Cardiometabolic, Physiological and Objective‐Sleep Responses to Transcendental Meditation: Secondary Analysis of a Randomised Controlled Trial Among University Staff
Mahesh Kumar Khanal, Leila Karimi, Peter Saunders, Kathy Nguyen, Kevin Lee, Barbora Vozarova de Courten
Diabetes Obesity and Metabolism November 3, 2026 DOI: 10.1111/dom.71514 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Open-label Peer reviewed |
|---|---|
| Sample size | 129 |
| Population | Australian university staff |
| Intervention | Transcendental Meditation |
| Topics | Meditation |
| Key findings | Transcendental Meditation was associated with a small, non-robust reduction in diastolic blood pressure (-1.18 mmHg) and no differences on other cardiometabolic or physiological outcomes. Exploratory analyses suggested burnout moderated the heart rate variability response and sex moderated the cholesterol response, but the authors state these findings are hypothesis-generating only. |
Abstract
Background: AND
Aims: Chronic stress contributes to cardiometabolic risk, and stress-reduction interventions have been proposed to improve stress-sensitive physiology and cardiometabolic health, though evidence remains inconsistent. This study examined the effects of a Transcendental Meditation (TM) intervention on cardiometabolic health and upstream physiological outcomes.
Methods: This two-arm, open-label RCT compared TM (n = 65) with control (access to university well-being resource, n = 64) among Australian university staff. Secondary outcomes included blood pressure (BP), fasting glucose, HOMA insulin resistance (IR), lipids, C-reactive protein, salivary cortisol, heart rate variability (HRV), sympathetic arousal, and a post hoc composite cardiometabolic risk (CMR) score. Post hoc exploratory analyses tested whether burnout, sex and baseline metabolic risk moderated TM effects on HRV, total cholesterol, cortisol slope and IR. Primary analyses were intention-to-treat.
Results: TM was associated with a small diastolic BP reduction (-1.18 mmHg [95% CI: -2.35, -0.01], interaction p = 0.036), with a non-significant trend in the endpoint-only analysis (p = 0.064); no other outcomes differed between groups. Burnout moderated the HRV response (p = 0.02), favouring higher-burnout participants and sex moderated the cholesterol response (p = 0.011), with TM attenuating the control-group rise in females, with uncertainty on LDL and HDL. Interactions for cortisol slope (by sex) and HOMA-IR (by metabolic risk) were non-significant; stratified comparisons suggested numerically greater improvement in TM males and higher-risk participants, respectively. Given no multiplicity correction, all findings are hypothesis-generating only.
Conclusion: TM was associated with small, non-robust diastolic BP reduction with no effect on other outcomes. Burnout may modify HRV response, but this finding requires confirmation in adequately powered trials.
Trial Registration: ACTRN12625000134426.
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 18
- Effects of a Randomized Controlled Trial of Transcendental Meditation on Components of the Metabolic Syndrome in Subjects With Coronary Heart Disease Archives of Internal Medicine June 12, 2006
- Meditation for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews February 15, 2024
- The impact of Transcendental Meditation on psychological distress and coping in the lives of women in Uganda: A randomized controlled trial. Health care for women international February 5, 2026
- Meditation and workplace health: a systematic review and meta-analysis of mental and cardiometabolic outcomes among employees Health Psychology Review April 16, 2026
- Effects of transcendental meditation on mental health and work productivity among university staff in Australia: A randomised controlled trial. Journal of Affective Disorders September 23, 2026
and 13 more in the library