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Cited by 19Mindfulness and Compassion InterventionsEating Disorders and BehaviorsNutrition, Health and Food Behavior

Effects of a mindfulness-induction on subjective and physiological stress response in adolescents at-risk for adult obesity.

Open access
Miller, Reagan L., Lucas-Thompson, Rachel G., Sanchez, Natalia, Smith, Amy D., Annameier, Shelly K., Casamassima, Milena, Verros, Megan, Melby, Christopher +2 more·2021·Eating Behaviors
DOI 10.1016/j.eatbeh.2020.101467PMC PMC7906939
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Abstract

Background: Mindfulness-training may benefit stress response and stress-eating, yet few studies have experimentally tested these effects in adolescents. In this short communication, we report whether a brief mindfulness-induction affected acute stress response and stress-eating in adolescents at-risk for adult obesity. We explored disordered eating as a moderator.Method: Twenty-nine adolescents (age 14 ± 2 y) at-risk for adult obesity participated in a within-subjects, randomized crossover experiment. Following a 10-minute mindfulness or neutral-induction on different days in random order, the Trier Social Stress Test adapted for adolescents was administered, followed by an ad libitum lunch meal. Physiological stress response (heart rate, blood pressure) and subjective stress response (anxiety, mindlessness) were determined with area under the curve with respect to increase. Stress-eating was measured as test meal energy consumed. Global disordered-eating and binge-eating were assessed with the Eating Disorders Examination-Questionnaire.Results: Relative to a neutral-induction, a mindfulness-induction reduced state anxiety response (p = .04). There were significant interactions of induction-type by global disordered-eating (p = .02) and binge-eating (p = .03), such that the mindfulness-induction most reduced anxiety response in adolescents with relatively lower global disordered-eating and those with no binge-eating. Induction-type also interacted with binge-eating in predicting diastolic blood pressure (p = .03). A mindfulness-induction, versus neutral-induction, most reduced diastolic blood pressure response in adolescents with binge-eating.Conclusions: Brief mindfulness-training may alter some aspects of acute stress response, with variations by disordered-eating. Future research should test alternative mindfulness induction-types (e.g., acceptance/self-compassion) to improve our understanding of how mindfulness-training may benefit adolescents at-risk for adult obesity.

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Crossref · 10.1016/j.eatbeh.2020.101467

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

9 of 35 cited sources checked · 4 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    Binge-eating typically emerges in adolescence.

    “Yet, binge-eating typically emerges in adolescence (Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011) and predicts excess weight gain and worsening metabolic problems (Tanofsky-Kraff et al., 2012).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011 source
  • Premisecitation

    Mindfulness may alleviate anxiety that precipitates the onset and exacerbation of binge-eating.

    “From an affective theoretical framework, mindfulness may alleviate anxiety that precipitates the onset and exacerbation of binge-eating (Rosenbaum & White, 2013).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Rosenbaum & White, 2013 source

      The ‘Anxiety as a risk factor for binge eating’ section describes anxiety as a possible precursor, while ‘Shared maintenance factors’ and ‘Clinical implications’ discuss its role in persistent binge eating. The paper suggests addressing anxiety in treatment, but our copy does not identify mindfulness as a way to alleviate it. Page numbers were unavailable. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Premisecitation

    In college students, higher mindfulness has been related to altered cortisol/anxiety response to a laboratory stressor.

    “In college students, higher mindfulness has been related to altered cortisol/anxiety response to a laboratory stressor (Brown, Weinstein, & Creswell, 2012; Lucas-Thompson, Miller, Seiter, & Prince, 2019), healthier eating (Jordan, Wang, Donatoni, & Meier, 2014), and less binge-eating (Roberts & Danoff-Burg, 2010).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Brown, Weinstein, & Creswell, 2012 source
    • cites Lucas-Thompson, Miller, Seiter, & Prince, 2019 source

      The Methods describe a laboratory Trier Social Stress Test in 150 adolescents aged 14–21, some recruited from a university. The Results and Discussion link higher mindfulness to greater cortisol reactivity and reduced negative emotional responding, but the study is not specifically a college-student study and measured negative affect rather than anxiety specifically. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Findingown data

    Induction type had no main effects on heart rate or systolic/diastolic blood pressure (p-values > .12).

    “There were no main effects of induction-type on HR or SBP/DBP (p-values>.12).”
    Quote in the paperNot a substantial claim
  • Findingown data

    In adolescents at risk for adult obesity, a mindfulness induction lowered state anxiety response (AUCi) relative to a neutral induction (p=.04).

    “Relative to a neutral-induction, a mindfulness-induction reduced state anxiety response (p=.04).”
    • Also stated in: § Subjective/Physiological Stress Response · plain
      “There was a main effect of induction-type on state anxiety AUCi (p=.04; Table 1).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 10-minute focused-breathing induction actually induces mindfulness in adolescents.
  • May combine two claims. 17
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Premisecitation

    State anxiety predicts greater intake among adolescents with binge-eating and precedes naturalistic binge-eating.

    “State anxiety predicts greater intake among adolescents with binge-eating and precedes naturalistic binge-eating (Ranzenhofer et al., 2014; Shank et al., 2017).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Ranzenhofer et al., 2014 source

      The Results (Path B; page unavailable) report that neither between-person nor within-person negative affect significantly predicted naturalistic loss-of-control eating. The Discussion (page unavailable) says the measure did not capture anxiety; it describes greater intake following premeal negative affect as a finding from a separate laboratory study, not this study’s finding about state anxiety. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites Shank et al., 2017 source

  • May combine two claims.

    Premisecitation

    Binge-eating predicts excess weight gain and worsening metabolic problems.

    “Yet, binge-eating typically emerges in adolescence (Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011) and predicts excess weight gain and worsening metabolic problems (Tanofsky-Kraff et al., 2012).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Tanofsky-Kraff et al., 2012 source

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Distinct obesity subtypes are likely undergirded by different mechanisms and require different interventions.

    “Distinct obesity subtypes are likely undergirded by different mechanisms and require different interventions (Gillman & Hammond, 2016).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Gillman & Hammond, 2016 source

      In “Precision Treatment and Precision Prevention” (page not supplied), the authors discuss tailoring interventions to individual characteristics and using social-systems analysis to improve obesity prevention. They do not identify distinct obesity subtypes or say that different mechanisms underlie those subtypes and require different interventions. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In adolescents with overweight/obesity, higher mindfulness has been associated with less disordered-eating, binge-eating, and eating in the absence of hunger.

    “In adolescents with overweight/obesity, higher mindfulness also has been associated with less disordered-eating, binge-eating, and eating in the absence of hunger (Annameier et al., 2018; Pivarunas et al., 2015).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Annameier et al., 2018 source
    • cites Pivarunas et al., 2015 source

  • Classified as probably not a substantial claim.

    Premisecitation

    Individuals with obesity or disordered-eating have blunted cardiovascular reactions to stress.

    “Additionally, some research suggests individuals with obesity or disordered-eating have blunted cardiovascular reactions to stress (Phillips, 2011), potentially making mindfulness-induction effects on stress responding difficult to detect in this population.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Phillips, 2011 source

      The “Body mass index, obesity, and cardiovascular reactivity” section (p. 13) reports that low cardiac reactivity was associated with greater BMI and a greater likelihood of obesity, supporting the obesity portion of the claim. The Concluding remarks (p. 16) mention disordered motivation toward food in obese individuals, but do not establish blunted stress reactions in people with disordered eating as a separate group. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    During the mindfulness induction, adolescents showed no rise in anxiety, while during the neutral induction they showed a rise (mindfulness 95% CI −14.37, 11.58 vs neutral 95% CI 3.95, 26.23).

    “In the mindfulness-induction, adolescents had no increase in anxiety compared to an increase in the neutral-induction (mindfulness:95%CI −14.37, 11.58 vs. neutral:95%CI 3.95, 26.23).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Among adolescents with binge-eating, diastolic blood pressure response fell more after mindfulness than after neutral induction, while the difference among those without binge-eating was less pronounced.

    “There was greater reduction in DBP response following the mindfulness versus neutral-induction among adolescents with binge-eating, whereas the difference in DBP response among adolescents without binge-eating was less pronounced after mindfulness versus neutral-inductions (Figure 1e/f).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The study used a within-subjects, randomized crossover design with two visits about 6±4 weeks apart.

    “A within-subjects, randomized crossover experiment occurred on two days 6±4weeks apart.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Brief mindfulness training may change some parts of acute stress response, with differences by disordered-eating.

    “Brief mindfulness-training may alter some aspects of acute stress response, with variations by disordered-eating.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 10-minute focused-breathing induction actually induces mindfulness in adolescents.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Analyses controlled for induction order, age, BMI-z, sex, and initial levels of the respective outcomes.

    “We controlled for induction-order (mindfulness/neutral first), age, BMI-z, sex, and initial levels of respective outcomes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Participants who received the neutral induction first had higher BMI-z and were younger.

    “There were no induction-order effects by disordered eating, but those who received the neutral-induction first had a higher BMI-z and were younger.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Stress may increase reliance on eating to cope, which likely affects obesity and cardiometabolic disease risk.

    “Stress may also increase reliance on eating to cope with difficulties (i.e., stress-eating), which likely affects obesity and cardiometabolic disease risk (Johnson, Cohen, Kasen, & Brook, 2002).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Johnson, Cohen, Kasen, & Brook, 2002 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    State mindlessness was assessed with the reliable and valid 5-item Mindfulness Attention and Awareness Scale-State Version (αs=.83-.85).

    “State mindlessness was assessed with the reliable/valid 5-item Mindfulness Attention and Awareness Scale–State Version (αs=.83–.85; Brown & Ryan, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Brown & Ryan, 2003 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    The mindfulness induction used only breath awareness, which may be less effective than attention combined with acceptance/compassion training.

    “Furthermore, the mindfulness-induction in this study was breath-awareness only, which may be less effective than attention plus acceptance/compassion-training (Lindsay, Young, Brown, Smyth, & Creswell, 2019).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lindsay, Young, Brown, Smyth, & Creswell, 2019 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Global disordered-eating and binge-eating were measured with the reliable and valid Eating Disorders Examination-Questionnaire (EDE-Q).

    “Global disordered-eating and binge-eating in the past four weeks were measured with the reliable/valid Eating Disorders Examination-Questionnaire (EDE-Q; Carter, Stewart, & Fairburn, 2001; Fairburn & Beglin, 1994).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Carter, Stewart, & Fairburn, 2001 source
    • cites Fairburn & Beglin, 1994 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    State anxiety was measured with the reliable and valid 6-item State-Trait Anxiety Inventory for Children-State Version (αs=.62-.85 across intervals).

    “State anxiety was measured on the reliable/valid 6-item State-Trait Anxiety Inventory for Children–State Version (αs=.62–.85 across intervals; Kirisci, Clark, & Moss, 1997).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kirisci, Clark, & Moss, 1997 source

  • May combine two claims.

    Study design and conductreasoning

    The study had a small sample, limited racial/ethnic minority representation, a wide age range, and no measure of previous mindfulness practice, which limits inferences.

    “The current study used a small sample with limited representation of racial/ethnic minorities, a wide age range, and previous mindfulness practice was not measured, limiting inferences.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Small samples tend to have greater standard error and less robust effect estimates, and the interaction results were exploratory/hypothesis-generating.

    “Small samples are prone to greater standard error/less robust estimates of effect and interaction results were exploratory/hypothesis-generating.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    There were no induction-order effects by disordered eating.

    “There were no induction-order effects by disordered eating, but those who received the neutral-induction first had a higher BMI-z and were younger.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Participants were exposed to the mindfulness or neutral induction in random order.

    “After resting for 10-minutes, adolescents were exposed in random order to either a 10-minute audio-recorded mindfulness-induction involving focused-breathing, shown to increase breath/body awareness, or an audio-recorded neutral-induction to focus on whatever came to mind (Hafenbrack, Kinias, & Barsade, 2014).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hafenbrack, Kinias, & Barsade, 2014 source

  • May combine two claims.

    Premisecitation

    Adolescence is characterized by increases in perceived stress, disordered-eating, and heightened subjective and physiological stress sensitivity.

    “Adolescence is characterized by increases in perceived stress, disordered-eating, and heightened subjective (e.g. anxiety) and physiological (e.g., heart rate, blood pressure) stress sensitivity (Loth, van den Berg, Eisenberg, & Neumark-Sztainer, 2008; Romeo & McEwen, 2006).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Loth, van den Berg, Eisenberg, & Neumark-Sztainer, 2008 source
    • cites Romeo & McEwen, 2006 source

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The short mindfulness induction and/or lack of acceptance/self-compassion training may have lowered its potency.

    “Brevity of the mindfulness-induction and/or omission of acceptance/self-compassion-training may have reduced potency.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Dispositional mindfulness can be taught and may address disordered-eating.

    “Dispositional mindfulness—a continuum of the propensity for non-judgmental present-moment attention (Kabat-Zinn, 1994)—can be taught and may address disordered-eating (Godfrey, Gallo, & Afari, 2015), maladaptive eating that includes binge-eating or consumption of a large amount accompanied by a sense of loss-of-control (American Psychiatric Association, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Godfrey, Gallo, & Afari, 2015 source

  • Classified as probably not a substantial claim.

    Premisecitation

    Brief mindfulness-inductions reduced perceived stress after a laboratory stressor in adults.

    “In a small body of experimental studies, brief (approximately 10–25 minute) mindfulness-inductions reduced perceived stress after a laboratory stressor in adults (Creswell, Pacilio, Lindsay, & Brown, 2014) and decreased snack food consumption among college students (Arch et al., 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Creswell, Pacilio, Lindsay, & Brown, 2014 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Trier Social Stress Test adapted for adolescents consistently demonstrates robust subjective and objective adolescent stress-response.

    “The TSST involves preparation (3-minutes) and delivery of a 5-minute speech and a challenging 4-minute oral arithmetic task in front of a neutral evaluator, and consistently demonstrates robust subjective/objective adolescent stress-response (Seddon et al., 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Seddon et al., 2020 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In college students, higher mindfulness has been related to less binge-eating.

    “In college students, higher mindfulness has been related to altered cortisol/anxiety response to a laboratory stressor (Brown, Weinstein, & Creswell, 2012; Lucas-Thompson, Miller, Seiter, & Prince, 2019), healthier eating (Jordan, Wang, Donatoni, & Meier, 2014), and less binge-eating (Roberts & Danoff-Burg, 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Roberts & Danoff-Burg, 2010 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In college students, higher mindfulness has been related to healthier eating.

    “In college students, higher mindfulness has been related to altered cortisol/anxiety response to a laboratory stressor (Brown, Weinstein, & Creswell, 2012; Lucas-Thompson, Miller, Seiter, & Prince, 2019), healthier eating (Jordan, Wang, Donatoni, & Meier, 2014), and less binge-eating (Roberts & Danoff-Burg, 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jordan, Wang, Donatoni, & Meier, 2014 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Stress-eating measured with this paradigm relates to heightened food-reward sensitivity.

    “Stress-eating measured with this paradigm relates to heightened food-reward sensitivity (Smith et al., 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Smith et al., 2020 source

  • Classified as probably not a substantial claim.

    Premisecitation

    Brief mindfulness-inductions decreased snack food consumption among college students.

    “In a small body of experimental studies, brief (approximately 10–25 minute) mindfulness-inductions reduced perceived stress after a laboratory stressor in adults (Creswell, Pacilio, Lindsay, & Brown, 2014) and decreased snack food consumption among college students (Arch et al., 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Arch et al., 2016 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The mindfulness induction involved focused-breathing, shown to increase breath/body awareness.

    “After resting for 10-minutes, adolescents were exposed in random order to either a 10-minute audio-recorded mindfulness-induction involving focused-breathing, shown to increase breath/body awareness, or an audio-recorded neutral-induction to focus on whatever came to mind (Hafenbrack, Kinias, & Barsade, 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hafenbrack, Kinias, & Barsade, 2014 source
30 of 30

  • The paper relies on this without support.

    The 10-minute focused-breathing induction actually induces mindfulness in adolescents.

    “a 10-minute audio-recorded mindfulness-induction involving focused-breathing, shown to increase breath/body awareness”
    “Main effect of induction-type on mindlessness AUCi was not significant (p=.26), with no change in either condition”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Discussion denies a physiological interaction reported in Results

    Minor

    The Discussion says the induction had no interactive effect on physiological stress, but the Results report a significant interaction between induction type and binge-eating for diastolic blood pressure response.

1 of 1

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Authors
Miller, R. L., Lucas-Thompson, R. G., Sanchez, N., Smith, A. D., Annameier, S. K., Casamassima, M., Verros, M., Melby, C., Johnson, S. A., & Shomaker, L. B.
Affiliations
  • Colorado State University (US)
  • Colorado School of Public Health (US)
Corresponding author
Shomaker, Lauren B.
ORCID
Venue
Eating Behaviors
Publisher
Elsevier BV
Published
2021-01
Volume
40
Pages
101467
ISSN
1471-0153 (ISSN-L)
DOI
10.1016/j.eatbeh.2020.101467
PMC
PMC7906939
OpenAlex
W3112315940
Semantic Scholar
f7bfcbfdc475e0a5e77b8091cad527a5608c24b0
Cited by
19
References
52
Citations by year
2026: 1 · 2025: 5 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 1
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Eating Behaviors (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Food and Agriculture
  • National Institutes of Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
mindfulness induction, acute stress response, stress eating, adolescents, obesity risk, disordered eating, binge eating, state anxiety, heart rate, blood pressure, Trier Social Stress Test, dietary habits
MeSH terms
Adolescent, Adult, Bulimia, Child, Humans, Obesity, Stress, Physiological, Binge-Eating Disorder, Mindfulness

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