Terme di Monticelli, via Basse 5, 43022, Monticelli Terme, Parma, Italy.
Institute of Public Health, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Int J Biometeorol. 2019 Aug;63(8):1117-1134. doi: 10.1007/s00484-019-01717-x. Epub 2019 Apr 18.
Forest bathing is a traditional practice characterized by visiting a forest and breathing its air. This review aims to investigate the effects of forest bathing on levels of salivary or serum cortisol as a stress biomarker in order to understand whether forest bathing can reduce stress. Medline/PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were systematically searched for relevant articles. The quality of included trials was assessed following the criteria of the NIH dedicated tools. Afterwards, a qualitative and quantitative synthesis of retrieved evidence was performed. A total of 971 articles were screened; 22 of them were included in the systematic review and 8 in the meta-analysis. In all but two included studies, cortisol levels were significantly lower after intervention in forest groups if compared with control/comparison groups, or a significant pre-post reduction of cortisol levels was reported in the forest groups. The main results of the meta-analysis showed that salivary cortisol levels were significantly lower in the forest groups compared with the urban groups both before (MD = - 0.08 μg/dl [95% CI - 0.11 to - 0.05 μg/dl]; p < 0.01; I = 46%) and after intervention (MD = - 0.05 μg/dl [95% CI - 0.06 to - 0.04 μg/dl]; p < 0.01; I = 88%). Overall, forest bathing can significantly influence cortisol levels on a short term in such a way as to reduce stress, and anticipated placebo effects can play an important role in it. Further research is advised because of the limited available data.
森林浴是一种传统的做法，其特点是到森林中呼吸空气。本综述旨在调查森林浴对唾液或血清皮质醇水平作为应激生物标志物的影响，以了解森林浴是否可以减轻压力。系统地检索了 Medline/PubMed、Embase、Scopus、Web of Science、Cochrane 图书馆和 Google Scholar 中的相关文章。根据 NIH 专用工具的标准评估纳入试验的质量。然后，对检索到的证据进行定性和定量综合。共筛选出 971 篇文章；其中 22 篇被纳入系统评价，8 篇被纳入荟萃分析。在所有纳入的研究中（除了两项研究），与对照组相比，森林组干预后皮质醇水平显著降低，或者森林组报告皮质醇水平有显著的前后降低。荟萃分析的主要结果表明，与城市组相比，森林组的唾液皮质醇水平在干预前（MD=-0.08μg/dl [95% CI -0.11 至-0.05μg/dl]；p<0.01；I=46%）和干预后（MD=-0.05μg/dl [95% CI -0.06 至-0.04μg/dl]；p<0.01；I=88%）均显著降低。总体而言，森林浴可以在短期内显著影响皮质醇水平，从而减轻压力，预期的安慰剂效应可能在其中发挥重要作用。由于现有数据有限，建议进一步研究。
