Mindfulness coupled with information on how food and exercise can impact blood pressure may be a winning combination that could improve heart health, according to a new study published today in JAMA Network Open.
“The findings showed that people with elevated blood pressure who participated in an eight-week mindfulness-based blood pressure reduction program showed significant improvement in adherence to a heart-healthy diet, which is one of the biggest drivers of blood pressure, as well as significant improvements in self-awareness, which appears to influence healthy eating habits,” says lead study author Eric B. Loucks, PhD, an associate professor of epidemiology and behavioral and social sciences, and the director of the Mindfulness Center at Brown University in Providence, Rhode Island.
High blood pressure, a major cause of heart disease, is the single most important risk factor for early death worldwide, according to a recent report by the World Health Organization, leading to an estimated 10.8 million avoidable deaths every year.
The important thing to note about those avoidable deaths is that there is ample research supporting effective strategies to control and prevent hypertension, says Dr. Loucks.
And that includes eating a healthy diet, getting regular physical activity, maintaining a healthy weight, limiting alcohol consumption, not smoking tobacco, and taking anti-hypertensive medications as directed, according to the Centers for Disease Control and Prevention (CDC).
Participants Learned How to Apply Mindfulness to Healthy Eating and Being More Active
The study looked at a combination of a program on mindfulness and the DASH (Dietary Approaches to Stop Hypertension) diet. Investigators placed 201 participants with elevated blood pressure into two groups, either an eight-week program based on the standardized Mindfulness-Based Stress Reduction (MBSR) or “usual care.”
The program was led by trained instructors with expertise in the causes, treatment, and prevention of heart disease, and included a group orientation session, eight 2.5-hour weekly group sessions, and a 7.5-hour one-day group session, for a total of 10 sessions. Participants were also encouraged to practice at home for 45 minutes, six days a week.
The goal of the intervention was to provide a foundation of mindfulness skills such as meditation, yoga, self-awareness, attention control, and emotion regulation, and then have participants use those skills to follow the DASH diet.
What Is the DASH Diet?
The DASH diet is designed to help improve blood pressure by limiting salt and focusing on foods high in calcium, potassium, magnesium, and fiber — which, when combined, help lower blood pressure, according to MedlinePlus.
Nonstarchy vegetables and fruit are a primary focus, which includes things like green beans, asparagus, Brussels sprouts, broccoli, kale, sugar snap peas, and squash. The diet also includes moderate amounts of:
- fat-free or low-fat dairy products
- whole grains
- lean meats and poultry
- beans, soy foods, and legumes
- eggs and egg substitutes
- fish
- nuts and seeds
- heart-healthy fats, such as olive and canola oil or avocados
In the DASH diet, sweets and sugar-sweetened beverages, foods high in saturated fats such as full-fat dairy, fatty meals, fried foods, tropical oils, most packaged snacks, and alcohol should be limited or avoided.
At least 30 minutes of exercise a day most days of the week (adding up to at least 2 hours and 30 minutes per week of activities) at a moderate-intensity level is also part of the DASH lifestyle. To help prevent weight gain, 60 minutes of daily exercise is recommended.
In addition to lowering blood pressure, research suggests that following the DASH diet may reduce the risk for heart disease, heart failure, and stroke, prevent or control type 2 diabetes, improve cholesterol levels, and reduce the chance of kidney stones.
The “usual care” control group received educational brochures on controlling high blood pressure. Both groups received a home blood-pressure monitoring device with usage training, and options for referral to primary care physicians.
Mindfulness Group Improved Self Awareness and Their Eating Habits
After six months, the mindfulness group showed a 0.34-point increase in the DASH diet score. For example, a person who would usually eat two or three servings of vegetables a day increased that amount to at least four servings — which is the recommended level, according to the authors. The control group showed a 0.04-point decrease in their DASH diet score.
The mindfulness group also showed a 0.71-point improvement in the average interoceptive awareness score (which measures the process of sensing and interpreting signals from one’s own body) compared with six months prior, which outperformed the control group by a significant 0.54 points.
The study helps explain the mechanism by which a customized mindfulness training program adapted toward improving diet can affect blood pressure, says Loucks.
“Improvements in our self-awareness, of how different foods make us feel, of how our body feels in general, as well as our thoughts, emotions, and physical sensations around eating healthy as well as unhealthy food, can influence people’s dietary choices,” he says.
The findings also provide further support for mindfulness interventions, including research published in May 2023 in the Journal of the American Heart Association by Loucks and colleagues that showed similar programs can help lower systolic blood pressure.
How Mindfulness Can Help Shift Eating Patterns
Mindfulness is defined as the awareness that comes from observing your own internal and external state in the present moment in a nonjudgmental way. Mindfulness-based stress reduction (MBSR) is a method for reducing physical and psychological suffering while building resilience, balance, and peace of mind, according to the Brown School of Public Health.
How can this be applied to change how we eat? A framework for how mindfulness training could influence dietary patterns is emerging through research, and it includes three domains: self-awareness, attention control, and emotion regulation, says Loucks.
Self-Awareness could influence dietary behaviors, including noticing hunger and fullness, noticing how different food types make us feel, and being aware of our eating behaviors, including our habits and what rewards and harms we receive from eating the way we typically do.
Attention Control can be applied to dietary behaviors by being present with the sensory properties of food (like taste, smell, and how it looks), making conscious choices for healthy eating patterns and against possibly unconscious unhealthy eating patterns, and shopping for specific foods that are better for our health.
Emotion Regulation can be applied to dietary behaviors in ways like lowering our reactivity to food cravings, self-kindness and compassion for our body and mind, and lowering our psychological distress, which can undermine efforts to stick to healthy dietary patterns that we know deep inside we’d like to follow.