Chronic diseases such as type 2 diabetes, cardiovascular disease, and certain cancers represent the leading causes of morbidity and mortality worldwide. Lifestyle interventions targeting stress reduction, physical activity, and health-promoting behaviors have shown potential in mitigating risk factors for these diseases.

Recent evidence suggests that:

• Mindfulness practices reduce physiological stress markers (e.g., cortisol), improve glycemic control, enhance cardiovascular health, and may influence immune regulation.

• Nature exposure (forest bathing, mindful walking, park engagement) has been associated with improved cardiovascular outcomes, lowered inflammation, enhanced mental well-being, and increased physical activity.

• Combined interventions may synergistically influence behavioral, psychological, and biological pathways, potentially modifying disease risk before onset.

This research aims to systematically evaluate whether structured programs integrating mindfulness with nature exposure can serve as effective preventive strategies for major chronic diseases.

Chronic disease prevalence is rising globally, significantly increasing deaths and healthcare costs; more than half of US adults have at least one chronic condition, and these conditions represent a major global health burden, causing 74% of worldwide deaths in 2019. Over 90% of adults aged 65+ in the US have a chronic condition, with prevalence also higher in rural areas, women, and lower-income groups. The trend is expected to continue, with a projected significant increase in the number of adults with chronic conditions and multi-morbidity by 2050.