# Forest Bathing (Shinrin-yoku) and Preventive Medicine: Immune Modulation, Stress Regulation, Neurocognitive Resilience, and Neurological Health

## TL;DR

Forest bathing, or Shinrin-yoku, may improve immune function, reduce stress, and support brain health through natural exposure to forest environments.

## Contribution

This paper reviews the evidence for forest bathing's effects on immune modulation, stress regulation, and neurocognitive resilience, highlighting its preventive health potential.

## Key findings

- Forest bathing is linked to increased natural killer cell activity and reduced cortisol levels.
- Exposure to forest environments may modulate inflammatory cytokines and promote parasympathetic dominance.
- Preliminary evidence suggests benefits for cognitive restoration and emotional regulation.

## Abstract

Background/Objectives: Forest bathing (Shinrin-yoku) is a nature-based approach with potential preventive health relevance. This review summarizes evidence on its effects on immune function, stress physiology, and neuroprotective pathways. Methods: A narrative review of peer-reviewed studies was conducted using major scientific databases, including observational and interventional research assessing physiological or neurocognitive outcomes following forest exposure. Results: Forest bathing is associated with enhanced natural killer (NK) cell activity, modulation of inflammatory cytokine profiles, reductions in cortisol levels, and shifts toward parasympathetic autonomic dominance. Evidence also suggests a contributory role of tree-derived biogenic volatile organic compounds and phytoncides in immune and stress-regulatory effects. Emerging findings indicate potential benefits for cognitive restoration, emotional regulation, and neurotrophic signaling; however, substantial heterogeneity in study design, exposure characteristics, and outcome measures limits direct comparability and causal inference. Conclusions: Current evidence supports forest bathing as a promising, low-risk strategy for supporting immune resilience, stress regulation, and neurocognitive well-being within a preventive health framework. Preliminary findings also suggest potential benefits in chronic neurological conditions, supporting its neuroprotective role within multimodal neurorehabilitation strategies. Standardized intervention protocols, mechanistic biomarkers, and longitudinal studies are required to strengthen clinical relevance and guide evidence-based integration into public health and lifestyle medicine.