Impact of Mindfulness-Based Eating Awareness on Diet and Exercise Habits in Adolescents.

Background: Childhood and adolescent overweight is one of the most important current public health concerns. There is an urgent need to initiate community-based prevention to support healthy eating and physical activity in children. Mindfulness-Based Eating Awareness Training (MB-EAT) is a 12-w eek manualized intervention developed by Kristeller et al. that uses focused meditation techniques to help obese individuals normalize eating behaviors, and improve exercise and dietary habits.

Objective: To adapt the MB-EAT program to adolescents (MB-EAT-A) and assess the impact of the MB-EAT-A program implemented in a high school setting on self-reported assessment of eating and exercise habits and dietary intake of fat.

Methods: 40 ninth grade adolescents (14 males; 35 African-Americans, 1 Caucasian, 4 Others; mean age 16.2±1.2 yrs; BMI=32.4±9.0, BMI range 19.1 to 58.4) from 6 high school health/physical education classes were randomly assigned to 12-weekly sessions of MB-EAT-A intervention (n=18) or health education control (CTL, n=22). Assessments of eating and exercise habits and dietary fat and caloric content were conducted at pre-test, post-test at 3 mo. immediately following intervention and follow-up, 3 months after intervention ended, with 85% retention at follow up.

Results: At 6 mo. follow-up, the MB-EAT-A group increased days/week of moderate exercise >30 min/day (0.8 vs -0.7 days/week), and intense aerobic exercise >20 min/day (1.4 vs. -0.5 days/week, both ps<.05) compared to decreases in CTLs. At 6 mo. follow-up the MB-EAT-A group increased number of servings per week of low calorie foods (7.7 vs. -.05, p<.02), foods with no saturated fats (5.1 vs. -0.4, p<.10) and low in saturated fats (4.6 vs. -2.7, p<.02). At 6 mo. follow-up the MBEAT-A group increased number of foods with no fat (3.9 vs -0.3, p<.08) and low in fat (5.8 vs. -1.4, p<.02) compared to decreases in CTLs. Weight gains at follow-up (4.2 vs 6.2 lbs, MB-EAT-A vs CTL) did not differ significantly between the two conditions (p=.87). In a sub-sample of 29 African American adolescents, 58% reported, a binge eating problem with most being mild to moderate in severity. Excessively eating on a regular basis and thinking about trying to control eating urges were the most common features present. Binge eating severity did not significantly correlate with anxiety, depression, or self-esteem.

Conclusion: The MB-EAT-A program increased moderate and intense aerobic exercise and improved dietary habits in favor of low calorie and low fat foods in an overweight/obese adolescent sample. The MB-EAT-A program increased moderate and intense aerobic exercise and improved consumption of low calorie and low fat foods in overweight/obese adolescents. The study demonstrated feasibility of conducting the MB-EAT-A program in a high school setting, and good acceptability by the students. The successful implementation of MB-EAT-A points to the potential of school-based mindful eating programs as a means of addressing early onset of obesity in high-risk youth.