Blood pressure-lowering effect of Shinrin-yoku (Forest bathing): a systematic review and meta-analysis

doi:10.1186/s12906-017-1912-z

Review

. 2017 Aug 16;17(1):409.

doi: 10.1186/s12906-017-1912-z.

Blood pressure-lowering effect of Shinrin-yoku (Forest bathing): a systematic review and meta-analysis

Yuki Ideno¹, Kunihiko Hayashi², Yukina Abe³, Kayo Ueda⁴, Hiroyasu Iso⁵, Mitsuhiko Noda⁶, Jung-Su Lee⁷, Shosuke Suzuki⁸

Affiliations

¹ Gunma University Initiative for Advanced Research, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan. y-ideno@gunma-u.ac.jp.
² Graduate School of Health Science, Gunma University, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan.
³ Tochigi Prefectural Western District Health and Welfare Services Center, 1664-1 Imamiya-cho, Kanuma City, Tochigi, 322-0068, Japan.
⁴ Department of Environmental Engineering, Kyoto University Graduate School of Engineering, Yoshida Honmachi, Sakyo-ku, Kyoto, 606-8501, Japan.
⁵ Public Health, Department of Social and Medicine, Graduate School of Medicine, Osaka University, 1-1 Yamadaoka, Suita, Osaka, 565-0871, Japan.
⁶ Department of Endocrinology and Diabetes, Saitama Medical University, 38 Morohongo, Moroyama-cho, Iruma-gun, Saitama, 350-0495, Japan.
⁷ School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
⁸ Professor Emeritus, Gunma University and NPO International Eco-Health Research Group, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan.

PMID: 28814305
PMCID: PMC5559777
DOI: 10.1186/s12906-017-1912-z

Review

Blood pressure-lowering effect of Shinrin-yoku (Forest bathing): a systematic review and meta-analysis

Yuki Ideno et al. BMC Complement Altern Med. 2017.

. 2017 Aug 16;17(1):409.

doi: 10.1186/s12906-017-1912-z.

Authors

Yuki Ideno¹, Kunihiko Hayashi², Yukina Abe³, Kayo Ueda⁴, Hiroyasu Iso⁵, Mitsuhiko Noda⁶, Jung-Su Lee⁷, Shosuke Suzuki⁸

Affiliations

¹ Gunma University Initiative for Advanced Research, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan. y-ideno@gunma-u.ac.jp.
² Graduate School of Health Science, Gunma University, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan.
³ Tochigi Prefectural Western District Health and Welfare Services Center, 1664-1 Imamiya-cho, Kanuma City, Tochigi, 322-0068, Japan.
⁴ Department of Environmental Engineering, Kyoto University Graduate School of Engineering, Yoshida Honmachi, Sakyo-ku, Kyoto, 606-8501, Japan.
⁵ Public Health, Department of Social and Medicine, Graduate School of Medicine, Osaka University, 1-1 Yamadaoka, Suita, Osaka, 565-0871, Japan.
⁶ Department of Endocrinology and Diabetes, Saitama Medical University, 38 Morohongo, Moroyama-cho, Iruma-gun, Saitama, 350-0495, Japan.
⁷ School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
⁸ Professor Emeritus, Gunma University and NPO International Eco-Health Research Group, 3-39-22 Showa-machi, Maebashi City, Gunma, 371-8511, Japan.

PMID: 28814305
PMCID: PMC5559777
DOI: 10.1186/s12906-017-1912-z

Abstract

Background: Shinrin-yoku (experiencing the forest atmosphere or forest bathing) has received increasing attention from the perspective of preventive medicine in recent years. Some studies have reported that the forest environment decreases blood pressure. However, little is known about the possibility of anti-hypertensive applications of Shinrin-yoku. This study aimed to evaluate preventive or therapeutic effects of the forest environment on blood pressure.

Methods: We systematically reviewed the medical literature and performed a meta-analysis.Four electronic databases were systematically searched for the period before May 2016 with language restriction of English and Japanese. The review considered all published, randomized, controlled trials, cohort studies, and comparative studies that evaluated the effects of the forest environment on changes in systolic blood pressure. A subsequent meta-analysis was performed.

Results: Twenty trials involving 732 participants were reviewed. Systolic blood pressure of the forest environment was significantly lower than that of the non-forest environment. Additionally, diastolic blood pressure of the forest environment was significantly lower than that of the non-forest environment.

Conclusions: This systematic review shows a significant effect of Shinrin-yoku on reduction of blood pressure.

Keywords: Blood pressure; Forest bathing; Meta-analysis; Pulse rate; Systematic review.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 1**
Flow chart of the study selection process for the present study

**Fig. 2**
Forest plot comparing changes in SBP (mmHg) between the forest environment and the non-forest environment based on 20 studies or subgroups CI, confidence interval.

**Fig. 3**
Two forest plots of the change in SBP (mmHg) in the two subgroup analyses of SBP levels of 1) ≥ 130 and 2) < 130 mmHg before the intervention. 1) SBP ≥ 130 mmHg. 2) SBP < 130 mmHg. CI, confidence interval

**Fig. 4**
Two forest plots of the change in SBP (mmHg) in the two subgroup analyses of differences in intervention methods (walking and non-walking). 1) Walking group. 2) Non-walking group. CI, confidence interval

**Fig. 5**
Three forest plots of the change in SBP (mmHg) in the two subgroup analyses of the three groups of sex and age differences. 1) Young male (university student) group. 2) Middle-aged or older male group. 3) Middle-aged or older female group. CI, confidence interval

**Fig. 6**
Funnel plot, using data from 20 trials of therapeutic effects of the forest environment on systolic blood pressure. SE, standard error; MD, mean difference

See this image and copyright information in PMC

Cited by

Exploring the Physiological and Psychological Effects of Digital Shinrin-Yoku and Its Characteristics as a Restorative Environment.
Takayama N, Morikawa T, Koga K, Miyazaki Y, Harada K, Fukumoto K, Tsujiki Y. Takayama N, et al. Int J Environ Res Public Health. 2022 Jan 21;19(3):1202. doi: 10.3390/ijerph19031202. Int J Environ Res Public Health. 2022. PMID: 35162221 Free PMC article.
Let Nature Be Thy Medicine: A Socioecological Exploration of Green Prescribing in the UK.
Robinson JM, Jorgensen A, Cameron R, Brindley P. Robinson JM, et al. Int J Environ Res Public Health. 2020 May 15;17(10):3460. doi: 10.3390/ijerph17103460. Int J Environ Res Public Health. 2020. PMID: 32429198 Free PMC article.
Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent).
Czakert J, Kandil FI, Boujnah H, Tavakolian P, Blakeslee SB, Stritter W, Dommisch H, Seifert G. Czakert J, et al. Sci Rep. 2024 Jun 19;14(1):14143. doi: 10.1038/s41598-024-63657-w. Sci Rep. 2024. PMID: 38898054 Free PMC article. Clinical Trial.
The influence of a walk in nature on human resting brain activity: a randomized controlled trial.
McDonnell AS, Strayer DL. McDonnell AS, et al. Sci Rep. 2024 Nov 8;14(1):27253. doi: 10.1038/s41598-024-78508-x. Sci Rep. 2024. PMID: 39516236 Free PMC article. Clinical Trial.
Associations between Nature Exposure and Health: A Review of the Evidence.
Jimenez MP, DeVille NV, Elliott EG, Schiff JE, Wilt GE, Hart JE, James P. Jimenez MP, et al. Int J Environ Res Public Health. 2021 Apr 30;18(9):4790. doi: 10.3390/ijerph18094790. Int J Environ Res Public Health. 2021. PMID: 33946197 Free PMC article. Review.

See all "Cited by" articles

References

1. Tsunetsugu Y, Park BJ, Miyazaki Y. Trend in research related to "Shinrin-yoku" (taking in the forest atmosphere or forest bathing) in Japan. Environ Health Prev Med. 2010;15:27–37. doi: 10.1007/s12199-009-0091-z. - DOI - PMC - PubMed
1. Lee J, Park BJ, Tsunetsugu Y, Ohira T, Kagawa T, Miyazaki Y. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health. 2011;125:93–100. doi: 10.1016/j.puhe.2010.09.005. - DOI - PubMed
1. Li Q, Kawada T. Possibility of clinical applications of forest medicine. Nihon Eiseigaku Zasshi (Jpn J Hyg) 2014;69:117–121. doi: 10.1265/jjh.69.117. - DOI - PubMed
1. Miyazaki Y, Ikei H, Song C. Forest medicine research in Japan. Nihon Eiseigaku Zasshi (Jpn J Hyg) 2014;69:122–135. doi: 10.1265/jjh.69.122. - DOI - PubMed
1. James P, Banay RF, Hart JE, Laden F. A review of the health benefits of greenness. Curr Epidemiol Rep. 2015;2:131–142. doi: 10.1007/s40471-015-0043-7. - DOI - PMC - PubMed

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

[1] Tsunetsugu Y, Park BJ, Miyazaki Y. Trend in research related to "Shinrin-yoku" (taking in the forest atmosphere or forest bathing) in Japan. Environ Health Prev Med. 2010;15:27–37. doi: 10.1007/s12199-009-0091-z. - DOI - PMC - PubMed

[2] Tsunetsugu Y, Park BJ, Miyazaki Y. Trend in research related to "Shinrin-yoku" (taking in the forest atmosphere or forest bathing) in Japan. Environ Health Prev Med. 2010;15:27–37. doi: 10.1007/s12199-009-0091-z. - DOI - PMC - PubMed

[3] Lee J, Park BJ, Tsunetsugu Y, Ohira T, Kagawa T, Miyazaki Y. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health. 2011;125:93–100. doi: 10.1016/j.puhe.2010.09.005. - DOI - PubMed

[4] Lee J, Park BJ, Tsunetsugu Y, Ohira T, Kagawa T, Miyazaki Y. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health. 2011;125:93–100. doi: 10.1016/j.puhe.2010.09.005. - DOI - PubMed

[5] Li Q, Kawada T. Possibility of clinical applications of forest medicine. Nihon Eiseigaku Zasshi (Jpn J Hyg) 2014;69:117–121. doi: 10.1265/jjh.69.117. - DOI - PubMed

[6] Li Q, Kawada T. Possibility of clinical applications of forest medicine. Nihon Eiseigaku Zasshi (Jpn J Hyg) 2014;69:117–121. doi: 10.1265/jjh.69.117. - DOI - PubMed

[7] Miyazaki Y, Ikei H, Song C. Forest medicine research in Japan. Nihon Eiseigaku Zasshi (Jpn J Hyg) 2014;69:122–135. doi: 10.1265/jjh.69.122. - DOI - PubMed

[8] Miyazaki Y, Ikei H, Song C. Forest medicine research in Japan. Nihon Eiseigaku Zasshi (Jpn J Hyg) 2014;69:122–135. doi: 10.1265/jjh.69.122. - DOI - PubMed

[9] James P, Banay RF, Hart JE, Laden F. A review of the health benefits of greenness. Curr Epidemiol Rep. 2015;2:131–142. doi: 10.1007/s40471-015-0043-7. - DOI - PMC - PubMed

[10] James P, Banay RF, Hart JE, Laden F. A review of the health benefits of greenness. Curr Epidemiol Rep. 2015;2:131–142. doi: 10.1007/s40471-015-0043-7. - DOI - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed