Daubenmier Jennifer, Moran Patricia J, Kristeller Jean, Acree Michael, Bacchetti Peter, Kemeny Margaret E, Dallman Mary, Lustig Robert H, Grunfeld Carl, Nixon Douglas F, Milush Jeffrey M, Goldman Veronica, Laraia Barbara, Laugero Kevin D, Woodhouse Leslie, Epel Elissa S, Hecht Frederick M
Osher Center for Integrative Medicine, University of California, San Francisco, California, USA.
Center for Obesity Assessment, Study and Treatment, University of California, San Francisco, California, USA.
Obesity (Silver Spring). 2016 Apr;24(4):794-804. doi: 10.1002/oby.21396. Epub 2016 Mar 9.
To determine whether adding mindfulness-based eating and stress management practices to a diet-exercise program improves weight loss and metabolic syndrome components.
In this study 194 adults with obesity were randomized to a 5.5-month program with or without mindfulness training and identical diet-exercise guidelines. Intention-to-treat analyses with multiple imputation were used for missing data. The primary outcome was 18-month weight change.
Estimated effects comparing the mindfulness to control arm favored the mindfulness arm in (a) weight loss at 12 months, -1.9 kg (95% CI: -4.5, 0.8; P = 0.17), and 18 months, -1.7 kg (95% CI: -4.7, 1.2; P = 0.24), though not statistically significant; (b) changes in fasting glucose at 12 months, -3.1 mg/dl (95% CI: -6.3, 0.1; P = 0.06), and 18 months, -4.1 mg/dl (95% CI: -7.3, -0.9; P = 0.01); and (c) changes in triglyceride/HDL ratio at 12 months, -0.57 (95% CI: -0.95, -0.18; P = 0.004), and 18 months, -0.36 (95% CI: -0.74, 0.03; P = 0.07). Estimates for other metabolic risk factors were not statistically significant, including waist circumference, blood pressure, and C-reactive protein.
Mindfulness enhancements to a diet-exercise program did not show substantial weight loss benefit but may promote long-term improvement in some aspects of metabolic health in obesity that requires further study.
确定在饮食 - 运动计划中加入基于正念的饮食和压力管理方法是否能改善体重减轻及代谢综合征各组分。
在本研究中，194名肥胖成年人被随机分配到一个为期5.5个月的计划中，该计划有或没有正念训练，但饮食 - 运动指导方针相同。对缺失数据采用多重填补的意向性分析。主要结局是18个月时的体重变化。
比较正念组与对照组的估计效应显示，在以下方面正念组更具优势：（a）12个月时体重减轻，为 -1.9千克（95%置信区间：-4.5，0.8；P = 0.17），18个月时体重减轻，为 -1.7千克（95%置信区间：-4.7，1.2；P = 0.24），虽无统计学显著性；（b）12个月时空腹血糖变化，为 -3.1毫克/分升（95%置信区间：-6.3，0.1；P = 0.06），18个月时为 -4.1毫克/分升（95%置信区间：-7.3，-0.9；P = 0.01）；（c）12个月时甘油三酯/高密度脂蛋白比值变化，为 -0.57（95%置信区间：-0.95，-0.18；P = 0.004），18个月时为 -0.36（95%置信区间：-0.74，0.03；P = 0.07）。其他代谢危险因素的估计值无统计学显著性，包括腰围、血压和C反应蛋白。
在饮食 - 运动计划中增加正念训练并未显示出显著的体重减轻益处，但可能促进肥胖患者代谢健康某些方面的长期改善，这需要进一步研究。
