Eating mindfully, or consuming food in response to physical cues of hunger and fullness, is just as effective as adhering to nutrition-based guidelines in reducing weight and blood sugar levels in adults with Type 2 diabetes, a new study suggests.
In a comparison study of the effectiveness of the two types of behavioral interventions, participants lost about the same amount of weight - an average of between 3 1/2 and 6 pounds - and lowered their long-term blood sugar levels significantly after three months.
One treatment group followed an established diabetes self-management education program, with a strong emphasis on nutrition information. The other group was trained in mindful meditation and a mindful approach to food selection and eating. Both interventions, involving weekly group meetings, also recommended physical activity.
"The more traditional education program includes general information about diabetes, but with more emphasis on nutrition and food choice: What are different types of carbohydrates and fats and how many am I supposed to have? What should I look for when I read a food label? What are healthy options when dining out? That was the traditional diabetes education program," said Carla Miller, associate professor of human nutrition at Ohio State University and lead author of the study.
"We compared it to an intervention where mindful meditation was applied specifically to eating and food choices. This intervention group did not receive specific nutrition goals. We said we want you to really tune into your body before you eat. Take a few minutes to assess how hungry you are and make conscious choices about how much you're eating. Stop eating when you're full.
"We studied two very different approaches, and we found they both worked. This means people with diabetes have choices when it comes to eating a healthy diet," Miller said.
The research is published in the November issue of the Journal of the Academy of Nutrition and Dietetics.
Participants were adults between age 35 and 65 years and had been diagnosed with Type 2 diabetes for at least one year. To be eligible, they had to have a body mass index, a measure of weight relative to height, of 27 or more, indicating they were overweight, and a hemoglobin A1c (HbA1c) reading of at least 7 percent. HbA1c measures blood glucose levels in the previous two to three months; normal HbA1c is 5.6 percent or lower.
Study participants were randomly assigned to a treatment group. Twenty-seven completed the mindful eating program, and 25 completed the traditional diabetes self-management program called "Smart Choices." Each intervention involved eight weekly and two biweekly 2 --hour sessions with trained facilitators.
Trainers of the mindfulness program encouraged participants to cultivate "inner wisdom," or mindful awareness related to eating, and "outer wisdom," which referred to personal knowledge of optimal nutrition choices for people with diabetes. Each session included guided meditation oriented toward participants' experiences and emotions associated with food. Participants received CDs for help with home meditation practice.
"We have so many environmental cues to eat in America that we've tuned out our normal physiological signals to eat. Being mindful means stopping long enough to become aware of these physiological cues," Miller said. "We also tried to generate awareness, staying in the moment, and living and eating in response to hunger instead of habits and unconscious eating."
The mindful intervention also included basic information about what is known as medical nutrition therapy: the relationships among calories consumed, carbohydrate and fat intake, weight regulation and high blood sugar.