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Mindfulness Training and Physical Health: Mechanisms and Outcomes
Open accessAbstract
Objective: There has been substantial research and public interest in mindfulness interventions, biological pathways, and health for the past two decades. This article reviews recent developments in understanding relationships between mindfulness interventions and physical health. Methods: A selective review was conducted with the goal of synthesizing conceptual and empirical relationships between mindfulness interventions and physical health outcomes. Results: Initial randomized controlled trials in this area suggest that mindfulness interventions can improve pain management outcomes among chronic pain populations, and there is preliminary evidence for mindfulness interventions improving specific stress-related disease outcomes in some patient populations (i.e., clinical colds, psoriasis, irritable bowel syndrome, posttraumatic stress disorder, diabetes, HIV). We offer a stress-buffering framework for the observed beneficial effects of mindfulness interventions and summarize supporting biobehavioral and neuroimaging studies that provide plausible mechanistic pathways linking mindfulness interventions with positive physical health outcomes. Conclusions: We conclude with new opportunities for research and clinical implementations to consider in the next two decades.
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“MBIs have been shown to decrease inflammation42,43”
From Feasibility, Acceptability, and Efficacy of Mindfulness Training in People With Upper Motor Neuron Disorders: A Systematic Review (2022) · cites this paper as [43]
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“decrease cortisol levels by altering hypothalamic-pituitary-adrenal axis function,42–45”
From Feasibility, Acceptability, and Efficacy of Mindfulness Training in People With Upper Motor Neuron Disorders: A Systematic Review (2022) · cites this paper as [43]
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“Creswell et al 32,33 suggest that mindfulness interventions foster resilience to stress in the brain by enhancing connectivity within stress regulatory regions of the prefrontal cortex and decreasing connectivity in regions of the brain controlling the fight-or-flight stress response.”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [33]
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“Furthermore, their work suggests that mindfulness training can buffer the sympathetic nervous system and hypothalamicpituitary-adrenal response to acute stress.”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [33]
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“Intervention studies have shown promising results for mindfulness interventions in patients living with long term health conditions and chronic pain (31, 32).”
From Mindfulness as Predictor of Itch Catastrophizing in Patients With Atopic Dermatitis: Results of a Cross-Sectional Questionnaire Study (2021) · cites this paper as [32]
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“the burgeoning literature on mindfulness for various medical conditions and for promoting behavior change has been promising. 77”
From Randomized Controlled Trials of Mindfulness and Acceptance-Based Interventions Over the Past Two Decades: A Bibliometric Analysis. (2021) · cites this paper as [77]
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“Mindfulness practices help reduce stress by altering brain structures and activity in regions associated with attention and emotional regulation [36,37].”
From The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic (2023) · cites this paper as [37]
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Cites
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Cited by
Sorted by citations
Mindfulness and Behavior Change
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“, 2015), along with physical health (Creswell et al., 2019).”
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“Mindfulness practices help reduce stress by altering brain structures and activity in regions associated with attention and emotional regulation [36,37].”
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“Previous research has linked mindfulness training and physical health, demonstrating improvements in stress-related diseases like irritable bowel syndrome, clinical colds, and posttraumatic stress disorder (Creswell et al., 2019).”
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Behavioral Management of Episodic Migraine: Maintaining a Healthy Consistent Lifestyle
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“Mindfulness-based interventions (MBIs) involving mental concepts, specific exercises, and class discussions that are intended to induce positive effects in terms of individual focus, mindfulness-related body sensations, cognitive factors, and emotional regulation (Kabat-Zinn, 1982, 2003; Creswell et al., 2019), have b…”
BackgroundUnderstanding mindfulness, one moment at a time: an introduction to the special issue
Bernstein, A., Vago, D. R., & Barnhofer, T. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.08.001 · Cited by 28
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“The mental and physical health benefits of meditation and aerobic exercise have been demonstrated independently in a variety of populations (e.g., Warburton, 2006; Gillison et al., 2009; Chiesa et al., 2011; Keng et al., 2011; Kvam et al., 2016; Stubbs et al., 2017; Creswell et al., 2019), including teachers (e.”
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“[3] argued that its mechanism of action consists of three pathways: the biological pathway, the health behavior pathway, and the psychological pathway.”
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Traits of cancer patients and CAM usage
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“It has been established in various studies that mindfulness promotes well-being and health (Baer 2003; Creswell et al. 2019).”
BackgroundMindfulness in adolescents and young adults with diabetes: An integrative review
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“Mindfulness-based interventions have been developed to cultivate mindfulness, and they tend to include practices, such as guided meditations, body scans, gentle stretching, and group discussions (Creswell et al., 2019).”
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“…tasks consisting of meditation sessions were also included in the protocol (Task 4 - Mindfulness Based Stress Reduction –MBSR; Crane et al., 2017; Creswell et al., 2019), and Task-5 Kirtan Kriya meditation (Khalsa, 2015), where participants’ performance during meditation was monitored using a…”
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“Finally, this study helps advance the field by testing underlying mechanisms, namely stress-buffering, that connect specific facets of mindfulness to specific outcomes, like stress-related physical symptoms (Creswell et al., 2019) .”
BackgroundTargeting automatic processes to reduce unhealthy behaviours: a process framework
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“Despite the well-known effects of mindfulness on mental health states, recent studies have shown that mindfulness can also improve physical health and health-related (addictive) behaviours, with changes in mindfulness linked to better outcomes (Alsubaie et al., 2017; Creswell et al., 2019).”
BackgroundMindfulness meditation alters neural oscillations independently of arousal
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The meditation app revolution.
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“These characteristics raise an important safety question now particularly since meditation is, by design, intended to be a skill building training program that challenges users to change how they relate to their own moment-to-moment experiences (Creswell, 2017; Creswell et al., 2019).”
Self-citationLindsay, E. K., Marsland, A. L., Cole, S. W., Dutcher, J. M., Greco, C. M., Wright, A. G. C., Brown, K. W., & Creswell, J. D. (2023) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001264 · Cited by 22
“Mindfulness training interventions show promise for reducing loneliness (7,8) and improving health-relevant outcomes (9).”
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“MLManalyses did not show a significant time by condition effect on GCR across pre, post, and follow-up time points (χ(2)(2) = 4.”
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“Previous science has illustrated that mindfulness modulates myriad mental and physical health outcomes (Creswell et al., 2019; Enkema et al., 2020; Keng et al., 2011; Sevilla-Llewellyn-Jones et al., 2018), setting the stage for continued research on a wider range of benefits, both reducing…”
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Stress-related health depreciation: Using allostatic load to predict self-rated health
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“, mental health, physical health, relational outcomes) across different populations (Carpenter et al., 2019; Creswell et al., 2019; Goldberg et al., 2021; Khoury et al., 2013; Quinn-Nilas, 2020).”
BackgroundSundheim, B., Hirani, K., Blaschke, M., Lemos, J. R. N., & Mittal, R. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14020383 · Cited by 15
“Lowered stress levels and improved overall well-being [56,143] Cognitive-behavioral therapy (CBT) is particularly effective in helping adolescents develop positive coping skills and reframe negative thought patterns associated with their health status (Table 4) [85,143–145].”
InfluentialBelliveau, C., Nagy, C., Escobar, S., Mechawar, N., Turecki, G., Rej, S., & Torres-Platas, S. G. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.804269 · Cited by 15
Effects of two online positive psychology and meditation programs on persistent self-transcendence.
Martin, J. A., Ericson, M., Berwaldt, A., Stephens, E. D., & Briner, L. (2021) · Psychology of Consciousness Theory Research and Practice · doi:10.1037/cns0000286 · Cited by 16
Lüßmann, K., Montgomery, K., Thompson, A., Gieler, U., Zick, C., Kupfer, J., & Schut, C. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.627611 · Cited by 13
“Intervention studies have shown promising results for mindfulness interventions in patients living with long term health conditions and chronic pain (31, 32).”
BackgroundBablis, P., Pollard, H. P., & Rosner, A. L. (2021) · Journal of Chinese Integrative Medicine · doi:10.1016/j.joim.2021.12.001 · Cited by 13
Datu, J. A. D., Yang, W., & Lau, W. K. (2022) · The Journal of Early Adolescence · doi:10.1177/02724316221137951 · Cited by 17
Chaharmahali, L., Gandomi, F., Yalfani, A., & Fazaeli, A. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2228691 · Cited by 13
“Therefore, controlling stress and catastrophizing pain in these patients probably increased their quality of life [46].”
BackgroundNo time for that? An investigation of mindfulness and stress in first-year engineering design
Nolte, H., Huff, J., & McComb, C. (2022) · Design Science · doi:10.1017/dsj.2022.5 · Cited by 14
“2017), lessened perceived pain (Creswell et al. 2019), improved attention (Zeidan et al.”
BackgroundThe role of mindful acceptance and lucid dreaming in nightmare frequency and distress
Tzioridou, S., Dresler, M., Sandberg, K., & Mueller, E. M. (2022) · Scientific Reports · doi:10.1038/s41598-022-19624-4 · Cited by 16
Li, W., Meng, X., Zhang, K., Yang, Z., Feng, Z., Tong, K., & Tian, J. (2022) · Arthroscopy The Journal of Arthroscopic and Related Surgery · doi:10.1016/j.arthro.2022.09.008 · Cited by 12
What We Took From Metaphors: A Case of Designing For Care After Abortion
Lusi, B., Vallgårda, A., Bewley, H., Mouritzen, H., & Ludden, G. (2024) · Nordic Conference on Human-Computer Interaction · doi:10.1145/3679318.3685347 · Cited by 12
“Meditation retreat applications can range from mobile-based interventions to broader treatment programs [12].”
Monin, J. K., Sperduto, C. M., Manigault, A. W., Dutton, A., Clark, M. S., & Jastreboff, A. M. (2020) · Mindfulness · doi:10.1007/s12671-019-01301-9 · Cited by 14
Schanche, E., Vøllestad, J., Visted, E., Svendsen, J. L., Binder, P., Osnes, B., Franer, P., & Sørensen, L. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12381 · Cited by 12
Kanchibhotla, D., Subramanian, S., & Kaushik, B. (2021) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104521994633 · Cited by 15
“Several existing studies have delineated the health benefits of mindfulness based interventions for youth (Cillessen et al., 2019; Creswell et al., 2019; Rogers et al., 2017).”
BackgroundFolch, A., Gasol, L., Heredia, L., Vicens, P., & Torrente, M. (2021) · Current Psychology · doi:10.1007/s12144-021-02572-z · Cited by 21
Huang, F., Chen, W.-T., Shiu, C.-S., Lin, S. H., Tun, M. S., Nwe, T. W., Nu Oo, Y. T., & Oo, H. N. (2022) · Mindfulness · doi:10.1007/s12671-021-01784-5 · Cited by 11
Leveraging generative AI for project management: The role of mindfulness and job crafting
Li, K., Zhang, F., Hughes, L., & Griffin, M. A. (2026) · International Journal of Project Management · doi:10.1016/j.ijproman.2026.102816 · Cited by 17
Chung, J., Mundy, M. E., & McKenzie, S. P. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.869765 · Cited by 11
Burić, I., Žderić, L., Onicas, A. I., Kolanović, M., & Collin, G. (2024) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2024.100507 · Cited by 13
“Second, when combined with acceptance, attention monitoring can foster emotion regulation and promote beneficial outcomes by modifying the relationship with experiences that are being observed (Lindsay & Creswell, 2019).”
BackgroundMethodInfluentialThe relationship between neuroticism as a personality trait and mindfulness skills: a scoping review
Angarita‐Osorio, N., Escorihuela, R. M., & Cañete, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1401969 · Cited by 17
“…and stress-related disease outcomes in different patient populations, suggesting that these benefits can come from increasing stress resilience pathways in the brain and regulating stress reactivity (hypothalamic pituitary adrenal and sympathetic adrenal medullary axis) (Creswell et al., 2019).”
Half a Century of Research for Mind–Body Interventions: A Scientometric Analysis
Sabé, M., Chen, C., Vancampfort, D., Firth, J., Smith, L., Stubbs, B., Rosenbaum, S., Schuch, F. B., Prada, P., Saccaro, L. F., et al. (2025) · Mindfulness · doi:10.1007/s12671-025-02592-x · Cited by 11
“Specifically, they are associated with a small to moderate reduction in various dimensions of psychological distress (Zhang et al., 2021) and stress-related disease (Creswell et al., 2019).”
Stress-system activation in children with chronic pain: A focus for clinical intervention
McInnis, P., Braund, T. A., Chua, Z. K., & Kozlowska, K. (2019) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104519864994 · Cited by 11
Mindfulness and self-compassion in dermatological conditions: a systematic narrative review
Meneo, D., Martoni, M., Giannandrea, A., Tengattini, V., & Baglioni, C. (2022) · Psychology and Health · doi:10.1080/08870446.2022.2070619 · Cited by 15
“Nevertheless, they all share the intent of training one’s ability to mindfully attend to body sensation and emotional states, that is, in an open and non-judgmental way (Creswell, lindsay, Villalba, & Chin, 2019).”
BackgroundResultLupini, F., Basch, M. C., Cooke, F., Vagadori, J., Gutierrez‐Colina, A. M., Kelly, K. P., Streisand, R. M., Shomaker, L. B., & Mackey, E. R. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107551 · Cited by 10
Tschenett, H., Vafai-Tabrizi, F., Zwick, R. H., Valipour, A., Funk, G., & Nater, U. M. (2025) · Respiratory Research · doi:10.1186/s12931-025-03243-4 · Cited by 13
“They are effective in reducing anxiety and depressive symptoms, self-reported stress [15], and biological stress markers [16], and in improving physical health outcomes in somatic conditions [17].”
Sugiura, M., Katayori, Y., Muratsubaki, T., Shiratori, M., Hanawa, S., Nejad, K. K., Tamura, D., Kawashima, R., & Fukudo, S. (2023) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2023.1059158 · Cited by 12
“, 2012) have had methodological issues in that meditation affects not only emotion regulation but also various physical and psychological measures (Lomas et al., 2017; Creswell et al., 2019) and is associated with preexisting functional differences in the brain (Mascaro et al.”
BackgroundLindsay, E. K. (2021) · Brain, Behavior, & Immunity - Health · doi:10.1016/j.bbih.2021.100338 · Cited by 10
“More recent RCTs show consistent effects of MBIs on upstream proinflammatory gene expression (Black et al., 2019) but not circulating inflammatory markers (Creswell et al., 2019).”
BackgroundInfluentialSelf-citationBerta-Otero, T., Barceló-Soler, A., Montero-Marin, J., Maloney, S., Pérez-Aranda, A., López-Montoyo, A., Salvo, V., Sussumu, M., García-Campayo, J., & Demarzo, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010225 · Cited by 11
“Past research has indicated that mindfulness skills are associated with several indicators of physical and psychological health [26,27].”
BackgroundRedwine, L. S., Schwartz, E. R., & Garland, E. L. (2022) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2022.0761 · Cited by 10
“7 The mental capacity of mindfulness is cultivated through a range of practices, including mindful breathing and body scan meditations.”
Mindfulness, psychological distress, and somatic symptoms among women engaged in sex work in China
Tam, C. C., Zhou, Y., Qiao, S., Li, X., & Shen, Z. (2022) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12362 · Cited by 10
Increased Interest for Mindfulness Online.
Misitzis, A. (2020) · PubMed Central · doi:10.4103/ijoy.ijoy_15_20 · Cited by 11
Utilizing Mindfulness Based CBT to Address Anger and Aggression in Middle Schools
Clark, L. B. (2020) · Journal of Child and Adolescent Counseling · doi:10.1080/23727810.2020.1719351 · Cited by 9
“A fair amount of research has linked mindfulness practice to certain areas of the brain, including executive functioning areas and areas that regulate feelings and behaviors (Creswell et al., 2019; Dunning et al., 2018; Meiklejohn et al., 2012).”
BackgroundKorupolu, R., Malik, A., Ratcliff, C., Robinson-Whelen, S., & Taylor, H. B. (2022) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2022.05.020 · Cited by 8
Soriano, J. R., de, E. B. M., Karaiskou, A.-Ι., Vuyst, H.-J. D., Rodriguez‐Larios, J., Feng, N., Varon, C., & Alaerts, K. (2024) · NeuroRegulation · doi:10.15540/nr.11.3.230 · Cited by 8
A cognitive neuroscience approach to understanding aggression and its treatment
Blair, J., Habel, U., Votinov, M., Wagels, L., & Denson, T. F. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106386 · Cited by 10
Nolte, H., Zurita, N. F. S., Starkey, E. M., & McComb, C. (2023) · Design Science · doi:10.1017/dsj.2023.20 · Cited by 9
“Originally, MBIs, like the prevalent Mindfulness-Based Stress Reduction program (Kabat-Zinn 1982, 2003), were used to treat adults in clinical settings and have been found to improve many conditions, including chronic pain (Kabat-Zinn 1982; Creswell 2017; Creswell et al. 2019), anxiety (Creswell 2017) and depression (…”
Metadata
- Authors
- Creswell, J. D., Lindsay, E. K., Villalba, D. K., & Chin, B.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Creswell, J. David
- Venue
- Psychosomatic Medicine
- Published
- 2019-04
- Volume
- 81
- Issue
- 3
- Pages
- 224-232
- ISSN
- 0033-3174 (ISSN-L)
- 1534-7796
- PMC
- PMC6613793
- OpenAlex
- W2913434882
- Semantic Scholar
- 8867cd2d818afb74ba3a269c72fa0e0653a68d13
- Cited by
- 252
- References
- 89
- Citations by year
- 2026: 30 · 2025: 49 · 2024: 41 · 2023: 28 · 2022: 46 · 2021: 36 · 2020: 14 · 2019: 8
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health (F32AT009508, R21AT008493, R01AT008685)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- mindfulness training, mindfulness-based interventions, physical health, chronic pain, stress buffering, stress-related disorders, psoriasis, irritable bowel syndrome, post-traumatic stress disorder, diabetes mellitus, HIV, neuroimaging, biobehavioral mechanisms
- MeSH terms
- Health Status, Humans, Inflammation, Stress, Psychological, Health Behavior, Mindfulness
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