Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial.

BACKGROUND: Lifelong physical activity is related to longer health span, which is reflected at an individual level, and is of substantial socioeconomic relevance. Sedentary lifestyles, on the other hand, pose an increasingly major public health problem. In addition, the COVID-19 pandemic had a negative impact on activity levels and well-being. Previous research indicates that contact with nature might improve exercise levels as well as well-being. METHODS: This randomized, controlled clinical trial (ANKER-study) investigated the effects of two types of nature-based therapies (forest therapy and mountain hiking) in couples (FTG: n = 23; HG: n = 22;) with a sedentary or inactive lifestyle on health-related quality of life, relationship quality and other psychological and physiological parameters. RESULTS: The results of this study displayed that healthy and highly functioning women and men with sedentary lifestyles mentally benefit from contact with nature (quality of life, satisfaction with life, mood, internal and external health-related control beliefs). The gender-specific effect on women is most visible in the physiological outcomes (hemopoietic system, aerobic capacity, skeletal muscle mass and hydration) of mountain hiking. Men and women showed small improvements in blood pressure as a result of the interventions. CONCLUSIONS: The ANKER-study provides a method for valid comparison of forest therapy interventions for the first time. Regarding the COVID-19 pandemic, the nature-based intervention presented could offer a multimodal contribution to maintaining a more active lifestyle, further contact with nature that affects peoples physical as well as mental health, and an improvement in social interaction.

Mountain Hiking vs. Forest Therapy: A Study Protocol of Novel Types of Nature-Based Intervention.

INTRODUCTION: The global rise of urbanization has much triggered scientific interest in how nature impacts on human health. Natural environments, such as alpine landscapes, forests, or urban green spaces, are potential high-impact health resources. While there is a growing body of evidence to reveal a positive influence of these natural environments on human health and well-being, further investigations guided by rigorous evidence-based medical research are very much needed. OBJECTIVE: The present study protocol aims at testing research methodologies in the context of a prospective clinical trial on nature-based interventions. This shall improve the standards of medical research in human-nature interactions. METHODS: The ANKER Study investigates the influence of two novel types of nature-based therapy-mountain hiking and forest therapy-on physiological, psychological, and immunological parameters of couples with a sedentary lifestyle. Two intervention groups were formed and spent a seven-day holiday in Algund, Italy. The "forest therapy group" participated in daily guided low-power nature connection activities. The "hiking group", by contrast, joined in a daily moderate hiking program. Health-related quality of life and relationship quality are defined as primary outcomes. Secondary outcomes include nature connection, balance, cardio-respiratory fitness, fractional exhaled nitric oxide, body composition and skin hydration. Furthermore, a new approach to measure health-related quality of life is validated. The so-called "intercultural quality of life" comic assesses the health-related quality of life with a digitally animated comic-based tool.

Positioning Climate Therapy Stays as a Health Tourism Product: An Evidence-Based Approach

Background: The relationship between Length Of Stay (LOS) and Metres Above Sea Level (MASL) of Climate Therapy Stays (CTSs) and their therapeutic effectiveness and efficiency has been under-researched in the last four decades. As a consequence, the potentials of short-term and low-altitude CTSs remain unknown. Objectives: The purpose of this study is twofold. Firstly, it aims to ascertain whether LOS and MASL are related to the percentage change of Forced Expiratory Volume in 1 second (FEV1) and the percentage change of FEV1 Compound Daily Improvement Rate (FEV1 CDIR % Change). Secondly, it aims to provide an evidence-based positioning of CTSs by considering the same specific variables. Methods/Analysis: The study focuses on young people (age ˂18) who have asthma problems. The Resource-Based Theory, postulating the valuability of natural resources generating above-average benefits, has been adopted as a conceptual lens. Primary studies carried out in eastern and western European countries and separately reviewed have been considered jointly. Spearman’s rank correlation coefficient was used to determine the relationship between LOS and MASL of CTSs with FEV1Change (%) and FEV1Change CDIR (%) as indicators of health improvements. The descriptive statistics were implemented in calculating standardized and aggregated values. Findings: Negative and significant relationships have been highlighted between FEV1 Change (%) and MASL and between FEV1 Change CDIR % and LOS. In other words, subjects can achieve significant health improvements even by experiencing very short climate therapy stays at very low altitude mountain centres. Considering the FEV1Change (%) and the FEV1 Change CDIR (%) of climate stays by duration and elevation, the evidence-based knowledge platform has been established as a possible framework for developing an evidence-based marketing strategy for new health tourism products. Novelty/Improvement: Notwithstanding the need for further research, the metrics facilitating interdisciplinary, human health and economic studies have been devised. Further research on the effects of low altitude climate therapy stays could help define the healing potentials of macro and microclimatic conditions as potentially valuable ‘health devices’ for those suffering from respiratory diseases living in the COVID-19 era. Quantifying these effects through further studies, an evidence-based approach to formulating marketing strategies may be devised, useful both for supporting public health provision and policies, and for facilitating practitioners in health tourism interested in offering nature-based activities for their clients. © 2022 by the authors. Licensee ESJ, Italy.