Stress Reduction May Improve Fasting Glucose in Overweight, Obese Women

SAN DIEGO — For obese and overweight female patients, mindfulness-based stress reduction treatment may decrease fasting glucose and improve quality in life, according to a poster presented at ENDO 2015.

“Increased mindfulness and reduced stress may lead to physiologic changes in the hypothalamic-pituitary-adrenal (HPA) axis and/or sympathetic nervous system that result in lower glucose levels,” Nazia Raja-Khan, MD, of the Penn State College of Medicine in Hershey, Pennsylvania, said in a press release.

Mindfulness-based stress reduction (MBSR) treatment involves paying attention to thoughts, feelings and bodily sensations in the present moment in a nonjudgmental and nonreactive manner through exercises such as breathing awareness.

To investigate if MBSR would reduce stress and ultimately lead to favorable changes in blood glucose, blood pressure (BP), psychological distress and quality of life, the researchers conducted a pilot randomized controlled trial involving 86 women with an average BMI greater than 25.

The study participants were randomly assigned to 8 weeks of MSBR or health education control (HEC). At baseline, 8 weeks and 16 weeks, fasting blood work and questionnaires were administered. A total of 53 patients completed the study.

Compared with the control group, patients who received MBSR treatment reported significantly reduced stress, as assessed by the Perceived Stress Scale-10, at 16 weeks (MBSR, –3.6 vs. HEC, –1.3; P=.01). The researchers also observed a borderline significant increase in salivary cortisol levels at waking in the MBSR treatment arm at 16 weeks (MBSR vs. HEC; P=.09).

Significant reductions in fasting glucose (at 8 weeks, –8.9 mg/dL; P=0.02 and at 16 weeks, –9.3 mg/dL; P=.02) were seen in among the group who received MBSR. Fasting glucose did not significantly improve in the HEC group, according to the researchers, who noted “the between group difference did not reach statistical significance likely because this pilot study was not powered to detect a difference in glucose.”

The MBSR treatment arm also demonstrated significant increases in the quality of life as measured by SF-36 mental component summary (at 8 weeks, 8.0; P<.001 and at 16 weeks, 5.3; P=.003). Both MBSR and HEC groups demonstrated reductions in PROMIS Sleep Related Impairment, depression, anxiety and overall psychological distress as assessed with the Brief Symptom Inventory-18.

There were no noteworthy changes in weight, BMI, BP, lipid profile, HbA1c, fasting insulin, HOMA-IR or high-sensitivity C-reactive protein (hs-CRP) with MBSR.

“This research supports the integration of mindfulness-based interventions with conventional medical approaches to obesity and diabetes prevention and treatment,” said Raja-Khan.

Reference

1. Raja-Khan N et al. Abstract FRI-550. Presented at: The Endocrine Society’s 97th Annual Meeting & Expo (ENDO 2015); March 5-8, 2015; San Diego.