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Grider HS, Douglas SM, Raynor HA. The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review. J Acad Nutr Diet 2020; 121:709-727.e1. [PMID: 33279464 DOI: 10.1016/j.jand.2020.10.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Stimuli that promote eating in the absence of the physiological need for food are pervasive and can facilitate excessive energy intake. The practices of mindful eating (ME) and intuitive eating (IE) have been developed to minimize external drivers of energy intake by helping individuals emphasize the sensory properties of foods and internal indicators of hunger and fullness. OBJECTIVE To enhance understanding about the effect of ME and IE interventions on dietary intake, this systematic review included randomized trials of ME and IE interventions that examined dietary intake, defined as energy intake or diet quality, in adults of varying weight status without a diagnosis of an eating disorder. METHODS The selection of literature followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review process, in which PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases were searched for studies published between January 1980 and November 2019. Studies were included if they met the following criteria: randomized trial design in which 1 arm was an intervention with an ME or IE component and there was at least 1 control or active comparison arm; enrolled participants were of a healthy weight or with overweight or obesity and reported not having an eating disorder (ie, anorexia, bulimia nervosa, or binge eating disorder) or other health conditions in which dietary restrictions were applied; were at least 18 years of age; and outcomes of energy intake or diet quality were reported at baseline and post intervention. The modified Downs and Black checklist was used to assess risk of bias for each study that met inclusion criteria. RESULTS A total of 13 studies, including 8 investigating ME interventions and 5 investigating IE interventions, represented in 14 articles, were included in the review. Seven of the 9 articles reporting on energy intake did not find significant group differences. Eight of the 12 articles reporting on diet quality did not find significant group differences. The mean bias assessment score was 13.6 out of 28, indicating poor quality. CONCLUSIONS Little evidence suggests that ME and IE interventions influence energy intake or diet quality. To draw strong conclusions about the effect of ME and IE on dietary intake, future research using study designs of high rigor are needed.
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Affiliation(s)
- Hannah S Grider
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Steve M Douglas
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN.
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Strategies designed to increase the motivation for and adherence to dietary recommendations in patients with chronic kidney disease. Nephrol Dial Transplant 2020; 36:2173-2181. [DOI: 10.1093/ndt/gfaa177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract
Chronic kidney disease (CKD) often requires several dietary adjustments to control the disease-related disturbances. This is challenging for both patients and healthcare providers, and particularly for dietitians, who deal closely with the poor adherence to dietary recommendations. Factors associated with poor adherence within the CKD scenario and the need for a shift in the paradigm have already been indicated in several studies; however, rarely are any different and/or potential strategies actually formulated in order to change this paradigm. In this review, we aimed to explore the concepts and factors surrounding adherence to dietary recommendations in CKD and further describe certain potential strategies for a nutritional counseling approach. Such strategies, while poorly explored within CKD, have shown positive results in other chronic disease scenarios. It is timely, therefore, for healthcare providers to acquire these new counseling skills; nevertheless, this would require a rethinking of the traditional attitudes and approaches in order to build a partnership, based on a nonjudgmental and compassionate style in order to guide behavior change. The reflections presented in this review may contribute towards enhancing motivation and the adherence to dietary recommendations in CKD patients.
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Li A, Cunich M, Fuller N, Purcell K, Flynn A, Caterson I. Improving Adherence to Weight-Loss Medication (Liraglutide 3.0 mg) Using Mobile Phone Text Messaging and Healthcare Professional Support. Obesity (Silver Spring) 2020; 28:1889-1901. [PMID: 32902905 PMCID: PMC7589266 DOI: 10.1002/oby.22930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/01/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adherence to weight-loss medication is suboptimal, leading to poor health outcomes. Short message service (SMS) can potentially improve adherence. METHODS A total of 3,994 participants with overweight or obesity in Australia receiving Saxenda® (liraglutide 3.0 mg) were enrolled from September 1, 2017, to February 28, 2018, through doctors, pharmacists, or websites and were randomly assigned to receive none, three, or five SMS per week. Participants were additionally offered a face-to-face consultation with a diabetes educator or a call from a dietitian. Medication adherence was measured as whether the total scripts claimed were at least as many as the total claims expected by March 31, 2018, and was modeled adjusting for age, sex, baseline BMI, residential region, enrolment channel, the total number of SMS, and additional patient support. RESULTS Participants receiving five SMS (OR, 6.25; 95% CI: 4.28-9.12) had greater adherence than those receiving three SMS (OR, 3.67; 95% CI: 2.67-5.03) or zero SMS per week. The effectiveness of SMS on adherence decreased as participants received more SMS over time. Moreover, the odds of adhering to liraglutide were higher for participants enrolled with pharmacists compared with those enrolled with doctors (OR, 2.28; 95% CI: 1.82-2.86) and for participants who received a face-to-face consultation (OR, 3.10; 95% CI: 1.82-5.29) or a call (OR, 1.31; 95% CI: 1.02-1.68) compared with those who received no extra support. CONCLUSIONS Integration of SMS into routine clinical practice should consider not only the frequency and content of reminders but also additional patient support to achieve higher and more sustained adherence to medication and health behavior changes.
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Affiliation(s)
- Ang Li
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating DisordersCentral Clinical SchoolCharles Perkins CentreThe University of SydneyCamperdownNew South WalesAustralia
- Sydney Health Economics CollaborativeSydney Local Health DistrictCamperdownNew South WalesAustralia
| | - Michelle Cunich
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating DisordersCentral Clinical SchoolCharles Perkins CentreThe University of SydneyCamperdownNew South WalesAustralia
- Sydney Health Economics CollaborativeSydney Local Health DistrictCamperdownNew South WalesAustralia
| | - Nicholas Fuller
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating DisordersCentral Clinical SchoolCharles Perkins CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Katrina Purcell
- Novo Nordisk Pharmaceuticals Pty. Ltd.Baulkham HillsNew South WalesAustralia
| | - Allanah Flynn
- Novo Nordisk Pharmaceuticals Pty. Ltd.Baulkham HillsNew South WalesAustralia
| | - Ian Caterson
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating DisordersCentral Clinical SchoolCharles Perkins CentreThe University of SydneyCamperdownNew South WalesAustralia
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Abstract
Objectives The goal of the present study was to determine whether baseline mindful eating, general mindful awareness, or acceptance was most strongly associated with short- and long-term weight loss in a lifestyle modification program. Methods Data were from 178 participants (baseline BMI=40.9±5.9 kg/m2, age=44.2±11.2 years; 87.6% female; 71.3% black) who enrolled in a two-phase trial. All participants attended an initial 14-week lifestyle modification program that included a meal replacement diet. Participants who had lost ≥5% of initial weight (N=137) were then randomized to 52 weeks of lifestyle modification with lorcaserin or placebo. Linear mixed models examined whether mindful eating (Mindful Eating Questionnaire) and general mindful awareness and acceptance (Philadelphia Mindfulness Scale) predicted short-term weight loss at week 14 in the full sample and long-term weight loss at the end of the trial in the subsample of randomized participants. Results In the full sample, higher baseline acceptance predicted greater short-term weight losses (p=.004). At week 14, individuals low in acceptance (-1SD) lost an average of 8.7 kg (SE=0.6) compared to 11.2 kg (SE=0.6) among those high in acceptance (+1SD). In the subsample of participants who successfully lost weight in phase 1, the independent effect of acceptance on total losses at the end of the trial did not reach statistical significance (p=.058). Neither mindful eating nor general mindful awareness independently predicted weight loss at either time point. Conclusions Acceptance was a stronger predictor than either general or eating-specific awareness of weight loss with lifestyle modification.
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Yu J, Song P, Zhang Y, Wei Z. Effects of Mindfulness-Based Intervention on the Treatment of Problematic Eating Behaviors: A Systematic Review. J Altern Complement Med 2020; 26:666-679. [DOI: 10.1089/acm.2019.0163] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jinyue Yu
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Peige Song
- Centre for Global Health Research, University of Edinburgh, Edinburgh, United Kingdom
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Yan Zhang
- Faculty of Life Science and Medicine, Kings College London, London, United Kingdom
| | - Zhuang Wei
- Centre of Child Health Care, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Knol LL, Lawrence JC, de la O R. Eat Like a Chef: A Mindful Eating Intervention for Health Care Providers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:719-725. [PMID: 32276881 DOI: 10.1016/j.jneb.2020.02.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/22/2020] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To compare changes in mindful eating habits between students receiving a mindful eating intervention (MEI) vs those who were engaged in usual course work. METHODS From 2017 to 2019, 109 nutrition and medical students completed a quasi-experimental study, including usual course work either with or without the addition of a 5-week MEI. The Mindful Eating Questionnaire (MEQ) was completed before and after the MEI. Repeated measures MANOVA was used to detect differences in changes in the overall MEQ score and its 5 subscales between groups. RESULTS Within the MEI group (n = 64), overall MEQ, disinhibition, and eating with awareness scores increased significantly (P < .001, P < .001, and P = .004, respectively). No significant changes were noted within the comparison group (n = 45). Significant between-group differences were noted for the changes in the overall MEQ (P = .03) and disinhibition scores (P = .01). CONCLUSIONS AND IMPLICATIONS MEI participation may improve students' overall mindful eating scores. Future research could assess a larger cohort of participants, including health care professionals from other disciplines, assess additional mindfulness measures, and follow students for a longer period to determine the long-term effects on participants' mindful eating.
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Affiliation(s)
- Linda L Knol
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, AL.
| | - Jeannine C Lawrence
- College of Human Environmental Sciences, University of Alabama, Tuscaloosa, AL
| | - Rebecca de la O
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, AL
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Keyte R, Egan H, Mantzios M. How does mindful eating without non-judgement, mindfulness and self-compassion relate to motivations to eat palatable foods in a student population? Nutr Health 2020; 26:27-34. [PMID: 31779514 DOI: 10.1177/0260106019888367] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Previous research acknowledges the impact mindfulness, mindful eating and self-compassion has upon weight regulation and motives to eat palatable foods, with mindful eating showing an increased impact of eating behaviours. Some research has identified that present moment awareness should be the primary focus of mindful eating. AIM This research aimed to explore the relationship between mindfulness, self-compassion and mindful eating with motivations to eat palatable food. METHODS A cross-sectional study was conducted to investigate this relationship among university students (n = 211), utilizing a newly developed mindful eating scale primarily focusing on present moment awareness. RESULTS Results indicated significant negative correlations between both self-compassion and mindful eating and motives to eat palatable foods. Mindful eating positively correlated with self-compassion and other mindfulness elements that are suggesting indirect acceptance measurements of the mindful eating scale. CONCLUSION Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work. In addition, suggestions are provided regarding the reinterpretation of elements that are investigated and explored in eating literature.
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Affiliation(s)
- Rebecca Keyte
- Department of Psychology, School of Social Sciences, Birmingham City University, UK
| | - Helen Egan
- Department of Psychology, School of Social Sciences, Birmingham City University, UK
| | - Michail Mantzios
- Department of Psychology, School of Social Sciences, Birmingham City University, UK
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Dieting, mindfulness and mindful eating:exploring whether or not diets reinforce mindfulness and mindful eating practices. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2019.88057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Adolescent Obesity: Diet Quality, Psychosocial Health, and Cardiometabolic Risk Factors. Nutrients 2019; 12:nu12010043. [PMID: 31877943 PMCID: PMC7020092 DOI: 10.3390/nu12010043] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 01/03/2023] Open
Abstract
Obesity is a multifaceted chronic condition with several contributing causes, including biological risk factors, socioeconomic status, health literacy, and numerous environmental influences. Of particular concern are the increasing rates of obesity in children and adolescents, as rates of obesity in youth in the United States have tripled within the last three decades. Youth from historically disadvantaged backgrounds tend to have higher rates of obesity compared to other groups. Adolescents often do not meet intake recommendations for certain food groups and nutrients, which may contribute to a heightened risk of obesity. With obesity disproportionately affecting adolescents (ages 12–19 years), negative effects of excess adiposity may be particularly salient during this critical period of development. The presentation of chronic cardiometabolic disease symptoms typically observed in adults, such as hypertension, hyperglycemia, dyslipidemia, and inflammation, are becoming increasingly common in adolescents with obesity. Additionally, there is dynamic interplay between obesity and psychosocial health, as adolescents with obesity may have increased levels of stress, depressive symptoms, and reduced resilience. To reduce and prevent adolescent obesity, the implementation of theory-driven multicomponent school- and community-based interventions have been suggested. These interventions promote knowledge and self-efficacy for healthful practices that have the potential to progress to sustained behavior change.
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Kawasaki Y, Akamatsu R. Appreciation for food, an important concept in mindful eating: association with home and school education, attitude, behavior, and health status in Japanese elementary school children. Glob Health Promot 2019; 27:140-149. [DOI: 10.1177/1757975919875650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Appreciating food is an important concept in mindful eating, mentioned by advocates of an expanded model of mindful eating in 2016. With the exception of Japan, this concept is not common in many countries. Objective: We aimed to describe the role that appreciation for food has in the health of children from two perspectives: 1) association between children’s appreciation for food and their backgrounds, such as home and school educational experiences related to food, and 2) association between their appreciation for food and outcomes, such as attitude toward food, eating behaviors, and health status. Design: Cross-sectional. Methods: Data were obtained from self-administered anonymous questionnaires sent to 2070 elementary school students in Tokyo, Japan, during October and December 2006. They contained several question items pertaining to the characteristics of participants: home and school educational experiences related to food, attitudes towards food (including level of appreciation for food), eating behaviors, and health status. T-test, Pearson’s correlation coefficient, and simple and multiple linear regression analyses were used to compare the total score of appreciation for food with other factors. Results: Surveys were completed by 1994 children (response rate: 96.3%) and significant correlations were indicated by gender, educational experiences at home and school, attitudes toward healthy food, recommended food preferences, breakfast consumption, and body mass index. Conclusions: We concluded that appreciation for food plays an important role in children’s health.
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Affiliation(s)
- Yui Kawasaki
- Natural Science Division, Ochanomizu University, Japan
| | - Rie Akamatsu
- Natural Science Division, Ochanomizu University, Japan
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A Randomised Experiment Evaluating the Mindful Raisin Practice as a Method of Reducing Chocolate Consumption During and After a Mindless Activity. JOURNAL OF COGNITIVE ENHANCEMENT 2019. [DOI: 10.1007/s41465-019-00159-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AbstractThe present study investigated the impact of the mindful raisin exercise on overeating during and after the experiment while controlling for wellbeing. One-hundred and twenty-eight participants were recruited and completed a questionnaire on wellbeing (i.e. depression, anxiety and stress) and state mindfulness. Participants were randomly allocated to either the mindful raisin exercise or a newspaper reading control condition. The State Mindfulness Scale was then completed again, and participants watched a neutral video while exposed to chocolate for 10 min. For those 10 min, results showed that the mindfulness condition translated into lower food consumption during the mindless activity when compared to the control condition. Post experiment, participants were asked to wait for 5 min, and any extra chocolate consumption during this time was recorded. Post-consumption was non-significantly different between the two groups, with those in the mindfulness condition consuming 1.3 g less than those in the control group. Controlling for wellbeing did not alter the impact of the mindfulness intervention on consumption. Implications for future work and practical applications for weight regulation are discussed.
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Morillo Sarto H, Barcelo-Soler A, Herrera-Mercadal P, Pantilie B, Navarro-Gil M, Garcia-Campayo J, Montero-Marin J. Efficacy of a mindful-eating programme to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomised trial protocol. BMJ Open 2019; 9:e031327. [PMID: 31753880 PMCID: PMC6886952 DOI: 10.1136/bmjopen-2019-031327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/19/2019] [Accepted: 10/24/2019] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Little is known about the applicability of mindfulness-based interventions in Spanish adults with overweight/obesity. The objective of the present study protocol is to describe the methods that will be used in a cluster randomised trial (CRT) that aims to evaluate the effectiveness of a mindfulness eating (ME) programme to reduce emotional eating (EE) in adults with overweight/obesity in primary care (PC) settings. METHODS AND ANALYSIS A CRT will be conducted with approximately 76 adults with overweight/obesity from four PC health centres (clusters) in the city of Zaragoza, Spain. Health centres matched to the average per capita income of the assigned population will be randomly allocated into two groups: 'ME +treatment as usual (TAU)' and 'TAU alone'. The ME programme will be composed of seven sessions delivered by a clinical psychologist, and TAU will be offered by general practitioners. The primary outcome will be EE measured by the Dutch Eating Behaviour Questionnaire (DEBQ) at post test as primary endpoint. Other outcomes will be external and restrained eating (DEBQ), binge eating (Bulimic Investigatory Test Edinburgh), eating disorder (Eating Attitude Test), anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9), mindful eating (Mindful Eating Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and self-compassion (Self-Compassion Scale). Anthropometric measures, vital signs and blood tests will be taken. A primary intention-to-treat analysis on EE will be conducted using linear mixed models. Supplementary analyses will include secondary outcomes and 1-year follow-up measures; adjusted models controlling for sex, weight status and levels of anxiety and depression; the complier average causal effect of treatment; and the clinical significance of improvements. ETHICS AND DISSEMINATION Positive results of this study may have a significant impact on one of the most important current health-related problems. Approval was obtained from the Ethics Committee of the Regional Authority. The results will be submitted to peer-reviewed journals, and reports will be sent to participants. TRIAL REGISTRATION NUMBER NCT03927534 (5/2019).
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Affiliation(s)
- Hector Morillo Sarto
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Basic Psychology Department, Faculty of Psychology, University of Zaragoza, Teruel, Spain
| | - Alberto Barcelo-Soler
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Paola Herrera-Mercadal
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Bianca Pantilie
- Oral and Maxillofacial Surgery Department, Miguel Servet University Hospital, Zaragoza, Aragón, Spain
| | - Mayte Navarro-Gil
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Javier Garcia-Campayo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Jesus Montero-Marin
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Spanish Association of Mindfulness and Compassion, Zaragoza, Spain
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Radin RM, Epel ES, Daubenmier J, Moran P, Schleicher S, Kristeller J, Hecht FM, Mason AE. Do stress eating or compulsive eating influence metabolic health in a mindfulness-based weight loss intervention? Health Psychol 2019; 39:147-158. [PMID: 31724424 DOI: 10.1037/hea0000807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aimed to understand the associations of compulsive eating (CE) and stress eating (SE) with metabolic health among adults with obesity and whether mindfulness-based weight loss training may buffer these associations. METHOD We used data from a trial in which we randomized 194 participants with obesity to a diet-exercise weight loss intervention with either mindful eating training plus mindfulness-based eating awareness and stress management training (n = 100) or active control components (n = 94). We measured CE, SE, weight, and fasting blood glucose (FBG) at baseline, and 6, 12 months, and 18 months. We tested CE and SE as both moderators and mediators of intervention effects on changes in metabolic health. RESULTS Participants higher (+ 1 SD) in CE at baseline randomized to the mindfulness (vs. control) intervention had greater improvements in FBG at 18 months (p = .05). Twelve-month reductions in CE mediated the effect of the intervention on changes in FBG and weight at 12 and 18 months postbaseline (p ≤ .05). Furthermore, those higher (+ 1 SD) in SE at baseline were nearly 2 BMI points higher than those lower (-1 SD) in SE (p < .01). Decreases in SE (B = 3.42; p < .001; 95% CI [2.55, 4.30]) and CE (B = 0.45; p < .001; 95% CI [0.36, 0.54]) in all participants at 6 months were associated with greater weight loss at 18 months. CONCLUSIONS Those with greater compulsive eating may reduce risk for metabolic decline by participating in a mindfulness-based weight loss program. Future obesity interventions should consider tailoring treatment toward trait-level characteristics, such as compulsive eating. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Increasing Dietary Carbohydrate as Part of a Healthy Whole Food Diet Intervention Dampens Eight Week Changes in Salivary Cortisol and Cortisol Responsiveness. Nutrients 2019; 11:nu11112563. [PMID: 31652899 PMCID: PMC6893582 DOI: 10.3390/nu11112563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/17/2019] [Accepted: 10/22/2019] [Indexed: 12/22/2022] Open
Abstract
It is largely unknown whether and how whole food diets influence psychological stress and stress system responsiveness. To better understand the effects of whole diets on stress system responsiveness, we examined randomized control trial effects of a whole food diet based on the Dietary Guidelines for Americans (DGA) on cortisol responsiveness. A randomized, double-blind, controlled 8-week intervention was conducted in overweight and obese women to examine differentiated effects between two diet intervention groups: one based on the 2010 DGA and the other one based on a typical American diet (TAD). During a test week that occurred at baseline and again after 8 weeks of the intervention, we assessed salivary cortisol collected at 14 selected times across the day, including upon awakening, at bedtime, and during a test visit, and administered a standardized social stress task (Trier Social Stress Test, TSST). There were no statistical differences between the diet groups in salivary cortisol at baseline or after 8 weeks. However, when considering differences in dietary carbohydrate, but not fat or protein, from the pre-intervention (habitual) to the intervention period, there was a significant (P = 0.0001) interaction between diet group, intervention week, saliva sample, and level of intervention-based change in carbohydrate consumption. This interaction was reflected primarily by an 8-week reduction in salivary cortisol during a period just prior to (log Δ −0.35 ± 0.12 nmol/L) and 30 (log Δ −0.49 ± 0.12 nmol/L), 60 (log Δ −0.50 ± 0.13 nmol/L), 90 (log Δ −0.51 ± 0.13 nmol/L), and 120 (log Δ −0.4476 ± 0.1231 nmol/L) min after the TSST in the DGA group having the highest increase (90th percentile) in carbohydrate consumption. In support of this finding, we also found significant (P < 0.05) and inverse linear associations between dietary carbohydrate and log salivary cortisol, with the strongest negative association (β: −0.004 ± 0.0015, P = 0.009) occurring at 30 min post-TSST, but only in the DGA group and at week 9 of the intervention. Together, increasing dietary carbohydrate as part of a DGA-based diet may reduce circulating cortisol and dampen psychological stress-related cortisol responsiveness.
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Mantzios M, Skillett K, Egan H. Examining the Effects of Two Mindful Eating Exercises on Chocolate Consumption. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2019. [DOI: 10.1027/2512-8442/a000040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Abstract. The present study aimed to investigate and compare the impact of the Mindful Construal Diary (MCD) and the Mindful Raisin Exercise on the sensory tasting experience of chocolate and participants’ chocolate consumption. Participants were randomly allocated into three conditions (MCD, mindful raisin exercise, and mindless control), and engaged with either the MCD, the mindful raisin exercise, or, were asked to read a news article, respectively, while they ate a piece of chocolate. They then rated their satisfaction and desire to consume more chocolate on a 10-point Likert scale, and filled in a state mindful eating scale. Afterward, participants were informed that the study had ended and were asked to wait while the experimenter recorded some information, and any extra chocolate consumption during this time was recorded. Participants in both mindfulness conditions consumed significantly less chocolate after the exercise than participants in the control condition. No significant differences were found between the three conditions on ratings of satisfaction and desire to consume more chocolate. Both the MCD and the raisin exercise can be used to successfully moderate the intake of calorific foods, while the MCD can be utilized as an alternative practice to the typical meditation-based interventions.
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Affiliation(s)
- Michael Mantzios
- Department of Psychology, Birmingham City University, United Kingdom
| | - Kirby Skillett
- Department of Psychology, Birmingham City University, United Kingdom
| | - Helen Egan
- Department of Psychology, Birmingham City University, United Kingdom
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Woods-Giscombe CL, Gaylord SA, Li Y, Brintz CE, Bangdiwala SI, Buse JB, Mann JD, Lynch C, Phillips P, Smith S, Leniek K, Young L, Al-Barwani S, Yoo J, Faurot K. A Mixed-Methods, Randomized Clinical Trial to Examine Feasibility of a Mindfulness-Based Stress Management and Diabetes Risk Reduction Intervention for African Americans with Prediabetes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:3962623. [PMID: 31511777 PMCID: PMC6710811 DOI: 10.1155/2019/3962623] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 07/21/2019] [Indexed: 12/29/2022]
Abstract
African Americans have disproportionately high rates of stress-related conditions, including diabetes and diabetes-related morbidity. Psychological stress may negatively influence engagement in risk-reducing lifestyle changes (physical activity and healthy eating) and stress-related physiology that increase diabetes risk. This study examined the feasibility of conducting a randomized trial comparing a novel mindfulness-based stress management program combined with diabetes risk-reduction education versus a conventional diabetes risk-reduction education program among African American adults with prediabetes and self-reported life stress. Participants were recruited in collaboration with community partners and randomized to the mindfulness-based diabetes risk-reduction education program for prediabetes (MPD; n = 38) or the conventional diabetes risk-reduction education program for prediabetes (CPD; n = 30). The mindfulness components were adapted from the Mindfulness-based Stress Reduction Program. The diabetes risk-reduction components were adapted from the Power to Prevent Program and the Diabetes Prevention Program. Groups met for eight weeks for 2.5 hours, with a half-day retreat and six-monthly boosters. Mixed-methods strategies were used to assess feasibility. Psychological, behavioral, and metabolic data were collected before the intervention and at three and six months postintervention to examine within-group change and feasibility of collecting such data in future clinical efficacy research. Participants reported acceptability, credibility, and cultural relevance of the intervention components. Enrollment of eligible participants (79%), intervention session attendance (76.5%), retention (90%), and postintervention data collection attendance (83%, 82%, and 78%, respectively) demonstrated feasibility, and qualitative data provided information to further enhance feasibility in future studies. Both groups exhibited an A1C reduction. MPD participants had reductions in perceived stress, BMI, calorie, carbohydrate and fat intake, and increases in spiritual well-being. Considering the high prevalence of diabetes and diabetes-related complications in African Americans, these novel findings provide promising guidance to develop a larger trial powered to examine efficacy of a mindfulness-based stress management and diabetes risk-reduction education program for African Americans with prediabetes.
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Affiliation(s)
| | - Susan A. Gaylord
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
| | - Yin Li
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Carrie E. Brintz
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
| | - Shrikant I. Bangdiwala
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - John B. Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - John D Mann
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
- Department of Neurology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Chanee Lynch
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
| | - Pamela Phillips
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
| | - Sunyata Smith
- Lehman College, City University of New York, New York, NY, USA
| | - Karyn Leniek
- Health Partners Central Minnesota Clinics, Sartell, MN, USA
| | - Laura Young
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Saada Al-Barwani
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeena Yoo
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Keturah Faurot
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
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Xia T, Hu H, Seritan AL, Eisendrath S. The Many Roads to Mindfulness: A Review of Nonmindfulness-Based Interventions that Increase Mindfulness. J Altern Complement Med 2019; 25:874-889. [PMID: 31241348 DOI: 10.1089/acm.2019.0137] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: Mindfulness-based interventions (MBIs) have become increasingly popular for treating various physical and mental disorders. An increase in mindfulness levels through the teaching of mindfulness meditation is the most well-studied mechanism of MBIs. Recent studies, however, suggest that an increase in mindfulness is also observed in physical or psychosocial interventions not explicitly labeled as MBIs, or what the authors call non-MBIs. The authors aimed to review what non-MBIs can increase mindfulness levels despite not explicitly teaching mindfulness meditation. Design: The authors conducted a literature search for studies that included a non-MBI study arm measuring pre- and postintervention mindfulness levels using one of the following eight validated self-reported mindfulness questionnaires: Five-Faceted Mindfulness Questionnaire, Mindful Awareness and Attention Scale, Freiburg Mindfulness Inventory, Toronto Mindfulness Scale, Philadelphia Mindfulness Scale, Kentucky Inventory of Mindfulness Skills, Child and Adolescent Mindfulness Measure, and Cognitive and Affective Mindfulness Scale-Revised. The authors identified 69 non-MBI study arms from 51 independent studies of the non-MBI itself or as active controls of an MBI under investigation. The authors documented or calculated, if not provided, effect sizes (ES) for changes in mindfulness levels following these interventions. Results: Among the 69 non-MBI arms, 36 showed no effect for change in mindfulness (ES <0.20), 3 were indeterminate (no ES available or unable to calculate), 13 had small effects (0.20 < ES <0.5), 13 had medium effects (0.50 < ES <0.80), 3 had large effects (0.80 < ES <1.3), and 1 had a very large effect (ES >1.3) for change in mindfulness. Conclusions: Analysis of the characteristics of non-MBIs with significant increases in mindfulness levels suggested some commonalities between MBIs and non-MBIs, shedding light on a spectrum of mindfulness-related interventions and the possibility that there are many roads to developing mindfulness.
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Affiliation(s)
- Tom Xia
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA
| | - Hiroe Hu
- College of Osteopathic Medicine, Touro University California, Vallejo, CA.,Department of Social and Behavioral Sciences, University of California San Francisco School of Nursing, San Francisco, CA
| | - Andreea L Seritan
- Department of Psychiatry, University of California San Francisco, San Francisco, CA.,Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA
| | - Stuart Eisendrath
- Department of Psychiatry, University of California San Francisco, San Francisco, CA.,Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA
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Radin RM, Mason AE, Laudenslager ML, Epel ES. Maternal caregivers have confluence of altered cortisol, high reward-driven eating, and worse metabolic health. PLoS One 2019; 14:e0216541. [PMID: 31075126 PMCID: PMC6510426 DOI: 10.1371/journal.pone.0216541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/23/2019] [Indexed: 01/01/2023] Open
Abstract
Animal models have shown that chronic stress increases cortisol, which contributes to overeating of highly palatable food, increased abdominal fat and lower cortisol reactivity. Few studies in humans have simultaneously examined these trajectories. We examined premenopausal women, either mothers of children with a diagnosis of an autism spectrum disorder (n = 92) or mothers of neurotypical children (n = 91). At baseline and 2-years, we assessed hair cortisol, metabolic health, and reward-based eating. We compared groups cross-sectionally and prospectively, accounting for BMI change. Caregivers, relative to controls, had lower cumulative hair cortisol at each time point, with no decreases over time. Caregivers also had stable levels of poor metabolic functioning and greater reward-based eating across both time points, and evidenced increased abdominal fat prospectively (all ps ≤.05), independent of change in BMI. This pattern of findings suggest that individuals under chronic stress, such as caregivers, would benefit from tailored interventions focusing on better regulation of stress and eating in tandem to prevent early onset of metabolic disease, regardless of weight status.
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Affiliation(s)
- Rachel M. Radin
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Ashley E. Mason
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Elissa S. Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
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69
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Mason AE, Jhaveri K, Schleicher S, Almeida C, Hartman A, Wackerly A, Alba D, Koliwad SK, Epel ES, Aschbacher K. Sweet cognition: The differential effects of glucose consumption on attentional food bias in individuals of lean and obese status. Physiol Behav 2019; 206:264-273. [PMID: 31002858 DOI: 10.1016/j.physbeh.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/18/2019] [Accepted: 04/15/2019] [Indexed: 11/15/2022]
Abstract
In general, glucose consumption improves cognitive performance; however, it is unknown whether glucose specifically alters attentional food bias, and how this process may vary by BMI status. We hypothesized that glucose consumption would increase attentional food bias among individuals of obese BMI status more so than among individuals of lean BMI status. Participants (N = 35) completed the n-back, a working memory task modified to assess attentional food bias (ATT-Food), under fasting and glucose challenge conditions. We computed pre-post changes in ATT-Food, blood glucose and insulin (∆BG & ∆BI), and perceived task-stress (∆stress). After the second cognitive test and blood draw, participants ate lunch and completed a "taste test" of highly palatable foods, and we recorded food consumption. Pre-post changes in ATT-Food were greater among participants of obese (relative to lean) BMI status (F(1,33) = 5.108, p = .031). Greater ∆ATT-Food was significantly associated with greater ∆BG (r = .462, p = .007) and reduced ∆stress (r =-.422, p = .011), and marginally associated with greater taste-test eating (r =.325, p = .057), but was not associated with ∆BI. Our findings suggest that individuals of obese BMI status may exhibit "sweet cognition," as indexed by greater attentional food bias following glucose ingestion, relative to individuals of lean BMI status. Among individuals of obese BMI status, sweet cognition may arise from difficulty broadening attention toward non-food cues after consuming a high glucose load, thereby potentially perpetuating sugar consumption. If confirmed by further research, measures of sweet cognition may help identify individuals with a phenotype of risk for obesity and greater sugar consumption, who may benefit from tailored interventions.
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Affiliation(s)
- Ashley E Mason
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), United States; Center for Health and Community, Department of Psychiatry, UCSF, United States.
| | - Kinnari Jhaveri
- Department of Psychology, University of Southern California, United States
| | - Samantha Schleicher
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), United States; Center for Health and Community, Department of Psychiatry, UCSF, United States; Department of Medicine, University of Maryland, United States
| | - Carlos Almeida
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), United States; Center for Health and Community, Department of Psychiatry, UCSF, United States
| | - Alison Hartman
- Department of Psychology, Drexel University College of Arts and Sciences, United States
| | - Angela Wackerly
- Center for Health and Community, Department of Psychiatry, UCSF, United States
| | - Diana Alba
- Department of Medicine, UCSF, United States; Diabetes Center, UCSF, United States
| | - Suneil K Koliwad
- Department of Medicine, UCSF, United States; Diabetes Center, UCSF, United States
| | - Elissa S Epel
- Osher Center for Integrative Medicine, University of California San Francisco (UCSF), United States; Center for Health and Community, Department of Psychiatry, UCSF, United States
| | - Kirstin Aschbacher
- Center for Health and Community, Department of Psychiatry, UCSF, United States; Department of Medicine, Division of Cardiology, UCSF, United States.
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Abstract
OBJECTIVE There has been substantial research and public interest in mindfulness interventions, biological pathways, and health for the past two decades. This article reviews recent developments in understanding relationships between mindfulness interventions and physical health. METHODS A selective review was conducted with the goal of synthesizing conceptual and empirical relationships between mindfulness interventions and physical health outcomes. RESULTS Initial randomized controlled trials in this area suggest that mindfulness interventions can improve pain management outcomes among chronic pain populations, and there is preliminary evidence for mindfulness interventions improving specific stress-related disease outcomes in some patient populations (i.e., clinical colds, psoriasis, irritable bowel syndrome, posttraumatic stress disorder, diabetes, HIV). We offer a stress-buffering framework for the observed beneficial effects of mindfulness interventions and summarize supporting biobehavioral and neuroimaging studies that provide plausible mechanistic pathways linking mindfulness interventions with positive physical health outcomes. CONCLUSIONS We conclude with new opportunities for research and clinical implementations to consider in the next two decades.
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71
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Mason AE, Saslow L, Moran PJ, Kim S, Wali PK, Abousleiman H, Hartman A, Richler R, Schleicher S, Hartogensis W, Epel ES, Hecht F. Examining the Effects of Mindful Eating Training on Adherence to a Carbohydrate-Restricted Diet in Patients With Type 2 Diabetes (the DELISH Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11002. [PMID: 30545813 PMCID: PMC6401674 DOI: 10.2196/11002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/30/2018] [Accepted: 09/19/2018] [Indexed: 01/03/2023] Open
Abstract
Background Diet patterns have a profound influence on glycemic control for individuals with type 2 diabetes mellitus (T2DM), and craving-related eating is an important obstacle to dietary adherence. A growing body of research suggests that carbohydrate-restricted (CR) diets can improve glycemic control and reduce medication dependence in T2DM. However, limited data speak to the effects of long-term adherence to CR diets. Mindful eating training has been shown to reduce craving-related eating in overweight populations but has yet to be examined as a behavioral support for dietary adherence in T2DM. This trial examines behavioral mechanisms, particularly craving-related eating, through which mindful eating training might improve adherence to CR dietary recommendations in T2DM. This will clarify the importance of focusing on craving-related eating in the optimization of dietary adherence interventions. Objective The aim of this trial is to determine whether providing training in mindful eating increases adherence to a CR dietary recommendation in T2DM. Methods We are randomizing 60 participants to receive a CR diet with or without mindful eating training (12-week group intervention) and are following participants for 12 weeks after intervention completion. We hypothesize that participants who receive mindful eating training (relative to those who do not) will demonstrate greater adherence to the CR diet. Results Our primary outcome is change in craving-related eating, as assessed using an ecological momentary assessment mobile phone–based platform. Secondary behavioral pathway outcomes include changes in stress-related eating, impulsivity, glycemic control, weight change, dietary adherence, and resumption of dietary adherence after dietary nonadherence. Conclusions This theory-driven trial will shed light on the impact of mindfulness training on mechanisms that may impact dietary adherence in T2DM. Trial Registration ClinicalTrials.gov NCT03207711; https://clinicaltrials.gov/ct2/show/NCT03207711 (Archived by WebCite at http://www.webcitation.org/73pXscwaU)
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Affiliation(s)
- Ashley E Mason
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,Center for Health and Community, Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Laura Saslow
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Patricia J Moran
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Sarah Kim
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, San Francisco General Hospital, San Francisco, CA, United States
| | - Priyanka K Wali
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hiba Abousleiman
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Alison Hartman
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Robert Richler
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | | | - Wendy Hartogensis
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Elissa S Epel
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,Center for Health and Community, Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Frederick Hecht
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
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72
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Dibb-Smith A, Chapman J, Brindal E. Breaking habits with mindful snacking? An email-based intervention targeting unwanted snacking habits in an Australian sample. Eat Behav 2019; 32:37-43. [PMID: 30557746 DOI: 10.1016/j.eatbeh.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/10/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the potential for an email-based, mindful eating exercise to improve unwanted snacking habits. METHOD Australian participants (N = 78, 86% female) with unwanted snacking habits engaged in a mindful eating email-based intervention, over a practice period of two weeks. All measures were completed using an online survey. Habit strength was measured using the Self-Report Habit Index (SHRI). Mindful eating was measured using the Mindful Eating Questionnaire (MEQ) and self-compassion was measured using the Self-Compassion Scale (SCS). Participants were emailed a mindful eating exercise and asked to make action plans to practice it. Reminders to perform the task were sent via email after one week. After two weeks, the MEQ, SCS and SHRI were readministered. RESULTS Habit strength significantly increased over the two-week period and self-compassion significantly decreased. The amount of practice reported was not associated with these changes, but self-reported effort expended during practice sessions was partially associated. DISCUSSION The intervention resulted in increased habit strength; potential mechanisms underlying these changes are discussed. Decreased self-compassion may be linked to both the electronic delivery of the intervention and the nature of the mindful eating task.
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Affiliation(s)
- Amanda Dibb-Smith
- The University of Adelaide, School of Psychology, Level 2, Hughes Building, North Tce, Adelaide, South Australia 5001, Australia.
| | - Janine Chapman
- Flinders Centre for Innovation in Cancer / National Centre for Education and Training on Addiction (NCETA), College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia
| | - Emily Brindal
- CSIRO, Health and Biosecurity, Kintore Ave, Adelaide 5001, Australia
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73
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Healthy and unhealthy eating amongst stressed students: considering the influence of mindfulness on eating choices and consumption. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.77913] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Carpenter KM, Vickerman KA, Salmon EE, Javitz HS, Epel ES, Lovejoy JC. A Randomized Pilot Study of a Phone-Based Mindfulness and Weight Loss Program. Behav Med 2019; 45:271-281. [PMID: 28985151 PMCID: PMC8462129 DOI: 10.1080/08964289.2017.1384359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study evaluated the feasibility and efficacy of integrating mindfulness training into a phone-based weight loss program to improve outcomes in those with high levels of emotional eating. Participants were 75 enrollees into an employer-sponsored weight loss program who reported high levels of overeating in response to thoughts and feelings. Seventy-five overweight and obese participants (92% female, 65% Caucasian, aged 26 to 68 years) were randomized to the new mindfulness weight loss program (n = 50) or the standard behavioral weight loss program (n = 25). Both programs consisted of 11 coaching calls with health coaches and registered dietitians with supplemental online materials. Satisfaction, engagement, and percent weight lost did not significantly differ for intervention vs. control at six months. Intervention participants had significantly better scores at six-month follow-up on mindful eating, binge eating, experiential avoidance, and one mindfulness subscale. Exploratory analyses showed that improvements on several measures predicted more weight loss in the intervention group. This pilot study found that integrating mindfulness into a brief phone-based behavioral weight loss program was feasible and acceptable to participants, but did not produce greater weight loss on average, despite hypothesized changes in mindful eating. Only one third of intervention participants reported participating in mindfulness exercises regularly. Mechanisms of change observed within the intervention group suggest that for adults with high levels of emotional eating those who embrace mindful eating and meditation may lose more weight with a mindfulness intervention.
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Affiliation(s)
| | | | - Erica E Salmon
- Center for Wellbeing Research, Alere Wellbeing, Seattle, WA USA
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75
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Mantzios M, Egan H, Hussain M, Keyte R, Bahia H. Mindfulness, self-compassion, and mindful eating in relation to fat and sugar consumption: an exploratory investigation. Eat Weight Disord 2018; 23:833-840. [PMID: 30066255 DOI: 10.1007/s40519-018-0548-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 07/09/2018] [Indexed: 11/29/2022] Open
Abstract
While much research has focused on overeating when exploring constructs of mindfulness, mindful eating, and self-compassion, there is limited research on the specific relationship of these constructs with consumption of energy-dense foods that have a large impact on weight regulation. In a cross-sectional study, university students (n = 546) were recruited to explore the relationship between mindfulness, mindful eating, self-compassion, and fat and/or sugar consumption. Results indicated that all constructs were negatively related to fat and sugar consumption, but self-compassion did not do so in a univariate fashion. When investigating subscales, negative aspects such as isolation and over-identification show a significant positive relationship to fat and sugar consumption. Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work. Level of Evidence: Level V, cross-sectional descriptive study.
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Affiliation(s)
- Michail Mantzios
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C307, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK.
| | - Helen Egan
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C307, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - Misba Hussain
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C307, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - Rebecca Keyte
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C307, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - Henna Bahia
- Department of Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Room C307, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
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Duckworth AL, Milkman KL, Laibson D. Beyond Willpower: Strategies for Reducing Failures of Self-Control. Psychol Sci Public Interest 2018; 19:102-129. [PMID: 30760176 DOI: 10.1177/1529100618821893] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Almost everyone struggles to act in their individual and collective best interests, particularly when doing so requires forgoing a more immediately enjoyable alternative. Other than exhorting decision makers to "do the right thing," what can policymakers do to reduce overeating, undersaving, procrastination, and other self-defeating behaviors that feel good now but generate larger delayed costs? In this review, we synthesize contemporary research on approaches to reducing failures of self-control. We distinguish between self-deployed and other-deployed strategies and, in addition, between situational and cognitive intervention targets. Collectively, the evidence from both psychological science and economics recommends psychologically informed policies for reducing failures of self-control.
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Affiliation(s)
| | - Katherine L Milkman
- 2 Operations, Information and Decisions Department, The Wharton School of the University of Pennsylvania
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Diet Quality for Sodium and Vegetables Mediate Effects of Whole Food Diets on 8-Week Changes in Stress Load. Nutrients 2018; 10:nu10111606. [PMID: 30388762 PMCID: PMC6266876 DOI: 10.3390/nu10111606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/23/2018] [Accepted: 10/27/2018] [Indexed: 12/26/2022] Open
Abstract
Very little is known about how whole food diets, such as those based on the Dietary Guidelines for Americans (DGA), influence psychological stress and physiological stress load. To better understand the effects of whole food diets on stress, we examined in a randomized control trial the effects of a DGA-based diet on markers of psychological and physiological stress. A randomized, double-blind, controlled 8-week intervention was conducted in overweight and obese women randomly assigned to one of two diet groups: a diet based on the 2010 DGA or a diet based on a Typical American Diet (TAD). The Perceived Stress Scale and allostatic load were used to assess stress load. Eight-week change in perceived stress did not significantly (p = 0.45) differ between the DGA (+0.53 ± 0.99) and TAD (-0.57 ± 0.99) groups. Likewise, 8-week change in allostatic load did not significantly (p = 0.79) differ between the two diet intervention groups (DGA: +0.001 ± 0.26 vs. TAD: +0.105 ± 0.28). However, we did find strong inverse associations between 8-week change in stress and intervention-based improvements in diet quality (lower sodium and higher vegetable consumption). When statistically accounting for these inverse associations, we found that perceived stress and allostatic load were higher (p < 0.04) in the DGA group. These findings suggest that improvements in dietary vegetable and sodium intake mediated effects of the diet intervention on psychological and physiological stress load. That is, adopting and adhering to a diet of higher quality (DGA) for 8 weeks may have been generally more stressful in the absence of improvements in vegetable or sodium consumption. This study provides further evidence for the mental health benefits of maximizing vegetable and minimizing sodium consumption.
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Schepers ST, Bouton ME. Stress as a context: Stress causes relapse of inhibited food seeking if it has been associated with prior food seeking. Appetite 2018; 132:131-138. [PMID: 30316872 DOI: 10.1016/j.appet.2018.10.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/27/2018] [Accepted: 10/10/2018] [Indexed: 12/12/2022]
Abstract
Three experiments with rats explored the hypothesis that inhibited food-seeking can be reinstated by stress if stress has been part of the context of earlier food-seeking. In all experiments, rats first learned to lever press for sucrose pellets and then had the response inhibited through extinction (where responding no longer yielded sucrose pellets). In a final test, inhibited responding was tested after exposure to a stressor or not. Previous research indicates that stress during testing does not normally reinstate extinguished food-seeking, although it reliably does so when animals are responding for drugs. In Experiment 1, stress caused a reinstatement of food seeking if and only if the rats had been exposed to stressors prior to sessions of lever press training. In Experiment 2, a new stressor that had not been associated with response acquisition also caused reinstatement if other stressors had been associated with response acquisition. Experiment 3 then established that stressors must be associated with the acquisition of lever pressing, rather than extinction, in order to allow a stressor to cause relapse of extinguished food seeking. The results support the view that stress can cause relapse of inhibited food seeking if it has been part of the context of original food seeking. The effect is therefore an example of the ABA renewal effect in which inhibited responding recovers after extinction when the response is returned to its training context. Implications for understanding relapse to overeating and other "addictive" behaviors are discussed.
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Hart SR, Pierson S, Goto K, Giampaoli J. Development and initial validation evidence for a mindful eating questionnaire for children. Appetite 2018; 129:178-185. [DOI: 10.1016/j.appet.2018.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/09/2017] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
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Kristeller JL, Jordan KD. Mindful Eating: Connecting With the Wise Self, the Spiritual Self. Front Psychol 2018; 9:1271. [PMID: 30154740 PMCID: PMC6102380 DOI: 10.3389/fpsyg.2018.01271] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/03/2018] [Indexed: 11/23/2022] Open
Abstract
In the Mindfulness-Based Eating Awareness Training program (MB-EAT) (Kristeller and Wolever, 2014; Kristeller and Wolever, in press), mindfulness practice is taught, mindful eating is cultivated, and self-acceptance and spiritual well-being are enhanced. An integrative concept is the value of cultivating ‘wisdom’ in regard to creating a new and sustainable relationship to eating and food. ‘Wisdom’ refers to drawing on personal experience and understanding in a flexible, insightful manner, rather than strictly following external rules and guidelines. Several clinical trials involving variations of MB-EAT have documented substantive improvement in how people relate to their eating, including individuals with both binge eating disorder (BED) and subclinical eating issues. Based on the traditional value of contemplative practices for cultivating spiritual engagement, and on evidence from related research showing that spiritual well-being increases in the Mindfulness-Based Stress Reduction (MBSR) program and is related to other effects, we hypothesized that the MB-EAT program would also engage this aspect of experience, as assessed by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being subscale (FACIT-Sp), and that increases in spiritual well-being would relate to other measures of adjustment such as emotional balance and improvement in disordered eating. Participants (N = 117) with moderate to morbid obesity, including 25.6% with BED, were randomly assigned to MB-EAT or a wait-list control, and assessed on the FACIT-Sp and other measures at baseline, immediate post (IP), and 2-month followup (F/Up). Both FACIT-Sp factors [Meaning/Peace (M/P) and Faith] increased significantly in the MB-EAT group and were stable/decreased in the control group. Increases in these factors related to improvement in emotional adjustment and eating regulation at IP and at F/Up, and to increases in aspects of mindfulness measured by the Five Facet Mindfulness Questionnaire (FFMQ). Increases in M/P during treatment mediated effects of the FFMQ Observe factor on eating regulation and depression at IP. Results are discussed in terms of the role that mindfulness practice plays in cultivating ‘wise mind’ and the related value of spirituality. It is argued that the core elements of the MB-EAT program lead to meaningful spiritual engagement, which plays a role in people’s ability to improve and maintain overall self-regulation.
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Affiliation(s)
- Jean L Kristeller
- Department of Psychology, Indiana State University, Terre Haute, IN, United States
| | - Kevin D Jordan
- Department of Psychology, Indiana State University, Terre Haute, IN, United States
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Salvo V, Kristeller J, Montero Marin J, Sanudo A, Lourenço BH, Schveitzer MC, D'Almeida V, Morillo H, Gimeno SGA, Garcia-Campayo J, Demarzo M. Mindfulness as a complementary intervention in the treatment of overweight and obesity in primary health care: study protocol for a randomised controlled trial. Trials 2018; 19:277. [PMID: 29751819 PMCID: PMC5948727 DOI: 10.1186/s13063-018-2639-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/10/2018] [Indexed: 01/22/2023] Open
Abstract
Background Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes—partly responsible for weight regain for a large number of people—and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. Methods/design A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme’s impact on the participants’ lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. Discussion This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. Trial registration ClinicalTrials.gov, NCT02893150. Registered retrospectively on 30 March 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2639-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vera Salvo
- DDepartment of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil.
| | - Jean Kristeller
- Department of Psychology, Indiana State University, Terra Haute, IN, USA
| | - Jesus Montero Marin
- Faculty of Health Sciences and Sports, University of Zaragoza, Zaragoza, Spain
| | - Adriana Sanudo
- DDepartment of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | | | - Vania D'Almeida
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Héctor Morillo
- Primary Care, Aragon Health Sciences Institute, Zaragoza, Spain
| | | | - Javier Garcia-Campayo
- Department of Psychiatry, Miguel Servet University Hospital, University of Zaragoza, Zaragoza, Spain
| | - Marcelo Demarzo
- DDepartment of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil. .,Hospital Israelita Albert Einstein, São Paulo, Brazil.
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Greater mindful eating practice is associated with better reversal learning. Sci Rep 2018; 8:5702. [PMID: 29632306 PMCID: PMC5890263 DOI: 10.1038/s41598-018-24001-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 03/22/2018] [Indexed: 12/12/2022] Open
Abstract
Mindfulness-based interventions are thought to reduce compulsive behavior such as overeating by promoting behavioral flexibility. Here the main aim was to provide support for mindfulness-mediated improvements in reversal learning, a direct measure of behavioral flexibility. We investigated whether an 8-week mindful eating intervention improved outcome-based reversal learning relative to an educational cooking (i.e., active control) intervention in a non-clinical population. Sixty-five healthy participants with a wide BMI range (19–35 kg/m2), who were motivated to change their eating habits, performed a deterministic reversal learning task that enabled the investigation of reward- and punishment-based reversal learning at baseline and following the intervention. No group differences in reversal learning were observed. However, time invested in the mindful eating, but not the educational cooking intervention correlated positively with changes in reversal learning, in a manner independent of outcome valence. These findings suggest that greater amount of mindfulness practice can lead to increased behavioral flexibility, which, in turn, might help overcome compulsive eating in clinical populations.
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Mason AE, Jhaveri K, Cohn M, Brewer JA. Testing a mobile mindful eating intervention targeting craving-related eating: feasibility and proof of concept. J Behav Med 2018; 41:160-173. [PMID: 28918456 PMCID: PMC5844778 DOI: 10.1007/s10865-017-9884-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/05/2017] [Indexed: 12/20/2022]
Abstract
Theoretically driven smartphone-delivered behavioral interventions that target mechanisms underlying eating behavior are lacking. In this study, we administered a 28-day self-paced smartphone-delivered intervention rooted in an operant conditioning theoretical framework that targets craving-related eating using mindful eating practices. At pre-intervention and 1-month post-intervention, we assessed food cravings among adult overweight or obese women (N = 104; M age = 46.2 ± 14.1 years; M BMI = 31.5 ± 4.5) using ecological momentary assessment via text message (SMS), self-reported eating behavior (e.g., trait food craving), and in-person weight. Seventy-eight participants (75.0%) completed the intervention within 7 months ('all completers'), and of these, 64 completed the intervention within 3 months ('timely completers'). Participants experienced significant reductions in craving-related eating (40.21% reduction; p < .001) and self-reported overeating behavior (trait food craving, p < .001; other measures ps < .01). Reductions in trait food craving were significantly correlated with weight loss for timely completers (r = .30, p = .020), this pattern of results was also evident in all completers (r = .22, p = .065). Taken together, results suggest that smartphone-delivered mindful eating training targeting craving-related eating may (1) target behavior that impacts a relative metabolic pathway, and (2) represent a low-burden and highly disseminable method to reduce problematic overeating among overweight individuals. ClinicalTrials.gov registration: NCT02694731.
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Affiliation(s)
- Ashley E Mason
- Department of Psychiatry, University of California - San Francisco, San Francisco, CA, USA.
- Osher Center for Integrative Medicine, University of California - San Francisco, San Francisco, CA, USA.
| | - Kinnari Jhaveri
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Michael Cohn
- Osher Center for Integrative Medicine, University of California - San Francisco, San Francisco, CA, USA
| | - Judson A Brewer
- University of Massachusetts Medical School, Worcester, MA, USA
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Horsch A, Gilbert L, Lanzi S, Gross J, Kayser B, Vial Y, Simeoni U, Hans D, Berney A, Scholz U, Barakat R, Puder JJ. Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial. BMJ Open 2018; 8:e020462. [PMID: 29487077 PMCID: PMC5855393 DOI: 10.1136/bmjopen-2017-020462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. METHODS AND ANALYSIS This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24-32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24-32 weeks of pregnancy, shortly after birth and at 6-8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). ETHICS AND DISSEMINATION We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02890693; Pre-results.
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Affiliation(s)
- Antje Horsch
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Leah Gilbert
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Service of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Yvan Vial
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Simeoni
- DOHad Laboratory, Pediatrics Division, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Didier Hans
- Center of Bone Diseases, Rheumatology Service, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Alexandre Berney
- Consultation Liaison Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Urte Scholz
- Applied Social and Health Psychology, Department of Psychology, University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Lausanne, Switzerland
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jardena J Puder
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Service of Pediatric Endocrinology, Diabetology and Obesity, Lausanne University Hospital, Lausanne, Switzerland
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Järvelä-Reijonen E, Karhunen L, Sairanen E, Muotka J, Lindroos S, Laitinen J, Puttonen S, Peuhkuri K, Hallikainen M, Pihlajamäki J, Korpela R, Ermes M, Lappalainen R, Kolehmainen M. The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial. Int J Behav Nutr Phys Act 2018; 15:22. [PMID: 29482636 PMCID: PMC5828146 DOI: 10.1186/s12966-018-0654-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 02/15/2018] [Indexed: 01/28/2023] Open
Abstract
Background Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. Results Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. Conclusions ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. Trial registration ClinicalTrials.gov (NCT01738256), registered 17 August, 2012. Electronic supplementary material The online version of this article (10.1186/s12966-018-0654-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elina Järvelä-Reijonen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.,Institute of Clinical Medicine and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland
| | - Essi Sairanen
- Department of Psychology, University of Jyväskylä, P.O. Box 35, FI-40014 University of Jyväskylä, Jyväskylä, Finland.,Department of Psychology, Karlstad University, SE-651 88, Karlstad, Sweden
| | - Joona Muotka
- Department of Psychology, University of Jyväskylä, P.O. Box 35, FI-40014 University of Jyväskylä, Jyväskylä, Finland
| | - Sanni Lindroos
- Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki, P.O. Box 63, FI-00014 University of Helsinki, Helsinki, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00251, Helsinki, Finland
| | - Sampsa Puttonen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00251, Helsinki, Finland
| | - Katri Peuhkuri
- Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki, P.O. Box 63, FI-00014 University of Helsinki, Helsinki, Finland
| | - Maarit Hallikainen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.,Institute of Clinical Medicine and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland
| | - Riitta Korpela
- Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki, P.O. Box 63, FI-00014 University of Helsinki, Helsinki, Finland
| | - Miikka Ermes
- VTT Technical Research Centre of Finland, P.O. Box 1300, FI-33101, Tampere, Finland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, P.O. Box 35, FI-40014 University of Jyväskylä, Jyväskylä, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.,Institute of Clinical Medicine and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland
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Janssen M, Heerkens Y, Kuijer W, van der Heijden B, Engels J. Effects of Mindfulness-Based Stress Reduction on employees' mental health: A systematic review. PLoS One 2018; 13:e0191332. [PMID: 29364935 PMCID: PMC5783379 DOI: 10.1371/journal.pone.0191332] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The purpose of this exploratory study was to obtain greater insight into the effects of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) on the mental health of employees. METHODS Using PsycINFO, PubMed, and CINAHL, we performed a systematic review in October 2015 of studies investigating the effects of MBSR and MBCT on various aspects of employees' mental health. Studies with a pre-post design (i.e. without a control group) were excluded. RESULTS 24 articles were identified, describing 23 studies: 22 on the effects of MBSR and 1 on the effects of MBSR in combination with some aspects of MBCT. Since no study focused exclusively on MBCT, its effects are not described in this systematic review. Of the 23 studies, 2 were of high methodological quality, 15 were of medium quality and 6 were of low quality. A meta-analysis was not performed due to the emergent and relatively uncharted nature of the topic of investigation, the exploratory character of this study, and the diversity of outcomes in the studies reviewed. Based on our analysis, the strongest outcomes were reduced levels of emotional exhaustion (a dimension of burnout), stress, psychological distress, depression, anxiety, and occupational stress. Improvements were found in terms of mindfulness, personal accomplishment (a dimension of burnout), (occupational) self-compassion, quality of sleep, and relaxation. CONCLUSION The results of this systematic review suggest that MBSR may help to improve psychological functioning in employees.
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Affiliation(s)
- Math Janssen
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
- * E-mail:
| | - Yvonne Heerkens
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Wietske Kuijer
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Beatrice van der Heijden
- Institute for Management Research, Radboud University, Nijmegen, the Netherlands
- Open University of the Netherlands, Heerlen, the Netherlands
- Kingston University, London, United Kingdom
| | - Josephine Engels
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
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87
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An exploratory examination of mindfulness, self-compassion, and mindful eating in relation to motivations to eat palatable foods and BMI. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.73052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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88
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Abstract
This article reviews the ways in which mindfulness practices have contributed to cognitive and behavioral treatments for depression and anxiety. Research on mindfulness-based interventions (MBIs) has increased rapidly in the past decade. The most common include mindfulness-based stress reduction and mindfulness-based cognitive therapy. MBIs are effective in reducing anxiety and depression symptom severity in a range of individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably with cognitive behavior therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with standard CBT.
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Affiliation(s)
- Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215, USA.
| | - Angelina F Gómez
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215, USA
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89
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Abstract
PURPOSE OF REVIEW This review examines the food addiction model and the role of food hedonic pathways in the pathogenesis and treatment of obesity. RECENT FINDINGS The hedonic pathway interacts with the obesogenic environment to override homeostatic mechanisms to cause increase in body weight. Weight gain sustained over time leads to "upward setting" of defended level of body-fat mass. There are neurobiological and phenotypic similarities and differences between hedonic pathways triggered by food compared with other addictive substances, and the entity of food addiction remains controversial. Treatment for obesity including pharmacotherapy and bariatric surgery impacts on neural pathways governing appetite and hedonic control of food intake. The food addiction model may also have significant impact on public health policy, regulation of certain foods, and weight stigma and bias. Recent rapid progress in delineation of food hedonic pathways advances our understanding of obesity and facilitates development of effective treatment measures against the disease.
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Affiliation(s)
- Phong Ching Lee
- Obesity and Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Bukit Merah, Singapore
| | - John B Dixon
- Clinical Obesity Research, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria, 3004, Australia.
- Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Australia.
- Primary Care Research Unit, Monash University, Melbourne, Australia.
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90
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Timmerman GM, Tahir MJ, Lewis RM, Samoson D, Temple H, Forman MR. Self-management of dietary intake using mindful eating to improve dietary intake for individuals with early stage chronic kidney disease. J Behav Med 2017; 40:702-711. [PMID: 28205015 PMCID: PMC5996381 DOI: 10.1007/s10865-017-9835-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/10/2017] [Indexed: 12/14/2022]
Abstract
Using mindful eating to improve specific dietary recommendations has not been adequately studied. This feasibility study examined an intervention, self-management of dietary intake using mindful eating, with 19 participants that had mild to moderate chronic kidney disease, using a prospective, single group, pretest-posttest design. The intervention had six weekly classes focused on self-management using mindful eating, goal-setting, problem-solving, and food label reading. Weight, body mass index (BMI), 3-day 24-h dietary recalls and fasting blood samples were measured. Participants improved significantly in mean weight (203.21 ± 42.98 vs 199.91 ± 40.36 lbs; P = 0.03) and BMI (32.02 ± 5.22 vs 31.57 ± 5.27 kg/m2; P = 0.04), but not in dietary intake nor blood measures with the exception of cis-beta-carotene levels (0.020 + 0.012 vs 0.026 + 0.012 mcg/mL; P = 0.008), which correlates to fruit and vegetable servings. These promising results warrant further testing of the intervention in randomized control trials.
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Affiliation(s)
- Gayle M Timmerman
- School of Nursing, The University of Texas at Austin, 1710 Red River, Austin, TX, 78701, USA.
| | - Muna J Tahir
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Richard M Lewis
- Renal Transplant Program, St. David's North Austin Medical Center, Austin, TX, USA
| | | | - Holli Temple
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - Michele R Forman
- Department of Nutritional Sciences and Population Research Center, The University of Texas at Austin, Austin, TX, USA
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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91
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Zhang X, Devlin HM, Smith B, Imperatore G, Thomas W, Lobelo F, Ali MK, Norris K, Gruss S, Bardenheier B, Cho P, Garcia de Quevedo I, Mudaliar U, Jones CD, Durthaler JM, Saaddine J, Geiss LS, Gregg EW. Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. PLoS One 2017; 12:e0176436. [PMID: 28493887 PMCID: PMC5426619 DOI: 10.1371/journal.pone.0176436] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/10/2017] [Indexed: 02/07/2023] Open
Abstract
Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk.
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Affiliation(s)
- Xuanping Zhang
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Heather M. Devlin
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bryce Smith
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - William Thomas
- Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Mohammed K. Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Keri Norris
- Health Policy and Administration, Fulton-DeKalb Hospital Authority, Atlanta, Georgia, United States of America
| | - Stephanie Gruss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Barbara Bardenheier
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Pyone Cho
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Isabel Garcia de Quevedo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Uma Mudaliar
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Christopher D. Jones
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey M. Durthaler
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jinan Saaddine
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Linda S. Geiss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Edward W. Gregg
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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92
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Zhang X, Imperatore G, Thomas W, Cheng YJ, Lobelo F, Norris K, Devlin HM, Ali MK, Gruss S, Bardenheier B, Cho P, Garcia de Quevedo I, Mudaliar U, Saaddine J, Geiss LS, Gregg EW. Effect of lifestyle interventions on glucose regulation among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2017; 123:149-164. [PMID: 28024276 PMCID: PMC6625761 DOI: 10.1016/j.diabres.2016.11.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 11/16/2016] [Accepted: 11/26/2016] [Indexed: 12/31/2022]
Abstract
This study systematically assessed the effectiveness of lifestyle interventions on glycemic indicators among adults (⩾18years) without IGT or diabetes. Randomized controlled trials using physical activity (PA), diet (D), or their combined strategies (PA+D) with follow-up ⩾12months were systematically searched from multiple electronic-databases between inception and May 4, 2016. Outcome measures included fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessment-estimated insulin resistance (HOMA-IR), and bodyweight. Included studies were divided into low-range (FPG <5.5mmol/L or HbA1c <5.5%) and high-range (FPG ⩾5.5mmol/L or HbA1c ⩾5.5%) groups according to baseline glycemic levels. Seventy-nine studies met inclusion criteria. Random-effect models demonstrated that compared with usual care, lifestyle interventions achieved significant reductions in FPG (-0.14mmol/L [95%CI, -0.19, -0.10]), HbA1c (-0.06% [-0.09, -0.03]), FI (%change: -15.18% [-20.01, -10.35]), HOMA-IR (%change: -22.82% [-29.14, -16.51]), and bodyweight (%change: -3.99% [-4.69, -3.29]). The same effect sizes in FPG reduction (0.07) appeared among both low-range and high-range groups. Similar effects were observed among all groups regardless of lengths of follow-up. D and PA+D interventions had larger effects on glucose reduction than PA alone. Lifestyle interventions significantly improved FPG, HbA1c, FI, HOMA-IR, and bodyweight among adults without IGT or diabetes, and might reduce progression of hyperglycemia to type 2 diabetes mellitus.
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Affiliation(s)
- Xuanping Zhang
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - William Thomas
- Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Yiling J Cheng
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Keri Norris
- Health Policy and Administration, Fulton-DeKalb Hospital Authority, Atlanta, GA, USA.
| | - Heather M Devlin
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Stephanie Gruss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Barbara Bardenheier
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Pyone Cho
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Isabel Garcia de Quevedo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Uma Mudaliar
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Jinan Saaddine
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Linda S Geiss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Edward W Gregg
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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93
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Abstract
Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.
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Affiliation(s)
- J David Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213;
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94
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Bravo-Sagua R, Mattar P, Díaz X, Lavandero S, Cifuentes M. Calcium Sensing Receptor as a Novel Mediator of Adipose Tissue Dysfunction: Mechanisms and Potential Clinical Implications. Front Physiol 2016; 7:395. [PMID: 27660614 PMCID: PMC5014866 DOI: 10.3389/fphys.2016.00395] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/24/2016] [Indexed: 01/09/2023] Open
Abstract
Obesity is currently a serious worldwide public health problem, reaching pandemic levels. For decades, dietary and behavioral approaches have failed to prevent this disease from expanding, and health authorities are challenged by the elevated prevalence of co-morbid conditions. Understanding how obesity-associated diseases develop from a basic science approach is recognized as an urgent task to face this growing problem. White adipose tissue (WAT) is an active endocrine organ, with a crucial influence on whole-body homeostasis. WAT dysfunction plays a key role linking obesity with its associated diseases such as type 2 diabetes mellitus, cardiovascular disease, and some cancers. Among the regulators of WAT physiology, the calcium-sensing receptor (CaSR) has arisen as a potential mediator of WAT dysfunction. Expression of the receptor has been described in human preadipocytes, adipocytes, and the human adipose cell lines LS14 and SW872. The evidence suggests that CaSR activation in the visceral (i.e., unhealthy) WAT is associated with an increased proliferation of adipose progenitor cells and elevated adipocyte differentiation. In addition, exposure of adipose cells to CaSR activators in vitro elevates proinflammatory cytokine expression and secretion. An increased proinflammatory environment in WAT plays a key role in the development of WAT dysfunction that leads to peripheral organ fat deposition and insulin resistance, among other consequences. We propose that CaSR may be one relevant therapeutic target in the struggle to confront the health consequences of the current worldwide obesity pandemic.
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Affiliation(s)
- Roberto Bravo-Sagua
- Institute of Nutrition and Food Technology, University of ChileSantiago, Chile; Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases and Center for Molecular Studies of the Cell, University of ChileSantiago, Chile
| | - Pamela Mattar
- Institute of Nutrition and Food Technology, University of ChileSantiago, Chile; Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases and Center for Molecular Studies of the Cell, University of ChileSantiago, Chile
| | - Ximena Díaz
- Institute of Nutrition and Food Technology, University of Chile Santiago, Chile
| | - Sergio Lavandero
- Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases and Center for Molecular Studies of the Cell, University of ChileSantiago, Chile; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Mariana Cifuentes
- Institute of Nutrition and Food Technology, University of Chile Santiago, Chile
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95
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Daubenmier J, Moran PJ, Kristeller J, Acree M, Bacchetti P, Kemeny ME, Dallman M, Lustig RH, Grunfeld C, Nixon DF, Milush JM, Goldman V, Laraia B, Laugero KD, Woodhouse L, Epel ES, Hecht FM. Effects of a mindfulness-based weight loss intervention in adults with obesity: A randomized clinical trial. Obesity (Silver Spring) 2016; 24:794-804. [PMID: 26955895 PMCID: PMC4898945 DOI: 10.1002/oby.21396] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/01/2015] [Accepted: 10/05/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine whether adding mindfulness-based eating and stress management practices to a diet-exercise program improves weight loss and metabolic syndrome components. METHODS In this study 194 adults with obesity were randomized to a 5.5-month program with or without mindfulness training and identical diet-exercise guidelines. Intention-to-treat analyses with multiple imputation were used for missing data. The primary outcome was 18-month weight change. RESULTS Estimated effects comparing the mindfulness to control arm favored the mindfulness arm in (a) weight loss at 12 months, -1.9 kg (95% CI: -4.5, 0.8; P = 0.17), and 18 months, -1.7 kg (95% CI: -4.7, 1.2; P = 0.24), though not statistically significant; (b) changes in fasting glucose at 12 months, -3.1 mg/dl (95% CI: -6.3, 0.1; P = 0.06), and 18 months, -4.1 mg/dl (95% CI: -7.3, -0.9; P = 0.01); and (c) changes in triglyceride/HDL ratio at 12 months, -0.57 (95% CI: -0.95, -0.18; P = 0.004), and 18 months, -0.36 (95% CI: -0.74, 0.03; P = 0.07). Estimates for other metabolic risk factors were not statistically significant, including waist circumference, blood pressure, and C-reactive protein. CONCLUSIONS Mindfulness enhancements to a diet-exercise program did not show substantial weight loss benefit but may promote long-term improvement in some aspects of metabolic health in obesity that requires further study.
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Affiliation(s)
- Jennifer Daubenmier
- Osher Center for Integrative MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Patricia J. Moran
- Osher Center for Integrative MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Jean Kristeller
- Department of Psychology, Indiana State UniversityTerre HauteIndianaUSA
| | - Michael Acree
- Osher Center for Integrative MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Peter Bacchetti
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Margaret E. Kemeny
- Department of PsychiatryUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Mary Dallman
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of PhysiologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Robert H. Lustig
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Carl Grunfeld
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Veterans Affairs Medical CenterSan FranciscoCaliforniaUSA
| | - Douglas F. Nixon
- Division of Experimental MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of MicrobiologyImmunology & Tropical Medicine, The George Washington UniversityWashingtonDCUSA
| | - Jeffrey M. Milush
- Department of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Veronica Goldman
- Osher Center for Integrative MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Barbara Laraia
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- School of Public HealthUniversity of CaliforniaBerkeleyCaliforniaUSA
| | - Kevin D. Laugero
- Western Human Nutrition Research Center, US Department of AgricultureDavisCaliforniaUSA
| | - Leslie Woodhouse
- Western Human Nutrition Research Center, US Department of AgricultureDavisCaliforniaUSA
| | - Elissa S. Epel
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of PhysiologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Frederick M. Hecht
- Osher Center for Integrative MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Center for Obesity Assessment, Study and TreatmentUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
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