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Abstract

Meditation is a popular form of stress management, argued to mediate stress reactivity. However, many studies in this field commonly fail to include an active control group. Given the frequency with which people are selecting meditation as a form of self-management, it is important to validate if the practice is effective in mediating stress-reactivity using well-controlled studies. Thus, we aimed to conduct a meta-analysis investigating the neurobiological effects of meditation, including focused attention, open monitoring and automatic self-transcending subtypes, compared to an active control, on markers of stress. In the current meta-analysis and systematic review, we included randomised controlled trials comparing meditation interventions compared to an active control on physiological markers of stress. Studied outcomes include cortisol, blood pressure, heart-rate, lipids and peripheral cytokine expression. Forty-five studies were included. All meditation subtypes reduced systolic blood pressure. Focused attention meditations also reduced cortisol and open monitoring meditations also reduced heart rate. When all meditation forms were analysed together, meditation reduced cortisol, C - reactive protein, blood pressure, heart rate, triglycerides and tumour necrosis factor-alpha. Overall, meditation practice leads to decreased physiological markers of stress in a range of populations.

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... Emerging evidence suggests that meditation may exert a regulatory effect on these stress hormones, offering a potential therapeutic avenue for mitigating the harmful effects of chronic stress. Various forms of meditation, including mindfulness meditation, transcendental meditation, and yoga, have been shown to reduce cortisol levels, lower blood pressure, and modulate autonomic nervous system activity, thereby promoting a state of relaxation and homeostasis [8]. Furthermore, meditation practices may help to rebalance adrenaline secretion, optimize growth hormone release during recovery, and stabilize glucagon levels, contributing to improved metabolic health and resilience to stress [9]. ...
... Serum growth hormone Median concentration of growth hormone in serum was 6.7 ng/ml (C25: 1.1; C75: 11.9) in levels, supporting the role of meditation in stress management. 8 Additionally, a study by Sudsuang et al. on Buddhist monks found lower catecholamine and cortisol levels compared to non-meditators, suggesting that long-term meditation can induce profound changes in stress physiology [15]. ...
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Background: Meditation, rooted in ancient traditions, has gained prominence as a tool for managing stress in modern health and wellness. This study aims on the impact of long-term Vipassana meditation on the regulation of stress hormones, including cortisol, adrenaline, growth hormone, and glucagon, to explore its physiological benefits.Methods: This comparative cross-sectional study involved 30 long-term Vipassana meditators and 30 age-, gender-, and education-matched non-meditator controls. Blood samples were analyzed for cortisol, adrenaline, growth hormone, and glucagon using ELISA. Statistical analysis was conducted using SPSS, with t-tests for parametric and Mann-Whitney U tests for non-parametric data.Results: Meditators exhibited significantly lower cortisol (126.4 ± 16.37 ng/ml) and adrenaline (35.9 ± 12.09 pg/ml) levels compared to controls (cortisol: 150.5 ± 18.62 ng/ml; adrenaline: 43.6 ± 14.98 pg/ml, p < 0.05). Growth hormone levels were higher in meditators (median: 6.7 ng/ml) compared to controls (median: 3.35 ng/ml), though not statistically significant (p > 0.05). In contrast, glucagon levels were slightly lower in meditators (median: 94.6 pg/ml) than in controls (median: 103.4 pg/ml), without reaching statistical significance (p > 0.05).Conclusion: Long-term Vipassana meditation is associated with reduced levels of stress hormones, particularly cortisol and adrenaline, highlighting its potential as an effective stress management tool. The non-significant differences in growth hormone and glucagon suggest that meditation’s endocrine effects may primarily target stress pathways. Future research is needed to explore these mechanisms further and assess broader endocrine implications.
... Several outcomes have been shown to be positively associated with MBSR, including the control of chronic pain in individuals with fibromyalgia, arthritis and low back pain, as well as several markers of inflammation. Other studies have shown that MBCT can relieve symptoms of depression, anxiety, or fatigue and improve metabolic control in individuals with diabetes mellitus [20][21][22][23][24][25][26]. ...
... The maintenance of homeostasis requires the participation of countless biochemical processes and physiological mediators, where hormones such as cortisol and catecholamines play a primary role. The combination of these hormones and the activation of the autonomic nervous system (ANS) and the central nervous system allow for better adaptation and responses to daily activities [24,30,31]. ...
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Background: Numerous studies have evaluated the effect that mindfulness-based interventions (MBIs) have on multiple health outcomes. For its part, stress is a natural response to environmental disturbances and within the associated metabolic responses, alterations in cortisol levels and their measurement in different tissues are a way to determine the stress state of an individual. Therefore, it has been proposed that MBIs can modify cortisol levels. Methods and results: The objective of this systematic review was to analyze and summarize the different studies that have evaluated the effect of MBIs on cortisol levels. The following databases were consulted: MEDLINE, AMED, CINAHL, Web of Science, Science Direct, PsycINFO, SocINDEX, PubMed, the Cochrane Library and Scopus. The search terms “mindfulness”, “mindfulness-based interventions” and “cortisol” were used (and the search was limited to studies from January 1990 to May 2024). In order to reduce selection bias, each article was scrutinized using the JBI Critical Appraisal Checklist independently by two authors. We included those studies with specified intervention groups with at least one control group and excluded duplicate studies or those in which the intervention or control group was not adequately specified. Significant changes in cortisol following MBIs were found in 25 studies, while 10 found no changes. The small sample size, lack of randomization, blinding, and probable confounding and interaction variables stand out in these studies. Conclusion: MBIs have biological plausibility as a means of explaining a positive effect on cortisol levels; however, the weakness of the studies and the absence of robust designs makes it difficult to establish a causal association between both variables. Registration number: INPLASY2024110017.
... Similarly, (Pascoe et al., 2017) (Brook et al., 2013). Additionally, reductions in cortisol levels, a main stress hormone, have been shown in those engaging in regular meditation, establishing a reasonable link between meditation and improved cardiovascular outcomes (Smyth et al., 2020). ...
... Meditation exerts enormous effects on both the body and mind by producing a state of deep relaxation and mental clarity (Sharma, 2015). Physiologically, meditation practices such as mindfulness and focused breathing assist reduce sympathetic nervous system activity, which is responsible for the body's stress response (Pascoe et al., 2017). This decrease leads to lower heart rate and blood pressure. ...
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This study examines how mindfulness, transcendental, and guided imagery meditation techniques affect blood pressure and subjective stress levels in higher education students in Uttarakhand, India. A sample of 400 participants was studied quantitatively using a quasi-experimental pretest-posttest design. Participants practiced various meditation techniques for eight weeks, and changes in systolic and diastolic blood pressure, as well as reported stress levels, were recorded. The intervention resulted in significant reductions in both blood pressure measures (systolic: 70%, diastolic: 65%) and perceived stress levels (75%). Regression and correlation studies revealed a robust link between meditation practice and improved cardiovascular health and stress management. These findings support for incorporating meditation into campus wellness programs to improve student well-being and academic performance, emphasizing the need for more study into long-term impacts and varied meditation modalities for optimal student health initiatives.
... Hair cortisol measurements have been suggested to provide a window into long-term impact of cortisol exposure (Stalder et al., 2017). These findings are contrasted by numerous null results (for meta-analyses see: Pascoe et al., 2017;Sanada et al., 2016), possibly due to modest samples sizes and mixed effects of different training contents on stress-related processes. Furthermore, 8 weeks eLife digest Too much stress is harmful to the brain and overall health, as it can lead to chronically high levels of the stress hormone cortisol. ...
... Participants were selected from a larger pool of potential volunteers by bootstrapping without replacement, creating cohorts not differing significantly with respect to several demographic and self-report traits (Singer et al., 2016). Each cultivated distinct cognitive and socio-affective capacities (Pascoe et al., 2017). Participants were divided in two 9-month training cohorts experiencing the modules in different orders, one 3-month Affect training cohort and one retest control cohort. ...
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The hippocampus is a central modulator of the HPA-axis, impacting the regulation of stress on brain structure, function, and behavior. The current study assessed whether three different types of 3 months mental Training Modules geared towards nurturing (a) attention-based mindfulness, (b) socio-affective, or (c) socio-cognitive skills may impact hippocampal organization by reducing stress. We evaluated mental training-induced changes in hippocampal subfield volume and intrinsic functional connectivity, by combining longitudinal structural and resting-state fMRI connectivity analysis in 332 healthy adults. We related these changes to changes in diurnal and chronic cortisol levels. We observed increases in bilateral cornu ammonis volume (CA1-3) following the 3 months compassion-based module targeting socio-affective skills ( Affect module), as compared to socio-cognitive skills ( Perspective module) or a waitlist cohort with no training intervention. Structural changes were paralleled by relative increases in functional connectivity of CA1-3 when fostering socio-affective as compared to socio-cognitive skills. Furthermore, training-induced changes in CA1-3 structure and function consistently correlated with reductions in cortisol output. Notably, using a multivariate approach, we found that other subfields that did not show group-level changes also contributed to changes in cortisol levels. Overall, we provide a link between a socio-emotional behavioural intervention, changes in hippocampal subfield structure and function, and reductions in cortisol in healthy adults.
... Elevated cortisol levels are strongly associated with cognitive impairment, as often observed in patients with MCI, AD, and mental disorders [28,29]. Meditation has been clinically proven to improve serum stress biomarkers such as cortisol [30]. In this study, we found that our loosening meditation session significantly decreased serum cortisol in adults with MCI. ...
... Mindfulness is suggested to improve emotion regulation and relaxation, and thus is likely to lower sympathetic arousal (19,20). However previous studies have demonstrated mixed findings on the effects of mindfulness interventions on physiological arousal (21)(22)(23). For instance, one study found that mindfulness interventions produced a significant reduction in heart rate to stressful experiences (24). ...
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Objective Although research on psychological interventions in generalized anxiety disorder (GAD) has provided evidence of their effectiveness regarding self-reported outcomes, few studies have examined their psychophysiological effects. Heart rate is emerging as a potential biomarker of efficacy in anxiety disorders. This study aimed to investigate the effects of a self-compassion intervention versus a mindfulness intervention on physiological arousal in response to induced stress. Methods Forty-seven patients with GAD had heart rate data collected during a stress task before and after a 2-week pharmacological treatment (known as treatment as usual, TAU), a self-compassion intervention + TAU or a mindfulness intervention + TAU. They also reported state anxiety, positive affect, and negative affect at pre- and post- intervention before the stress task. ANOVAs were conducted to analyze the effects on electrocardiogram data self-reported measurements. Results Self-compassion intervention uniquely decreased heart rate response to a stressor whereas mindfulness intervention did not. Both treatments decreased state anxiety and negative affect to a stressor, while increased positive affect in this context. We also demonstrated a significant correlation between decreased heart rate response and less negative emotions. Conclusion The Findings provides novel physiological evidence that self-compassion interventions buffer stress reactivity in individuals with GAD. Attention shall be paid to the limitations in small and unequal sample size and a non-randomized study design.
... This finding is consistent with experimental results in the literature that find optimism is associated with healthier arousal responses to stress (Birkeland et al., 2017;Brydon et al., 2009;Oveis et al., 2009). Additionally, maintaining arousal in these states is a key concept behind meditation or breathwork interventions for anxiety and stress (Pascoe et al., 2017). ...
... For example, offering time management workshops or implementing adaptive systems such as real-time workload monitoring tools can support professionals in high-pressure environments. Organizations can also leverage insights from stress management research to implement targeted interventions aimed at reducing both psychological and physiological stress [e.g., [65][66][67][68][69]. Such programs, which may include mindfulness training or other stress-reduction techniques, improve employees' well-being and job satisfaction by enhancing their ability to manage interruptions and focus on high-priority tasks. ...
Conference Paper
The integration of digital technologies has transformed modern business practices, offering both productivity gains and interruptions (e.g., due to instant messages). Interruption science examines the prevalence of interruptions that have emerged particularly in the digital business environment, where digital technology can serve as both an enabler and a disruptor. With respect to digital technologies' role as disruptor, evidence indicates a high potential to disrupt workflows, impair cognitive functions, and undermine productivity and well-being. To understand how digital business professionals cope with work interruptions , our pilot study examines the coping strategies used to manage work interruptions and the factors that influence interruption management decisions. Based on interview data collected from 10 professionals working in Austrian companies and analyzed qualitative content analysis, we identify 13 coping strategies grouped into three overarching categories: organizational (e.g., offering self-management courses), personal (e.g., avoiding unnecessary information and communication technologies during task performance), and technological (e.g., adjusting user status in information and communication technologies). Moreover, we outline 7 factors that influence interruption management decisions (e.g., current task activity/workload). Overall, our study provides insights into how individuals cope with interruptions, which can inform the development of strategies to enhance productivity and well-being.
... Despite their benefits, mind-body interventions have some limitations, such as the requirement for extensive training and time to master, as well as the need for regular practice and often group-based delivery [20,21]. In this study, we selected a short-term stress reduction method known as the brain wave modulation technique (BWM-T) [22][23][24][25][26][27], which has its roots in the interplay between Oriental doctrines and the scientific study of the mind-body dialogue [17,28,29]. ...
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Background: Recent advances in psychophysiology have underscored the importance of autonomic nervous system modulation in managing short-term stress. While several interventions have demonstrated efficacy in reducing short-term stress and anxiety symptoms, there remains a gap in understanding how different short-term techniques compare in terms of both psychological and physiological outcomes. This study investigated the effects of a single session of the Brain Wave Modulation Technique (BWM-T) compared with a psychoeducational session on short-term stress management. Methods: A total of 72 university students participated in this study (mean age = 27.5 years, 79% female). They were randomly assigned to either an experimental group (n = 36) receiving BWM-T or a control group (n = 36) receiving a standard psychoeducational short-term stress management session. Pre- and post-intervention measures included HRV parameters, perceived stress (using the Distress Thermometer, DT), and anxiety (using the STAI-Y State Anxiety Scale, S-ANX). Results: Both groups experienced significant reductions in perceived stress (DT: MD = 1.42, p < 0.001) and anxiety (S-ANX: MD = 6.93, p < 0.001). However, only the experimental group demonstrated physiological changes indicative of improved autonomic function: decreased low-frequency (LF) power (MD = −0.369, p < 0.05) and a lower LF/HF ratio (MD = −1.09, p < 0.05). These findings highlight the unique physiological benefits of BWM-T, beyond the general psychological improvements seen in both interventions. Conclusions: BWM-T appears to be a promising, effective short-term intervention for reducing short-term stress and enhancing autonomic regulation. Further studies are needed to evaluate its long-term effects and potential for broader implementation.
... These practices may reduce physiological stress by lowering cortisol levels and enhancing parasympathetic nervous system activity (Pascoe et al., 2017). Mindfulness also plays a key role in emotional regulation by increasing awareness of emotional triggers and habitual reactions, allowing for more thoughtful responses rather than impulsive reactions (Guendelman et al., 2017;Hölzel et al., 2011;Teper et al., 2013;. ...
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Background This study explores how personality traits and mindfulness facets interact to influence perceived stress, focusing on a Chinese adult sample. It aims to address gaps in understanding the combined effects of dispositional and mindfulness factors on stress. Methods A sequential explanatory mixed-methods design was employed. In the quantitative phase, 637 Chinese adults completed surveys measuring personality traits, mindfulness (attention, acceptance), and perceived stress. Hierarchical multiple regression, moderation, and mediation analyses were conducted. In the qualitative phase, semi-structured interviews with selected participants provided deeper insights into the quantitative findings. Results Neuroticism (β = 0.29, p < 0.001) and conscientiousness (β = 0.15, p < 0.01) were positively associated with perceived stress, while mindfulness-acceptance (β = −0.25, p < 0.001) was a significant negative predictor. Neuroticism and mindfulness-acceptance uniquely explained 8 and 6% of the variance in stress, respectively. Mindfulness-attention moderated the relationship between agreeableness and stress, amplifying agreeableness’ stress-buffering effect in individuals with low mindfulness-attention. Mediation analysis revealed mindfulness-acceptance partially mediated the agreeableness-stress link. Qualitative interviews underscored the role of personality and mindfulness in shaping stress responses and coping mechanisms. Conclusion The findings highlight mindfulness-acceptance as a critical factor in reducing stress, particularly in individuals with agreeable personalities. These results support the development of mindfulness-based interventions targeting acceptance to enhance stress resilience across diverse personality profiles.
... The MOPR program also demonstrated significant effects on arousal modulation, as evidenced by increases in the Optimal Arousal Zone (OAZ) and reductions in maladaptive stress responses, including hyperarousal (Fight/Flight, Freeze) and hypoarousal (Feigned Death). This outcome suggests that the mindfulness practices and vagal stimulation exercises included in the MOPR program, such as resonance frequency breathing, provided participants with effective tools for autonomic regulation [65,66]. Regression analysis findings further substantiated that arousal regulation, represented by the breadth of the OAZ, serves as a critical factor in enhancing professional quality of life. ...
Article
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Background/Objectives: Compassion Fatigue (CF) is a critical issue among healthcare professionals, exacerbated by exposure to trauma and chronic workplace stress. This pilot study evaluates the effectiveness of a Mindfulness-Oriented Professional Resilience (MOPR) program, a structured intervention designed to mitigate CF and enhance resilience in healthcare professionals. The program integrates mindfulness practices, arousal modulation techniques, and resilience-building strategies over six weekly sessions. Methods: A sample of 73 healthcare workers (mean age 48.6, SD = 9.42) participated in the study, and pre–post data were analyzed using repeated measures ANOVA. Results: Results indicated significant improvements in professional quality of life, with increased Compassion Satisfaction (p < 0.001) and reductions in Burnout (p = 0.003) and Secondary Traumatic Stress (p < 0.001). Mindfulness skills improved significantly across four dimensions—Observing, Describing, Acting with Awareness, and Non-reactivity—with p-values ranging from <0.01 to <0.001. Arousal modulation showed increased Optimal Arousal Zone scores (p < 0.001) and reduced maladaptive stress responses, including Fight/Flight, Freeze, and Feigned Death (p < 0.05). Psychological well-being improvements were observed, particularly in Self-Acceptance (p = 0.014) and Positive Relations (p = 0.041). Conclusions: These findings suggest that the MOPR program is a promising intervention for healthcare professionals, supporting resilience and reducing the psychological burden of caregiving. Future controlled studies should explore its long-term efficacy in diverse clinical settings and in larger samples.
... The study found that THM effectively reduces stress by promoting positive and refined emotions. Regular mindfulness meditation lowers cortisol levels, which is a key physiological marker of stress (Pascoe, 2017). THM activates the heart Chakra which is related to positive refined emotions like love, peace, and compassion (Sui, 1990) and triggers the parasympathetic nervous system, which counteracts the physiological effects of anxiety. ...
Article
Twin Heart Meditation (THM) is a popularly used meditative practice which focuses on activating the heart and crown chakras. It is known for its potential to cultivate loving-kindness, compassion, and spiritual connection, thereby enhancing psychological well-being. This study evaluates the efficacy of THM in reducing psychological distress a secondary-level school students in Pokhara, Nepal. Employing a quasi-experimental single-group pretest-posttest design, the study involved 182 students from Sainik Awashiya Mahavidhyalaya, selected through convenience sampling procedure. The Depression Anxiety Stress Scale (DASS-21) and Ryff's Psychological Well-Being Scale (RPWBS) were administered to assess psychological well-being before and after a four-week THM intervention. Results demonstrated significant reductions in stress, anxiety, and depression, along with positive changes in select dimensions of psychological well-being. The results were organized into four main themes: stress and THM, anxiety and THM, depression and THM, and psychological well-being and THM. These findings suggest that integrating THM into educational settings could effectively promote mental health and ease psychological distress among students.
... Changes in the activation and connectivity of brain regions, including the default mode network (e.g., posterior cingulate cortex and medial prefrontal cortex), the salience network (e.g., insula), and the executive control network (e.g., dorsolateral prefrontal cortex), have been observed in individuals who participated in long-term mindfulness interventions. [30][31][32] Michaela et al. 33 demonstrated that mindfulness meditation significantly reduces cortisol levels, blood pressure, heart rate, and other indicators of stress. Previous studies have shown that mindfulness is more effective than psychoeducation, cognitive behavioral therapy, and medication in treating depression. ...
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Background Given the distinctive physiological characteristics of pregnant women, non-pharmacological therapies are increasingly being used to improve depressive and anxiety symptoms. Our objective was to explore and compare the impact of various non-pharmacological interventions in improving depressive and anxiety symptoms, and to identify the most effective strategies for pregnant women with depressive and/or anxiety symptoms. Methods We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science for randomized controlled trials (RCTs) that compared non-pharmacological interventions to usual care, from the inception of each database up to October 5, 2024. We included pregnant women with singleton pregnancies who, at baseline, exhibited early signs of depressive and/or anxiety symptoms but did not meet clinical diagnostic criteria or exceed the threshold for clinically significant symptoms. We excluded pregnant women diagnosed with schizophrenia, bipolar disorder, or severe acute psychiatric conditions, those with a history of substance abuse, and those undergoing in vitro fertilisation. We performed both pairwise meta-analyses and random-effects network meta-analyses (NMAs), calculating standardised mean differences (SMDs) with 95% credible intervals (CrI). We used the surface under the cumulative ranking probability curve (SUCRA) to estimate treatment ranking probabilities. The outcomes were assessed in two groups of participants: a high-risk pregnancy group, including pregnant women with depressive and/or anxiety symptoms and high-risk pregnancies (defined as having a history of miscarriage, pregnancy complications such as gestational hypertension, gestational diabetes mellitus, or preeclampsia, and advanced maternal age (i.e., over 35 years old); and a healthy group, including participants who exhibited depressive and/or anxiety symptoms only during pregnancy and did not have other high-risk pregnancy conditions or underlying health issues. This study is registered with PROSPERO, CRD42024523053. Findings We included 101 studies (92 RCTs and 9 quasi-RCTs) involving a total of 15,330 participants across 11 interventions (mindfulness, education, counseling, cognitive behavioral therapy, muscle acupoint therapy, relaxation, mind-body exercise, psychotherapy, foetal movement counting, physical exercise, and music). Among the studies included in this analysis, 73 studies exhibited a low risk of bias, 9 studies had an unclear risk of bias, and 19 studies demonstrated a high risk of bias. The results indicate that, for both high-risk pregnancy population and healthy populations, mindfulness therapy was found to be an effective non-pharmacological treatment for significantly improving depressive and anxiety symptoms in pregnant women compared with control groups. For pregnant women with depressive symptoms, mindfulness therapy (SUCRA = 80%; SMD = −0.86, 95% CrI = −1.2, −0.52; Nn = 598), cognitive behavioral therapy (CBT) (SUCRA = 65%; SMD = −0.69, 95% CrI = −1.0, −0.39; Nn = 712), and education therapy (SUCRA = 48%; SMD = −0.54, 95% CrI = −0.86, −0.23; Nn = 2285) all significantly improve depressive symptoms. In the subgroup analysis of healthy populations, muscle acupoint therapy (SUCRA = 77.17%; SMD = −0.89, 95% CrI = −1.55, −0.23; N = 99) and mind-body exercise (SUCRA = 47.54%; SMD = −0.53, 95% CrI = −0.88, −0.19; N = 352) also significantly reduce depressive symptoms. Subgroup analysis shows that, in addition to mindfulness therapy, mind-body exercises (SUCRA = 67.43%; SMD = −0.97, 95% CrI = −1.61, −0.33; N = 382) and cognitive-behavioral therapy (SUCRA = 52.60%; SMD = −0.74, 95% CrI = −1.38, −0.09; N = 480) may also be effective in alleviating anxiety symptoms among healthy pregnant women. Interpretation Our findings indicate that mindfulness therapy significantly reduces the risk of depressive and anxiety symptoms in both high-risk pregnancy population and healthy populations. Therefore, when selecting non-pharmacologic therapies for managing depressive and anxiety symptoms during pregnancy, it is recommended that this therapy be considered. We cannot overlook the limitations of this study. For example, some interventions, such as muscle acupoint therapy for depressive symptoms and relaxation therapy for anxiety symptoms, have limited literature support. Additionally, the diversity of conditions within the high-risk pregnancy population and the high heterogeneity observed in certain interventions are also issues that require attention. These factors may affect the accuracy of the data results. Although we have employed reliable methods to address these issues, the findings of this study should still be interpreted with caution. Funding None.
... Various meta-analyses have confirmed that mindfulness meditation can positively influence the level of immune-related physiological markers of inflammation and biological aging, reduce the activity of the cellular transcription factor NF-kB, as well as lower circulating levels of C-reactive protein and telomerase activity (Black & Slavich, 2016), and the levels of physiological stress markers such as cortisol, systolic blood pressure, heart rate, triglyceride levels and others (Pascoe et al., 2017). The results of the study conducted by Mitsea et al. (2022) confirmed the hypothesis that mindfulness training reduces stress hormones, while increasing the release of hormones and neurotransmitters that are positively correlated with relaxation, positivity, and contentment. ...
Article
Mindfulness (usredotočena svjesnost) se odnosi na proces usmjeravanja pažnje, odnosno svjesnost o onome što se događa u našem umu, tijelu i vanjskoj okolini u sadašnjem trenutku, sa stavom prihvaćanja, neprosuđivanja, prijateljstva i otvorenosti. Različita istraživanja iz područja medicine, psihologije, neuroznanosti i drugih srodnih disciplina ukazuju na to da provođenje mindfulness programa i tehnika može imati brojne dobrobiti kod različite populacije korisnika u području poticanja psihofizičke homeostaze, emocionalne samoregulacije i uspješnijih socijalnih odnosa. Na temelju ovih spoznaja definiran je cilj ovoga rada koji se odnosio na pregled i analizu rezultata dosadašnjih istraživanja u svrhu razmatranja načina i učinkovitosti primjene mindfulnessa u području edukacijske rehabilitacije, u sljedećim skupinama korisnika: 1) djeca s teškoćama u razvoju / osobe s invaliditetom, 2) roditelji, 3) stručnjaci uključeni u edukacijsko-rehabilitacijski proces. Rezultati recentnih istraživanja, obuhvaćenih pregledom literature u ovom radu, upućuju na pozitivne utjecaje mindfulnessa, na tjelesne, psihoemocionalne i socijalne dimenzije temeljene na promjenama u neurološkom i endokrinološkome statusu te aktivnostima autonomnog živčanog sustava. Promjene se također očituju u doživljaju sebe, kvaliteti međuljudskih odnosa, razini percipiranog stresa te usvojenim tehnikama i strategijama suočavanja s nepovoljnim životnim situacijama. Također, uočena je potreba provođenja daljnjih znanstvenih i primijenjenih istraživanja koja bi doprinijela brojnijoj i učinkovitijoj primjeni mindfulnessa u području edukacijske rehabilitacije.
... Although yoga might have an impact via meditation and increased energy expenditure, 23,24 mindfulness probably does so through meditation and by modulating stress, anxiety, appetite signals, and the inflammatory status that usually accompanies obesity. [25][26][27][28][29] The practice of yoga in adults has been associated with mainly nonserious musculoskeletal adverse events. Compared with other physical activity interventions, the risk of adverse events related to yoga was comparable; most were mild and transient. ...
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The neuroplasticity of adolescents could make them responsive to interventions affecting brain maturation such as yoga and mindfulness. We aimed to determine their efficacy and safety for the management of children and adolescents with obesity. A systematic search using MEDLINE, EMBASE, and PsycInfo was performed up to March 2024. We considered randomized controlled trials (RCTs) using yoga or mindfulness alone (or combined with standard therapy) compared to placebo, nothing, or standard therapy for weight loss. Methodological quality of studies was assessed with the Risk of Bias 2 tool. The primary outcomes were changes in weight and adiposity (kg, body mass index [BMI], BMI z‐score, fat mass, waist circumference, waist‐to‐hip ratio). We assessed 4 yoga and 7 mindfulness RCTs, including 620 participants 8–19 years old. The number of participants varied per type of intervention (yoga, n = 10–63; mindfulness, n = 11–47). Comparators were no‐intervention or active controls. All yoga trials reported anthropometric improvements, but all trials combined yoga with extra physical activity. Five out of seven mindfulness trials reported anthropometric improvements. The methodological quality of the RCTs was low. No safety information was reported. The effect of yoga and mindfulness on psychological and metabolic variables was inconsistent. This evidence is insufficient to recommend yoga or mindfulness for the management of adolescents with obesity.
... • Lowering stress hormones: Reducing stress hormones can be achieved by incorporating relaxation techniques, such as deep breathing exercises [47]. ...
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Psychological capacity encompasses cognitive, emotional, behavioral, social, motivational, and coping abilities crucial for effective functioning and well-being. These capacities play a pivotal role in mental health, influencing resilience, self-efficacy, and overall psychological stability. Theoretical frameworks like cognitive processing, emotional intelligence, and resilience theory explain how individuals harness these capacities to manage stress and adapt to challenges. Psychological capacity is influenced by biological, environmental, and social factors, and its compression can lead to increased vulnerability to mental health disorders, such as depression and anxiety. Enhancing psychological capacity through targeted interventions—ranging from cognitive-behavioral therapy to lifestyle adjustments—can improve resilience and mental health outcomes. Recognizing early warning signs of psychological capacity compression and understanding its interaction with mental health disturbances are critical for timely intervention. Integrating pharmacological and non-pharmacological strategies, alongside regular medical consultations, can provide comprehensive management of psychological stress and enhance overall well-being. The Root and Branches Theory underscores the importance of addressing the root causes of psychological capacity compression to alleviate symptoms of mental distress, promoting a holistic approach to mental health care.
... Tendo em vista a forte associação entre a psicose e as alterações na regulação do cortisol, opções de tratamento não farmacológico que contribuem para a redução do estresse podem ser benéficas a esses pacientes (MONDELLI et al., 2010). Dentre essas alternativas, destaca-se a técnica de Mindfulness, que tem apresentado efeitos positivos na redução dos níveis séricos de cortisol (PASCOE et al., 2017). Estudos realizados a partir dos programas de redução de estresse de Kabat-Zinn (1982) A palavra Mindfulness pode ser traduzida como atenção plena, ou seja, a concentração intencional no momento presente, sem julgamentos. ...
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O espectro da esquizofrenia e outros transtornos psicóticos caracteriza-se pela presença de delírios, alucinações, fala desorganizada, comportamento desorganizado e sintomas negativos. Diante do forte impacto gerado pelos sintomas psicóticos em diferentes áreas da vida do indivíduo, é imprescindível o desenvolvimento de opções terapêuticas que possam atenuar sintomas residuais e refratários e fornecer uma melhor qualidade de vida. Os programas de Mindfulness surgem como potenciais ferramentas para o alívio de sintomas relacionados a doenças crônicas, estresse e sofrimento emocional. Assim, esse estudo buscou avaliar como as Intervenções Baseadas em Mindfulness (IBM) têm sido abordadas na literatura científica no contexto da psicose. Foi realizada uma revisão integrativa da literatura por meio das bases PubMed e Biblioteca Virtual em Saúde, com os descritores Esquizofrenia, Meditação, Mindfulness e Transtornos Psicóticos. A busca foi realizada em 2020, sendo incluídos 11 artigos de ensaios clínicos, em português ou inglês, publicados nos últimos 10 anos. As publicações analisadas evidenciaram diferentes tipos de IBMs aplicadas que, em sua maioria, foram adaptadas ou embasadas em protocolos de intervenção desenvolvidos em outros estudos. A maioria dos autores optou pela utilização de instrumentos de avaliação pré-estabelecidos e já validados. Os resultados encontrados dependeram do tipo de IBM utilizada, do contexto em que foram implementadas, do seu público-alvo, dos objetivos propostos e das medidas de avaliação empregadas. Foram encontrados benefícios relacionados à redução de sintomas psicóticos, depressivos e obsessivos-compulsivos, a redução do estresse e do sofrimento geral e relacionado aos sintomas, a melhora do humor e dos níveis de atenção e de funcionamento psicossocial, o aperfeiçoamento da função laboral e da performance de mindfulness, a melhora nos parâmetros de hospitalizações, recuperação e de saúde geral, e o aumento da percepção sobre si mesmo, sobre a doença e sobre seu tratamento. Dessa forma, conclui-se que as IBMs são ferramentas com resultados promissores, podendo ser adicionadas ao tratamento farmacológico dos transtornos psicóticos, como opções terapêuticas complementares viáveis e seguras.
... The latter could be due to the toxic effect of H2O2. On the other hand, the results of the cortisol dosage that we obtained confirm the beneficial effects of mindfulness meditation, by the reduction of the cortisol level reported in several studies[45][46]. Our results suggest that mindfulness meditation through Islamic prayer and pilgrimage decreases cortisol activation and regulates HHC. ...
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It is well established in the literature that mindfulness meditation helps in reducing metabolic and psychological stress, thus improving well-being. The present study aims at investigating this beneficial effect of mindfulness meditation in the context of the Islamic Pilgrimage (El-Hajj), through an oxidative and metabolic approach. Our experimental group includes 30 volunteer subjects who regularly practiced mindfulness meditation through Islamic prayer. The control group includes 30 subjects who do not practice prayer. Those who practice prayer (hajjis) are sampled one week prior to their departure to the pilgrimage and one week after their return from it. Stress parameters include Malondialdehyde (MDA), Catalase (CAT), and Cortisol. Metabolic parameters include control of fasting blood glucose, triglycerides, total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Our results show a significant reduction in plasma cortisol levels (p=0.014) in the hajjis after return from the pilgrimage. This decrease is associated with a decrease in lipid peroxidation levels (p = 0.082) and a significant increase in antioxidant defense by catalase (p = 0.0466). We suggest that mindfulness meditation through Islamic pilgrimage and prayer accounts for a downward modulation of plasma cortisol, MDA and the activation of antioxidant defense by catalase in hajjis after pilgrimage.
... Research shows that Transcendental Meditation can reduce burnout and promote overall well-being [75]. Similarly, Mindfulness meditation has been demonstrated to reduce perceived stress, improve emotional well-being, and enhance physiological markers of stress reactivity [76]. It involves present-moment awareness and nonjudgmental acceptance, helping to regulate stress responses and promote emotional resilience [77,78]. ...
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In the high-pressure environment of public service, professionals are frequently exposed to chronic stress and burnout, leading to significant physical, mental, and emotional health challenges. This chapter explores the physiological and psychological underpinnings of stress and burnout, providing a comprehensive overview of the yogic strategies that can be employed to foster resilience and well-being in this demanding field. The chapter delves into the effects of asanas on cardiovascular and orthopedic health, the impact of pranayama on mental stability and respiratory function, and the role of dhyana in enhancing cognitive control and ethical values. By integrating evidence-based yoga practices, public service professionals can develop a holistic approach to managing stress, improving overall health, and enhancing professional effectiveness. This chapter aims to bridge the gap between ancient yogic wisdom and modern scientific understanding, offering practical applications of yoga as a sustainable solution for the prevention and management of burnout in public service organizations.
... We developed a narrative empathy game, Mindful Fido, that actively engages players with 3 mindfulness techniques in the form of mini-games while encountering various types of stress factors faced in adolescence. These mini-games consist of a breathing exercise [26][27][28], an exercise to ground the player in the present moment [29][30][31], and a mindful eating exercise [32][33][34]. Each of these exercises offers a different approach to learning and practicing mindfulness, with the main goal being to encourage player engagement and interaction in an authentic context with real-life exercises. ...
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The importance of coping with stress for adolescents is well documented. Various approaches to providing stress-coping strategies have been proposed, and mindfulness has been one of the commonly introduced techniques. It has shown clinical evidence of effectiveness, and questionnaires measuring its efficiency have been developed as well. However, the majority of current methods take a conventional approach of involving verbal or text-based explanations of mindfulness practices, which suffer from a distinct lack of engagement and long-term adherence. However, there are still limited methods for introducing mindfulness to adolescents. In order to make mindfulness not only more accessible for teens but also more engaging and effective, we introduce Mindful Fido, an interactive narrative empathy game that involves players in three different mindfulness techniques, making the learning process more enjoyable and relatable to their daily experiences. In Mindful Fido, players follow the story of a teenage student who faces common stress factors of adolescence. The game is designed to keep players engaged and present mindfulness techniques as game mechanics that naturally allow players to practice mindfulness.
... Mind-body interventions, including mindfulness and yoga, are effective in reducing stress, improving sleep quality, and promoting better physical and mental health outcomes. These practices can help HCWs cope with the demands of their jobs while fostering healthier lifestyle habits [19]. The literature also highlights the importance of cognitive-behavioral therapy for insomnia in reducing sleep problems and increasing mental health outcomes among healthcare professionals [18,20]. ...
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Introduction The impact of lifestyle changes on the physical and mental health of emergency medicine staff has been a topic of increasing concern due to its effect on healthcare quality. This study aimed to assess the impact of lifestyle changes on emergency medicine staff's physical and mental health and their association with well-being at a major tertiary hospital. Methods A cross-sectional study was conducted in December 2023 using an online questionnaire targeting Emergency Department (ED) staff in Prince Sultan Medical City, Riyadh, Saudi Arabia. The data were analyzed using SPSS software (IBM Corp., Armonk, NY), with a Spearman correlation test and simple linear regression analysis used to determine the relationship between variables. Results The study included 149 participants, primarily male (59.7%) and predominantly within the age group of 30-39 years (59.1%). The sample consisted of ED nurses, residents, consultants, and paramedics, with over half having more than five years of experience in emergency medicine. Lifestyle changes were evident among participants, with 60.4% reporting worsened sleep patterns, 49.7% engaging in less physical activity, and 56.4% reporting poorer eating habits after joining the ED. Well-being assessments revealed moderate well-being scores (mean = 11.7 ± 5.61), with substantial variability in emotional states. Factors such as night sleep quality, physical activity, and nutrition were significantly correlated with well-being, with night sleep quality showing the strongest positive correlation (rho = 0.349, p < 0.001). Night sleep quality, nutritional intake, and physical activity are significant predictors of well-being, with night sleep quality being the strongest predictor (R2 = 0.122, F = 20.39, p < 0.001). Conclusion The study underscores the need for targeted interventions to address lifestyle challenges faced by ED personnel, particularly focusing on improving sleep quality, promoting regular physical activity, and encouraging healthier nutritional habits.
... People can increase their self-awareness when practicing mindfulness meditation, which helps them to better comprehend their own emotions and states, thus increasing flexibility of thought and driving positive thoughts 45 . In addition, mindfulness meditation can help people relieve stress and detach from negative feelings 50,[52][53][54] . Results of a meta-analysis showed a significant effect of mindfulness meditation on depressive symptoms and recommended the use of meditation-based interventions as evidence-based treatments 55 . ...
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Currently, 280 million people worldwide experience depression, ranking it third in the global burden of disease. The incidence of depression has risen due to the COVID-19 pandemic, making it essential to examine evidence-based practices in reducing depressive symptoms during this unprecedented time. This systematic review and meta-analysis aim to analyze randomized controlled trials during the COVID-19 pandemic that evaluated the effect of mindfulness meditation on depressive symptoms in individuals with depression. Four databases (PubMed, Embase, Web of Science, and Scopus) were searched in November 2023 using search terms including meditation, mindfulness, depression, and depressive symptoms. The meta-analysis was conducted using Review Manager 5.4 software (Cochrane Collaboration). A random model and Standard Mean Difference analysis with 95% CIs were used for continuous variables. The systematic review included 26 RCT studies. The meta-analysis showed significant effects of mindfulness meditation interventions (SMD = − 1.14; 95% CI − 1.45 to − 0.83; P < 0.001) in reducing depressive symptoms compared to comparison groups. The findings suggest a positive effect of mindfulness meditation on depressive symptoms in individuals with depression during the COVID-19 pandemic.
... Os resultados observados destes estudos demonstram que a meditação mindfulness reduz o nível de estresse, sintomas depressivos e inflamação corporal, reduzindo em consequência o nível de déficit cognitivo associado a tais fatores em pacientes com risco de desenvolvimento da doença de Alzheimer (Larouche, Judon, & Goulet, 2015). Em uma meta-análise de estudos clínicos controlados de meditação onde foram avaliados marcadores fisiológicos do estresse, a meditação mindfulness reduziu significativamente os níveis de cortisol, pressão arterial sistólica e a frequência cardíaca (Pascoe, Thompson, Jenkins, & Ski, 2017). ...
... Still, a systematic review and meta-analysis suggests that meditation decreases physiological stress-related substances, such as cortisol, C-reactive protein, triglycerides, and TNF-. A relaxation state induced by meditation decreases heart rate, blood pressure, and expression of inflammatory cytokines, leading to feelings of well-being [101]. ...
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There is a growing body of research exploring Complementary and Alternative Medicine (CAM) for the overall population; however, few studies have examined the effectiveness and applications of CAM practices in the paediatric population. According to the World Health Organization (WHO), parent's prevalence using CAM in their dependents is estimated to be as high as 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM applications and effectiveness caused mainly by variances in sociodemographic factors and national healthcare systems differences. Additionally, a lack of consensus and polarised positions among mainstream professionals regarding the CAM mechanism of action, applications, and effectiveness were identified. This narrative review shows debatable results for most CAM therapies and their applications. However, some evidence suggests that acupuncture, Yoga, Tai Chi, and massage might benefit users' physical and mental health. Additionally, meditation's available evidence indicates that it might be only helpful in the enhancement of mental health, whereas Reiki only displays an effect on patients' perceptions of comfort. Lastly, herbal medicine was observed to have non-specific evidence to support its claim, given the diverse nature and complexity of herbal compounds and procedures. This comprehensive narrative review might offer health professionals a reference to guide their health practices towards a personalised approach, taking into account the patient's values and beliefs, both important aspects of integrated, evidence-based practice, aiming to improve the quality of the offered health services and patients' satisfaction.
... Studies have shown that regular practice of hatha yoga can lead to significant reductions in anxiety levels. [16] ...
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Yoga has emerged as a new approach as a favorable adjunctive therapy in the management of anxiety disorders, offering a complete approach that integrates physical postures (asanas), breathing techniques (pranayama), and meditation practices (Dhyana). This integrative review synthesizes current research findings to explore the efficiency of yoga in alleviating signs of anxiety. By examining a range of studies, including randomized controlled trials, with control observational research, and data analyses, this review evaluates the mechanisms through which yoga influences anxiety levels, such as stress reduction, modulation of physiological responses, and enhancement of emotional regulation. In addition, the review discusses practical implications for health-care practitioners, highlighting yoga's potential as a safe and accessible intervention for anxiety management across diverse populations. Moreover, it identifies gaps in current research and proposes directions for future studies to further elucidate yoga's role in promoting mental well-being. Ultimately, this review underscores the therapeutic potential of yoga as a corresponding approach in the comprehensive treatment of anxiety disorders.
... Still, a systematic review and meta-analysis suggests that meditation decreases physiological stress-related substances, such as cortisol, C-reactive protein, triglycerides, and TNF-α. The relaxation state induced by meditation decreases the heart rate, blood pressure, and expression of inflammatory cytokines, leading to feelings of well-being [110]. ...
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While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM’s applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients’ perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
... Additionally, research on MBSR has demonstrated positive effects on physical health outcomes (Grossman et al., 2004). Studies have indicated that MBSR can improve immune system functioning, cardiovascular health, blood pressure and cortisol levels, sleep quality, and reduce chronic pain (Carlson et al., 2007;Brand et al., 2012;Pascoe et al., 2017;Chen et al., 2020). Mindfulness practice can result in enduring changes in brain structure and function (Kral et al., 2018). ...
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Introduction This study aimed to explore the time-varying impact of the Mindfulness-Based Stress Reduction (MBSR) program, specifically examining its effects on various variables 3 months, 1 year, and 3 years after program completion. Additionally, the study aimed to identify the barriers and facilitators in maintaining mindfulness practice over time and the preferred mindfulness practices among participants in three distinct time groups. Methods The study utilized a qualitative research design, conducting semi-structured interviews with 45 participants who had completed the 8-week MBSR program at different time points. Thematic analysis was employed to analyze the qualitative data obtained from the interviews, allowing for the identification of key themes and patterns. Results The findings revealed that the effectiveness of the MBSR program varied at different times and across different variables. Immediately after completing the program, participants experienced a significant decrease in stress levels and an increase in awareness. One year later, the program continued to have positive effects on inner calm, coping mechanisms, and relationships. Three years after completing the program, its long-term impact was observed in the adoption of a mindful lifestyle, increased compassion and kindness, and ongoing personal growth. Discussion The study highlights the transformative potential of the MBSR program beyond short-term symptom relief. The long-term effects observed in overall wellbeing emphasize the sustained efficacy of mindfulness-based interventions. The identified barriers and facilitators in maintaining mindfulness practice provide insights for program implementation and individual engagement. By understanding the long-term impact and preferences of participants, tailored interventions can be developed to maximize the benefits of the MBSR program for individuals over time.
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The synthesis of AI and yoga during the COVID-19 lockdown has created a new paradigm for personalized wellness, emphasizing the importance of digital solutions in sustaining mental and physical health during global crises. This review examines the recent advancements in AI, including Machine Learning and computer vision, focusing on AI's potential applications in yoga, such as posture alignment, personalized practice plans, and intelligent systems that adapt to the user’s physical and psychological state. The necessity for remote access to health-promoting activities, the ethical considerations, and the challenges of this integration are discussed. BlazePose is an architecture of convolutional neural networks optimized for real-time inference on mobile devices, and it is used to recognize human poses in images. Convolutional neural networks (CNN), pre-trained TensorFlow MoveNet model, autoencoder (SAE) algorithms, standard RGB webcam, and long short–term Memory (LSTM) are used in a hybrid deep learning Model that is proposed for Yoga recognition on real-time videos. Machine learning algorithms and OpenCV technology programs can recognize and assess users' body positions and movements during yoga practice This technology could be transformative in addressing limitations faced by practitioners and instructors in traditional settings, such as lack of immediate feedback and difficulty in ensuring correct alignment and engagement in asanas. Furthermore, AI’s potential to monitor physiological data like heart rate, breath patterns, and stress levels offers new dimensions for cultivating mindfulness and enhancing meditation practices. It concludes by suggesting future research by merging ancient wisdom with cutting-edge technology, AI has the potential to expand the horizons of yoga practice and promote holistic well-being on a larger scale.
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Human resource factors such as job stress and job satisfaction are important topics in both the science and practice of software development. However, existing studies use different conceptualizations of stress. In this paper, a new theoretical perspective on stress, the effort-reward imbalance framework, is presented and empirically investigated. According to this framework, stress results from an imbalance between perceived effort and reward. A moderated mediation model is proposed that conceptualizes stress as a mediator in explaining the relationship between agility (measured by eight agile practices) (independent variable) and developers' job satisfaction (dependent variable). In addition, the theoretical model proposes that overcommitment, a personality trait, moderates the relationship between agility and stress. Based on a sample of N = 178 software developers in Austria, the data confirm the model. The results show that agility indirectly increases job satisfaction via reduced stress perceptions. There was no significant direct effect of agility on job satisfaction. However, looking specifically at the effort and reward components, a stress-reducing effect of agility and a consequent satisfaction-enhancing effect were observed, primarily because the use of an agile approach increases developers' reward perceptions. Furthermore, it was found that the agile practices of requirements change and customer relation have a stress-increasing effect, while the other six practices (pair programming, continuous integration, refactoring, unit testing, collective ownership, coding standards) have a stress-reducing effect. However, since the results show that agility has an overall stress-reducing effect, this means that the unfavorable influence of requirements change and customer relationship on stress is overcompensated by the other six practices, predominantly via their positive influence on reward perceptions. Finally, the results show that developers with high levels of overcommitment experience a reduced benefit from agility.
Chapter
Epigenetic mechanisms are key processes that constantly reshape genome activity carrying out physiological responses to environmental stimuli. Such mechanisms regulate gene activity without modifying the DNA sequence, providing real-time adaptation to changing environmental conditions. Both favorable and unfavorable lifestyles have been shown to influence body and brain by means of epigenetics, leaving marks on the genome that can either be rapidly reversed or persist in time and even be transmitted trans-generationally. Among virtuous habits, meditation seemingly represents a valuable way of activating inner resources to cope with adverse experiences. While unhealthy habits, stress, and traumatic early-life events may favor the onset of diseases linked to inflammation, neuroinflammation, and neuroendocrine dysregulation, the practice of mindfulness-based techniques was associated with the alleviation of many of the above symptoms, underlying the importance of lifestyles for health and well-being. Meditation influences brain and body systemwide, eliciting structural/morphological changes as well as modulating the levels of circulating factors and the expression of genes linked to the HPA axis and the immune and neuroimmune systems. The current chapter intends to give an overview of pioneering research showing how meditation can promote health through epigenetics, by reshaping the profiles of the three main epigenetic markers, namely DNA methylation, histone modifications, and non-coding RNAs.
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The intricate relationship between Breath, Gut flora, and Sleep Quality significantly impacts overall well-being. This article explores how proper breathing techniques enhance relaxation and oxygenation, fostering better sleep. It also delves into the gut microbiome's role in serotonin production and circadian rhythm regulation. By understanding and optimizing these connections, we can improve sleep quality and consequently, our overall health. Proper breathing techniques, as recommended by Ayurveda, enhance prana (life force) and support mental calmness, aiding sleep. The gut, considered the seat of health (Agni), is crucial for maintaining balance . This relationship between breath, gut flora, and sleep quality is pivotal for overall health and well-being. This article explores how proper breathing positively influence gut health and sleep. The gut microbiome plays a crucial role in regulating neurotransmitters and inflammation, directly impacting sleep patterns. By understanding the synergy between breath, gut flora, and sleep, we can adopt holistic strategies to improve our nightly rest and daily vitality. Harmonizing breath and gut health through Ayurvedic practices like pranayama (mindful breathing practice), balanced diet, and daily routines (dinacharya) promotes good quality of sleep and overall vibrant growth, reflecting the profound synergy between these elements in achieving optimal health and harmony.
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: Mindfulness is the conscious awareness of the present moment, with an open and nonjudgmental mind. In recent years, mindfulness meditation practices have seen a significant expansion, gaining popularity, with a marked increase in research dedicated to exploring its health effects. These mindfulness-based therapies (MBT) include a range of practices, encompassing both sitting methods (mindfulness meditation, Vipassana, Zen), and moving approaches (Yoga, Tai Chi, and Qigong). Epigenetic mechanisms provide a way to control gene expression without changing the underlying DNA sequence, enabling the genome to adjust its functions to varying environmental conditions. Moreover, these changes in epigenetics and gene expression can serve as markers of different biological processes associated with health and diseases. Stress, stress-related disorders, cancers, and many other diseases have been often associated with changes in epigenetic mechanisms, and different MBT acts as promising additions to conventional therapeutic interventions, preventing diseases and improving health. Recent research studies have focused on unraveling the molecular and epigenetic mechanisms influenced by different MBTs, as these practices show positive outcomes through physiological and biochemical activities. This review summarizes the recent developments related to the molecular and epigenetic effects of Mindfulness therapies, emphasizing their clinical advantages in reducing the burden of various diseases.
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Although research suggests that trait mindfulness has been negatively associated with perceived stress, an integrative examination of the underlying mechanisms is lacking. Consequently, the purpose of this study was to establish an integrative model within Monitor and Acceptance Theory (MAT). This model examined the relationship between trait mindfulness and perceived stress by assessing two important psychological resources: basic psychological needs satisfaction (BPNS) and psychological flexibility. A total of 679 young adults (Mage = 19.27 years, SD = 1.06) participated in this research. They completed a set of standardized instruments that assessed trait mindfulness, BPNS, psychological flexibility, and perceived stress. Serial multiple mediation analyses showed that trait mindfulness was associated with higher levels of BPNS and psychological flexibility, which in turn were associated with less perceived stress. Furthermore, the path coefficient of the serial multiple mediation was higher than other pathways. These findings demonstrate that BPNS and psychological flexibility are important mechanisms that underlie the relationship between trait mindfulness and perceived stress, particularly when they are synergistic.
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Chronic stress can directly and indirectly promote carcinogenesis through immune, metabolic, and microbial pathways. Our overarching hypothesis is that reducing chronic stress will have important implications for colorectal cancer (CRC) risk reduction among vulnerable and high-risk populations. A promising approach for reducing chronic stress is Mindfulness. Mindfulness is a meditation-based technique that achieves a state of mind that is used to experience higher awareness or consciousness. Existing small studies suggest Mindfulness can positively regulate stress response in a way that translates to anti-cancer effects, including reduced systemic inflammation. We propose to evaluate an 8-week Mindfulness intervention delivered in a hybrid format (synchronous and asynchronous sessions) among 40 Black women at elevated risk of CRC who reside in vulnerable communities and who report moderate to high perceived stress. At baseline and post-intervention, participants will provide blood, hair, and stool, undergo body composition analysis, and complete mood and lifestyle-related surveys. The specific aims are to assess the feasibility and acceptability of the intervention and explore changes on stress, weight, fasting glucose, inflammation markers, and the gut microbiota - risk markers and risk pathways associated with CRC. The data generated through this project will inform if Mindfulness is a feasible option for CRC risk reduction among high-risk individuals.
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Mindfulness training has gained increasing attention as a potential intervention to improve cardiovascular health, particularly in populations with chronic conditions, such as type 2 diabetes. Given the heightened cardiovascular risk associated with type 2 diabetes, identifying effective non-pharmacological strategies to mitigate these risks is crucial. This critical review assessed the current evidence on the impact of mindfulness training on cardiovascular health in individuals with type 2 diabetes. A comprehensive literature search was conducted using the PubMed database, and studies were selected based on stringent inclusion and exclusion criteria. The search strategy was meticulously designed to filter out high-quality articles and ensure that only the most relevant and rigorous studies were included in the analysis. The findings from this review suggest that while mindfulness training has the potential to improve cardiovascular health in individuals with type 2 diabetes, evidence remains mixed. Some studies have reported significant improvements in cardiovascular markers, such as blood pressure and inflammation, while others have shown limited or no effects. This variability highlights the need for further research to better understand the mechanisms underlying these outcomes and identify the most effective mindfulness interventions for this population. In conclusion, mindfulness training appears to be a promising approach for enhancing cardiovascular health in Type 2 diabetes patients, yet the current evidence is inconclusive. Future research should focus on standardizing mindfulness interventions, conducting larger clinical trials, and exploring the long-term benefits of these interventions on cardiovascular outcomes in high-risk populations.
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Background Adolescents and young adults (AYAs) diagnosed with inflammatory bowel disease (IBD) are at an increased risk for poor physical and mental health due to the complexity of pediatric onset IBD and the unique developmental challenges of this period of life. Self-compassion is increasingly recognized as having an important role in explaining health outcomes and well-being across a range of populations. This study examines the relationship between self-compassion and psychosocial and physical health outcomes in AYAs with IBD. Methods In this cross-sectional study, AYAs with IBD aged 15 to 25 years completed an online survey between February 2020 and October 2021. Questionnaires included the Self-Compassion Scale—Short Form, Patient-Reported Outcomes Measurement Information System (PROMIS) measures for psychosocial, physical and global health outcomes, and IBD disease activity indices. Results AYAs with higher levels of self-compassion were found to have better psychosocial (ie, anxiety, depressive symptoms, psychological stress, physical stress, peer relationships), physical (ie, fatigue), and global health outcomes. Self-compassion was a significant independent predictor of anxiety (β = −5.80, P = < .001), depressive symptoms (β = −7.09, P = < .001), psychological stress (β = −4.66, P = < .001), physical stress (β = −3.19, P = < .001), peer relationships (β = 3.39, P = .003), fatigue (β = −2.05, P = .019), and improved global health (β = 5.15, P = < .001). Conclusions This study offers preliminary support for the importance of self-compassion in AYAs with IBD and demonstrates the need for further research in this area.
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In the face of the increasingly serious background of overweight and obesity rates among adolescents in China, mindfulness, as an emerging therapeutic approach, has shown its unique effectiveness. This article reviewed the research progress of mindfulness in the intervention of adolescent obesity, summarized its effects on improving physiological and psychological indicators, and listed the different options for implementing mindfulness therapy. These studies supported the preliminary effectiveness of mindfulness in the intervention of adolescent obesity, providing a basis for mindfulness to become a new approach for obesity intervention in the future.
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This mixed-methods pilot study investigates the effects of a brief seven-minute heartfulness relaxation intervention on interpreting students’ cognitive performance, perceived stress, and consecutive interpreting skills. Seven participants completed pre- and post-intervention measures, including the Stroop test, Perceived Stress Scale (PSS-10), and consecutive interpreting tasks. Qualitative data were collected through participant interviews and analyzed using thematic analysis. The quantitative results revealed significant improvements in executive function (p<.001), perceived stress (p=.078), and Chinese to English and English to Chinese consecutive interpreting (p=.028) following the intervention. The qualitative findings indicated predominantly positive effects on interpreting performance, concentration, and focus, with mixed responses regarding relaxation, environmental factors, and effect sustainability. The convergence of the qualitative themes and quantitative improvements suggested that the heartfulness relaxation intervention enhanced the participants’ cognitive function, reduced fatigue, and optimized essential skills. These findings highlight the potential benefits of incorporating a brief relaxation practice into interpreter training and professional development. Limitations and future research directions are discussed, emphasizing the need for larger controlled trials to confirm the generalizability and long-term effects of the intervention. Overall, this pilot study provides a foundation for further investigations into the application of the brief heartfulness relaxation technique in the interpreting field.
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The reliability of experimental findings depends on the rigour of experimental design. Here we show limited reporting of measures to reduce the risk of bias in a random sample of life sciences publications, significantly lower reporting of randomisation in work published in journals of high impact, and very limited reporting of measures to reduce the risk of bias in publications from leading United Kingdom institutions. Ascertainment of differences between institutions might serve both as a measure of research quality and as a tool for institutional efforts to improve research quality.
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Meditation is becoming increasingly practiced, especially for stress-related medical conditions. Meditation may improve cellular health; however, studies have not separated out effects of meditation from vacation-like effects in a residential randomized controlled trial. We recruited healthy women non-meditators to live at a resort for 6 days and randomized to either meditation retreat or relaxing on-site, with both groups compared with ‘regular meditators' already enrolled in the retreat. Blood drawn at baseline and post intervention was assessed for transcriptome-wide expression patterns and aging-related biomarkers. Highly significant gene expression changes were detected across all groups (the ‘vacation effect') that could accurately predict (96% accuracy) between baseline and post-intervention states and were characterized by improved regulation of stress response, immune function and amyloid beta (Aβ) metabolism. Although a smaller set of genes was affected, regular meditators showed post-intervention differences in a gene network characterized by lower regulation of protein synthesis and viral genome activity. Changes in well-being were assessed post intervention relative to baseline, as well as 1 and 10 months later. All groups showed equivalently large immediate post-intervention improvements in well-being, but novice meditators showed greater maintenance of lower distress over time compared with those in the vacation arm. Regular meditators showed a trend toward increased telomerase activity compared with randomized women, who showed increased plasma Aβ42/Aβ40 ratios and tumor necrosis factor alpha (TNF-α) levels. This highly controlled residential study showed large salutary changes in gene expression networks due to the vacation effect, common to all groups. For those already trained in the practice of meditation, a retreat appears to provide additional benefits to cellular health beyond the vacation effect.
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The practice of mindfulness has not been well-developed for cancer survivors and their partners, and its effects on relational well-being and cortisol responses are unknown. This 14-month study aimed to examine the effects of the mindfulness-incorporated couples support group on psychological individual and relational well-being, and cortisol stress responses in breast cancer survivors and their partners. The participants were randomized into two groups: 21 couples in couples support group (CSG) and 19 couples in individual support program (ISP). Outcome measures for both survivors and their partners included Medical Outcomes Study Sleeping scale (MOS), Beck Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI), Meaning of Life Questionnaire (MLQ), Short form-12 Health-related Quality of Life (SF-12 QOL), Experiences in close relationships-revision scale (ECR-R), and salivary cortisol. Among breast cancer survivors, the most significant effects of CSG were greater reductions of anxiety ECR-R compared with ISP. For partners, decreased levels of BDI-II, anxiety, and avoidant ECR-R, and increased levels of search and presence aspects of MLQ, physical, and mental QOL were identified in CSG compared with ISP. Moreover, CSG contributed to reduced cortisol levels at time of awakening and at 12:00 for both breast cancer survivors and their partners, cortisol levels at 30 min after awakening for survivors, and night cortisol levels at 21:00 for partners. In conclusion, mindfulness including individual and interactive breathing and meditation could guide clinical professionals to practice mindfulness themselves and become trainers to enhance the effective communication and relational well-being for cancer survivors and their partners.
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Objective: This study's objective was to evaluate the effect of two common components of meditation (mindfulness and slow breathing) on potential mechanistic pathways. Methods: A total of 102 combat veterans with posttraumatic stress disorder (PTSD) were randomized to (a) the body scan mindfulness meditation (MM), (b) slow breathing (SB) with a biofeedback device, (c) mindful awareness of the breath with an intention to slow the breath (MM+SB), or (d) sitting quietly (SQ). Participants had 6 weekly one-on-one sessions with 20 minutes of daily home practice. The mechanistic pathways and measures were as follows: (a) autonomic nervous system (hyperarousal symptoms, heart rate [HR], and heart rate variability [HRV]); (b) frontal cortex activity (attentional network task [ANT] conflict effect and event-related negativity and intrusive thoughts); and (c) hypothalamic-pituitary-adrenal axis (awakening cortisol). PTSD measures were also evaluated. Results: Meditation participants had significant but modest within-group improvement in PTSD and related symptoms, although there were no effects between groups. Perceived impression of PTSD symptom improvement was greater in the meditation arms compared with controls. Resting respiration decreased in the meditation arms compared with SQ. For the mechanistic pathways, (a) subjective hyperarousal symptoms improved within-group (but not between groups) for MM, MM+SB, and SQ, while HR and HRV did not; (b) intrusive thoughts decreased in MM compared with MM+SB and SB, while the ANT measures did not change; and (c) MM had lower awakening cortisol within-group (but not between groups). Conclusion: Treatment effects were mostly specific to self-report rather than physiological measures. Continued research is needed to further evaluate mindfulness meditation's mechanism in people with PTSD.
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Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated (a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and (b) the effects of 2 sleep-focused mind-body interventions, mind-body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months' duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self-compassion were observed in the MBB group compared with those in SHE. The findings in this exploratory study suggest that sOT may be a reliable biological measure over time that may provide insight into the effects of mind-body interventions on health outcomes in cancer survivors. © The Author(s) 2015.
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Meditation can be defined as a form of mental training that aims to improve an individual's core psychological capacities, such as attentional and emotional self-regulation. Meditation encompasses a family of complex practices that include mindfulness meditation, mantra meditation, yoga, tai chi and chi gong 1. Of these practices , mindfulness meditation — often described as non-judgemental attention to present-moment experiences (BOX 1) — has received most attention in neuroscience research over the past two decades 2–8. Although meditation research is in its infancy, a number of studies have investigated changes in brain activation (at rest and during specific tasks) that are associated with the practice of, or that follow, training in mindfulness meditation. These studies have reported changes in multiple aspects of mental function in beginner and advanced meditators, healthy individuals and patient populations 9–14. In this Review, we consider the current state of research on mindfulness meditation. We discuss the methodological challenges that the field faces and point to several shortcomings in existing studies. Taking into account some important theoretical considerations, we then discuss behavioural and neuroscientific findings in light of what we think are the core components of meditation practice: attention control, emotion regulation and self-awareness (BOX 1). Within this framework, we describe research that has revealed changes in behaviour, brain activity and brain structure following mindfulness meditation training. We discuss what has been learned so far from this research and suggest new research strategies for the field. We focus here on mindfulness meditation practices and have excluded studies on other types of meditation. However, it is important to note that other styles of meditation may operate via distinct neural mechanisms
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Mindfulness meditation is increasingly used in health interventions and may reduce stress and blood pressure. We aimed to investigate the effectiveness of brief mindfulness meditation in reducing cardiovascular reactivity and recovery during a laboratory stressor. We randomly assigned 62 meditation-naïve participants to a mindfulness meditation group or a matched non-mindful listening exercise control group. There were no differences between groups in blood pressure, demographic, or mood variables at baseline. Mindfulness participants showed lower systolic blood pressure following the mindfulness exercise and decreased systolic and diastolic blood pressure reactivity during a speeded math stressor. Specifically, as the stressor progressed, blood pressure in the mindfulness group began to decrease, whereas in the control group, it continued to increase. There were no group differences during recovery. Overall, brief mindfulness meditation reduced cardiovascular reactivity to stress and may be an effective intervention for reducing stress-related blood pressure reactivity.
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The aim of this study was to examine the efficacy of a 3 week mindfulness inspired protocol, delivered by an Android application for smartphones, in reducing stress in the adult population. By using a controlled pragmatic trial, a self-help intervention group of meditators was compared with a typical control group listening to relaxing music and a waiting list group. The final sample included 56 Italian workers as participants, block randomized to the three conditions. The self-reported level of perceived stress was assessed at the beginning and at the end of the protocol. Participants were also instructed to track their heart rate before and after each session. The results did not show any significant differences between groups, but both self-help intervention groups demonstrated an improvement in coping with stress. Nevertheless, meditators and music listeners reported a significant decrease in average heartbeats per minute after each session. Furthermore, both groups perceived a moderate but significant change in stress reduction perceptions, even if with some peculiarities. Limitations and opportunities related to the meditation protocol supported by the mobile application to reduce stress are discussed.
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The authors hypothesized that a social and emotional learning (SEL) program involving mindfulness and caring for others, designed for elementary school students, would enhance cognitive control, reduce stress, promote well-being and prosociality, and produce positive school outcomes. To test this hypothesis, 4 classes of combined 4th and 5th graders (N = 99) were randomly assigned to receive the SEL with mindfulness program versus a regular social responsibility program. Measures assessed executive functions (EFs), stress physiology via salivary cortisol, well-being (self-reports), prosociality and peer acceptance (peer reports), and math grades. Relative to children in the social responsibility program, children who received the SEL program with mindfulness (a) improved more in their cognitive control and stress physiology; (b) reported greater empathy, perspective-taking, emotional control, optimism, school self-concept, and mindfulness, (c) showed greater decreases in self-reported symptoms of depression and peer-rated aggression, (d) were rated by peers as more prosocial, and (e) increased in peer acceptance (or sociometric popularity). The results of this investigation suggest the promise of this SEL intervention and address a lacuna in the scientific literature-identifying strategies not only to ameliorate children's problems but also to cultivate their well-being and thriving. Directions for future research are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Background: Group psychosocial interventions including mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET) can help breast cancer survivors decrease distress and influence cortisol levels. Although telomere length (TL) has been associated with breast cancer prognosis, the impact of these two interventions on TL has not been studied to date. Methods: The objective of the current study was to compare the effects of MBCR and SET with a minimal intervention control condition (a 1-day stress management seminar) on TL in distressed breast cancer survivors in a randomized controlled trial. MBCR focused on training in mindfulness meditation and gentle Hatha yoga whereas SET focused on emotional expression and group support. The primary outcome measure was relative TL, the telomere/single-copy gene ratio, assessed before and after each intervention. Secondary outcomes were self-reported mood and stress symptoms. Results: Eighty-eight distressed breast cancer survivors with a diagnosis of stage I to III cancer (using the American Joint Committee on Cancer (AJCC) TNM staging system) who had completed treatment at least 3 months prior participated. Using analyses of covariance on a per-protocol sample, there were no differences noted between the MBCR and SET groups with regard to the telomere/single-copy gene ratio, but a trend effect was observed between the combined intervention group and controls (F [1,84], 3.82; P = .054; η(2) = .043); TL in the intervention group was maintained whereas it was found to decrease for control participants. There were no associations noted between changes in TL and changes in mood or stress scores over time. Conclusions: Psychosocial interventions providing stress reduction and emotional support resulted in trends toward TL maintenance in distressed breast cancer survivors, compared with decreases in usual care.
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This article describes the various forms of meditation and provides an overview of research using these techniques for children, adolescents, and their families. The most researched techniques in children and adolescents are mindfulness-based stress reduction, mindfulness-based cognitive therapy, yoga meditation, transcendental meditation, mind-body techniques (meditation, relaxation), and body-mind techniques (yoga poses, tai chi movements). Current data are suggestive of a possible value of meditation and mindfulness techniques for treating symptomatic anxiety, depression, and pain in youth. Clinicians must be properly trained before using these techniques.
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Dysregulated reward processing is a hallmark feature of drug addiction; however, scant research has evaluated restructuring reward processing in the context of addiction treatment. We examined effects of Mindfulness-Oriented Recovery Enhancement (MORE) on reward responsiveness (RR) and opioid cue-reactivity in a sample of chronic pain patients with opioid use problems. We previously reported that MORE decreased pain, opioid misuse, and craving relative to a social support control group (SG). Here, we examined whether these outcomes were linked to changes in RR in a subset of participants. Participants were chronic pain patients (71 % women, age 46.6 ± 13.9) who received MORE (n = 20) or SG (n = 29). RR was measured before and after 8 weeks of treatment via heart rate (HR) and heart rate variability (HRV) responses during a dot probe task that included opioid-related, pain-related, and natural reward stimuli, as well as craving ratings. The MORE group, who reported decreased opioid misuse and opioid craving during treatment, evidenced less subjective opioid cue-reactivity, greater HR decelerations, and greater increases in HRV to all cues after treatment compared to the SG; HR and HRV effects were most pronounced for natural reward cues. Within the MORE group, HR deceleration to natural reward cues was correlated with increased subjective arousal to the cues, whereas HR deceleration to opioid cues was correlated with decreased subjective arousal. Effects of MORE on craving were mediated by enhanced RR. Results suggest that during treatment with MORE, cardiac-autonomic responsiveness to non-drug reward increases, while reactivity to opioid reward decreases. Studies are needed to discern whether changes in RR were a result or a determinant of reductions in opioid misuse and craving. RR may play a role in addiction treatment.
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Background/aims: The primary therapeutic goals in ulcerative colitis (UC) are to maintain excellent quality of life (QOL) by treating flare-ups when they occur, and preventing flare-ups. Since stress can trigger UC flare-ups, we investigated the efficacy of mindfulness-based stress reduction (MBSR) to reduce flare-ups and improve QOL. Methods: Patients with moderately severe UC, in remission, were randomized to MBSR or time/attention control. Primary outcome was disease status. Secondary outcomes were changes in markers of inflammation and disease activity, markers of stress and psychological assessments. Results: 55 subjects were randomized. Absence of flares, time to flare and severity of flare over 1 year were similar between the two groups. However, post hoc analysis showed that MBSR decreased the proportion of participants with at least one flare-up among those with top tertile urinary cortisol and baseline perceived stress (30 vs. 70%; p < 0.001). MBSR patients who flared demonstrated significantly lower stress at the last visit compared to flared patients in the control group (p = 0.04). Furthermore, MBSR prevented a drop in the Inflammatory Bowel Disease Quality of Life Questionnaire during flare (p < 0.01). Conclusion: MBSR did not affect the rate or severity of flare-ups in UC patients in remission. However, MBSR might be effective for those with high stress reactivity (high perceived stress and urinary cortisol) during remission. MBSR appears to improve QOL in UC patients by minimizing the negative impact of flare-ups on QOL. Further studies are needed to identify a subset of patients for whom MBSR could alter disease course.
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Objectives: The objectives of this study were to determine the effects of the novel Buddhism-based walking meditation (BWM) and the traditional walking exercise (TWE) on depression, functional fitness, and vascular reactivity. Design: This was a randomized exercise intervention study. Settings/location: The study was conducted in a university hospital setting. Subjects: Forty-five elderly participants aged 60-90 years with mild-to-moderate depressive symptoms were randomly allocated to the sedentary control, TWE, and BWM groups. Interventions: The BWM program was based on aerobic walking exercise incorporating the Buddhist meditations performed 3 times/week for 12 weeks. Outcome measures: Depression score, functional fitness, and endothelium-dependent vasodilation as measured by the flow-mediated dilation (FMD) were the outcome measures used. Results: Muscle strength, flexibility, agility, dynamic balance, and cardiorespiratory endurance increased in both exercise groups (p<0.05). Depression score decreased (p<0.05) only in the BWM group. FMD improved (p<0.05) in both exercise groups. Significant reduction in plasma cholesterol, triglyceride, high-density lipoprotein cholesterol, and C-reactive protein were found in both exercise groups, whereas low-density lipoprotein cholesterol, cortisol, and interleukin-6 concentrations decreased only in the BWM group. Conclusions: Buddhist walking meditation was effective in reducing depression, improving functional fitness and vascular reactivity, and appears to confer greater overall improvements than the traditional walking program.
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The brain network governing meditation has been studied using a variety of meditation practices and techniques practices eliciting different cognitive processes (e.g., silence, attention to own body, sense of joy, mantras, etc.). It is very possible that different practices of meditation are subserved by largely, if not entirely, disparate brain networks. This assumption was tested by conducting an activation likelihood estimation (ALE) meta-analysis of meditation neuroimaging studies, which assessed 150 activation foci from 24 experiments. Different ALE meta-analyses were carried out. One involved the subsets of studies involving meditation induced through exercising focused attention (FA). The network included clusters bilaterally in the medial gyrus, the left superior parietal lobe, the left insula and the right supramarginal gyrus (SMG). A second analysis addressed the studies involving meditation states induced by chanting or by repetition of words or phrases, known as “mantra.” This type of practice elicited a cluster of activity in the right SMG, the SMA bilaterally and the left postcentral gyrus. Furthermore, the last analyses addressed the effect of meditation experience (i.e., short- vs. long-term meditators). We found that frontal activation was present for short-term, as compared with long-term experience meditators, confirming that experts are better enabled to sustain attentional focus, rather recruiting the right SMG and concentrating on aspects involving disembodiment.
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This paper juxtaposes Asian spiritual narratives on meditation alongside medical and scientific narratives that emphasize meditation's efficacy in mitigating distress and increasing well-being. After proposing a working definition of meditation that enables it usefully to be distinguished from categories of similar practices such as prayer, I examine meditation's role in Mind/Body medicine in the West. Here, I survey a number of scientific studies of meditation, including the work of Dr. Herbert Benson and his colleagues who examine a meditational variant they call the ‘Relaxation Response', to examine the breadth of efficacy claims made on behalf of the complex and multidimensional grouping of diverse practices we have come to as ‘meditation'. Among other positive outcomes, meditation has been credited with reducing blood pressure, anxiety, addiction, and stress, while Relaxation Response has been shown to decrease sympathetic nervous system (SNS) activity, metabolism, pain, anxiety, depression, hostility, and stress. I conclude the paper by suggesting that findings from cognitive neuroscience on the subject of visual imagery can be used to elucidate genres of meditative practice that focus on internal visualization sequences, and I use practices from the Rnying ma tradition of Tibetan Buddhism to illustrate why certain integral aspects of meditation forever will remain beyond scientific grasp.
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Chronic inflammation is highly prevalent in patients on hemodialysis (HD), as evidenced by increased levels of C-reactive protein (CRP). We compared CRP to high-sensitivity C-reactive protein (hs-CRP) to determine whether it has any clinical implications and prognostic significance in terms of mortality. CRP was measured using a standard immunoturbidometric assay on the COBAS® INTEGRA system and hs-CRP was measured using the Dade Behring on the Konelab Nephelometer in 50 patients on HD. CRP (≥6 mg/L) and hs-CRP (≥3 mg/L) levels were elevated in 30% and 54% of the patients, respectively. A significant correlation was noted between hs-CRP and CRP levels (r = 0.98, P <0.001). Deming regression analysis showed that the slope was near one (r = 0.90; 0.83-0.94) and that the intercept was small. Multivariate regression confirmed that age above 40 years (RR = 3.69, P = 0.027) and duration on HD greater than five years (RR = 3.71, P = 0.028) remained significant independent predictors of serum hs-CRP. Thirteen patients died during follow-up (26%). Multivariate Cox regression demonstrated that hs-CRP (RR = 1.062, P = 0.03) and CRP levels (RR = 1.057, P = 0.009) and age (RR = 1.078, P = 0.001) were the most powerful predictors of mortality. The CRP standard assay presents a reasonable alternative to the hs-CRP assay in patients on HD. The advantages of the CRP standard assay are its online and real-time availability as well as lower costs, particularly in developing countries.
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Stress has been implicated in both somatic and mental disorders. The mechanisms by which stress leads to poor health are largely unknown. However, studies in animals suggest that chronic stress causes high basal cortisol and low cortisol response to acute stressors and that such changes may contribute to disease. Previous studies of the Transcendental Mediation® (TM) technique as a possible means of countering effects of stress have reported altered levels of several hormones both during the practice and longitudinally after regular practice of this technique. In this prospective, random assignment study, changes in baseline levels and acute responses to laboratory stressors were examined for four hormones—cortisol, growth hormone, thyroid-stimulating hormone and testosterone—before and after 4 months of either the TM technique or a stress education control condition. At pre- and post-test, blood was withdrawn continuously through an indwelling catheter, and plasma or serum samples were frozen for later analysis by radioimmunoassay. The results showed significantly different changes for the two groups, or trends toward significance, for each hormone over the 4 months. In the TM group, but not in the controls, basal cortisol level and average cortisol across the stress session decreased from pre- to post-test. Cortisol responsiveness to stressors, however, increased in the TM group compared to controls. The baselines and/or stress responsiveness for TSH and GH changed in opposite directions for the groups, as did the testosterone baseline. Overall, the cortisol and testosterone results appear to support previous data suggesting that repeated practice of the TM technique reverses effects of chronic stress significant for health. The observed group difference in the change of GH regulation may derive from the cortisol differences, while the TSH results are not related easily to earlier findings on the effects of chronic stress.
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Hypertension affects a large proportion of urban African-American older adults. While there have been great strides in drug development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction (MBSR) has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years old and residents of a low-income senior residence. All participants were African-American, and one was male. Twenty participants were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention. A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements, controlling for age, education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable, blood pressure. Attendance remained >80% in all 8 weeks of both the intervention and the control groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant (p = 0.020). The average diastolic blood pressure decreased in the intervention group post-intervention, but increased in the social support group. Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared to the social support group post-intervention, and this value was statistically significant (p = 0.003). Older adults are at a time in life when a reflective, stationary intervention, delivered in residence, could be an appealing mechanism to improve blood pressure. Given our preliminary results, larger trials in this hypertensive study population are warranted.
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Improvements in attentional performance are at the core of proposed mechanisms for stress reduction in mindfulness meditation practices. However, this claim can be questioned because no previous studies have actively manipulated test effort in control groups and controlled for effects of stress reduction per se. In a blinded design, 48 young, healthy meditation novices were randomly assigned to a mindfulness-based stress reduction (MBSR), nonmindfulness stress reduction (NMSR), or inactive control group. At posttest, inactive controls were randomly split into nonincentive and incentive controls, the latter receiving a financial reward to improve attentional performance. Pre- and postintervention, 5 validated attention paradigms were employed along with self-report scales on mindfulness and perceived stress and saliva cortisol samples to measure physiological stress. Attentional effects of MBSR, NMSR, and the financial incentive were comparable or significantly larger in the incentive group on all reaction-time-based measures. However, selective attention in the MBSR group improved significantly more than in any other group. Similarly, only the MBSR intervention improved the threshold for conscious perception and visual working memory capacity. Furthermore, stress-reducing effects of MBSR were supported because those in the MBSR group showed significantly less perceived and physiological stress while increasing their mindfulness levels significantly. We argue that MBSR may contribute uniquely to attentional improvements but that further research focusing on non-reaction-time-based measures and outcomes less confounded by test effort is needed. Critically, our data demonstrate that previously observed improvements of attention after MBSR may be seriously confounded by test effort and nonmindfulness stress reduction.
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To evaluate the effect of breathing awareness meditation (BAM), Botvin LifeSkills Training (LST), and health education control (HEC) on ambulatory blood pressure and sodium excretion in African American adolescents. Following 3 consecutive days of systolic blood pressure (SBP) screenings, 166 eligible participants (i.e., SBP >50th-95th percentile) were randomized by school to either BAM (n = 53), LST (n = 69), or HEC (n = 44). In-school intervention sessions were administered for 3 months by health education teachers. Before and after the intervention, overnight urine samples and 24-hour ambulatory SBP, diastolic blood pressure, and heart rate were obtained. Significant group differences were found for changes in overnight SBP and SBP, diastolic blood pressure, and heart rate over the 24-hour period and during school hours. The BAM treatment exhibited the greatest overall decreases on these measures (Bonferroni adjusted, ps < .05). For example, for school-time SBP, BAM showed a change of -3.7 mmHg compared with no change for LST and a change of -.1 mmHg for HEC. There was a nonsignificant trend for overnight urinary sodium excretion (p = .07), with the BAM group displaying a reduction of -.92 ± 1.1 mEq/hr compared with increases of .89 ± 1.2 mEq/hr for LST and .58 ± .9 mEq/hr for HEC group. BAM appears to improve hemodynamic function and may affect sodium handling among African American adolescents who are at increased risk for development of cardiovascular disease.
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The objectives of this study were to evaluate whether a mindfulness meditation intervention may be effective in caregivers of close relatives with dementia and to help refine the protocol for future larger trials. The design was a pilot randomized trial to evaluate the effectiveness of a mindfulness meditation intervention adapted from the Mindfulness-Based Cognitive Therapy program in relation to two comparison groups: an education class based on Powerful Tools for Caregivers serving as an active control group and a respite-only group serving as a pragmatic control. This study was conducted at the Oregon Health & Science University, Portland, OR. The subjects were community-dwelling caregivers aged 45-85 years of close relatives with dementia. The two active interventions lasted 7 weeks, and consisted of one 90-minute session per week along with at-home implementation of knowledge learned. The respite-only condition provided the same duration of respite care that was needed for the active interventions. Subjects were assessed prior to randomization and again after completing classes at 8 weeks. The primary outcome measure was a self-rated measure of caregiver stress, the Revised Memory and Behavior Problems Checklist (RMBPC). Secondary outcome measures included mood, fatigue, self-efficacy, mindfulness, salivary cortisols, cytokines, and cognitive function. We also evaluated self-rated stress in the subjects' own environment, expectancy of improvement, and credibility of the interventions. There were 31 caregivers randomized and 28 completers. There was a significant effect on RMBPC by group covarying for baseline RMBPC, with both active interventions showing improvement compared with the respite-only group. Most of the secondary outcome measures were not significantly affected by the interventions. There was an intervention effect on the caregiver self-efficacy measure and on cognitive measures. Although mindfulness was not impacted by the intervention, there were significant correlations between mindfulness and self-rated mood and stress scores. Both mindfulness and education interventions decreased the self-rated caregiver stress compared to the respite-only control.
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This paper proposes a third meditation-category--automatic self-transcending--to extend the dichotomy of focused attention and open monitoring proposed by Lutz. Automatic self-transcending includes techniques designed to transcend their own activity. This contrasts with focused attention, which keeps attention focused on an object; and open monitoring, which keeps attention involved in the monitoring process. Each category was assigned EEG bands, based on reported brain patterns during mental tasks, and meditations were categorized based on their reported EEG. Focused attention, characterized by beta/gamma activity, included meditations from Tibetan Buddhist, Buddhist, and Chinese traditions. Open monitoring, characterized by theta activity, included meditations from Buddhist, Chinese, and Vedic traditions. Automatic self-transcending, characterized by alpha1 activity, included meditations from Vedic and Chinese traditions. Between categories, the included meditations differed in focus, subject/object relation, and procedures. These findings shed light on the common mistake of averaging meditations together to determine mechanisms or clinical effects.
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Prior research had shown that an additional training session immediately after acute stress increased release of salivary secretory immunoglobin A (sIgA) in a group trained with 5-day Integrative Body-Mind Training (IBMT) in comparison to a control group given the same amount of relaxation training. However, 5 days of training did not influence the basal secretion of sIgA. The current study seeks to extend this finding and determine whether increasing amounts of IBMT will increase the basal sIgA level, suggesting further improvements in mucosal immune function. Thirty-five (35) Chinese undergraduates were randomly assigned either to an experimental group receiving 4 weeks of IBMT or a relaxation control. Salivary sIgA levels at baseline before training and three stages (i.e., rest, stress, and additional 20-minute practice) after 2 and 4 weeks training were assessed. The basal sIgA levels increased significantly in the experimental subjects but not in controls after 4 weeks of training. An additional IBMT practice session immediately after acute stress produced significantly higher sIgA release for the IBMT-trained group in comparison with controls at week 2 and 4. This effect was larger at week 4 than week 2. These results indicate that the IBMT produces a change in the basal immune system and larger acute effects as the dose of training increases.
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We studied publication bias in the social sciences by analyzing a known population of conducted studies—221 in total—in which there is a full accounting of what is published and unpublished. We leveraged Time-sharing Experiments in the Social Sciences (TESS), a National Science Foundation–sponsored program in which researchers propose survey-based experiments to be run on representative samples of American adults. Because TESS proposals undergo rigorous peer review, the studies in the sample all exceed a substantial quality threshold. Strong results are 40 percentage points more likely to be published than are null results and 60 percentage points more likely to be written up. We provide direct evidence of publication bias and identify the stage of research production at which publication bias occurs: Authors do not write up and submit null findings.
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This study used subjective reports and eLORETA analysis to assess to what extent Transcendental Meditation (TM) might involve focused attention-voluntary control of mental content. Eighty-seven TM subjects with one month to five years TM experience participated in this study. Regression analysis of years TM practice and self-reported transcendental experiences (lack of time, space and body sense) during meditation practice was flat (r=.07). Those practicing Transcendental Meditation for 1month reported as much transcending as those with 5years of practice. The eLORETA comparison of eyes-closed rest/task and TM practice/task identified similar areas of activation: theta and alpha activation during rest and TM in the posterior cingulate and precuneus, part of the default mode network, and beta2 and beta3 activation during the task in anterior cingulate, ventral lateral and dorsolateral prefrontal cortices, part of the central executive network. In addition, eLORETA comparison of rest and TM identified higher beta temporal activation during rest and higher theta orbitofrontal activation during TM. Thus, it does not seem accurate to include TM practice with meditations in the catgory of Focused Attention, which are characterized by gamma EEG and DMN deactivation. Mixing meditations with different procedures into a single study confounds exploration of meditation effects and confounds application of meditation practices to different subject populations.
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Objectives: Fibromyalgia (FM) is a syndrome characterized by severe pain, fatigue and sleep disturbance. There is evidence of central hyper-responsiveness to sensory stimulation and impaired cardiovascular autonomic control. Laboratory investigations suggest that mindfulness-based stress reduction (MBSR) may improve autonomic functioning in FM. However, these findings may not reflect what occurs during naturalistic conditions, and MBSR studies during real-life functioning are lacking. We conducted a randomized controlled, 3-armed study with 168 female FM patients. This report describes cardiac, respiratory, and physical activity findings. Methods: Eight-week MBSR was compared with wait-list and active control intervention. Ambulatory accelerometry and cardiorespiratory function were monitored over 24-h periods at 3 time points: preintervention, postintervention, and at the 8-week follow-up. Also, baseline levels were compared with an age-matched group of 33 healthy women. Findings: Activity heart rate, respiratory sinus arrhythmia, and ventilation were measured. Comparison with controls confirmed differences in cardiac autonomic tone and activity pattern among patients. Most measures also showed effects of time of day and point of measurement. Regarding the intervention study, there were no effects of treatment. In addition, there were no relations between patient-reported clinical improvement and objective physiological or accelerometry parameters. Intervention-related benefits in wellbeing were not associated with changes in daytime cardiorespiratory measures or pattern of physical activity. Conclusions: MBSR did not produce cardiac autonomic benefits or changes in daily activity in FM. Furthermore, the lack of an association between patient-experienced clinical improvement and objective physiological measures suggests that subjective changes in the wellbeing of FM patients over time are not related to alterations in the cardiorespiratory autonomic function or activity levels.
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Objective: This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery. Design: Randomized, controlled pilot trial. Setting: Beth Israel Deaconess Medical Center, Boston, MA, USA. Interventions: Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention. Main outcome measures: Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted. Results: Attendance was excellent (6 of 9 patients attended ≥7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (-4.9±13.7 in mindfulness vs. 6.2±28.4 in standard, p for between-group difference=0.03) but not weight. We also observed a significant increase in HbA1C (0.34±0.38 vs. -0.06±0.31, p=0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews. Conclusions: This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population. Clinical trial registration: ClinicalTrials.gov identifier NCT02603601.
Article
Objective: To investigate and compare the effects of Buddhist walking meditation and traditional walking on glycemic control and vascular function in patients with type 2 diabetes mellitus. Methods: Twenty three patients with type 2 diabetes (50-75 years) were randomly allocated into traditional walking exercise (WE; n=11) or Buddhism-based walking meditation exercise (WM; n=12). Both groups performed a 12-week exercise program that consisted of walking on the treadmill at exercise intensity of 50-70% maximum heart rate for 30min/session, 3 times/week. In the WM training program, the participants performed walking on the treadmill while concentrated on foot stepping by voiced "Budd" and "Dha" with each foot step that contacted the floor to practice mindfulness while walking. Results: After 12 weeks, maximal oxygen consumption increased and fasting blood glucose level decreased significantly in both groups (p<0.05). Significant decrease in HbA1c and both systolic and diastolic blood pressure were observed only in the WM group. Flow-mediated dilatation increased significantly (p<0.05) in both exercise groups but arterial stiffness was improved only in the WM group. Blood cortisol level was reduced (p<0.05) only in the WM group. Conclusion: Buddhist walking meditation exercise produced a multitude of favorable effects, often superior to traditional walking program, in patients with type 2 diabetes.
Article
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.
Article
Background: Mindfulness meditation training interventions have been shown to improve markers of health, but the underlying neurobiological mechanisms are not known. Building on initial cross-sectional research showing that mindfulness meditation may increase default mode network (DMN) resting-state functional connectivity (rsFC) with regions important in top-down executive control (dorsolateral prefrontal cortex [dlPFC]), here we test whether mindfulness meditation training increases DMN-dlPFC rsFC and whether these rsFC alterations prospectively explain improvements in interleukin (IL)-6 in a randomized controlled trial. Methods: Stressed job-seeking unemployed community adults (n = 35) were randomized to either a 3-day intensive residential mindfulness meditation or relaxation training program. Participants completed a 5-minute resting-state scan before and after the intervention program. Participants also provided blood samples at preintervention and at 4-month follow-up, which were assayed for circulating IL-6, a biomarker of systemic inflammation. Results: We tested for alterations in DMN rsFC using a posterior cingulate cortex seed-based analysis and found that mindfulness meditation training, and not relaxation training, increased posterior cingulate cortex rsFC with left dlPFC (p < .05, corrected). These pretraining to posttraining alterations in posterior cingulate cortex-dlPFC rsFC statistically mediated mindfulness meditation training improvements in IL-6 at 4-month follow-up. Specifically, these alterations in rsFC statistically explained 30% of the overall mindfulness meditation training effects on IL-6 at follow-up. Conclusions: These findings provide the first evidence that mindfulness meditation training functionally couples the DMN with a region known to be important in top-down executive control at rest (left dlPFC), which, in turn, is associated with improvements in a marker of inflammatory disease risk.
Article
The authors conducted a study to assess the effects of yoga on blood pressure (BP). Patients were randomized to yoga (Blood Pressure Education Program [BPEP]), or a combined program (COMBO). Ambulatory BP was measured at baseline and at 12 and 24 weeks. Data are presented for all enrolled patients (n=137) and for completers only (n=90). Systolic BP (SBP) and diastolic BP (DBP) were significantly decreased within all groups at 12 and 24 weeks (P<.001) for enrolled patients and completers. SBP was significantly reduced in the yoga and COMBO groups as compared with the BPEP group at 12 weeks in all enrolled and completers. SBP differences were no longer significant at 24 weeks between groups in all enrolled patients; however, there was a greater reduction in SBP at 24 weeks in completers favoring BPEP over yoga. No differences in DBP between groups or in BP between the yoga and COMBO groups were present. The authors did not observe an additive benefit from combining yoga with BPEP measures. Reasons for this are unclear at this time. BP lowering with yoga, however, was similar to that achieved with lifestyle measures.
Article
The purpose of this study was to compare the effects of Korean mindfulness-based stress reduction (K-MBSR), walking, and patient education regarding diabetes mellitus (DM) on stress response, glycemic control, and vascular inflammation in patients with diabetes mellitus. A cluster randomized trial including 56 adults with diabetes mellitus (K-MBSR group = 21, walking group = 18, patient education group = 17) was conducted between 13 July and 14 September 2012. The questionnaire included the Diabetes Distress Scale and Perceived Stress Response Inventory. Fasting blood samples were used to measure levels of cortisol, blood glucose, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). There were no statistically significant differences between the effects of K-MBSR, walking, and patient education on stress, glycemic control, or vascular inflammation. However, in the K-MBSR and walking groups, significant reductions in the levels of serum cortisol and PAI-1 were observed. A significant reduction in psychological responses to stress was observed in the walking and patient education groups. Longitudinal studies could provide better insight into the impact of K-MBSR, walking, and patient education on health outcomes in adults with diabetes mellitus. © 2015 Wiley Publishing Asia Pty Ltd.