Cited by 161Mindfulness and Compassion InterventionsStress Responses and CortisolHealth, psychology, and well-being

Effects of mindfulness-based interventions on salivary cortisol in healthy adults: a meta-analytical review

Open access
Sanada, Kenji, Montero-Marin, Jesus, Alda Díez, Marta, Salas-Valero, Montserrat, Pérez-Yus, María C., Morillo, Héctor, Demarzo, Marcelo M. P., García-Toro, Mauro +1 more·2016·Frontiers in Physiology

Abstract

Objective. The aim of the present study was to elucidate the effects of Mindfulness-based interventions (MBIs) on salivary cortisol levels in healthy adult populations. Method. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), published between January 1980 and June 2015 in PubMed, EMBASE, PsycINFO and the Cochrane library. The PRISMA and Cochrane guidelines were followed. The pooled effect sizes were calculated with the random-effects model, using Hedges’ g values, and heterogeneity was measured using the I2 statistic. The contribution of different characteristics of participants and programmes were assessed by meta-regression models, using beta coefficients. Results. Five RCTs with 190 participants in total were included in this systematic review. The overall effect size (ES) for improving the state of health related to cortisol levels was moderately low (g=0.41; p=0.025), although moderate heterogeneity was found (I2=55; p=0.063). There were no significant differences between active (g=0.33; p=0.202) and passive (g=0.48; p=0.279) controls, but significant differences were found when comparing standard (g=0.81; p=0.002) and raw (g=0.03; p=0.896) measures. The percentage of women in each study was not related to ES. Nevertheless, age (beta=-0.03; p=0.039), the number of sessions (beta=0.33; p=0.007) and the total hours of the MBI (beta=0.06; p=0.005) were significantly related to ES, explaining heterogeneity (R2=1.00). Conclusions. Despite the scarce number of studies, our results suggest that MBIs might have some beneficial effect on cortisol secretion in healthy adult subjects. However, there is a need for further RCTs implemented in accordance with standard programmes and measurements of salivary cortisol under rigorous strategies in healthy adult populations.

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  • A previous systematic review found mindfulness-based interventions had limited effectiveness on cortisol outcomes but were more effective when standardised measures of cortisol (CAR and diurnal slope) were assessed rather than unstandardised measures.

    “A previous systematic re­ view reported varied success for mindfulness-based interventions on changing cortisol outcomes, finding mindfulness-based interventions had limited effectiveness but that they were more effective when standardised measures of cortisol were assessed such as the CAR and diurnal slope, instead of unstandardised measures such as averages of raw cortisol concentrations (Sanada”
  • A recent meta-analysis found that mindfulness-based interventions had beneficial effects on cortisol in healthy adults but also recognised the heterogeneity in delivery of studies and what is the true driver of the effect.

    “For example, a recent meta-analysis found that mindfulness-based in­ terventions had beneficial effects on cortisol in healthy adults but also recognised the heterogeneity in delivery of studies and what is the true driver of the effect (Sanada et al., 2016).”

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  1. Izawa S. Ogawa N. Haratani T. (2010). Assessment of stress by using salivary cortisol and protocols for saliva sampling. Jpn. J. Occup. Saf. Health Res. 3, 119– 124. 10.2486/josh.3.119 · DOI

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Authors
Sanada, K., Montero-Marin, J., Alda Díez, M., Salas-Valero, M., Pérez-Yus, M. C., Morillo, H., Demarzo, M. M. P., García-Toro, M., & García-Campayo, J.
Affiliations
  • SHOWA Medical University (JP)
  • Red de Investigación en Actividades Preventivas y Promoción de la Salud (ES)
  • Hospital Israelita Albert Einstein (BR)
Corresponding author
Pérez-Yus, María C.
Venue
Frontiers in Physiology
Published
2016-10-19
Volume
7
Pages
471-471
ISSN
1664-042X (ISSN-L)
OpenAlex
W2534613071
Cited by
161
References
82
Citations by year
2026: 10 · 2025: 10 · 2024: 12 · 2023: 59 · 2022: 17 · 2021: 19 · 2020: 10 · 2019: 7 · 2018: 10 · 2017: 7
FWCI
10.71
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Physiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Docusalut (Conselleria de Salut i Consum del Govern de les Illes Balears) (submittedVersion, cc-by)
  • Hispana (submittedVersion, cc-by)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
  • Zaguan (Universidad de Zaragoza) (submittedVersion, cc-by)
Funders
  • European Commission
  • Instituto de Salud Carlos III (RD12/0005)
  • European Regional Development Fund (RD12/0005)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
Keywords
mindfulness-based interventions, salivary cortisol, cortisol secretion, stress response, healthy adults, intervention duration, sex differences, effect size heterogeneity

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