more green natural spaces, especially forests with multiple plant levels, as well as to improve the restorative nature of urban parks through appropriate landscape space design. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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14 pages, 3670 KiB

Open AccessArticle

Gender Differences and Optimizing Women’s Experiences: An Exploratory Study of Visual Behavior While Viewing Urban Park Landscapes in Tokyo, Japan

by Ruochen Ma, Yuxin Luo and Katsunori Furuya

Sustainability 2023, 15(5), 3957; https://doi.org/10.3390/su15053957 - 22 Feb 2023

Cited by 11 | Viewed by 3854

Abstract

Improving the inclusiveness of urban green spaces and enabling various groups to equally enjoy their benefits is the basis of sustainable urban development. Urban park design generally starts from a gender-neutral perspective, ignoring differences in needs related to gender, particularly women’s sensitivity to [...] Read more.

Improving the inclusiveness of urban green spaces and enabling various groups to equally enjoy their benefits is the basis of sustainable urban development. Urban park design generally starts from a gender-neutral perspective, ignoring differences in needs related to gender, particularly women’s sensitivity to the environment. This study focused on visual perception and explored gender differences and proposed causes of visual-behavior differences while viewing landscapes. We used photo data from Mizumoto Park in Tokyo and recruited 16 master’s students living nearby to participate in an eye-tracking experiment. The results indicate that men and women have different eye-movement patterns and that elemental ratios affect eye movement behavior more among women than men. Moreover, this study found that men gaze longer at trees and more briefly at shrubs, flowers, and artificial elements than women. Attention-grabbing paths/grounds had a negative effect on the aesthetic evaluation of the scene among women but not men. Based on these findings, suggestions for optimizing women’s experiences at the visual level are proposed for aspects of vegetation density, visual focus, and road design. This study informs park design and improvement with the premise that gender alters the perception of these environments. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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15 pages, 1857 KiB

Open AccessArticle

Research on the Relationship between the Environmental Characteristics of Pocket Parks and Young People’s Perception of the Restorative Effects—A Case Study Based on Chongqing City, China

by Huiyun Peng, Xiangjin Li, Tingting Yang and Shaohua Tan

Sustainability 2023, 15(5), 3943; https://doi.org/10.3390/su15053943 - 21 Feb 2023

Cited by 13 | Viewed by 2949

Abstract

Work and life stresses can cause spiritual fatigue and emotional tension, threatening the physical and psychological health of young people. Several studies have demonstrated the important role and value of pocket parks in the emotional and spiritual refreshment of people. This study quantitatively [...] Read more.

Work and life stresses can cause spiritual fatigue and emotional tension, threatening the physical and psychological health of young people. Several studies have demonstrated the important role and value of pocket parks in the emotional and spiritual refreshment of people. This study quantitatively evaluated the perceived restorative effects associated with the environmental characteristics of a pocket park, and determined the relationships between the physical-environmental characteristics, psychological-environmental characteristics and the restorative effects. In this study, pocket parks in Chongqing City were chosen as the study areas, and a total of 25 sample pictures of the parks were chosen for analysis. Each picture was quantized into 14 physical-environmental indices and three psychological-environmental indices for measurement of the restorative effect. The results showed that the environmental characteristics of parks with a restorative effect include naturality, sense of distance, charm and privacy. The physical-environmental characteristics related to young people’s restoration and their degree of influence were determined through quantitative analysis. Moreover, a prediction model of the environmental restoration effect of pocket parks was established. The research conclusions can provide a reference for the evaluation and comparison of the environmental restoration performance of pocket parks and the design of restorative pocket parks. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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9 pages, 2751 KiB

Open AccessBrief Report

Physiological and Psychological Responses of Viewing a Waterfall Image: A Crossover Study

by Hyunju Jo, Harumi Ikei and Yoshifumi Miyazaki

Int. J. Environ. Res. Public Health 2023, 20(1), 565; https://doi.org/10.3390/ijerph20010565 - 29 Dec 2022

Cited by 5 | Viewed by 2872

Abstract

Growing interest in the relaxation effect of nature has elicited demands for scientific verification of the various natural elements. This study investigated the physiological and psychological responses of 27 females in their 20 s to viewing a waterfall and urban images (control) presented [...] Read more.

Growing interest in the relaxation effect of nature has elicited demands for scientific verification of the various natural elements. This study investigated the physiological and psychological responses of 27 females in their 20 s to viewing a waterfall and urban images (control) presented via a large, high-resolution display for 90 s. High-frequency [HF] for parasympathetic nervous activity and the ratio of low-frequency (LF)/[LF + HF] for sympathetic nervous activity by heart rate variability and heart rate were recorded. Simultaneous changes in oxyhemoglobin concentration in the prefrontal cortex were recorded by near-infrared time-resolved spectroscopy. The modified semantic differential method and Profile of Mood States Second Edition were used to assess the psychological effects on the participants after viewing each image. The results showed that viewing the waterfall image, compared with viewing the urban image, (1) increased sympathetic nervous activity; (2) provided comfortable, relaxed, and natural impressions; (3) improved mood states. In conclusion, visual contact with a waterfall image physiologically activated sympathetic nervous activity and psychologically evoked positive moods and feelings. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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11 pages, 1759 KiB

Open AccessArticle

Effects of Vegetation Structure on Psychological Restoration in an Urban Rooftop Space

by Juyoung Lee, Minji Kang, Sungku Lee and Seoyong Lee

Int. J. Environ. Res. Public Health 2023, 20(1), 260; https://doi.org/10.3390/ijerph20010260 - 24 Dec 2022

Cited by 11 | Viewed by 3091

Abstract

Connectedness to nature has been recognized as an important factor for well-being, with rooftop green spaces being used for stress reduction in modern cities. This study aimed to examine psychological and physiological responses to three different vegetation models on an urban rooftop. An [...] Read more.

Connectedness to nature has been recognized as an important factor for well-being, with rooftop green spaces being used for stress reduction in modern cities. This study aimed to examine psychological and physiological responses to three different vegetation models on an urban rooftop. An analysis of psychological parameters indicated that the existence of vegetation in rooftop spaces could have positive effects on mood states, and the size of the effect was greater in a structured vegetation design than in a monotonous one. An analysis of the physiological parameters of heart rate variability and systolic blood pressure indicated that greater restorative effects are elicited from the use of vertical elements, such as shrubs and trees, added to grassy areas than from concrete environments. However, a fully enclosed vegetation with trees was not associated with higher parasympathetic activities than a half-open vegetation model. Based on these findings, an open and structured vegetation design that includes both grass and shrubs may have more potential for stress reduction than a monotonous vegetation model. A larger volume of vegetation was not necessarily linked to higher psychological and physiological benefits. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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16 pages, 3945 KiB

Open AccessReview

Perspectives on the Psychological and Physiological Effects of Forest Therapy: A Systematic Review with a Meta-Analysis and Meta-Regression

by Sung Ryul Shim, JinKyung Chang, JooHee Lee, WooJin Byeon, Jeongwon Lee and Kyung Ju Lee

Forests 2022, 13(12), 2029; https://doi.org/10.3390/f13122029 - 30 Nov 2022

Cited by 7 | Viewed by 3542

Abstract

The effects of urbanization on the health of city dwellers have spurred research on the health-promoting benefits of forest exposure, and potential health-promoting benefits of human-nature relationships. In this meta-analysis, meta-regression, and systematic review, we aimed to analyze how forest-based interventions improved overall [...] Read more.

The effects of urbanization on the health of city dwellers have spurred research on the health-promoting benefits of forest exposure, and potential health-promoting benefits of human-nature relationships. In this meta-analysis, meta-regression, and systematic review, we aimed to analyze how forest-based interventions improved overall well-being through psychological and physiological changes by examining psychological scores and biomarkers. In December 2021, systematic searches were conducted on bibliographic databases (PubMed, Embase, and Cochrane) for studies involving psychological scores and physiological indicators. Data from 17 studies with 1418 participants showed that psychological symptoms (anxiety, depression, anger, fatigue, confusion, vigor), systolic blood pressure (BP), and malondialdehyde levels significantly improved in the forest-exposed group compared to in the nonexposed group, with high heterogeneity (I² = 66%–93%). Well-being-related psychological symptoms (friendliness, well-being, attention deficit hyperactivity disorder, self-esteem) and physiological markers (diastolic BP and cortisol) exhibited better tendencies in the forest-exposed group, with high heterogeneity (I² = 16%–91%), and meta-regression showed that moderators (age, country group, number of participants, study design, female participation rate, BMI) were significantly associated with forest-related therapeutic effects. In conclusion, forest visits have health-promoting effects that reduce the incidence of stress and lifestyle-related diseases, and are positively associated with psychological and physiological health. Full article

(This article belongs to the Topic Nature Therapy: The Physiological Effects of Nature on Humans)

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