Therapeutic Effects of Forest Bathing on Human Health: A Systematic Review
DOI:
https://doi.org/10.12775/JEHS.2025.82.60242Keywords
forest bathing, Shinrin-yoku, human health, well-beingAbstract
Introduction and Purpose: This comprehensive review aims to synthesize and analyze the existing scientific literature concerning the multifaceted impact of forest bathing, also known as shinrin-yoku, on human health and overall well-being. We will delve into the historical origins of shinrin-yoku while also meticulously examining the specific health domains.
Materials and Methods: A systematic search of the PubMed database was conducted to extract relevant articles published between 1975 and 2023. The search strategy employed the following key terms: "forest bathing," "shinrin-yoku," "human health," and "well-being."
Results: The analysis of the retrieved data revealed a consistent pattern of beneficial physiological effects associated with forest bathing. Specifically, a reduction in heart rate, as well as systolic and diastolic blood pressure, was observed in individuals who participated in forest excursions. The biogenic volatile organic compounds (BVOCs) emitted by forest vegetation were shown to exert potent anti-inflammatory effects, inhibiting inflammatory processes implicated in conditions such as asthma, atopic dermatitis (AD), and rheumatoid arthritis (RA). Notably, a lower incidence of COVID-19 was observed in densely forested areas, potentially attributable to the natural barrier effect of forest vegetation against viral transmission and the lower levels of air pollution prevalent in these environments. Shinrin-yoku was also found to play a crucial role in maintaining mental health. In patients with dementia symptoms, forest bathing interventions resulted in improvements in language function and memory, among other cognitive domains.
Conclusions: Forest bathing represents an accessible and cost-effective intervention that holds significant potential for enhancing human quality of life. Therefore, it should be considered as an integral component of a healthy lifestyle and incorporated into routine daily activities.
References
1. 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.
2. 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.
3. Editorial. Urban forest for human health and wellbeing. Urban Forestry & Urban Greening. 2007;6:195–7
4. Li Q, Morimoto K, Nakadai A, Inagaki H, Katsumata M, Shimizu T, Hirata Y, Hirata K, Suzuki H, Miyazaki Y, Kagawa T, Koyama Y, Ohira T, Takayama N, Krensky AM, Kawada T. Forest bathing enhances human natural killer activity and expression of anti-cancer proteins. Int J Immunopathol Pharmacol. 2007 Apr-Jun;20(2 Suppl 2):3-8. doi: 10.1177/03946320070200S202. PMID: 17903349.
5. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15-21;365(9455):217-23. doi: 10.1016/S0140-6736(05)17741-1. PMID: 15652604.
6. Deussen A, Kopaliani I. Targeting inflammation in hypertension. Curr Opin Nephrol Hypertens. 2023 Mar 1;32(2):111-117. doi: 10.1097/MNH.0000000000000862. Epub 2022 Dec 7. PMID: 36476561; PMCID: PMC9872860.
7. Sun Q, Hong X, Wold LE. Cardiovascular effects of ambient particulate air pollution exposure. Circulation. 2010 Jun 29;121(25):2755-65. doi: 10.1161/CIRCULATIONAHA.109.893461. PMID: 20585020; PMCID: PMC2924678.
8. Li Q, Kobayashi M, Kumeda S, Ochiai T, Miura T, Kagawa T, Imai M, Wang Z, Otsuka T, Kawada T. Effects of Forest Bathing on Cardiovascular and Metabolic Parameters in Middle-Aged Males. Evid Based Complement Alternat Med. 2016;2016:2587381. doi: 10.1155/2016/2587381. Epub 2016 Jul 14. PMID: 27493670; PMCID: PMC4963577.
9. editor, Lennart Levi. Emotions, their parameters and measurement, Raven Press, c1975. 0890040192. https://ndlsearch.ndl.go.jp/books/R100000136-I1130282269921402496
10. Therapeutic effect of forest bathing on human hypertension in the elderly; Mao, Gen-Xiang et al. Journal of Cardiology, Volume 60, Issue 6, 495 - 502
11. Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011 Jan;8(1):30-41. doi: 10.1038/nrcardio.2010.165. Epub 2010 Nov 9. PMID: 21060326; PMCID: PMC3033496.
12. Kennelly P, Sapkota R, Azhar M, Cheema FH, Conway C, Hameed A. Diuretic therapy in congestive heart failure. Acta Cardiol. 2022 Apr;77(2):97-104. doi: 10.1080/00015385.2021.1878423. Epub 2021 Mar 3. PMID: 33653227.
13. Heart Failure Society of America; Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, Katz SD, Klapholz M, Moser DK, Rogers JG, Starling RC, Stevenson WG, Tang WH, Teerlink JR, Walsh MN. HFSA 2010 Comprehensive Heart Failure Practice Guideline. J Card Fail. 2010 Jun;16(6):e1-194. doi: 10.1016/j.cardfail.2010.04.004. PMID: 20610207.
14. Mao G, Cao Y, Wang B, Wang S, Chen Z, Wang J, Xing W, Ren X, Lv X, Dong J, Chen S, Chen X, Wang G, Yan J. The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure. Int J Environ Res Public Health. 2017 Mar 31;14(4):368. doi: 10.3390/ijerph14040368. PMID: 28362327; PMCID: PMC5409569.
15. Latini R, Masson S, Anand I, Salio M, Hester A, Judd D, Barlera S, Maggioni AP, Tognoni G, Cohn JN; Val-HeFT Investigators. The comparative prognostic value of plasma neurohormones at baseline in patients with heart failure enrolled in Val-HeFT. Eur Heart J. 2004 Feb;25(4):292-9. doi: 10.1016/j.ehj.2003.10.030. PMID: 14984917.
16. Unsicker SB, Kunert G, Gershenzon J. Protective perfumes: the role of vegetative volatiles in plant defense against herbivores. Curr Opin Plant Biol. 2009 Aug;12(4):479-85. doi: 10.1016/j.pbi.2009.04.001. Epub 2009 May 19. PMID: 19467919.
17. Kim T, Song B, Cho KS, Lee IS. Therapeutic Potential of Volatile Terpenes and Terpenoids from Forests for Inflammatory Diseases. Int J Mol Sci. 2020 Mar 22;21(6):2187. doi: 10.3390/ijms21062187. PMID: 32235725; PMCID: PMC7139849.
18. Abuabara K, Magyari A, McCulloch CE, et al. Prevalence of atopic eczema among patients seen in primary care: data from the health improvement network. Ann Intern Med. 2019;170(5):354-356.
19. Frazier W, Bhardwaj N. Atopic Dermatitis: Diagnosis and Treatment. Am Fam Physician. 2020 May 15;101(10):590-598. PMID: 32412211.
20. Severity scoring of atopic dermatitis: the SCORAD index. Consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186(1):23-31.
21. Boguniewicz M, Leung DY. Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev. 2011;242(1):233-246.
22. Al-Naqeeb J, Danner S, Fagnan LJ, et al. The burden of childhood atopic dermatitis in the primary care setting: a report from the Meta-LARC consortium. J Am Board Fam Med. 2019;32(2):191-200.
23. Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis.. J Am Acad Dermatol. 2014;70(2):338-351.
24. Noh G, Lee J. Atopic dermatitis and cytokines: the immunoregulatory and therapeutic implications of cytokines in atopic dermatitis--part II: negative regulation and cytokine therapy in atopic dermatitis. Recent Pat Inflamm Allergy Drug Discov. 2012 Sep;6(3):248-61. doi: 10.2174/187221312802652802. PMID: 22827754.
25. Takaishi M, Uchida K, Fujita F, Tominaga M. Inhibitory effects of monoterpenes on human TRPA1 and the structural basis of their activity. J Physiol Sci. 2014 Jan;64(1):47-57. doi: 10.1007/s12576-013-0289-0. PMID: 24122170; PMCID: PMC3889502.
26. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016 Oct 22;388(10055):2023-2038. doi: 10.1016/S0140-6736(16)30173-8. Epub 2016 May 3. Erratum in: Lancet. 2016 Oct 22;388(10055):1984. doi: 10.1016/S0140-6736(16)30794-2. PMID: 27156434.
27. Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J. Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies. Bone Res. 2018 Apr 27;6:15. doi: 10.1038/s41413-018-0016-9. PMID: 29736302; PMCID: PMC5920070.
28. Brown JS, Amend SR, Austin RH, Gatenby RA, Hammarlund EU, Pienta KJ. Updating the Definition of Cancer. Mol Cancer Res. 2023 Nov 1;21(11):1142-1147. doi: 10.1158/1541-7786.MCR-23-0411. PMID: 37409952; PMCID: PMC10618731.
29. Chen S, Cao Z, Prettner K, Kuhn M, Yang J, Jiao L, Wang Z, Li W, Geldsetzer P, Bärnighausen T, Bloom DE, Wang C. Estimates and Projections of the Global Economic Cost of 29 Cancers in 204 Countries and Territories From 2020 to 2050. JAMA Oncol. 2023 Apr 1;9(4):465-472. doi: 10.1001/jamaoncol.2022.7826. PMID: 36821107; PMCID: PMC9951101.
30. Roy PS, Saikia BJ. Cancer and cure: A critical analysis. Indian J Cancer. 2016 Jul-Sep;53(3):441-442. doi: 10.4103/0019-509X.200658. PMID: 28244479.
31. Kägi D, Vignaux F, Ledermann B, Bürki K, Depraetere V, Nagata S, Hengartner H, Golstein P. Fas and perforin pathways as major mechanisms of T cell-mediated cytotoxicity. Science. 1994 Jul 22;265(5171):528-30. doi: 10.1126/science.7518614. PMID: 7518614.
32. Kägi D, Ledermann B, Bürki K, Seiler P, Odermatt B, Olsen KJ, Podack ER, Zinkernagel RM, Hengartner H. Cytotoxicity mediated by T cells and natural killer cells is greatly impaired in perforin-deficient mice. Nature. 1994 May 5;369(6475):31-7. doi: 10.1038/369031a0. PMID: 8164737.
33. Smyth MJ, Kelly JM, Sutton VR, Davis JE, Browne KA, Sayers TJ, Trapani JA. Unlocking the secrets of cytotoxic granule proteins. J Leukoc Biol. 2001 Jul;70(1):18-29. PMID: 11435481.
34. Hanson DA, Kaspar AA, Poulain FR, Krensky AM. Biosynthesis of granulysin, a novel cytolytic molecule. Mol Immunol. 1999 May;36(7):413-22. doi: 10.1016/s0161-5890(99)00063-2. PMID: 10449094.
35. Roviello V, Gilhen-Baker M, Vicidomini C, Roviello GN. Forest-bathing and physical activity as weapons against COVID-19: a review. Environ Chem Lett. 2022;20(1):131-140. doi: 10.1007/s10311-021-01321-9. Epub 2021 Sep 21. PMID: 34566548; PMCID: PMC8453031.
36. Roviello V, Roviello GN. Lower COVID-19 mortality in Italian forested areas suggests immunoprotection by Mediterranean plants. Environ Chem Lett. 2021;19(1):699-710. doi: 10.1007/s10311-020-01063-0. Epub 2020 Aug 14. PMID: 32837486; PMCID: PMC7427271.
37. Paital B, Agrawal PK. Air pollution by NO2 and PM2.5 explains COVID-19 infection severity by overexpression of angiotensin-converting enzyme 2 in respiratory cells: a review. Environ Chem Lett. 2021;19(1):25-42. doi: 10.1007/s10311-020-01091-w. Epub 2020 Sep 18. PMID: 32982622; PMCID: PMC7499935.
38. Quirt J, Hildebrand KJ, Mazza J, Noya F, Kim H. Asthma. Allergy Asthma Clin Immunol. 2018 Sep 12;14(Suppl 2):50. doi: 10.1186/s13223-018-0279-0. PMID: 30275843; PMCID: PMC6157154.
39. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated 2017. http://www.ginasthma.org. Accessed 19 Feb 2017. [Ref list]
40. Bourdin A, Gras D, Vachier I, Chanez P. Upper airway x 1: allergic rhinitis and asthma: united disease through epithelial cells. Thorax. 2009 Nov;64(11):999-1004. doi: 10.1136/thx.2008.112862. PMID: 19864543.
41. Martinez FD. Genes, environments, development and asthma: a reappraisal. Eur Respir J. 2007 Jan;29(1):179-84. doi: 10.1183/09031936.00087906. PMID: 17197483.
42. 9.Lemanske RF, Busse WW. Asthma: clinical expression and molecular mechanisms. J Allergy Clin Immunol. 2010;125:S95–S102. doi: 10.1016/j.jaci.2009.10.047.
43. Bai TR, Vonk JM, Postma DS, Boezen HM. Severe exacerbations predict excess lung function decline in asthma. Eur Respir J. 2007;30(3):452–456. doi: 10.1183/09031936.00165106.
44. Hirota R, Nakamura H, Bhatti SA, Ngatu NR, Muzembo BA, Dumavibhat N, Eitoku M, Sawamura M, Suganuma N. Limonene inhalation reduces allergic airway inflammation in Dermatophagoides farinae-treated mice. Inhal Toxicol. 2012 May;24(6):373-81. doi: 10.3109/08958378.2012.675528. PMID: 22564095.
45. Worth H, Dethlefsen U. Patients with asthma benefit from concomitant therapy with cineole: a placebo-controlled, double-blind trial. J Asthma. 2012 Oct;49(8):849-53. doi: 10.3109/02770903.2012.717657. PMID: 22978309.
46. Juergens UR. Anti-inflammatory properties of the monoterpene 1.8-cineole: current evidence for co-medication in inflammatory airway diseases. Drug Res (Stuttg). 2014 Dec;64(12):638-46. doi: 10.1055/s-0034-1372609. Epub 2014 May 15. PMID: 24831245.
47. Oh B, Lee KJ, Zaslawski C, Yeung A, Rosenthal D, Larkey L, Back M. Health and well-being benefits of spending time in forests: systematic review. Environ Health Prev Med. 2017 Oct 18;22(1):71. doi: 10.1186/s12199-017-0677-9. PMID: 29165173; PMCID: PMC5664422.
48. Anderson A. Technostress. Another Japanese discovery. Nature. 1985 Sep 5-11;317(6032):6. doi: 10.1038/317006b0. PMID: 4033790.
49. Jones R, Tarter R, Ross AM. Greenspace Interventions, Stress and Cortisol: A Scoping Review. Int J Environ Res Public Health. 2021 Mar 10;18(6):2802. doi: 10.3390/ijerph18062802. PMID: 33801917; PMCID: PMC8001092.
50. Hellhammer DH, Wüst S, Kudielka BM. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology. 2009 Feb;34(2):163-171. doi: 10.1016/j.psyneuen.2008.10.026. Epub 2008 Dec 18. PMID: 19095358.
51. Jones R, Tarter R, Ross AM. Greenspace Interventions, Stress and Cortisol: A Scoping Review. Int J Environ Res Public Health. 2021 Mar 10;18(6):2802. doi: 10.3390/ijerph18062802. PMID: 33801917; PMCID: PMC8001092.
52. Geiger A.W., Davis L., A Growing Number of American Teenagers–Particularly girls–Are Facing Depression Pew Research Center. 2019. [(accessed on 4 December 2021)]. Available online: https://www.pewresearch.org/short-reads/2019/07/12/a-growing-number-of-american-teenagers-particularly-girls-are-facing-depression/
53. Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA. Social Media Use and Depression and Anxiety Symptoms: A Cluster Analysis. Am J Health Behav. 2018 Mar 1;42(2):116-128. doi: 10.5993/AJHB.42.2.11. PMID: 29458520; PMCID: PMC5904786.
54. Oberle E, Schonert-Reichl KA, Thomson KC. Understanding the link between social and emotional well-being and peer relations in early adolescence: gender-specific predictors of peer acceptance. J Youth Adolesc. 2010 Nov;39(11):1330-42. doi: 10.1007/s10964-009-9486-9. Epub 2009 Nov 29. PMID: 20091211.
55. Keller J, Kayira J, Chawla L, Rhoades JL. Forest Bathing Increases Adolescents' Mental Well-Being: A Mixed-Methods Study. Int J Environ Res Public Health. 2023 Dec 20;21(1):8. doi: 10.3390/ijerph21010008. PMID: 38276796; PMCID: PMC10815422.
56. Lee I, Choi H, Bang KS, Kim S, Song M, Lee B. Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review. Int J Environ Res Public Health. 2017 Mar 20;14(3):321. doi: 10.3390/ijerph14030321. PMID: 28335541; PMCID: PMC5369157.
57. Poulsen DV, Stigsdotter UK, Djernis D, Sidenius U. 'Everything just seems much more right in nature': How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden. Health Psychol Open. 2016 Mar 31;3(1):2055102916637090. doi: 10.1177/2055102916637090. PMID: 28070397; PMCID: PMC5193293.
58. Bielinis E, Jaroszewska A, Łukowski A, Takayama N. The Effects of a Forest Therapy Programme on Mental Hospital Patients with Affective and Psychotic Disorders. Int J Environ Res Public Health. 2019 Dec 23;17(1):118. doi: 10.3390/ijerph17010118. PMID: 31877954; PMCID: PMC6982075.
59. Morita E, Kadotani H, Yamada N, Sasakabe T, Kawai S, Naito M, Tamura T, Wakai K. 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. Int J Environ Res Public Health. 2024 Mar 15;21(3):350. doi: 10.3390/ijerph21030350. PMID: 38541349; PMCID: PMC10970638.
60. Pigeon WR, Pinquart M, Conner K. Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. J Clin Psychiatry. 2012 Sep;73(9):e1160-7. doi: 10.4088/JCP.11r07586. PMID: 23059158.
61.Morita E, Imai M, Okawa M, Miyaura T, Miyazaki S. A before and after comparison of the effects of forest walking on the sleep of a community-based sample of people with sleep complaints. Biopsychosoc Med. 2011 Oct 14;5:13. doi: 10.1186/1751-0759-5-13. PMID: 21999605; PMCID: PMC3216244.
62. 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.
63. Kavanaugh J, Hardison ME, Rogers HH, White C, Gross J. Assessing the Impact of a Shinrin-Yoku (Forest Bathing) Intervention on Physician/Healthcare Professional Burnout: A Randomized, Controlled Trial. Int J Environ Res Public Health. 2022 Nov 4;19(21):14505. doi: 10.3390/ijerph192114505. PMID: 36361384; PMCID: PMC9658142.
64. Dewa CS, Loong D, Bonato S, Trojanowski L. The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review. BMJ Open. 2017 Jun 21;7(6):e015141. doi: 10.1136/bmjopen-2016-015141. PMID: 28637730; PMCID: PMC5734243.
65. Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral and psychological symptoms of dementia. Front Neurol. 2012 May 7;3:73. doi: 10.3389/fneur.2012.00073. PMID: 22586419; PMCID: PMC3345875.
66. Frisoni GB, Rozzini L, Gozzetti A, Binetti G, Zanetti O, Bianchetti A, Trabucchi M, Cummings JL. Behavioral syndromes in Alzheimer's disease: description and correlates. Dement Geriatr Cogn Disord. 1999 Mar-Apr;10(2):130-8. doi: 10.1159/000017113. PMID: 10026387.
67. Park J, Wang SM, Kang DW, Lee B, Choi H. Effect of Anti-Aging Standard Forest Healing Program With Multiple Visits to a Forest Facility on Cognition in Older Age Patients. Dement Neurocogn Disord. 2024 Jan;23(1):44-53. doi: 10.12779/dnd.2024.23.1.44. Epub 2024 Feb 6. PMID: 38362051; PMCID: PMC10864698.
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