Effects of Adapted Mindfulness Training on Interoception and Adherence to the Dietary Approaches to Stop Hypertension (DASH) Diet: The MB-BP Randomized Clinical Trial.
Eric B Loucks, Ian M Kronish, Frances B Saadeh, Matthew M Scarpaci, Jeffrey Proulx, Roee Gutman, Willoughby B. Britton, Zev Schuman-Olivier
medRxiv May 15, 2023 preprint DOI: 10.1101/2023.05.10.23289818 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial |
|---|---|
| Sample size | 201 |
| Population | Adults with elevated unattended office blood pressure (at least 120/80 mmHg); 58.7% female, 81.1% non-Hispanic white, mean age 59.5 years |
| Intervention | Mindfulness-Based Blood Pressure Reduction (MB-BP) program |
| Duration | 6 months follow-up |
| Measures | Multidimensional Assessment of Interoceptive Awareness (MAIA), DASH adherence score assessed via a 163-item Food Frequency Questionnaire |
| Topics | Meditation |
| Keywords | Blood pressure Diet Hypertension Interoception |
| Registration | NCT03859076 NCT03256890 |
| Key findings | MB-BP increased interoceptive awareness (MAIA score) by 0.54 points (95% CI 0.35, 0.74) at 6 months versus control. Among participants with poor baseline DASH adherence, MB-BP increased DASH adherence by 0.62 points (95% CI 0.13, 1.11). The authors suggest MB-BP could support DASH dietary adherence in adults with elevated blood pressure. |
Abstract
Hypertension is a major cause of cardiovascular disease. The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP). However, adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. The primary objective of the MB-BP trial was to evaluate effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness. Secondary objectives assessed whether MB-BP impacts DASH adherence, and explored whether interoceptive awareness mediates DASH dietary changes. Parallel-group phase 2 randomized clinical trial conducted from June 2017-November 2020 with 6 months follow-up. Data analyst was blinded to group allocation. Participants had elevated unattended office BP (≥120/80 mmHg). We randomized 201 participants to MB-BP (n=101) or enhanced usual care control (n=100). Loss-to-follow-up was 11.9%. Outcomes were the Multidimensional Assessment of Interoceptive Awareness (MAIA; range 0-5) score, and the DASH adherence score (range 0-11) assessed via a 163-item Food Frequency Questionnaire. Participants were 58.7% female, 81.1% non-Hispanic white, with mean age 59.5 years. Regression analyses demonstrated that MB-BP increased the MAIA score by 0.54 (95% CI: 0.35,0.74; p<.0001) at 6 months follow-up vs. control. MB-BP increased the DASH score by 0.62 (95% CI: 0.13,1.11; p=0.01) at 6 months vs. control, in participants with poor DASH adherence at baseline. A mindfulness training program adapted to improving health behaviors that lower BP improved interoceptive awareness and DASH adherence. MB-BP could support DASH dietary adherence in adults with elevated BP. Clinicaltrials.gov identifier NCT03859076 (https://clinicaltrials.gov/ct2/show/NCT03859076; MAIA) and NCT03256890 (https://clinicaltrials.gov/ct2/show/NCT03256890; DASH diet adherence).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 7
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Can Mindfulness Address Maladaptive Eating Behaviors? Why Traditional Diet Plans Fail and How New Mechanistic Insights May Lead to Novel Interventions. Frontiers in Psychology 2018
- Mindfulness-Based Blood Pressure Reduction (MB-BP): Stage 1 single-arm clinical trial PLoS One November 27, 2019
- Mindfulness-Based Programs: Why, When, and How to Adapt? Global Advances in Health and Medicine 2022
- Mindfulness-oriented recovery enhancement improves negative emotion regulation among opioid-treated chronic pain patients by increasing interoceptive awareness. Journal of Psychosomatic Research November 1, 2021
and 2 more in the library