Effects of a mindfulness-based intervention on depressive symptoms, stress eating, and telomere length in adolescents at-risk for adult obesity
Date
2019
Authors
Hendrich, Silas Grant, author
Shomaker, Lauren, advisor
Quirk, Kelley, committee member
Bailey, Susan, committee member
Journal Title
Journal ISSN
Volume Title
Abstract
Rates of adolescent obesity and cardiometabolic diseases such as type 2 diabetes are increasing. Recent studies suggest that depression symptoms may be one contributor to obesity and cardiometabolic diseases through stress-related behavioral mechanisms (e.g., stress-eating) and physiological mechanisms (e.g. shortened telomeres). From an allostatic load framework, depression symptoms affect the biological system, potentially exerting sustained damage on stress physiology, and thus, contributing to cardiometabolic disease risk. Mindfulness-based interventions (MBIs) have demonstrated favorable impacts for lowering depression symptoms and lowering symptoms of stress-related eating patterns, yet these effects have not been well studied in adolescents. In the current randomized controlled pilot study, I conducted secondary analyses to explore the effects of a six-session MBI group on lowering depression symptoms, reducing stress-eating, and preserving telomere length, compared to a six-session health education (HE) control group, in 25 adolescent girls (n=14; 56%) and boys (n=11; 44%) at-risk for adult obesity (body mass index [BMI] z-score M=1.56, SD=.55). At baseline/prior to the intervention and again, at an 18-month follow-up, perceived stress and depression symptoms were assessed with validated surveys, stress-eating by laboratory test meal, and average telomere length from whole blood. Dispositional mindfulness by questionnaire, BMI from fasting weight and height, and fasting blood glucose levels were also measured at the same intervals. Analyses of covariance were used to test group condition as a predictor of baseline to 18-month change scores, controlling for the respective baseline level of the outcome variable. Results showed that adolescents who were randomized to the MBI group had less change in stress-eating from baseline to 18-months than those randomized to HE (M=-49.44, SD=81.47 kcal vs. M=217.42, SD=84.88 kcal, Cohen's d=.74, p=.04). There were no other significant between-condition effects. There were moderate, favorable non-significant effects of MBI, compared to HE, for perceived stress (d=.45, p=.21) and depression symptoms (d=.50, p=.23). There was no significant effect on telomere length (d=.05, p=.91). Changes in dispositional mindfulness, BMI, and fasting blood glucose levels were small and also non-significant. Findings from the current project suggest that a relatively brief, MBI group reduces stress-eating in adolescents at-risk for adult obesity over a year and a half later. To what extent MBI, delivered alone or in combination with additional supports, ultimately affects allostatic load and cardiometabolic health remains to be tested in a larger trial.