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The Psychological and Physical Effects of Forests on Human Health: A Systematic Review of Systematic Reviews and Meta-Analyses

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  • Marita Stier-Jarmer

    (Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany
    Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany)

  • Veronika Throner

    (Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany
    Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany)

  • Michaela Kirschneck

    (Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany
    Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany)

  • Gisela Immich

    (Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany
    Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany)

  • Dieter Frisch

    (Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany
    Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany)

  • Angela Schuh

    (Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany
    Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, 81377 Munich, Germany)

Abstract

Background: The aim of this systematic review of systematic reviews was to identify, summarise, and synthesise the available evidence of systematic reviews (SRs) and meta-analyses (MAs) on the preventative and therapeutic psychological and physical effects of forest-based interventions. Methods: Both bibliographic databases and grey literature sources were searched for SRs and MAs published until May 2020. Eight databases were searched for relevant articles: MEDLINE, Embase, Web of Science, Cochrane Library, PsycInfo, CiNii, EBSCO, and Scopus. Grey literature was sourced from Google Scholar and other web-based search tools. SRs and MAs that included randomised controlled (RCT), non-randomised controlled (NRCT), and non-controlled trials (NCT) on health-related effects of forest-based interventions were eligible if they had searched at least two databases. The methodological quality of eligible reviews was assessed by AMSTAR-2. Results: We evaluated 11 systematic reviews covering 131 different primary intervention studies, mostly from Asian countries, three of which included supplementary meta-analyses. 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. Discussion/Conclusions: Evidence suggests beneficial therapeutic effects of forest-based interventions on hypertension, stress, and mental-health disorders, such as depression and anxiety. Changes in immunological and inflammatory parameters after forest therapy should be verified in bio-geographically native forests. In the future, more attention should be paid to careful planning, implementation, and reporting of primary studies and to systematic reviews on the effects of forest-based interventions.

Suggested Citation

  • Marita Stier-Jarmer & Veronika Throner & Michaela Kirschneck & Gisela Immich & Dieter Frisch & Angela Schuh, 2021. "The Psychological and Physical Effects of Forests on Human Health: A Systematic Review of Systematic Reviews and Meta-Analyses," IJERPH, MDPI, vol. 18(4), pages 1-39, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1770-:d:497865
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    References listed on IDEAS

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    2. Quan Qiu & Ling Yang & Mei He & Wen Gao & Harrison Mar & Jiyue Li & Guangyu Wang, 2022. "The Effects of Forest Therapy on the Blood Pressure and Salivary Cortisol Levels of Urban Residents: A Meta-Analysis," IJERPH, MDPI, vol. 20(1), pages 1-20, December.
    3. Eun Young Park & Min Kyung Song & Mi Young An, 2023. "Experiences of Forest Healing Instructors Who Met Cancer Patients in Forest Healing Programs: FGI Research," IJERPH, MDPI, vol. 20(5), pages 1-12, March.
    4. Daniela Huber & Johanna Freidl & Christina Pichler & Michael Bischof & Martin Kiem & Renate Weisböck-Erdheim & Gabriella Squarra & Vincenzo De Nigris & Stefan Resnyak & Marcel Neberich & Susanna Bordi, 2023. "Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial," IJERPH, MDPI, vol. 20(2), pages 1-20, January.
    5. Kwang-Hi Park, 2022. "Analysis of Urban Forest Healing Program Expected Values, Needs, and Preferred Components in Urban Forest Visitors with Diseases: A Pilot Survey," IJERPH, MDPI, vol. 19(1), pages 1-14, January.
    6. Yunjeong Yi & Eunju Seo & Jiyeon An, 2022. "Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials," IJERPH, MDPI, vol. 19(17), pages 1-21, August.
    7. Christina Pichler & Johanna Freidl & Michael Bischof & Martin Kiem & Renate Weisböck-Erdheim & Daniela Huber & Gabriella Squarra & Paul Clemens Murschetz & Arnulf Hartl, 2022. "Mountain Hiking vs. Forest Therapy: A Study Protocol of Novel Types of Nature-Based Intervention," IJERPH, MDPI, vol. 19(7), pages 1-17, March.
    8. Emi Morita & Hiroshi Kadotani & Naoto Yamada & Tae Sasakabe & Sayo Kawai & Mariko Naito & Takashi Tamura & Kenji Wakai, 2024. "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 Coh," IJERPH, MDPI, vol. 21(3), pages 1-12, March.
    9. Eleanor M. Taylor & Noelle Robertson & Courtney J. Lightfoot & Alice C. Smith & Ceri R. Jones, 2022. "Nature-Based Interventions for Psychological Wellbeing in Long-Term Conditions: A Systematic Review," IJERPH, MDPI, vol. 19(6), pages 1-23, March.
    10. Dorothy Day Huntsman & Grzegorz Bulaj, 2022. "Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression," IJERPH, MDPI, vol. 19(4), pages 1-16, February.
    11. Kyung-Sook Bang & Sungjae Kim & Gumhee Lee & Sinyoung Choi & Da-Ae Shin & Misook Kim, 2021. "The Development of a Health Promotion Program for Unmarried Mothers Living in Residential Facilities Using Urban Forests: An Intervention Mapping Approach Based on the Transtheoretical Model," IJERPH, MDPI, vol. 18(16), pages 1-19, August.
    12. Vito Imbrenda & Rosa Coluzzi & Francesca Mariani & Bogdana Nosova & Eva Cudlinova & Rosanna Salvia & Giovanni Quaranta & Luca Salvati & Maria Lanfredi, 2023. "Working in (Slow) Progress: Socio-Environmental and Economic Dynamics in the Forestry Sector and the Contribution to Sustainable Development in Europe," Sustainability, MDPI, vol. 15(13), pages 1-21, June.
    13. Sujin Park & Yeji Choi & Geonwoo Kim & Eunsoo Kim & Soojin Kim & Domyung Paek, 2021. "Physiological and Psychological Assessments for the Establishment of Evidence-Based Forest Healing Programs," IJERPH, MDPI, vol. 18(17), pages 1-42, September.
    14. Elena Bermejo-Martins & María Pueyo-Garrigues & María Casas & Raúl Bermejo-Orduna & Ana Villarroya, 2022. "A Forest Bathing Intervention in Adults with Intellectual Disabilities: A Feasibility Study Protocol," IJERPH, MDPI, vol. 19(20), pages 1-12, October.
    15. Mi-Jung Kang & Hyun-Sun Kim & Ji-Yeon Kim, 2022. "Effects of Forest-Based Interventions on Mental Health: A Meta-Analysis of Randomized Controlled Trials," IJERPH, MDPI, vol. 19(8), pages 1-13, April.
    16. Adriano Bressane & Rogério Galante Negri & Irineu de Brito Junior & Liliam César de Castro Medeiros & Isabela Lopes Lima Araújo & Mirela Beatriz Silva & Amanda Louisi dos Santos Galvão & Graziele Cora, 2022. "Association between Contact with Nature and Anxiety, Stress and Depression Symptoms: A Primary Survey in Brazil," Sustainability, MDPI, vol. 14(17), pages 1-10, August.
    17. Shravan G. Aras & J. Ray Runyon & Josh B. Kazman & Julian F. Thayer & Esther M. Sternberg & Patricia A. Deuster, 2024. "Is Greener Better? Quantifying the Impact of a Nature Walk on Stress Reduction Using HRV and Saliva Cortisol Biomarkers," IJERPH, MDPI, vol. 21(11), pages 1-16, November.
    18. Takafumi Abe & Kenta Okuyama & Tsuyoshi Hamano & Miwako Takeda & Masayuki Yamasaki & Minoru Isomura & Kunihiko Nakano & Kristina Sundquist & Toru Nabika, 2021. "Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(9), pages 1-11, April.
    19. Poung-Sik Yeon & Jin-Young Jeon & Myeong-Seo Jung & Gyeong-Min Min & Ga-Yeon Kim & Kyung-Mi Han & Min-Ja Shin & Seong-Hee Jo & Jin-Gun Kim & Won-Sop Shin, 2021. "Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(23), pages 1-27, December.
    20. Matthew Owens & Hannah L. I. Bunce, 2022. "Nature-Based Meditation, Rumination and Mental Wellbeing," IJERPH, MDPI, vol. 19(15), pages 1-19, July.
    21. Davide Donelli & Francesco Meneguzzo & Michele Antonelli & Diego Ardissino & Giampaolo Niccoli & Giorgio Gronchi & Rita Baraldi & Luisa Neri & Federica Zabini, 2023. "Effects of Plant-Emitted Monoterpenes on Anxiety Symptoms: A Propensity-Matched Observational Cohort Study," IJERPH, MDPI, vol. 20(4), pages 1-16, February.
    22. Derrien, Monika M. & Bratman, Gregory N. & Cerveny, Lee K. & Levy, Chaja & Blahna, Dale J. & Frank, Paulo & Serio, Naomi, 2024. "Public nature and health for homeless populations: Professionals’ perceptions of contingent human benefits and harms," Social Science & Medicine, Elsevier, vol. 347(C).

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