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.

Background: Physical exercise is often recommended as additional treatment for people suffering from allergic rhinitis and/or asthma, but less is known about the specific effects of recreational winter outdoor exercise on allergic airway inflammation. Methods: We performed a longitudinal, randomized controlled intervention study to investigate the effects of recreational winter exercise on allergic airway inflammation, quality of life, spirometry and cardiorespiratory fitness in adults suffering from allergic rhinitis and/or asthma. The exercise group participated in a ten-day winter sports program. The control group did not receive any intervention. Results: A significant improvement of fractional oral exhaled nitric oxide (FeNO; p = 0.008, day 10) and a significant decrease in FeNO after a single 4 h hiking tour (p < 0.001, time effect) were observed for the exercise group. The nasal eosinophilic cell count revealed a short-term reduction (p = 0.021, treatment effect) in the exercise group and for the visual analogue scale sustainable improvements in allergic symptoms (p < 0.001, day 60) were found. No adverse effects of outdoor winter exercise were observed. Conclusion: Recreational winter exercise at moderately cold temperatures reduces allergic airway inflammation measured as FeNO, nasal eosinophilic cell count and induces sustainable improvements in allergic symptoms.

(1) Background: The prevalence of allergic respiratory diseases is still rising and efforts towards holistic treatments should be made. Although speleotherapy is widely applied in Europe to treat chronic airway diseases, the existing scientific evidence is rather low. Recreational winter exercise has been shown to improve allergic airway inflammation, but little is known about the combined effects of speleotherapy and recreational winter exercise. (2) Methods: In this clinical study we investigated the effects of winter exercise and speleotherapy on adults with allergic rhinitis and/or asthma. The speleotherapy group (n = 23) participated in a ten-day combined winter exercise and speleotherapy program and the exercise group (n = 18) joined a full-day winter sports program. The effects on allergic airway inflammation, quality of life, spirometry and cardiorespiratory fitness were assessed. (3) Results: No significant effects were found for fractional exhaled nitric oxide or nasal nitric oxide. Quality of life (p < 0.001 time effect) and allergic symptoms (p < 0.001 time effect) were improved in the speleotherapy and in the exercise group. (4) Conclusions: Winter exercise alone and winter exercise in combination with speleotherapy improve quality of life and allergic symptoms in adults with allergic rhinitis and/or asthma. Further studies are required to investigate the specific effects of speleotherapy. To our knowledge, this is the first investigation examining speleotherapy in combination with winter exercise. Recreational outdoor winter exercise and speleotherapy may be recommended for highly functioning patients with good disease control.

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.

Although strong evidence shows that physical inactivity and sedentary behavior are associated with many negative health outcomes, inactive lifestyles are still increasing. Consequently, new approaches must be developed to increase adherence to an active lifestyle and hence a longer life. Green exercise and health coaching could be effective ways to induce long-lasting lifestyle changes geared towards more physical activity. In this randomized controlled trial, we investigated the effects of mountain hiking and psychological coaching on adults with a sedentary lifestyle. The coaching group (n = 26) participated in a 7-day guided hiking program with three personal coaching sessions, whereas the hiking group (n = 32) received no coaching. The effects on aerobic capacity, spirometry and quality of life were assessed at baseline (day 0), after the intervention week (day 7) and after 80 days. Fully nonparametric statistical analysis revealed a gender-based effect for aerobic capacity—the female participants of the coaching group showed a greater improvement (p = 0.03) than the hiking group. No significant effects were found for spirometry. Quality of life parameters improved in both groups. In conclusion, both green exercise and health coaching are capable of inducing improvements in health-related quality of life and cardiorespiratory fitness. No superior effects of health coaching were found.

Sunlight controls endogen hormone balances and numerous health effects. Therefore, it is important to provide building users, such as schoolchildren, with sufficient daylight. Too much of it, however, leads to overheating, which is why shading systems are used. Consequently, these systems improve energy balance, but might not have positive effects on present people’s health. Within this study, shading systems were installed in classrooms of a middle school: common shading in two rooms, while two others were equipped with shading blades “Schlotterer RETROLux 80D” in an innovative design, reflecting more daylight indoors. The participating classes were divided between rooms with ordinary daylighting (n = 43) and advanced daylighting (n = 42). They spent, on average, 5 days weekly and 5–8 h daily in these classrooms. Saliva samples were collected during three semesters to detect hormonal changes. Questionnaires were collected to obtain more information about the mental alterations and, furthermore, to support the physiological results. A significant reduction in cortisol levels between 6:30 AM and 11:30 AM (p < 0.001) was observed within the group that had advanced daylighting. Questionnaires show that both groups sleep less as study duration increases (p < 0.001 time effect), but only the control group has a concurrent increase in daytime sleepiness according to relative treatment effects. The results show that increased daylight supply indoors leads to a significant greater reduction in cortisol levels of children and that those positive outcomes can be achieved by using innovative technologies for buildings.