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Nature-based interventions reduce physiological stress in children with chronic illnesses: evidence from salivary biomarkers

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dc.contributor.advisorJuan Antonio Ortega García
dc.contributor.advisorOrtega García, Juan Antonio
dc.contributor.authorDíaz Martínez, Francisco
dc.contributor.authorSánchez Sauco, Miguel Felipe
dc.contributor.authorOrenes-Piñero, Esteban
dc.contributor.authorHernández-Vera, María José
dc.contributor.authorRobledano Aymerich, Francisco
dc.contributor.authorClaudio, Luz
dc.contributor.authorOrtega García, Juan Antonio
dc.contributor.departmentEcología e Hidrología
dc.contributor.departmentCirugía, Pediatría y Obstetricia y Ginecología
dc.contributor.editorJuan Antonio Ortega García
dc.contributor.otherFacultades de la UMU::Facultad de Medicina
dc.date.accessioned2026-04-15T11:32:20Z
dc.date.available2026-04-15T11:32:20Z
dc.date.copyright© 2025 Díaz-Martínez, Sánchez-Sauco, Orenes-Piñero, Hernández-Vera, Robledano Aymerich, Claudio and Ortega-García.
dc.date.created2025
dc.date.issued2025
dc.description.abstractIntroduction: Contact with nature is increasingly recognized as an important determinant of public health, yet limited objective evidence exists regarding its benefits for children with chronic illnesses. This study aimed to evaluate the short-term effects of a forest-based intervention on stress-related salivary biomarkers in vulnerable pediatric populations, including cancer survivors and children with neurodevelopmental disorders. Methods: A quasi-experimental design was used to assess 52 children aged 8-17 years, including both patients and their healthy siblings. Participants completed a 2.5-h guided immersion in a Mediterranean forest. Saliva samples were collected immediately before and after the intervention to measure cortisol, alpha-amylase, and immunoglobulin A levels. The study was approved by the Ethics Committee of the Hospital Clínico Universitario "Virgen de la Arrixaca" on June 29, 2021 (CEIC Code, 2021-6-10-HCUVA). Results: At the group level, significant reductions in cortisol and alpha-amylase were observed following the intervention, indicating acute stress relief. Subgroup analyses revealed notable decreases in cortisol and immunoglobulin A among children with neurodevelopmental disorders, while cancer survivors showed significant reductions in alpha-amylase. Discussion: This study provides novel biomarker-based evidence that brief exposure to natural environments can reduce physiological stress in children with chronic illnesses. These findings support the integration of accessible nature-based interventions into healthcare and community programmes to promote health, resilience, and overall wellbeing in pediatric populations.
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dc.identifier.citationDíaz-Martínez F, Sánchez-Sauco MF, Orenes-Piñero E, Hernández-Vera MJ, Robledano Aymerich F, Claudio L, Ortega-García JA. Nature-based interventions reduce physiological stress in children with chronic illnesses: evidence from salivary biomarkers. Front Public Health. 2025 Dec 11;13:1698278. doi: 10.3389/fpubh.2025.1698278. PMID: 41458415; PMCID: PMC12738948.
dc.identifier.doi10.3389/fpubh.2025.1698278
dc.identifier.eissn2296-2565
dc.identifier.urihttp://hdl.handle.net/10201/225821
dc.languageeng
dc.publisherFrontiers
dc.relationThe author(s) declare that financial support was received for the research and/or publication of this article. Luz Claudio's work in this project was supported by grants awarded by the National Institutes of Health T37MD001452, D43TW011403, and R01MD020109. Additional support was provided by the “Healthy Ecosystems, Healthy Neurodevelopment project” in IMIB-Pascual Parrilla (8437 ID), funded by the National Drugs Plan of the Spanish Ministry of Health; the Paediatric Department of the University Hospital “Virgen de la Arrixaca” and the “Environmental Health Profile for Children in the Murcia Region Project” in the Foundation for Formation and Research (FFIS), funded by Sociedad Pediatría Sureste of Spain (SPSE.ES) (FFIS-DF-2022-36).
dc.relation.publisherversionhttps://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1698278/full
dc.rightsAttribution 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectContact nature
dc.subjectForest environments
dc.subjectPhysiological benefits
dc.subjectSalivary cortisol
dc.subjectscientific evidence
dc.subjectChildren
dc.subject.odsObjetivo 15: Bosques, desertificación y diversidad biológica
dc.subject.odsObjetivo 13: Cambio climático
dc.subject.odsObjetivo 3: Salud
dc.titleNature-based interventions reduce physiological stress in children with chronic illnesses: evidence from salivary biomarkers
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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