ESPA has formal confirmed that Texel meets the criteria for a Thalasso Health Destination in accordance with the generally accepted European guidelines.

This means that Texel is officially recognized as a destination where health, well-being, and prevention are central, in line with the quality and health standards applied across Europe for Thalasso health regions. The recognition was preceded by various studies and assessments. Climatic conditions, as well as the salt content of both the seawater and the air, were taken into account.

Following the analysis, a medical balneological report was prepared, including preventive and therapeutic recommendations. These form the foundation for further development.

The recognition highlights, among other things:

• the quality of the natural environment on the seaside, clean air, tranquility, and open space),
• the range of health and wellness facilities,
• professional care and preventive services,
• and an integrated approach to vitality and recovery.

This makes Texel, along with Cadzand, Domburg, and Noordwijk, one of the four Dutch seaside resorts to receive this special recognition.

With this European recognition, the municipal executive is fulfilling one of the ambitions of the second Implementation Agenda for the Tourism Future Plan 2025-2027: conscious and worthwhile visits.

With a conscious and valuable offering, we cater to the Texel visitor who visits during the early and late season and highly values ​​the island’s core values ​​(peace, space, nature, scenic quality, cultural history, and darkness at night). This isn’t a new market, but rather a market deepening opportunity. This recognition aligns with Texel’s ambition to promote sustainable tourism.

Texel, naturally healthy: opportunities for the island and its visitors

Both the NBTC (Netherlands Board of Tourism and Conventions) and the Texel Tourist Information Office (VVV Texel) see significant opportunities to further enhance the island’s image under the banner “Texel, naturally healthy.” “We want to attract visitors who appreciate nature, tranquility, and quality,” says alderman Kieft. “The recognition confirms what we already knew: life on Texel is healthy. This unique designation helps us communicate this even more effectively to our residents, businesses, and everyone who comes here to recharge.”

The new theme page https://www.texel.net/en/see-and-do/texel-naturally-healthy/ showcases Texel’s significance as a healthy seaside resort. Visitors will find tips for experiencing health in an accessible, down-to-earth way. The page features recognizable labels that reflect what Texel already offers: outdoor exercise, active relaxation, mindfulness on Texel, local products, wellness on the island, and accommodations with wellness. These labels form the basis for existing and future activities, products, and packages that contribute to a healthy experience on the island.

For questions, please contact:
Rosalie Lap, Director of the Texel Tourist Office
T: +31 222 314741
E: r.lap@texel.net

The importance of medical spas and health resorts within European healthcare is growing, especially as chronic diseases affect up to a quarter of the population. Traditional medicine alone cannot meet the long-term needs of these patients, while health resorts offer a unique combination of physical therapy, rehabilitation, well-being, and patient education, making them an effective complement to classical treatment.

For medical spas to be fully integrated and recognised, Prof. Carpentier stresses the need for rigorous scientific evidence. Treatments must be evaluated with methodologies comparable to pharmacological research – randomised studies, control groups, and blinded assessments wherever possible. Only strong scientific validation will convince insurance providers, ensure affordability for all income groups, and prevent spa therapies from becoming a luxury accessible only to the wealthy.

“While artificial intelligence may support healthcare delivery, it cannot replace the human relationship essential in chronic disease care. Europe’s diversity in spa practices is both a challenge and an opportunity, and the European Spa Association plays a key role in unifying standards and sharing experience across countries,” says Carpentier.

Looking ahead, Carpentier sees two priorities: significantly more research and better education for medical professionals, including integrating balneotherapy into medical training.

The ISMH World Congress is one of the most important international scientific meetings in the field of balneology, medical hydrology and climatology. The 48th Congress will bring together clinicians, researchers, academics, and health professionals from around the world to exchange knowledge, present current research, and discuss future directions in medical hydrology and spa medicine.

Organisers are proud to announce that participants from 27 countries have already registered, confirming strong international interest and the global relevance of this Congress.

Main Topics

The Congress will cover a broad range of multidisciplinary topics, including:

• Pain management and healthy ageing
• Balneotherapy in musculoskeletal, neurological, dermatological, metabolic, respiratory, and cardiovascular diseases
• Post-COVID rehabilitation and recovery
• Integrative and complementary medicine
• Balneotherapy in paediatrics
• Peloid therapy and thalassotherapy
• Health resort management and economics
• The Global H₂S Initiative

The scientific program will feature plenary lectures by internationally recognised invited speakers, oral and poster presentations, and thematic sessions designed to encourage discussion and international collaboration.

The Congress will take place in Banja Koviljača, one of the oldest and most renowned spa towns in Serbia, in Southeast Europe, known for its long tradition in medical hydrology and rehabilitation medicine. Scientific and official events will be held at several venues within walking distance, including the historic Kur-Salon, Specialized Rehabilitation Hospital and nearby congress and hotel facilities within the spa complex.

Banja Koviljača is easily accessible via Belgrade Nikola Tesla International Airport (BEG), approximately 120 km away (70-minute drive), with organised transfers available. An alternative option is Tuzla International Airport (TZL), located about 60 km from the venue.

Registration and Participation

The Congress is open to ISMH members and non-members, physicians, researchers, health professionals, and students with an interest in balneology and related disciplines.

Early bird registration is available until February 1st 2026, offering reduced registration fees.

Further information regarding registration, abstract submission, accommodation, and official deadlines is available at the website and by e-mail: ismh@balneologija.rs and www.balneologija.rs/ismh.html.

The Synthesis Report, published in December 2025, has revealed that Europe faces an urgent need to modernise its health systems to cope with rising chronic diseases, ageing populations and workforce shortages. The report highlights four critical priorities for action: prevention of non-communicable diseases (NCDs), digital health transformation, strengthening primary care and equitable access to innovative therapies.

The European Spas Association (ESPA) welcomes the report and emphasis that medical spas, natural health resorts and climate-health destinations already provide evidence-based, cost-effective solutions to many of these challenges, yet remain underused in current health policies.

Medical Spas Are Ready to Support Europe’s NCD Crisis

The report notes that over 725,000 premature deaths from NCDs could have been prevented in 2022, and that 62 million Europeans live with cardiovascular disease. Medical spas across Europe have a long tradition of delivering preventive, rehabilitative and chronic-care programmes, particularly for:

• cardiovascular diseases 
• musculoskeletal conditions 
• respiratory disorders 
• diabetes 
• obesity 
• stress and burnout 

Natural therapeutic resources: thermal waters, peloids, clean mountain air, marine aerosols and therapeutic climates are scientifically recognised for improving vascular health, lung function, mobility, and overall well-being.

The report raises alarming trends: rising childhood obesity, physical inactivity, and increased use of e-cigarettes among teenagers.
Climate-health destinations – mountain, healing forest, forest and coastal resorts with measurable therapeutic environments – offer:

• structured physical activity 
• respiratory rehabilitation 
• stress reduction 
• long-term behavioural change 
• mobile-free and nature-rich settings for youth

ESPA’s Thalasso working group strengthens scientific standards, exchange and development of high-quality services for younger generations.

Supporting Digital Health and Workforce Capacity

The EU urges Member States to speed up digital transformation and tackle health workforce shortages. Medical spas are actively innovating in both areas, like digital physiotherapy & VR-assisted rehabilitation support therapists, and expanding accessibility.

Strengthening Primary and Chronic Care – Cost Effectively

Primary care across Europe is under strain due to ageing, chronic conditions and lack of personnel.
Medical spas and natural health resorts reduce pressure on hospitals by providing:

• non-invasive therapies 
• post-hospital rehabilitation 
• long-term disease management programmes 
• prevention-oriented lifestyle counselling

These services are cost-effective, sustainable and already integrated in many national health insurance systems. European Medical Spas Are Part of the Solution.

More from the report

The report highlights the following key health system reform challenges and the support the EU is providing to overcome them: 1. Addressing the major health concern of non-communicable diseases (NCDs): NCDs are the leading cause of preventable illness and death in the EU. In 2022, more than 725,000 deaths could have been prevented. They are increasingly affecting younger populations. Across Europe, rates of childhood inactivity and obesity are rising; more than 20% of 15-year-olds use e-cigarettes. Preventing NCD mortality in the EU would reduce the workforce decline due to an ageing population by 12% between 2022 and 2040. With around 62 million people living with cardiovascular disease in the EU, the Commission will also this year present an EU cardiovascular health plan, targeting diabetes and obesity, especially in younger generations. To address the threat of NCDs more broadly, the Commission has launched Europe’s Beating Cancer Plan, the Healthier Together Initiative and is supporting Member States and health organisations with funding from the EU4Health Programme. 2. Strengthening the backbone of EU health care: EU primary care is facing challenges such as rising demand linked to an ageing population, chronic diseases, workforce shortages and underinvestment.

More information: https://ec.europa.eu/commission/presscorner/detail/en/ip_25_3014

This special edition embodies our core values: Health, Quality and Innovation.

From thermal water, climate therapy, and thalassotherapy to mineral waters and modern medical spa trends, the magazine highlights how Europe’s medical spas play a vital role in prevention, resilience, and sustainable wellbeing.

In the foreword, ESPA President Dr Siyka Katsarova underlines that today, more than ever, medical spas are not only places of recovery – they are strategic health infrastructures supporting prevention, rehabilitation, and long-term well-being.

Edited by Csilla Mezősi with contributions from leading spa experts across Europe, this anniversary edition celebrates three decades of European Spas’ commitment to advancing spa medicine and natural remedies, and connecting a diverse network of innovators, practitioners, and destinations.

Inside, readers can explore presentations of European Spas’ 18 National Members and 8 Advisory Members, showcasing the rich diversity of Europe’s medical spa landscape.

…and discover our shared vision for a future where natural remedies, science, and sustainability drive Europe’s approach to health and wellbeing.

An interview with Dr. Martin Gehlen, Rheumatologist and Chief Physician of the Fürstenhof Klinik, Staatsbad Pyrmont, Germany – Special Jury Winner of the ESPA Innovation Awards in the category Innovative Spa Research

1. “Fibromyalgia patients with severe symptoms are often told nothing works for them. Your three-week programme proves otherwise. What’s the key to reaching this particularly difficult-to-treat group?”

One very important task of rehabilitation is to give patients back the feeling of self-efficacy. When a person is suffering from severe pain, exhaustion and sleep disorders, it is disastrous if they feel that none of the possible measures are having any effect. In psychology, the term self-efficacy is used. This means that a person has the confidence that certain measures will lead to an improvement.  The topic of self-efficacy is not only found in the field of health, but runs through all areas of life. A person who has the basic attitude that they can achieve anything if they work hard enough will cope better with health restrictions than a person who feels that they cannot do anything about the restrictions and is passively at their mercy.

The 6-minute walk test is a simple method that we use in our clinic, along with many other methods, to show people that they are very much capable of taking control of their own destiny.

“Even small steps, like the 6-minute walk test, can help patients rediscover
their ability to influence their own health.”

Dr. Martin Gehlen

2. “Your programme is based on neurocognitive models like ‘predictive coding’. Can you explain that in simple terms? How do you change the brain’s perception of pain, fatigue and effort?”

Our brain makes predictions that influence how we evaluate stimuli. Our perception is therefore by no means objective, but is influenced by experience and expectations. In concrete terms, this means that people with severe chronic pain syndromes (e.g. fibromyalgia) often associate physical activity primarily with pain. The aim of our programme is to change the assessment of sporting activity through a sense of achievement at the end of a strenuous 3-week rehabilitation programme. The goal is for this sporting activity to be assessed positively because it leads to an improvement in overall fitness.

More information: www.fuerstenhof-klinik.staatsbad-pyrmont.de

ONKOFIT-SPA programme is the winner of the ESPA Special Jury Innovation Award 2025 in category Innovative Health Spa Programme.

“Excess body fat increases recurrence risk for breast cancer survivors. How do you talk about weight and nutrition with women who’ve just been through cancer treatment? What’s your approach to making this feel supportive rather than pressuring?”

Excess body fat is indeed a known risk factor for breast cancer recurrence. We explain to women that in postmenopausal patients, adipose tissue becomes the main source of estrogen production – a risk particularly relevant for hormone-dependent breast cancers, where elevated estrogen levels may support tumour growth. Because this is such a sensitive topic, we approach it with great empathy, clarity, and without any form of judgement.

In the ONKOFIT-SPA programme, we never create pressure related to body image or performance. These women come to us after a demanding period of cancer treatment, often exhausted physically and emotionally. Our role is to support their recovery, confidence, and sense of safety. When we discuss weight and nutrition, we use exclusively health-focused language, emphasising long-term prognosis and quality of life. We highlight that even small, realistic adjustments in physical activity and eating habits can bring meaningful benefits.

A very important element of the programme is the structured spa stay within a supportive female community of patients who share the same diagnosis. Sharing experiences, participating in group activities, and regaining a sense of physical strength often increases self-confidence and fosters strong motivation to continue the new habits at home after the spa stay.

Our approach is fully individualised. Each participant has access to a nutrition therapist and physiotherapist in a respectful, safe environment where she can speak openly. We focus on sustainable lifestyle habits rather than restrictive diets.

Our data clearly show that this combination of empathetic communication, education, and expert guidance has a long-term positive impact—improving physical performance, body composition, and overall quality of life after cancer treatment. Through this supportive approach, we help women regain not only their health but also a sense of control over their bodies and their future.

Read more about the Oncology Recovery Retreat Programme
Website: https://lazneml.cz/post-onkologicky-program/
Watch the video

And we had plenty of data during this online meeting, thanks to our engaging speakers!

Marketing Marine Minerals

Speaker: Dr. Marcus Wengel (Prof. Dr. Biener GmbH, Saxony, Germany)

Dr. Wengel shared his expertise on minerals in the ocean that can be beneficial for human health. Seawater contains over 70 different minerals. Some of these dissolved inorganic salts are known to have positive effects on human health and are used in medical wellness products.

The best scientific knowledge currently exists for magnesium ions and their behaviour in the skin. Treatments such as balneophototherapy make use of this knowledge for treating skin irritations.

The mineral lithium—commonly used in high concentrations as a therapeutic drug—has proven to be beneficial in low concentrations for people living in areas with little sunlight. Bathing in lithium-enriched water can improve mood and reduce stress.

Selenium is a powerful antioxidant, often called the anti-ageing mineral, as it helps protect cells.

“All these minerals can have new applications in medical wellness. We must show them to our guests—let them feel, see, and smell. Lithium or calcium will cause a warm feeling when added to water, while potassium can be used in a refreshing peeling treatment because it stimulates the skin’s cold sensors. Show what is in the sea and underline the uniqueness of these minerals. It is old knowledge that we must bring to people in a modern way. They want to understand why these minerals and trace elements are important for their bodies—they want to be healthy and feel exclusive. This is a small but important part of the Thalasso universe.”

More information: www.prof-dr-biener-salze.com

Tailor-Made Treatments

Speaker: Claudia Wagner (Fit Reisen, Germany)

Claudia Wagner illustrated how the ancient Thalasso remedy has evolved into modern, tailor-made health cures using natural resources from the sea.

Since the 1980s, Fit Reisen has been creating and promoting healthy holiday experiences—ranging from holistic and natural healing retreats to health spa hotels that integrate the latest advances in modern spa medicine and medical wellness.

The global wellness economy reached a value of $6.3 trillion in 2023, making it larger than the sports and pharmaceutical industries. With an annual growth rate of 6.8%, it is an impressive market. The average spending per guest is €1,700, with an average stay of 12.5 days, and 85% of guests are repeat customers.

As a best practice, she presented the Oceano Health Spa Hotel in Tenerife, featuring both indoor and outdoor seawater pools directly connected to the ocean.

The treatment, as we know it today, was introduced in 1730 by an English doctor, and it continues to evolve to meet new and strong market demands. Guests now seek premium quality, personalised treatments, and authentic experiences focused on prevention, fitness, and a healthy lifestyle.

This evolution requires the integration of digital health tools, mental wellbeing, and holistic approaches. For evidence-based programs, people are willing to spend more. Today, the effects of Thalasso treatments on skin conditions, rheumatism, diabetes, and respiratory diseases are clinically proven.

More information: oceano.de/en/health-spa-hotel-tenerife-health-beauty-wellness-by-the-sea/spa-menu

Doctor’s Prescription: A Walk by the Coast

Speaker: Silke Lambert (Blue Growth Research Lab, Ghent University, Belgium)

Silke Lambert, a young researcher at the Blue Growth Research Lab, investigates how exposure to coastal environments supports physiological health. Traditionally, a stay at the sea was considered healthy because of the high iodine concentration in the air, but today different hypotheses exist.

One theory suggests that a thin layer at the sea’s surface is enriched with bioactive molecules. When waves break, underwater bubbles capture these molecules and burst, releasing sea spray aerosols into the air, which we can inhale.

To analyse their health benefits, these aerosols are captured in liquid and on filters. In the laboratory, they are added to human cell lines to study effects on organs such as the lungs and kidneys.

The Blue Growth team now aims to extend these laboratory experiments to studies involving human participants. Volunteers provide nasal swab and blood droplet samples. Two groups are being compared: one living at the Belgian coast and another living inland.

“We keep investigating,” said Lambert, “and maybe, one day, doctors will prescribe a walk by the coast.”

Thalasso News

• From 24–26 September, the German Thalasso Congress was held in Carolinensiel. ESPA was represented by Marlies Sobczak, leader of the ESPA Thalasso Working Group. The congress was an initiative of DHV Lower Saxony, and an important topic was the Thalasso criteria.
• From 8–10 October, the European Spas and Balneology Congress took place in Haapsalu, Estonia.
• ESPA (The European Spas Association) published a special edition of Health, Quality and Spas magazine on the occasion of its 30th anniversary, featuring the article “Thalasso: Wellbeing by the Waves – Europe’s Thalasso Vision.”
• The Thalasso Working Group is active on social media, including LinkedIn and Facebook.
• Our members Dr. M. Lourdes Mourelle (University of Vigo, Spain) and Haresh S. Kalasariya (INTI International University, Malaysia) published the book “Thalassotherapy and Cosmeceuticals”, available online: europeanspas.eu/new-book-thalassotherapy-and-cosmeceuticals

1. Your system is the first MDR-certified VR rehabilitation in spa settings. What do patients typically do in the virtual environment, and how does it differ from traditional physiotherapy?

In VR Medical, patients are immersed in carefully designed virtual scenarios that replicate meaningful movements and real-life activities. They can move, reach, stretch, and balance in visually rich, motivating environments, training both upper and lower limbs, improving coordination, and even practising everyday tasks. Many forget that they are exercising because they are focused on completing engaging and purposeful activities.

What makes this approach different from traditional physiotherapy is the sense of immersion and motivation. Virtual reality helps patients overcome fear and pain, keeps their attention focused, and allows them to move more naturally. Therapists often tell us that even patients who had lost interest in conventional therapy become active and positive once they experience VR. It helps people rediscover the joy of movement and achievement.

2. When conducting larger group therapy sessions, how do you ensure individualised care? How does this approach work in practice?

Each VR headset tracks the user’s movement and performance in real time, while the therapist monitors everyone’s progress on a tablet. This setup allows one therapist to guide six or more clients simultaneously, while each person still trains at their own pace and on their own program.

For clients, it feels like a shared, social experience that is enjoyable and motivating. For therapists, it is an efficient and flexible way to deliver quality care to more people without losing personal attention. This combination of modern technology and a human-centred approach is why medical spas appreciate the VR Medical system.

3. You’re MDR-certified and implemented in facilities like Royal Spa and Darkov. What was the turning point that convinced medical professionals that VR was a legitimate therapeutic tool?

The real breakthrough came when doctors and therapists witnessed the results themselves. In facilities, patients showed noticeable improvements in mobility, confidence, and pain reduction. Many therapists observed that patients were suddenly completing more repetitions than ever before, not because they were told to, but because they genuinely wanted to continue.

And of course, MDR certification also played a key role, confirming that VR Medical complies with the strict European standards for medical devices. The combination of clinical evidence, patient progress, and regulatory credibility convinced even the most sceptical professionals that VR can serve as a real therapeutic tool, not just an interesting innovation.

4. Looking to the future, where do you see the next step in virtual rehabilitation?

We are now working on an exciting research project supported by the Technology Agency of the Czech Republic, in collaboration with the National Institute of Mental Health and the University Hospital Královské Vinohrady. This project explores “rehabilitation by the brain,” which uses kinesthetic illusions in virtual reality to stimulate neural recovery and support patients with very limited mobility.

We believe this is the future of rehabilitation — a new way to help the brain heal the body through immersive, evidence-based technology.

This comprehensive text offers an in-depth exploration of the research and issues related to the use of seawater and marine environment for therapies, as well as the composition of cosmeceuticals derived from seaweed. With contributions from an international team of experts, the book describes the amazing field of thalassotherapy, highlighting the characteristics of seawater, the techniques of applying seawater and the mechanisms of action, as well as the climatic factors that complement marine therapies. Of particular relevance are cosmeceuticals derived from seaweed, which have been the subject of intense research in recent years. In addition, highly topical aspects are addressed, such as nutrition linked to thalassotherapy.

Editors: M. Lourdes Mourelle (FA2 Research Group, Department of Applied Physics, University of Vigo, Spain), and Haresh S. Kalasariya (Faculty of Health and Life Sciences at INTI International University, Malaysia)

The book can be ordered here >>>

Opening the session, Prof. Christian-François Roques, President of the International Society of Medical Hydrology and Climatology, delivered a recorded address emphasizing the growing relevance of spa medicine in managing stress-related conditions.

Prof. Lorena Vela of the Complutense University of Madrid provided an overview of the general and epidemiological aspects of stress disorders, laying the groundwork for a deeper examination of therapeutic approaches.

Prof. Antonella Fioravanti from the University of Siena presented on fibromyalgia, highlighting the potential of balneotherapy as an effective complementary treatment for this complex and often misunderstood condition.

The discussion continued with Prof. Pedro Cantista of Porto University, who addressed the long-term effects of COVID-19. He underscored the increasing demand for integrative rehabilitation strategies, including those offered through spa-based therapies.

In a compelling presentation, Dr. Olivier Dubois, founder of the Balneology School of Stress, introduced the concept of structured stress management through natural spa treatments. Drawing on experiences from the Saujon Balneology Resort in France, he offered practical insights into this innovative approach.

The session concluded with a panel discussion and closing remarks by Prof. Patrick Carpentier, President of the ESPA Medical Commission, who reinforced the importance of cross-disciplinary collaboration in promoting spa medicine as a viable approach to stress and post-viral recovery.

This session marked a significant milestone in highlighting how traditional spa therapies can contribute meaningfully to contemporary medical care.

This information is part of the online publication Health in the European Union and, more specifically, is part of the domain of healthcare expenditure statistics. It presents key statistics on preventive healthcare expenditure in the European Union (EU) for the reference year 2022. 

With the release of 2022 data, the data in the article relates information on preventive healthcare expenditure during the final full calendar year of the COVID-19 pandemic. Preventive healthcare expenditure in the EU was 76.3% higher in current price terms in 2022 than in 2020. Relative to GDP, preventive healthcare expenditure increased from 0.38% of GDP in 2020 to 0.66% in 2021 and then fell slightly back to 0.57% in 2022. This reflects the impact of the COVID-19 pandemic, in particular for the category of immunisation programmes (which includes vaccination campaigns). The aggregated expenditure of the 19 EU countries which provided separate data on such programmes for 2020 22 increased greatly: in 2021, it was 335% higher than in 2020, while it was still 317% higher in 2022 than in 2020. Consequently, the share of immunisation programmes in the overall expenditure on preventive healthcare increased from 13.6% in 2020 to 28.2% in 2021 and 28.0% in 2022.

More information:

https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Preventive_health_care_expenditure_statistics