Some of the simplest, safest lessons to help adolescents combat obesity may be raising their awareness of what they are eating and whether they are even hungry, researchers say.
A pilot study of 40 adolescents in Richmond County, Georgia, showed that mindfulness-based eating awareness training encouraged adolescents to eat healthier and exercise more and marginalized their tendency to gain weight.
"This gives us a safe, inexpensive intervention that could be translated into a real-world program for overweight kids," said Dr. Vernon A. Barnes, physiologist at the Georgia Prevention Institute at the Medical College of Georgia at Augusta University. "If you can make a practice of keeping the awareness with you at every meal, this could benefit you throughout your life."
"If you can make a practice of keeping the awareness with you at every meal, this could benefit you throughout your life," said Barnes, corresponding author of the study in the International Journal of Complementary & Alternative Medicine.
In this first study looking at the impact of mindfulness approaches on the diet, exercise and eating behavior of adolescents, ninth-graders from six high school health physical education classes were randomly assigned to the control group, which just continued health classes or 12-week sessions of mindfulness intervention. Intervention starts with easier techniques such as breathing awareness meditation, where students focus on the movement of their diaphragm as a way to learn to pay more attention to their bodies. The dozen sessions also included researchers using chocolate to increase awareness of taste and taste satiety, explaining how emotions can trigger overeating as well as the benefit of mindful movement, including using pedometers and walking meditation.
The majority of the adolescents were overweight; most had bad eating habits and most were black. About 20 percent of intervention participants reported they were not conscious of the fact that they were eating too fast or that they were uncomfortable afterward. Nearly 60 percent reported a binge-eating problem, which, unfortunately, mindfulness-based eating awareness did not reduce, Barnes said.
Progress, including what they ate, how often they exercised and whether they continued to binge, was assessed at the end of the 12-week session and again three months later, Barnes said.
Study co-author, Dr. Jean L. Kristeller, clinical psychologist and professor emeritus at Indiana State University, had already adapted mindfulness-based stress reduction into an eating awareness program so adult consumers would be more aware of what they are eating and ideally better regulate it. She and Barnes further adapted that two-hour program into a 50-minute session that would fit into normal class time for younger individuals.
Adolescents in the intervention arm ate better and exercised more, said Barnes. Moderate physical activity for participants increased 1.4 days per week compared with controls who actually decreased their activity over the study period by about half a day per week. Over six months, intervention participants went from 2.9 to 3.6 to 4.3 days of activity each week vigorous enough to make them breathe hard and/or sweat. Controls dropped from nearly three days to about two days of vigorous activity per week.
Adolescents in the intervention group experienced a slight downward trend in their weight compared with their also mostly overweight peers who continued to trend slightly upward. Weight loss, even maintaining a steady weight, is difficult among adolescents, who typically experience multiple growth spurts and puberty, Barnes said. "At least for this group, we were able to keep them on an even keel for a few months," he said.
While those in the intervention arm were consuming a healthier diet - lower fat and calories - many also continued binge behavior, with most continuing to report mild to moderate binge behavior. Intervention participants did report a decrease in perceived hunger.