What Activities in Forests Are Beneficial for Human Health? A Systematic Review

Abstract

Over the past decade, clinical trials of forest-based interventions have increased, leading to their recognition as preventive medicine. However, little is known about the differences in health effects according to the activity characteristics of interventions. This study aimed to understand the types of activities and their associated health effects to identify differences in health effects between activities. PubMed, PsycINFO, Web of Science, and Scopus databases were searched, and methodological quality was assessed using Cochrane ROB2. A total of 32 randomized controlled trials (RCTs) met the eligibility criteria. Health outcomes were collected from 6264 participants aged 6–98 years, and the sample size was 12–585. The Interventions were walking (n = 21), staying (n = 7), exercise (n = 4), indirect exposure (n = 4), and the activity time was between 10 and 240 min. Overall, walking showed consistent positive health effects, and there were differences in effects on anxiety and depression, cognitive function, stress hormone, and inflammation according to the activity. However, most of the included studies had a high risk of bias, and interventions were limited to specific activities, durations, and frequencies. Although a few limitations remain, the findings in this study are of great significance in providing the basis for the design of forest-based interventions.

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

“…Accumulated research provided positive evidence of nature-based therapy for the prevention and treatment of mental health problems, reduction of stress hormone levels, health regulating effects of green space, etc. ( Dzhambov et al, 2020 ; Park et al, 2022 ).…”

“…The progressive growth of systemic reviews and meta-analyses suggested that the research showed a tendency from early empirical knowledge to potential non-pharmacological treatments, which will help nature therapy serve as preventive medicine to reduce medical expenditures of the whole society ( Yeon et al, 2021 ; Park et al, 2022 ). However, it is noteworthy that the systematic errors can affect the accuracy of the results of meta-analyses, such as different search strategies, selection criteria, research heterogeneity, and misestimated effect sizes caused by a small number of primary studies ( Mikolajewicz and Komarova, 2019 ; Rojas-Rueda et al, 2019 ; Rosa et al, 2021 ; Stier-Jarmer et al, 2021 ; Yeon et al, 2021 ; Park et al, 2022 ).…”

“…The progressive growth of systemic reviews and meta-analyses suggested that the research showed a tendency from early empirical knowledge to potential non-pharmacological treatments, which will help nature therapy serve as preventive medicine to reduce medical expenditures of the whole society ( Yeon et al, 2021 ; Park et al, 2022 ). However, it is noteworthy that the systematic errors can affect the accuracy of the results of meta-analyses, such as different search strategies, selection criteria, research heterogeneity, and misestimated effect sizes caused by a small number of primary studies ( Mikolajewicz and Komarova, 2019 ; Rojas-Rueda et al, 2019 ; Rosa et al, 2021 ; Stier-Jarmer et al, 2021 ; Yeon et al, 2021 ; Park et al, 2022 ). Accordingly, future meta-analyses should pay attention to the comprehensiveness of the publication language and time in search strategies, the quality of selected articles, and more cautious interpretation of the results ( Mikolajewicz and Komarova, 2019 ; Rojas-Rueda et al, 2019 ; Rosa et al, 2021 ; Stier-Jarmer et al, 2021 ; Yeon et al, 2021 ; Park et al, 2022 ).…”

Is altitude a determinant of the health benefits of nature exposure? A systematic review and meta-analysis

“…Additionally, more than half of the included studies did not provide a detailed randomization process and preregistered analysis plan. Thus, future investigations should utilize trial registry platforms and sophisticated randomization methods to improve the quality of evidence (15,208).…”

“…A recent surge in scientific and clinical trials on nature and health has led to the social acceptance of nature-based interventions (13)(14)(15)(16). Mounting evidence confirms the significant association between nature and health (1,(17)(18)(19); therefore, the World Health Organization and other health entities have emphasized nature as a health-promoting resource.…”