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Description : The medical presentation titled, "Forest Bathing and Forest Medicine - The Impact of Shinrin-Yoku on Wellness" delivered during Global Wellness Summit".

Tags : Shinrin-Yoku, Japan, wellness, healthcare, alternative medicine, Forest Bathing, Forest medicine

Published on : Jul 19, 2020 | Views : 2881 | Downloads : 7

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Keynote presentation Forest Bathing and Forest Medicine The Impact of Shinrin-Yoku on Wellness Qing Li, MD, PhD Nippon Medical School Hospital President of Japanese Society of Forest Medicine Vice-president and general secretary of International Society of Nature and Forest Medicine (INFOM) Director of Forest Therapy Society in Japan 2019 Global Wellness Summit, October 15-17, Singapore
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Penguin Random House UK Penguin Random House USA On April 5, 2018, Penguin Random House UK published my book: Shinrin-Yoku The book also was published in USA under the title of Forest Bathing on April 17, 2018 by Viking Books. The book has been translated into 1.French, 2.Spanish, 3.Dutch, 4.German, 5.Italian, 6.Russian, 7.Portuguese, 8.Hungarian, 9.Czech, 10.Slovak, 11.Polish, 12.Bulgarian, 13.Finnish, 14.Chinese Complex, 15.Danish, 16.Swedish, 17.Estonian, 18.Thai, 19.Romania, 20.Simplified Chinese, 21.Korean, 22. Slovenia, 23.Lithuania, 24.Turkish, 25.Japanese The book has been translated into 25 languages
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2018.4.17 Penguin Random House USA Bestseller list in USA
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Why is Shinrin-Yoku so popular in the world? Because Shinrin-Yoku has changed From a Feeling to a Science
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What is forest bathing (Shinrin-yoku)? Shinrin in Japanese means ‘forest’, and yoku means ‘bath’. So shinrin-yoku means bathing in the forest atmosphere, or taking in the forest through our senses. This is not exercise, or hiking, or jogging. It is simply being in nature, connecting with it through our sense of sight, hearing, taste, smell and touch. Shinrin-yoku is like a bridge. By opening our senses, it bridges the gap between us and the natural world.
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Why do people love (like) forests? The forest environment has been enjoyed by humans for a long time because of The quiet atmosphere The beautiful scenery The mild climate The clean fresh air in the forest The special good smell
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How to enjoy forest bathing People can enjoy forest bathing through five senses: Sense of sight: green color, forest landscape Sense of smell: special good smell, fragrance, phytoncides Sense of hearing: forest sounds, birds song Sense of touch: Touching trees, put your whole body in the forest atmosphere, Sense of taste: Eating foods from forest, taste the fresh air in forest.
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Why Shinrin-yoku? and the background
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Stress and Shinrin-yoku Stress can induce almost all lifestyle-related diseases, such as: cancers, hypertension, depression, cardiovascular diseases (myocardial infarction), stroke (cerebral haemorrhage), gastric ulcer, obesity, alcoholism, panic disorder, eating disorder, You name it. On the other hand, Shinrin-yoku can reduce stress.
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Why Shinrin-yoku? and the background Based on the above background, in Japan, a national health programme for forest-bathing was proposed by the Forest Agency of Japan in 1982 for reducing stress in workers. In 2004, the Forest Agency of Japan organized the project team to investigate the effect of shinrin-yoku on human health (about 1.5 million dollars). I was invited as a main member of the project team. Some people study forest, some people study medicine, I study forest medicine to find the beneficial effects of forest bathing on Wellness.
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My hypothesis Relationship between Shinrin-yoku/forest bathing and immune function It is well known that immune system including natural killer (NK) cells plays an important role in defense against bacteria, viruses and tumors. It is also well known that stress inhibits immune function. Forest environment (Shinrin-yoku/forest bathing) may reduce stress. Therefore, I speculated that forest environment (Shinrin- yoku/forest bathing) may have beneficial effect on immune function by reducing stress.
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Relationship between incidence rate of cancer and NK activity People with lower NK activity People with higher NK activity Kazue Imai, et al. Lancet 2000; 356: 1795–99 Subjects: 3625 Periods of follow-up：11 years People with lower NK activity People with higher NK activity Incidence rate of Cancer Incidence rate of Cancer Males Females People with lower NK activity show higher incidence rate of cancer, whereas people with higher NK activity show lower incidence rate of cancer in both males and females. From these findings, you can find the importance of NK cells for human health.
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Today’s topics Effect of Shinrin-yoku on human immune function Effect of Shinrin-yoku on stress hormones Effect of Shinrin-yoku on psychological responses Effect of Shinrin-yoku on blood pressure and heart rate What is Forest Medicine The Impact of Shinrin-Yoku on Wellness The future development of Forest Medicine
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Effect of Shinrin-yoku on human immune function Preventive effect of Shinrin-yoku on cancers
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The first forest bathing/shinrin-yoku study in Japan (in the world) In 2005, I conducted the first forest bathing study in Iiyama city, Ngano Li Q, et al. Forest bathing enhances human natural killer activity and expression of anti-cancer proteins. Int J Immunopathol Pharmacol. 2007;20(2):3-8. The terms of forest bathing and Shinrin-yoku in English were first used and defined in this paper. Japanese oak, Japanese white birch, Bamboo grass a short break in the forest in 2005
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Subjects were taking a rest in the forest in 2005
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Shinrin-yoku significantly enhances human NK activity in males 40 NK activity ( ) * **,# 30 20 10 0 Before Day 1 Day 2 *: p<0.05, **: p<0.01, from before the trip #: p<0.05 from Day 1 Li Q. et al., Int J Immunopathol Pharmacol. 2007;20(2 Suppl 2):3-8.
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A trip to a place without forest does not enhance human NK activity in males Effect ofa trip in a place w ithout forest on N K activity 35 30 25 20 15 10 5 0 B efore D ay 1 D ay 2 N K avtivity （％） Li Q et al. Int J Immunopathol Pharmacol. 2008;21(1):117-27.
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Question Q: Why do Shinrin-yoku increase human NK activity? A1: The number of NK cells increased.↑ A2: The intracellular anti-cancer proteins increased.↑
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Shinrin-yoku significantly increased the number of NK cells in males 800 1000 NK N um ber/ul ** **,# 600 400 200 0 B efore D ay 1 D ay 2 **: p<0.01, significantly different from before the trip, #: p<0.01 significantly different from Day 1 Li Q. et al., Int J Immunopathol Pharmacol. 2007;20(2 Suppl 2):3-8.
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Shinrin-yoku significantly increased granulysin (GRN), perforin, granzyme (Gr) A/B-expressing cells **: p<0.01, from before the trip $: p<0.01 from Day 1 Li Q. et al., Int J Immunopathol Pharmacol. 2007;20(2 Suppl 2):3-8. 1400 1800 1600 N um ber ofcells/ul B efore D ay 1 D ay 2 ＊＊＊＊＊＊ 1200 ＊＊ 1000 ＊＊ 800 600 400 200 0 G R N Perforin G rA G rB ＊＊＊＊＊＊
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The 2nd and 3rd forest bathing/shinrin-yoku study in Japan (sustained effect of forest bathing) In 2006 and 2007, I conducted the second and third forest bathing study in Akasawa (the birthplace of forest bathing in Japan) and Shinano tawn, Ngano prefecture to investigate the sustained effect of forest bathing and the results were published as follows: Li Q, et al. Visiting a forest, but not a city, increases human natural killer activity and expression of anti-cancer proteins. Int J Immunopathol Pharmacol. 2008;21(1):117-27. Li Q, et al. A forest bathing trip increases human natural killer activity and expression of anti-cancer proteins in female subjects. J Biol Regul Homeost Agents. 2008;22(1):45-55.
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Japanese cypress (the birthplace of forest bathing in Japan)
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The birthplace of forest bathing in Japan There are no mosquitos in the forest!!
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Learning breathing method
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Female subjects enjoy the Forest Therapy
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Shinrin-yoku increased NK activity and this effect lasted for 30 days in both males and females 35 30 25 20 15 10 5 0 Before Day 1 Day 2 Day 7 Day30 NK activity (%) *: p<0.05, **: p<0.01, from before the trip Li Q et al. Int J Immunopathol Pharmacol. 2008;21(1):117-27. Li Q. et al. J Biol Regul Homeost Agents 2008;22(1):45-55. * * ** Male ** 35 30 25 20 15 10 5 0 Before Day 1 Day 2 Day 7 Day 30 NK activity (%) Female ** ** *
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Shinrin-yoku increased the number of NK cells and this effect lasted for 30 days in both males and females Male 600 500 400 300 200 100 0 Before Day 1 Day 2 Day 7 Day30 No of NK cells/ul *: p<0.05, **: p<0.01, from before the trip Li Q et al. Int J Immunopathol Pharmacol. 2008;21(1):117-27. Li Q. et al. J Biol Regul Homeost Agents 2008;22(1):45-55. ** ** ** * 25 20 15 10 5 0 30 Female Before Day 1 Day 2 Day 7 Day 30 NK cells (%) ** ** **
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Shinrin-yoku increased intracellular anti-cancer proteins and this effect lasted for 30 days in both males and females Male 50 40 30 20 10 0 70 60 Perforin GrA GrB GRN Positive rate（％） Before Day 1 Day 2 Day 7 Day30 *: p<0.05, **: p<0.01, from before the trip Li Q et al. Int J Immunopathol Pharmacol. 2008;21(1):117-27. Li Q. et al. J Biol Regul Homeost Agents 2008;22(1):45-55. ** * Female 0 10 40 30 20 60 50 Perforin GrA GrB GRN Positive rate (%) Before Day 1 Day 2 Day 7 Day 30 ** ** ** * **** ** *** * **** ** ** ** ** ** * **** ** *
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Effect of Shinrin-yoku on stress hormones
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Shinrin-yoku reduced urinary adrenaline, whereas a city tourist trip did not affect this *: p<0.05 from Before Li Q et al. Int J Immunopathol Pharmacol. 2008;21(1):117-27. ug/gCr Adrenaline is a stress hormone.
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Shinrin-yoku reduced urinary adrenaline and noradrenaline in females Urinary adrenaline 0 2 6 4 8 10 Before Day 1 Day 2 ug/g Creatinine **:p<0.01 Li Q. et al., J Biol Regul Homeost Agents 2008;22(1):45-55. Urinary noradrenaline 0 20 40 60 80 100 Before Day 1 Day 2 ug/g Creatinine ** ** 68％↓ ** Adrenaline and noradrenaline are stress hormones.
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Shinrin-yoku reduced cortisol in serum in males Cortisol is another stress hormone N=16, mean ± ＳＥ. **: p<0.01, #: p=0.053 Li Q, et al. A day trip to a forest park increases human natural killer activity and the expression of anti-cancer proteins in male subjects. J Biol Regul Homeost Agents. 2010 Apr-Jun;24(2):157-65.
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Effect of Shinrin-yoku on psychological responses
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Effect of Shinrin-yoku on blood pressure and heart rate
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Forest bathing experiment
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Slide 46-

Control experiment (urban tour)
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Shinrin-yoku significantly reduces blood pressure compered with city walking Blood pressure was decreased about 7-8mmHg by forest bathing *: p<0.05, **: p<0.01 forest vs city (n=16) Li et al: Eur J Appl Physiol. 2011;111(11):2845-53. SBP: Systolic blood pressure, DBP: Diastolic blood pressure
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Shinrin-yoku reduced heart rate Heart rate is a basic index of activity of the autonomic nervous system, the decrease in heart rate indicates a state of relaxation with a higher activity of parasympathetic nerve and lower activity of sympathetic nerve 90 65 70 80 85 Heart rate/min * 75 * * ** ** ** ** ** ** 森林 Shinrin-yoku 都市 City walking 60 11:00 11:20 11:40 12:00 12:20 12:40 13:20 13:40 14:00 14:20 14:40 15:00 15:20 *: p<0.05, **: p<0.01 vs shinrin-yoku (n=19) Li Q, et al. Effects of Forest Bathing on Cardiovascular and Metabolic Parameters in Middle-Aged Males. Evid Based Complement Alternat Med. 2016;2016:2587381.
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Mechanism of Shinrin-yoku on blood pressure Shinrin-yoku Adrenaline↓ Noradrenaline↓ Cortisol↓ activity of sympathetic nerves ↓ activity of parasympathetic nerves ↑ Blood pressure Stress ↓
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New science Forest Medicine
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On July 5, 2010, The New York Times reported our studies and cited 4 papers Environ Health Prev Med. 2010;15:27-37. Environ Health Prev Med. 2010;15:18-26. Int J Immunopathol Pharmacol. 2007;20:3-8. J Biol Regul Homeost Agents. 2008;22:45-55. After this report, a publisher in NY invited me to write a book: Forest Medicine and the book was published in 2012
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What is Forest Medicine Since 2004, we have conducted many studies to investigate the effect of forest bathing on human health. We have established a new science, Forest Medicine and published the book: Forest Medicine in 2012. Imagine a new medical science that could let you know how to be more active, more relaxed and healthier with reduced stress and reduced risk of lifestyle-related disease and cancer by visiting forests. This new medical science is called Forest medicine. Forest Medicine is a new, interdisciplinary science, belonging to the categories of environmental medicine and preventive medicine, which studies the effects of forest environments on human wellness.
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Forest Medicine (Editor: Dr. Qing Li) English edition(2012 in USA) Chinese translation edition (2013) Korean translation edition(2017)
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The Impact of Shinrin-Yoku on Wellness Increase the activity of natural killer cells—immune cells that play an important role in defense against bacteria, viruses, and tumors; → has a potential preventive effect on cancers Reduce blood pressure and heart rate; → has a potential preventive effect on hypertension, cardiovascular diseases Reduce stress and stress hormones; → has a effect on stress management Increase the activity of the parasympathetic nervous system (part of rest and recover) and reduce the activity of the sympathetic nervous system (part of fight or flight), producing psychologically calming effects; → has a potential preventive effect on depression and mental disorders
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The Impact of Shinrin-Yoku on Wellness Reduce symptoms of anxiety, depression, anger, fatigue, and confusion; → has a potential preventive effect on depression Improve sleep; → has a potential preventive effect on sleep disorder Increase energy; → keeps health status Potential preventive effects on lifestyle related diseases by reducing stress.
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The future development of Forest Medicine Based on the above background, I would like to propose the future development of Forest Medicine. To expand the philosophy of Forest Medicine into global wellness field in the world. To verify the preventive effects of Forest Medicine on lifestyle-related diseases in the world. To establish an international certification system for Forest Medicine specialist and Forest Therapist. To establish the Shinrin-yoku/Forest bathing as a treatment for some lifestyle-related diseases. To apply the Shinrin-yoku/Forest bathing into rehabilitation medicine.
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The Society of Forest Medicine established in 2007 http://forest-medicine.com (in Japanese, English, Chinese） President: Dr. Qing Li
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International Society of Nature and Forest Medicine (INFOM) established in 2011 http://infom.org President: Dr. Michiko Imai Vice-President & Secretary-General: Dr. Qing Li
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Slide 60-

Fuji TV （News Speak） November 8, 2005
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The Japan Times 2008.5.2
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An interview from Bloomberg TV July 1, 2009
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American Scientist
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BBC Radio http://www.bbc.co.uk/programmes/b01p7fgv Date: December 8, 2012, 10:30 AM～ Title:‘The Secret Power of Trees’ Dr. Qing Li, the Vice-President and the Secretary- General of INFOM received an interview by BBC Radio on Forest Medicine
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BBC world news (April 25, 2018) http://www.bbc.com/news/av/health-43867400/forest-bathing- how-a-walk-in-the-woods-could-do-you-good French radio (April 16, 2018) https://www.francetvinfo.fr/replay-radio/mise-a-jour/dr-qing-li-plus-il-y-a- darbres-et-plus-ils-sont-grands-plus-vous-aurez-deffets_2685216.html
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German TV interview（2016.11）
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French TV interview （2016.11）
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NHK program on 2018.04.27 about Phytoncide
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Nippon Medical School website
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Let’s go to shinrin-yoku！

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