Mindfulness training can boost heart-healthy eating

More than two decades ago, NIH-supported researchers developed a heart-healthy eating plan called Dietary Approaches to Stop Hypertension (DASH). The DASH diet encourages eating fruits, vegetables, and whole grains while avoiding saturated fats. Many studies have since confirmed that the DASH diet can help to reduce hypertension, or high blood pressure, and lead to other heart-protecting changes.

Despite its proven benefits, some research has found that adherence to the DASH diet tends to be low. Dr. Eric B. Loucks and his colleagues at Brown University suspected that adding mindfulness training to the DASH eating plan might help people follow the diet and reduce hypertension. Mindfulness is a focus on the present moment and being aware of what’s going on inside and around you.

The researchers developed a training program to teach mindfulness skills—including yoga, meditation, and self-awareness—and apply these skills toward taking steps to reduce blood pressure. Such steps include following the DASH diet, boosting physical activity, and taking blood pressure medicines.

To test the program, the researchers recruited about 200 people who had elevated blood pressure (over 120/80 mm Hg). Participants were mostly white (81%), college-educated (73%), and female (59%). Their average age was about 60 years. Half received enhanced usual care, which included a blood pressure device with training in how to use it, brochures about hypertension control, and doctor referrals when needed. Those in the mindfulness group were asked to engage in mindfulness practices at home for at least 45 minutes a day, six days a week. They also attended group training sessions, including a daylong retreat and weekly 2.5-hour classes.

All participants were assessed at the start of the study and six months later. DASH diet adherence was assessed via a recognized food questionnaire. The researchers also used an established questionnaire to measure participants’ interoceptive awareness—their awareness of their body’s internal signals and processes, such as hunger cues and other mind-body interactions.

Results published earlier this year showed that those in the program had a significant 4.5 mm Hg reduction in blood pressure at six months compared to the control group. In their new study, the researchers gleaned insights into the reasons why. The results appeared in JAMA Network Open on November 2, 2023.

By the end of six months, measures of interoceptive awareness improved significantly in the mindfulness group compared to controls. The mindfulness group had a 0.54-point boost to their awareness scores (in a 0-5 range) over six months compared to the control group.

The program also improved adherence to the DASH diet. The mindfulness group had a 0.32-point boost (in a 0-11 range) to their DASH diet score compared to the control group. This improvement is akin to shifting from two or three servings of vegetables a day to the recommended four or more servings. When the researchers focused only on the 97 participants who entered the study with poor adherence to DASH, this improvement was even greater. The mindfulness training led to a difference of 0.62 points between the training and controls.

“Participants in the program showed significant improvement in adherence to a heart-healthy diet, which is one of the biggest drivers of blood pressure, as well as significant improvements in self-awareness, which appears to influence healthy eating habits,” Loucks says. Additional research is needed, with more diverse participants, to determine if this type of mindfulness intervention might also be effective among other populations.

—by Vicki Contie