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.

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.

The Alpine space disposes of excellent prerequisites to respond to the increasing demand of nature-based health tourism. Despite a growing scientific knowledge on the manifold benefits of human interaction with Alpine natural resources, the health tourism potential has not yet been fully exploited by Alpine regions. Based on major push and pull factors, the current state of scientific knowledge on the healing potential of nine selected natural Alpine resources is presented and discussed with regard to their health tourism potential. Major research gaps as well as starting points for future studies are demonstrated. In this way, the present work contributes to an applicable knowledge base on the health benefits of Alpine resources to enhance regional innovation capacity in terms of sustainable health tourism development. As tourism regions are increasingly taking evidence-based approaches to health tourism and regional development, the resulting lighthouses will contribute to the positioning of the Alpine space as globally attractive healing environment.

Tourism has been one of the most important economic sectors in the Alps for many years. However, not least because of the cuts due to the pandemic, new and innovative approaches are needed to meet current challenges such as climate change, shortage of skilled workers or demographic change in order to make Alpine tourism fit for the future. The topic of health offers great potential in this context. With the KPI approach, therefore, a possible access to a nature-based health tourism with medical evidence is presented, which should support the actors from the tourism practice in the further development of the Alpine tourism. At the same time, the KPI approach also offers possibilities to enable an overall more sustainable development of the Alpine region. This paper places the KPI approach in a larger development framework and explains the underlying analytical system based on selected indicators. Keywords Health tourism Nature-based health tourism Evidence Sustainable development Product development Key performance indicators Alpine region

Nature-based health tourism is experiencing a resurgence. To determine its potential as a development opportunity for alpine destinations, it is necessary to analyse both the demand and supply side. Two surveys were conducted: a representative survey of the population of six countries of the Alpine Space exploring the perception of the Alps as a healthy destination in general and on the personal assessment of the health effect of natural resources in particular and an exploratory survey of tourism stakeholders in destination management, accommodation and gastronomy as well as (health) tourism services with a focus on the expected economic developments and the relevance of individual target groups for nature-based health tourism. The results demonstrate the need for a strategic development process which aligns perceptions with destination strategy and pre-existing offers. Two potential strategies are briefly outlined: 1. destinations with non-locally specific alpine natural health resources can develop broad tourism experiences for health conditions that occur across society with health a secondary aspect in marketing. 2. destinations featuring locally specific natural health resources with proven evidence can develop offers for a specific condition and are thus able to target a very specific group.

As most of our time is spent indoors, indoor air quality is crucial, especially during seasonal virus outbreaks. Acute upper respiratory tract infections (URTIs) are among the most prevalent diseases globally, leading to symptoms like coughing, nasal congestion, and fatigue, along with significant healthcare costs. Since aerosols play a key role in infection transmission, improving indoor air quality is essential. Nonthermal plasma (NTP) has shown promise in inactivating airborne microorganisms, offering a potential solution for antiviral air purification without the need for filters. The AirDisP_URTI study investigated whether NTP air germ inactivation in real‐world office settings could reduce URTI incidence over a 5‐month period. Initially, the NTP air purifier’s effectiveness was tested in a laboratory. This was followed by an intervention study that measured infection events and severity using the WURSS‐21 questionnaire, health checks, saliva samples, and an aerobic endurance test. A total of 230 participants were randomized, with 150 included in the final analysis: 73 in the NTP group and 77 in the control group. The NTP group experienced noticeably milder symptoms compared to controls. Statistically, symptom severity was significantly reduced ( p = 0.028). Based on infection counts—24 in the NTP group and 32 in the control group—the odds of infection were higher in the control group, with an OR of 1.45 (95% CI: 0.75–2.78), indicating a 45% increased risk of infection without the NTP air purifier. The absolute risk reduction (ARR) was 8.68%, favoring the NTP group. Molecular analysis of saliva revealed lower levels of salivary immunoglobulin A and C‐reactive protein in the NTP group, supporting a milder disease course; IgA differences were statistically significant ( p = 0.039). These findings suggest that NTP air purifiers can reduce the incidence and severity of URTIs, though larger studies are needed to confirm broader impacts. Trial Registration: ISRCTN identifier: ISRCTN11050992