Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial

Abstract

We evaluated changes in mindful eating as a potential mechanism underlying the effects of a mindfulness-based intervention for weight loss on eating of sweet foods and fasting glucose levels. We randomized 194 obese individuals (M age = 47.0 ± 12.7 years; BMI = 35.5 ± 3.6; 78 % women) to a 5.5-month diet-exercise program with or without mindfulness training. The mindfulness group, relative to the active control group, evidenced increases in mindful eating and maintenance of fasting glucose from baseline to 12-month assessment. Increases in mindful eating were associated with decreased eating of sweets and fasting glucose levels among mindfulness group participants, but this association was not statistically significant among active control group participants. Twelve-month increases in mindful eating partially mediated the effect of intervention arm on changes in fasting glucose levels from baseline to 12-month assessment. Increases in mindful eating may contribute to the effects of mindfulness-based weight loss interventions on eating of sweets and fasting glucose levels.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Notes

  1. 1.

    Results do not change when using the full MEQ.

References

  1. American Diabetes Association. (2013). Economic costs of diabetes in the US in 2012. Diabetes Care, 36, 1033–1046.

    Article  PubMed Central  Google Scholar 

  2. Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and Biobehavioral Reviews, 32, 20–39.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  3. Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.

    Google Scholar 

  4. Bellisle, F., Drewnowski, A., Anderson, G. H., Westerterp-Plantenga, M., & Martin, C. K. (2012). Sweetness, satiation, and satiety. The Journal of Nutrition, 142, 1149S–1154S.

    CAS  Article  PubMed  Google Scholar 

  5. Bergomi, C., Tschacher, W., & Kupper, Z. (2013). The assessment of mindfulness with self-report measures: Existing scales and open issues. Mindfulness, 4, 191–202.

    Article  Google Scholar 

  6. Boucher, B., Cotterchio, M., Kreiger, N., Nadalin, V., Block, T., & Block, G. (2006). Validity and reliability of the Block98 food-frequency questionnaire in a sample of Canadian women. Public Health Nutrition, 9, 84–93.

    Article  PubMed  Google Scholar 

  7. Byrne, S., Cooper, Z., & Fairburn, C. (2003). Weight maintenance and relapse in obesity: A qualitative study. International Journal of Obesity, 27, 955–962.

    CAS  Article  PubMed  Google Scholar 

  8. Chaput, J., Klingenberg, L., Astrup, A., & Sjödin, A. M. (2011). Modern sedentary activities promote overconsumption of food in our current obesogenic environment. Obesity Reviews, 12, e12–e20.

    Article  PubMed  Google Scholar 

  9. Colantuoni, C., Rada, P., McCarthy, J., Patten, C., Avena, N. M., Chadeayne, A., & Hoebel, B. G. (2002). Evidence that intermittent, excessive sugar intake causes endogenous opioid dependence. Obesity Research, 10, 478–488.

    CAS  Article  PubMed  Google Scholar 

  10. Dalen, J., Smith, B. W., Shelley, B. M., Sloan, A. L., Leahigh, L., & Begay, D. (2010). Pilot study: Mindful Eating and Living (MEAL): Weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Complementary Therapies in Medicine, 18, 260–264.

    Article  PubMed  Google Scholar 

  11. Daubenmier, J., Moran, P. J., Kristeller, J., Acree, M., Bacchetti, P., Kemeny, M., … Hecht, F. (in press). Effects of a mindfulness-based weight loss program in obese adults: A randomized clinical trial. Obesity.

  12. Finlayson, G., & Dalton, M. (2012). Hedonics of food consumption: Are food “liking”and “wanting”viable targets for appetite control in the obese? Current Obesity Reports, 1, 42–49.

    Article  Google Scholar 

  13. Finlayson, G., King, N., & Blundell, J. E. (2007). Liking vs. wanting food: Importance for human appetite control and weight regulation. Neuroscience and Biobehavioral Reviews, 31, 987–1002.

    Article  PubMed  Google Scholar 

  14. Framson, C., Kristal, A. R., Schenk, J. M., Littman, A. J., Zeliadt, S., & Benitez, D. (2009). Development and validation of the mindful eating questionnaire. Journal of the American Dietetic Association, 109, 1439–1444.

    Article  PubMed  PubMed Central  Google Scholar 

  15. French, S. A., Harnack, L., & Levenson, R. W. (2000). Fast food restaurant use among women in the pound of prevention study: Dietary, behavioral and demographic correlates. International Journal of Obesity, 24, 1353–1359.

    CAS  Article  PubMed  Google Scholar 

  16. Gross, L. S., Li, L., Ford, E. S., & Liu, S. (2004). Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: An ecologic assessment. The American Journal of Clinical Nutrition, 79, 774–779.

    CAS  PubMed  Google Scholar 

  17. Havermans, R. C., Janssen, T., Giesen, J. C., Roefs, A., & Jansen, A. (2009). Food liking, food wanting, and sensory-specific satiety. Appetite, 52, 222–225.

    Article  PubMed  Google Scholar 

  18. Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76, 408–420.

    Article  Google Scholar 

  19. Hetherington, M. M. (1996). Sensory-specific satiety and its importance in meal termination. Neuroscience and Biobehavioral Reviews, 20, 113–117.

    CAS  Article  PubMed  Google Scholar 

  20. IBM Corp. (2013). IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

    Google Scholar 

  21. Ismail, K., Winkley, K., & Rabe-Hesketh, S. (2004). Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes. The Lancet, 363, 1589–1597.

    Article  Google Scholar 

  22. Johnson, R. K. (2002). Dietary intake—how do we measure what people are really eating? Obesity Research, 10, 63S–68S.

    Article  PubMed  Google Scholar 

  23. Johnson, B. A., Herring, A. H., Ibrahim, J. G., & Siega-Riz, A. M. (2007). Structured measurement error in nutritional epidemiology: Applications in the pregnancy, infection, and nutrition (PIN) study. Journal of the American Statistical Association, 102, 856–866.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  24. Jonnalagadda, S. S., Mitchell, D. C., Smiciklas-Wright, H., Meaker, K. B., VAN Heel, N., Karmally, W., & Kris-Etherton, P. M. (2000). Accuracy of energy intake data estimated by a multiplepass, 24-hour dietary recall technique. Journal of the American Dietetic Association, 100, 303–311.

    CAS  Article  PubMed  Google Scholar 

  25. Kabat-Zinn, J., & Hanh, T. N. (2009). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Random House LLC.

    Google Scholar 

  26. Kahn, B. B., & Flier, J. S. (2000). Obesity and insulin resistance. Journal of Clinical Investigation, 106, 473–481.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  27. Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4, 357–363.

    CAS  Article  PubMed  Google Scholar 

  28. Kristeller, J. L., & Wolever, R. Q. (2010). Mindfulness-based eating awareness training for treating binge eating disorder: The conceptual foundation. Eating Disorders, 19, 49–61.

    Article  Google Scholar 

  29. Kristeller, J. L., Wolever, R. Q., & Sheets, V. (2013). Mindfulness-based eating awareness training (MB-EAT) for binge eating: A randomized clinical trial. Mindfulness, 5, 282–297.

    Article  Google Scholar 

  30. Lake, A., & Townshend, T. (2006). Obesogenic environments: Exploring the built and food environments. The Journal of the Royal Society for the Promotion of Health, 126, 262–267.

    Article  PubMed  Google Scholar 

  31. Mann, T., Janet, A., Westling, E., Lew, A.-M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, 62, 220–233.

    Article  PubMed  Google Scholar 

  32. Miller, C., Kristeller, J. L., Headings, A., & Nagaraja, H. (2013). Comparison of a mindful eating intevention to a diabetes self-management intervention among adults with type 2 diabetes: A randomized controlled trial. Health Education & Behavior, 41, 145–154.

    Article  Google Scholar 

  33. Mokdad, A. H., Bowman, B. A., Ford, E. S., Vinicor, F., Marks, J. S., & Koplan, J. P. (2001). The continuing epidemics of obesity and diabetes in the United States. JAMA, 286, 1195–1200.

    CAS  Article  PubMed  Google Scholar 

  34. O’Reilly, G. A., Cook, L., Spruijt-Metz, D., & Black, D. S. (2014). Mindfulness-based interventions for obesity-related eating behaviours: A literature review. Obesity Reviews, 15, 453–461.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ogden, J., Coop, N., Cousins, C., Crump, R., Field, L., Hughes, S., & Woodger, N. (2013). Distraction, the desire to eat and food intake. Towards an expanded model of mindless eating. Appetite, 62, 119–126.

    Article  PubMed  Google Scholar 

  36. Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717–731.

    Article  Google Scholar 

  37. Profiling food consumption in America. (2003). Agriculture Factbook 2001–2002 (pp. 13–21). United States Department of Agriculture.

  38. Rada, P., Avena, N. M., & Hoebel, B. G. (2005). Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell. Neuroscience, 134, 737–744.

    CAS  Article  PubMed  Google Scholar 

  39. Rosenzweig, S., Reibel, D. K., Greeson, J. M., Edman, J. S., Jasser, S. A., McMearty, K. D., & Goldstein, B. J. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: A pilot study. Alternative Therapies in Health and Medicine, 13, 36–38.

    PubMed  Google Scholar 

  40. Schulze, M. B., Manson, J. E., Ludwig, D. S., Colditz, G. A., Stampfer, M. J., Willett, W. C., & Hu, F. B. (2004). Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA, 292, 927–934.

    CAS  Article  PubMed  Google Scholar 

  41. Thompson, F. E., Subar, A. F., Loria, C. M., Reedy, J. L., & Baranowski, T. (2010). Need for technological innovation in dietary assessment. Journal of the American Dietetic Association, 110, 48–51.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Timmerman, G. M., & Brown, A. (2012). The effect of a mindful restaurant eating intervention on weight management in women. Journal of Nutrition Education and Behavior, 44, 22–28.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Wansink, B. (2007). Mindless eating: Why we eat more than we think. Random House LLC.

  44. Wansink, B., & Kim, J. (2005). Bad popcorn in big buckets: Portion size can influence intake as much as taste. Journal of Nutrition Education and Behavior, 37, 242–245.

    Article  PubMed  Google Scholar 

  45. Wansink, B., Painter, J. E., & Lee, Y.-K. (2006). The office candy dish: Proximity’s influence on estimated and actual consumption. International Journal of Obesity, 30, 871–875.

    CAS  Article  PubMed  Google Scholar 

  46. Wells, H. F., & Buzby, J. C. (2008). Dietary assessment of major trends in US food consumption, 1970–2005. Washington: US Department of Agriculture, Economic Research Service.

    Google Scholar 

  47. Wilcox, R. R. (2012). Introduction to robust estimation and hypothesis testing. Massachusetts: Academic Press.

    Google Scholar 

  48. Willett, W. (2012). Nutritional epidemiology. Oxford: Oxford University Press.

    Google Scholar 

Download references

Acknowledgments

This research was supported by funding from the National Institutes of Health (NCCIH) to Frederick M. Hecht (1P01AT005013; K24AT007827) and Jennifer Daubenmier (K01AT004199). Ashley E. Mason was supported by NCCIH (T32AT003997). This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number UL1 TR000004. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Ashley E. Mason.

Ethics declarations

Conflict of interest

Ashley E. Mason, Elissa S. Epel, Patricia J. Moran, Mary Dallman, Robert H. Lustig, Michael Acree, Peter Bacchetti, Barbara A. Laraia, Frederick M. Hecht, and Jennifer Daubenmier declare that they have no conflicts of interest. Jean Kristeller participated in a paid webinar on ‘mindful snacking’ for Allidura Consumer.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Additional information

Frederick M. Hecht and Jennifer Daubenmier have contributed equally as co-senior authors.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Mason, A.E., Epel, E.S., Kristeller, J. et al. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. J Behav Med 39, 201–213 (2016). https://doi.org/10.1007/s10865-015-9692-8

Download citation

Keywords

  • Mindful eating
  • Fasting glucose
  • Sweet foods
  • Obese adults
  • Mindfulness intervention