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Time in nature

Pooled short studies found time in forests and other natural settings lowered blood pressure by about 3 mmHg, heart rate and cortisol, and eased negative mood and anxiety, though most studies were small and at high risk of bias. Living amid more greenery is linked to fewer deaths. Outdoor work carries a higher Lyme disease risk.

Checked 2026-11-13
Status
A daily life factor, not a product.
Also called
forest bathing, shinrin-yoku, forest therapy, nature walk, green space, greenspace, green exercise, blue space, time outdoors in nature, nature therapy, park time, nature prescription, green prescription
Studied for
stress, cortisol, anxiety, mood, depression, blood pressure, heart rate, relaxation, rumination, wellbeing, living longer, diabetes prevention

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help7

Reported risks1

What it was studied for, and what was found

Shown to help7

Moderate

Stress and cortisol

Shown to lower salivary cortisol slightly in forest groups in one meta-analysis, and serum cortisol fell after forest visits in two small trials in men.

Compared with urban groups [1]; people with lower greenspace exposure [2]; the group sent to a city area [3]; the day before forest therapy, in the same men [4]

The numbers and sources
Effect
Salivary cortisol was lower in forest groups than urban groups after the intervention (MD -0.05 μg/dL, 95% CI -0.06 to -0.04, I² 88%), and also before it (MD -0.08 μg/dL). In all but two of 22 studies, cortisol was lower after forest time than in comparison groups or than before [1]. Across observational and intervention studies, greenspace exposure was linked to lower salivary cortisol (-0.05, 95% CI -0.07 to -0.04) [2]. After a two-night forest trip, serum cortisol was lower than in a group sent to a city, as were interleukin-6 and tumor necrosis factor alpha [3]. In middle-aged men with high-normal blood pressure, serum cortisol and urinary adrenaline were lower after forest therapy than the day before [4].
Population
22 studies, 8 pooled [1]. 103 observational and 40 interventional studies [2]. 20 healthy male university students, randomized [3]. Middle-aged men with high-normal blood pressure [4].
Sources
[1], [2], [3], [4]
Caveats
The forest groups' cortisol was already lower before the visit, which the reviewers tie to anticipation and placebo effects [1]. Studies were short, small and mostly in Japan, and nobody can be blinded to a forest. The serum trials studied only men [3][4].
Moderate

Blood pressure and heart rate

Shown to lower systolic blood pressure by about 3 mmHg and diastolic by about 2 mmHg in forest settings, in one meta-analysis of 20 trials, with heart rate also lower.

Compared with non-forest environments [5]; people with lower greenspace exposure [2]; before the forest bathing, in the same people [6]; control conditions, mostly passive [7]

The numbers and sources
Effect
Systolic blood pressure was lower in the forest than in non-forest environments (MD -3.15 mmHg, 95% CI -4.12 to -2.18, I² 1%), as was diastolic pressure (MD -1.75 mmHg, 95% CI -2.38 to -1.13) [5]. Greenspace exposure was linked to lower diastolic pressure (-1.97 mmHg) and heart rate (-2.57 beats a minute) [2]. Heart rate fell after forest bathing (MD -4.00, 95% CI -6.90 to -1.09) at very low certainty [6]. Across reviews, nature-based programs lowered heart rate (SMD -0.70, 95% CI -1.17 to -0.23) [7].
Population
732 participants in 20 trials, 17 in Japan [5]. 143 studies [2]. 11 studies [6]. 30 reviews in a second-order meta-analysis [7].
Sources
[5], [2], [6], [7]
Caveats
Trials were short, and 17 of the 20 were in Japan [5]. Walking, quiet and cleaner air come with forest time and cannot be separated from it. No trial located tested whether the drop lasts.
Strong

Mood, anxiety and depressive feelings

Shown to ease negative mood, anxiety and depressive feelings and raise positive mood after time in nature, in several meta-analyses rating study quality mostly low.

Compared with control conditions, mostly passive [7]; control groups [8]; built environments [9]; before the forest bathing, in the same people [6]; a 90-minute walk in an urban setting [10]

The numbers and sources
Effect
Across 30 reviews, nature-based programs lowered anxiety (SMD -0.83, 95% CI -1.19 to -0.47), depressive symptoms (SMD -0.72) and negative affect (SMD -0.61), and raised positive affect (SMD 0.52). Physiological measures did not rise significantly (SMD 0.24, 95% CI -0.19 to 0.67) [7]. An umbrella review found lower tension (SMD -0.87) and negative affect (SMD -0.51) and higher positive affect (SMD 0.98) and wellbeing (SMD 0.40), at moderate credibility [8]. Short visits to natural settings had a small effect on depressive mood (mean g -0.29) [9]. After forest bathing, tension-anxiety and depression-dejection scores fell [6]. A 90-minute nature walk lowered rumination and activity in a brain region tied to it, and an urban walk did not [10].
Population
3,870 primary studies in 30 reviews [7]. 344 studies in 28 reviews [8]. 33 studies [9]. 11 studies [6]. Healthy adults in one trial [10].
Sources
[7], [8], [9], [6], [10]
Caveats
Most primary studies used passive controls, short follow-up and self-report, and were rated at high risk of bias [7][9]. Only 10 of 91 associations had moderate credibility [8]. Heterogeneity was large [9].
Limited

Weekly time in nature and wellbeing

One national survey linked at least 120 minutes a week in nature to higher odds of good health and wellbeing, with no further gain beyond 200 to 300 minutes.

Compared with people with no nature contact in the past week [11]

The numbers and sources
Effect
Against no nature contact in the past week, 120 to 179 minutes was linked to higher odds of good health (OR 1.59, 95% CI 1.31 to 1.92) and high wellbeing (OR 1.23, 95% CI 1.08 to 1.40). Benefits peaked at 200 to 300 minutes a week. It did not matter whether the time came in one visit or several [11].
Population
19,806 adults in England, weighted to be nationally representative [11].
Sources
[11]
Caveats
Cross-sectional and self-reported. Healthier, happier people may simply visit nature more, which is reverse causation.
Strong

Death and living near green space

Linked to fewer deaths in people living amid more greenery, in two meta-analyses, about 4% fewer per step of greenness within 500 meters of home.

Compared with people with lower greenspace exposure [2]; people with 0.1 lower NDVI greenness within 500 meters of home [12]

The numbers and sources
Effect
Greenspace exposure was linked to lower all-cause mortality (0.69, 95% CI 0.55 to 0.87) and cardiovascular mortality (0.84, 95% CI 0.76 to 0.93) [2]. Each 0.1 rise in satellite-measured greenness within 500 meters of home was linked to 4% lower mortality (HR 0.96, 95% CI 0.94 to 0.97, I² 95%) [12].
Population
143 studies [2]. 8,324,652 people in 9 cohorts from 7 countries [12].
Sources
[2], [12]
Caveats
Observational, and about where people live, not time they spend in nature. Income, air pollution and activity differ between greener and less green areas. Heterogeneity was very high [12], and the broader review notes poor study quality [2].
Moderate

Type 2 diabetes

Linked to 28% less type 2 diabetes with more greenspace exposure in one meta-analysis of mostly observational studies.

Compared with people with lower greenspace exposure [2]

The numbers and sources
Effect
Greenspace exposure was linked to a lower risk of type 2 diabetes (0.72, 95% CI 0.61 to 0.85) [2].
Population
Studies of greenspace exposure within 103 observational and 40 interventional studies [2].
Sources
[2]
Caveats
Observational. Wealthier, more active people tend to live near green space, which could explain the link.
Moderate

Blue spaces: coasts, lakes and rivers

Linked to more physical activity and restoration with more blue space nearby or more contact with it, in one meta-analysis. Living closer was not linked to restoration.

Compared with people living farther from, with less, or with less contact with blue space [13]; comparisons the source does not describe [14]

The numbers and sources
Effect
Living closer to blue space was linked to more physical activity (Cohen's d 0.122). More contact with blue space was linked to more restoration (d 0.191, 95% CI 0.084 to 0.298). Shorter distance was not linked to restoration (d 0.123, 95% CI -0.037 to 0.284) or social interaction [13]. A review of 33 therapeutic blue space programs found mostly positive or weak links with mental health and wellbeing, and very few findings on physical health [14].
Population
50 studies [13]. 33 intervention studies in people with a defined need [14].
Sources
[13], [14]
Caveats
Mostly observational. The program review gave no pooled estimates [14]. Effects are small.

Amounts studied

Forest bathing studies used visits to a forest, from a single session of forest therapy [4] to a two-night trip [3], and one measured blood pressure and cortisol the day before and about 2 hours after the session [4]. One rumination trial used a 90-minute walk [10]. The national survey grouped weekly nature contact in 60-minute blocks and found the link began at 120 minutes and leveled off at 200 to 300 minutes [11]. Mortality cohorts measured greenness around the home by satellite, within 500 meters [12].

Risks

Reported risks1

ModerateHow often is not known

Lyme disease in outdoor workers

Linked to about twice the odds of Lyme disease antibodies in outdoor workers, and 2.4 times in forestry and farm workers, in one meta-analysis.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Outdoor workers had a 20.5% rate of antibodies to Borrelia burgdorferi. Outdoor work raised the odds of antibodies against controls (OR 1.93, 95% CI 1.15 to 3.23), and forestry and agricultural work more so (OR 2.36). In studies after 2010 the raised odds were not significant (OR 1.08, 95% CI 0.63 to 1.85) [15].
Population
35 studies, 15 pooled with 3,932 people [15].
Sources
[15]
Caveats
Antibodies show past infection, not illness. The studies are of people working outdoors in endemic areas, not people taking walks. Risk depends on region and season.

Claims tested and not found

  1. That living close to water brings restoration. Shorter distance to blue space was not linked to restoration (d 0.123, 95% CI -0.037 to 0.284) or to social interaction [13].
  2. That nature programs improve physiological measures as much as feelings. Pooled positive physiological outcomes did not rise significantly (SMD 0.24, 95% CI -0.19 to 0.67), while psychological outcomes did [7].

Related

Sunlight

Sources

  1. Antonelli M, Barbieri G, Donelli D. Effects of forest bathing (shinrin-yoku) on levels of cortisol as a stress biomarker: a systematic review and meta-analysis. International Journal of Biometeorology. 2019. https://doi.org/10.1007/s00484-019-01717-x
  2. Twohig-Bennett C, Jones A. The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environmental Research. 2018. https://doi.org/10.1016/j.envres.2018.06.030
  3. Mao GX, Lan XG, Cao YB, et al. Effects of short-term forest bathing on human health in a broad-leaved evergreen forest in Zhejiang Province, China. Biomedical and Environmental Sciences. 2012. https://pubmed.ncbi.nlm.nih.gov/22840583/
  4. Ochiai H, Ikei H, Song C, et al. Physiological and psychological effects of forest therapy on middle-aged males with high-normal blood pressure. International Journal of Environmental Research and Public Health. 2015. https://doi.org/10.3390/ijerph120302532
  5. Ideno Y, Hayashi K, Abe Y, et al. Blood pressure-lowering effect of Shinrin-yoku (Forest bathing): a systematic review and meta-analysis. BMC Complementary and Alternative Medicine. 2017. https://doi.org/10.1186/s12906-017-1912-z
  6. Andrade AM, Durães SDF, Franco Netto LCR, et al. Short-term cardiovascular and mental health responses to Shinrin-Yoku (forest bathing): a systematic review and meta-analysis. Frontiers in Psychology. 2026. https://doi.org/10.3389/fpsyg.2026.1707829
  7. Saeedy Robat E, Bayazi MH, Nayyeri M, et al. A systematic overview and second-order meta-analysis of nature-based interventions for stress, anxiety and depression. Nature Human Behaviour. 2026. https://doi.org/10.1038/s41562-026-02433-4
  8. Brandt L, De Prisco M, Nocera D, et al. Climate-Related and Nature-Based Interventions for Mental Health: An Umbrella Review and Meta-Analysis. JAMA Psychiatry. 2026. https://doi.org/10.1001/jamapsychiatry.2026.0037
  9. Roberts H, van Lissa C, Hagedoorn P, et al. The effect of short-term exposure to the natural environment on depressive mood: A systematic review and meta-analysis. Environmental Research. 2019. https://doi.org/10.1016/j.envres.2019.108606
  10. Bratman GN, Hamilton JP, Hahn KS, et al. Nature experience reduces rumination and subgenual prefrontal cortex activation. Proceedings of the National Academy of Sciences. 2015. https://doi.org/10.1073/pnas.1510459112
  11. White MP, Alcock I, Grellier J, et al. Spending at least 120 minutes a week in nature is associated with good health and wellbeing. Scientific Reports. 2019. https://doi.org/10.1038/s41598-019-44097-3
  12. Rojas-Rueda D, Nieuwenhuijsen MJ, Gascon M, et al. Green spaces and mortality: a systematic review and meta-analysis of cohort studies. The Lancet Planetary Health. 2019. https://doi.org/10.1016/S2542-5196(19)30215-3
  13. Georgiou M, Morison G, Smith N, et al. Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021. https://doi.org/10.3390/ijerph18052486
  14. Britton E, Kindermann G, Domegan C, Carlin C. Blue care: a systematic review of blue space interventions for health and wellbeing. Health Promotion International. 2020. https://doi.org/10.1093/heapro/day103
  15. Magnavita N, Capitanelli I, Ilesanmi O, Chirico F. Occupational Lyme Disease: A Systematic Review and Meta-Analysis. Diagnostics. 2022. https://doi.org/10.3390/diagnostics12020296

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