Forest therapy and its presumed preventive effects have recently received growing attention in the international scientific world. Many international studies have reported the health-promoting effects of exposure to the forest environment on both body and mind [9,11]. Primary studies, systematic reviews (SRs) and meta-analyses (MAs) have been conducted to determine the preventive and therapeutic effects of forest bathing, forest therapy, and forest medicine for various indications. Special attention has been paid to the benefits of forest therapy on mental health, as especially people living in urban areas are at increased risk of being exposed to stressful situations and developing chronic mental health disorders [15,16,17]. As a result of sedentary and/or hectic lifestyles, chronic stress combined with little physical activity plays an important role in the development of so-called diseases of civilisation [18], such as chronic cardiovascular and respiratory diseases, diabetes, skin diseases, and a weakened immune system [3,19]. Patients suffering from these types of diseases are among the target groups of interventional studies in the forest environment. Forest bathing is indicated not only for patients, but also for healthy individuals due to its mainly preventive character. Improving the quality of life and increasing well-being are particularly important goals.
We were unable to conduct literature searches in Korean, Japanese, or Chinese databases. Thus, we may have missed a systematic review. However, since we used seven major international medical databases and searched for systematic reviews (not for single studies), we believe that we identified most for this comprehensive overview. We also conducted a recent update and identified currently ongoing reviews (see Section 4.2). Very recent findings may have been missed because recently published single studies could not have been captured by the reviews included.
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There are no internationally agreed definitions of forest bathing, forest therapy, and other forest-based interventions and programs. Both the goals and the contents of forest therapy differ in the different countries. While in Japan, forest bathing is supposed to help stressed-out people find peace of mind, the focus in South Korea is on general health promotion and the enhancement of the common welfare through various forest programs for all population groups [51]. In America, a connection to nature is to be established through immersion in the forest environment [52].
In Japan, where Shinrin-Yoku has a decades-long tradition, it is defined as forest bathing in specially selected forests with the aim of maintaining physical vitality and mental health, as well as preventing disease. The focus is especially on stress reduction and strengthening the immune system. The Forest Therapy Society of Japan attempts to establish an international standard for practice through information events and training. The definition and potential elements of forest therapy remain imprecise and very broad. The forest should be experienced with all five senses during the forest bath/forest therapy. Activities such as hiking/walking, but also mindfulness exercises for the perception of the environment, can be practiced. Measures such as nutritional therapy can complement these activities [53]. 2ff7e9595c
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