Mindfulness-Based Stress Reduction Decreases Fasting Glucose in Overweight and Obese Women

Program: Abstracts - Orals, Poster Previews, and Posters
Session: FRI 542-551-Obesity - Clinical Trials II
Clinical
Friday, March 6, 2015: 1:00 PM-3:00 PM
Hall D-F, Obesity (San Diego Convention Center)

Poster Board FRI-550
Nazia Raja-Khan, M.D.1, Katrina Agito, M.D.1, Julie Shah, M.D.1, Christy M. Stetter, B.S.1, Theresa S Gustafson, M.S., R.D.1, Holly Socolow, M.H.S., C.E.A.P.1, Allen R Kunselman, M.A.1, Diane K Reibel, Ph.D.2 and Richard S Legro, MD1
1Penn State Univ Coll of Med, Hershey, PA, 2Thomas Jefferson University, Philadelphia, PA
Stress may contribute to increased diabetes and cardiovascular disease in women who are overweight or obese. Our objective was to conduct a pilot randomized controlled trial to determine the feasibility and effects of Mindfulness-Based Stress Reduction (MBSR) in overweight/obese women. We randomized 86 women with body mass index (BMI) ≥25 kg/m2 to 8 weeks of MBSR or health education control (HEC). At baseline, 8 weeks and 16 weeks fasting blood work and questionnaires were administered. Our overall hypothesis was that MBSR would increase mindfulness, reduce stress and ultimately lead to favorable changes in blood glucose, blood pressure, psychological distress and quality of life. Fifty three women completed the study. Results were analyzed by intention-to-treat. The two groups were similar in age and BMI (mean ± SD in MBSR group 47.0 ± 11.5 years and 39.0 ± 7.7 kg/m2; HEC 42.2 ± 13.1 years and 38.8 ± 9.7 kg/m2). Compared to HEC, MBSR significantly increased the primary outcome mindfulness assessed with the Toronto Mindfulness Scale total score at 8 weeks [mean change from baseline (95% CI) in MBSR was 4.5 (1.2 to 7.7) (18.5% change from baseline) vs. HEC -1.0 (-4.4 to 2.5), P = 0.03]. Compared to HEC, MBSR significantly reduced stress assessed with the Perceived Stress Scale-10 at 16 weeks [MBSR -3.6 (-4.7 to -2.5) (-15.8% change from baseline) vs. HEC -1.3 (-2.6 to -0.002), P = 0.01]. There was a borderline statistically significant increase in salivary cortisol levels at waking with MBSR at 16 weeks (MBSR vs. HEC, P = 0.09). In the MBSR group there were significant reductions in fasting glucose [at 8 weeks -8.9 (-16.5 to -1.3) mg/dl, P = 0.02; at 16 weeks -9.3 (-17.1 to -1.5) mg/dl, P = 0.02]. Fasting glucose did not significantly improve in the HEC group. However, the between group difference did not reach statistical significance likely because this pilot study was not powered to detect a difference in glucose. The MBSR group also demonstrated significant increases in the quality of life SF-36 mental component summary [at 8 weeks 8.0 (4.9 to 11.1), P <0.001; at 16 weeks 5.3 (1.8 to 8.8), P = 0.003]. Both MBSR and HEC demonstrated reductions in PROMIS Sleep Related Impairment, and depression, anxiety and overall psychological distress assessed with the Brief Symptom Inventory-18. There were no significant changes in weight, BMI, blood pressure, lipid profile, hemoglobin A1c, fasting insulin, HOMA-IR or hsCRP with MBSR. In conclusion, MBSR significantly reduces fasting glucose and improves quality of life without changing body weight or insulin resistance in overweight/obese women. This may be due to increased mindfulness and reduced stress leading to physiological changes in the HPA axis and cortisol secretion. Our findings support the integration of MBSR with conventional medical approaches to overweight/obesity and diabetes prevention and treatment. ClinicalTrials.gov Identifier: NCT01464398.

Nothing to Disclose: NR, KA, JS, CMS, TSG, HS, ARK, DKR, RSL

*Please take note of The Endocrine Society's News Embargo Policy at https://www.endocrine.org/news-room/endo-annual-meeting

Sources of Research Support: NIH Grant K23AT006340 to NR; NIH National Center for Research Resources and the National Center for Advancing Translational Sciences Grant UL1TR000127.