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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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InfluentialWhat Do We Really Know About Mindfulness-Based Stress Reduction?
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“in irritable bowel syndrome (IBS) symptom immediately after a mindfulness intervention and at a 6-month follow-up (26,27).”
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“Although some RCTs suggest that mindfulness interventions may reduce IL-6 (14) or CRP (32–34) among older adults and high-stress adults, other studies have failed to show any reduction (IL-6: (32,34,42); CRP: (35).”
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“in irritable bowel syndrome (IBS) symptom immediately after a mindfulness intervention and at a 6-month follow-up (26,27).”
Loucks, E. B., Schuman-Olivier, Z., Britton, W. B., Fresco, D. M., Desbordes, G., Brewer, J. A., & Fulwiler, C. (2015) · Current Cardiology Reports · doi:10.1007/s11886-015-0668-7 · Cited by 158 · cited 1×
“mindfulness interventions impact other stress-related diseases that are highly prevalent and drive a significant burden of health care costs ((76), e.”
Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial
Barrett, B., Hayney, M. S., Muller, D., Rakel, D., Ward, A., Obasi, C. N., Brown, R., Zhang, Z., Zgierska, A., Gern, J., et al. (2012) · The Annals of Family Medicine · doi:10.1370/afm.1376 · Cited by 156 · cited 1×
“However, this mindfulness intervention did not significantly decrease the number of overall health care visits or cold-related missed work days (25).”
Dispositional Mindfulness Co-Varies with Smaller Amygdala and Caudate Volumes in Community Adults
Taren, A. A., Creswell, J. D., & Gianaros, P. J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0064574 · Cited by 151
Self-citationEngert, V., Kok, B. E., Papassotiriou, I., Chrousos, G. P., & Singer, T. (2017) · Science Advances · doi:10.1126/sciadv.1700495 · Cited by 151 · cited 1×
“both a monitor only mindfulness training group and a structurally matched placebo control training group (16) (cf, (80)).”
Davis, M. C., Zautra, A. J., Wolf, L. D., Tennen, H., & Yeung, E. W. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0038200 · Cited by 146
Jedel, S., Hoffman, A., Merriman, P., Swanson, B., Voigt, R., Rajan, K. B., Shaikh, M., Li, H., & Keshavarzian, A. (2014) · Digestion · doi:10.1159/000356316 · Cited by 143 · cited 2×
“(2014) (33) reported that a mindfulness intervention reduced CRP, they questioned its clinical significance given that this reduction in CRP did not lower the incidence of ulcerative colitis flare-ups.”
Britton, W. B., Haynes, P. L., Fridel, K. W., & Bootzin, R. R. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181dc1bad · Cited by 125 · cited 1×
“, actigraphy or polysomnography) (cf, (71)).”
Mason, A. E., Epel, E. S., Aschbacher, K., Lustig, R. H., Acree, M., Kristeller, J., Cohn, M., Dallman, M., Moran, P. J., Bacchetti, P., et al. (2016) · Appetite · doi:10.1016/j.appet.2016.02.009 · Cited by 125 · cited 1×
“eating behaviors, such as reducing binge eating (66) and sweet consumption (67,68).”
Meditation and vacation effects have an impact on disease-associated molecular phenotypes
Epel, E. S., Puterman, E., Lin, J., Blackburn, E. H., Lum, P. Y., Beckmann, N. D., Zhu, J., Lee, E., Gilbert, A., Rissman, R. A., et al. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.164 · Cited by 105 · cited 1×
“tested and show promise for improving health-related biomarkers— including residential mindfulness meditation retreats (14,15), smartphone-delivered mindfulness programs (16), and brief 3- to 4-day audio-guided mindfulness training in the laboratory (17).”
Gordon, W. V., Shonin, E., Dunn, T. J., García‐Campayo, J., & Griffiths, M. D. (2016) · British Journal of Health Psychology · doi:10.1111/bjhp.12224 · Cited by 103 · cited 1×
“For example, 8-week mindfulness interventions have been shown to significantly reduce functional disability and improve pain management in chronic low back pain patients (19–21), chronic pain patients misusing opioids (21), rheumatoid arthritis patients (22), and fibromyalgia patients (23) (cf, (24)).”
Chin, B., Lindsay, E. K., Greco, C. M., Brown, K. W., Smyth, J. M., Wright, A. G. C., & Creswell, J. D. (2019) · Health Psychology · doi:10.1037/hea0000763 · Cited by 103
Self-citationBritton, W. B., Davis, J. H., Loucks, E. B., Peterson, B., Cullen, B. H., Reuter, L., Rando, A., Rahrig, H., Lipsky, J., & Lindahl, J. R. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.09.010 · Cited by 100 · cited 1×
“work (and others, (84)) has focused on the most stringent treatment-controlled approach to date—namely, pitting two different forms of mindfulness intervention against each other in a dismantling study approach (16).”
Shomaker, L. B., Bruggink, S. M., Pivarunas, B., Skoranski, A. M., Foss, J., Chaffin, E., Dalager, S. L., Annameier, S. K., Quaglia, J. T., Brown, K. W., et al. (2017) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2017.04.003 · Cited by 95
González-García, M., Ferrer, M. J., Borràs, X., Muñoz-Moreno, J. A., Miranda, C., Puig, J., Pérez‐Álvarez, N., Soler, J., Feliu‐Soler, A., Clotet, B., et al. (2013) · AIDS and Behavior · doi:10.1007/s10461-013-0612-z · Cited by 84
SeyedAlinaghi, S., Jam, S., Foroughi, M., Imani, A., Mohraz, M., Djavid, G. E., & Black, D. S. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31825abfaa · Cited by 76
Erickson, K. I., Creswell, J. D., Verstynen, T., & Gianaros, P. J. (2014) · Current Directions in Psychological Science · doi:10.1177/0963721414549350 · Cited by 69 · cited 1×
“a broad spectrum of stress-related diseases (40,44,45).”
Self-citationSevinc, G., Hölzel, B. K., Hashmi, J., Greenberg, J., McCallister, A., Treadway, M., Schneider, M. L., Dusek, J. A., Carmody, J., & Lazar, S. W. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000590 · Cited by 67 · cited 1×
“group support, relaxation, daily home practice, and placebo expectancies (cf, (83)).”
Fogarty, F. A., Booth, R. J., Gamble, G. D., Dalbeth, N., & Consedine, N. S. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2014-205946 · Cited by 56 · cited 1×
“Although some RCTs suggest that mindfulness interventions may reduce IL-6 (14) or CRP (32–34) among older adults and high-stress adults, other studies have failed to show any reduction (IL-6: (32,34,42); CRP: (35).”
A randomized, controlled trial of mindfulness-based stress reduction in HIV infection
Hecht, F. M., Moskowitz, J. T., Moran, P., Epel, E. S., Bacchetti, P., Acree, M., Kemeny, M. E., Mendes, W. B., Duncan, L. G., Weng, H., et al. (2018) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2018.05.017 · Cited by 52
Robinson, A. C., Knowlton, A. R., Gielen, A. C., & Gallo, J. J. (2016) · Journal of Behavioral Medicine · doi:10.1007/s10865-015-9670-1 · Cited by 44
Cognitive and Mind-Body Therapies for Chronic Low Back Pain and Neck Pain
Cherkin, D. C., & Herman, P. M. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.0113 · Cited by 42 · cited 1×
“Group-based MBSR may be more cost-effective compared with individually focused treatments (82).”
Freedland, K. E. (2013) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3182851b75 · Cited by 34 · cited 1×
“Whereas waitlist and TAU studies provide an important initial evaluation of whether mindfulness interventions impact health (cf, (18)), active treatment comparators allow for inferences about mindfulness-specific effects on health.”
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“Studies have shown that mindfulness meditation is significantly superior to placebo treatments in reducing both the intensity and unpleasantness of pain [17].”
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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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