Suzanne Leigh, UC San Francisco
A diet and exercise program that included mindfulness training resulted in participants having lower metabolic risk factors compared to those who underwent the same program without the training, according to a study led by researchers at UC San Francisco.
Metabolic risk factors include large waist circumference, high blood pressure, elevated blood sugar and triglycerides, and low levels of HDL cholesterol, the “good” cholesterol. The presence of at least three of these risk factors warrants a diagnosis of metabolic syndrome, a condition that raises the likelihood of heart disease, type II diabetes and stroke.
In the study, which was published in the March issue of the journal Obesity, 194 adults with obesity were randomly divided into two groups. Both underwent the same diet and exercise program, which included information on healthy eating and exercise. One group received additional information on nutrition and exercise, together with relaxation and cognitive-behavioral techniques for managing stress, while the other participated in a program that focused on “attention to present-moment experience, including experiences of eating and the thoughts and emotions related to it.”
“Mindful eating practices promote awareness of experiences related to the desire to eat, actual sensations of hunger, fullness, satisfaction and enjoyment,” said first author Jennifer Daubenmier, Ph.D., of the Osher Center for Integrative Medicine; Center for Obesity Assessment, Study and Treatment and the Department of Medicine at UCSF.
While the difference in weight loss between the two groups was not statistically significant, the mindfulness participants were found to have lower triglyceride/HDL ratios at six months after the program and lower blood sugar levels at 12 months after the program.
Non-judgment and kindness key to mindfulness
“High stress levels, sedentary lifestyles and availability of inexpensive high-calorie foods mean it is easy to fall into the habit of mindless eating,” Daubenmier said. “We often find ourselves overeating not because we’re hungry, but because the food looks or tastes delicious, we’re distracted or we wish to soothe away unpleasant feelings. When we do overeat, we may feel guilt or shame for doing so, and overeating can spiral out of control.
“Practicing mindfulness can be effective in allowing us to recognize our patterns without judging ourselves, and to make more thoughtful food choices about when, what and how much to eat in ways that are both satisfying and healthy,” she said.
In addition to mindful eating exercises, the five-and-a-half month program included meditation, yoga, breathing exercises and “loving kindness,” in which “one actively cultivates feelings of love and kindness for oneself and others.”
Eighteen months after the initiation of the program, researchers found that participants in the mindfulness group had an estimated 4.1 mg/dl lower fasting blood sugar levels on average compared to those in the control group. Additionally their triglyceride/HDL ratio was an estimated 0.36 lower than the control group. While modest, these reductions can be impactful in people at risk for metabolic syndrome, Daubenmier said.
Sweet treats easier to resist for mindfulness participants
“While we did not instruct participants to avoid calorie-dense foods altogether, we encouraged them to make choices to savor favorite sugary or fatty foods in smaller portions that fit within their calorie goals, or to notice food cravings and allow them to pass.
“These results suggest that mindfulness training may promote sustained improvements in healthy eating that may contribute to better longer-term improvement in some aspects of metabolic health in the context of behavioral weight-loss programs for obesity,” Daubenmier said.
The study was supported by National Institutes of Health grants from the National Center for Complementary and Integrative Health, as well as the National Center for Advancing Translational Sciences.
Researcher Jean Kristeller, Ph.D., participated in a paid webinar on mindful snacking for Allidura Consumer. The authors declare no further conflicts of interests.
Senior co-authors are Elissa Epel, Ph.D., of the UCSF Department of Psychiatry and Frederick Hecht, M.D., of the UCSF Department of Medicine. Other authors are Patricia Moran, Ph.D.; Michael Acree, Ph.D.; Peter Bacchetti, Ph.D.; Margaret Kemeny, Ph.D.; Mary Dallman, Ph.D.; Veronica Goldman; Robert Lustig, M.D., and Jeffrey Milush, Ph.D., all of UCSF; Jean Kristeller, Ph.D., of Indiana State University; Carl Grunfeld, M.D., Ph.D., of UCSF and Veterans Affairs Medical Center, San Francisco; Douglas Nixon, M.D., Ph.D., of UCSF and George Washington University; Barbara Laraia, M.D., MPH, of UCSF and University of California, Berkeley; Kevin Laugero, Ph.D., and Leslie Woodhouse, Ph.D., both of the U.S. Department of Agriculture.