Practicing mindfulness can help people make heart-healthy eating choices

Practicing mindfulness focused on healthy eating can be good for the heart, a new study shows, because it improves self-awareness and helps people stick to a heart-healthy diet.

When people who had elevated blood pressure participated in an eight-week mindfulness-based blood pressure reduction program for the study, they significantly improved their scores on measures of self-awareness and adherence to a heart-healthy diet compared to a control group. The results were published in JAMA Network Open.

“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,” said lead study author Eric B. Loucks, an associate professor of epidemiology, behavioral and social sciences, and director of the Mindfulness Center at Brown University.

Loucks said the study helps explain the mechanism by which a customized mindfulness training program adapted toward improving diet can affect blood pressure.

“Improvements in our self-awareness, of how different foods make us feel, of how our body feels in general, as well as our thoughts, emotions and physical sensations around eating healthy as well as unhealthy food, can influence people’s dietary choices,” he said.

High blood pressure, a major cause of cardiovascular disease, is the single most important risk factor for early death worldwide, according to a recent report by the World Health Organization, leading to an estimated 10.8 million avoidable deaths every year. The important thing to note about those avoidable deaths, Loucks said, is that there is ample research supporting effective strategies to control and prevent hypertension.

“Almost everyone has the power to control blood pressure through changes in diet and physical activity, adherence to antihypertensive medications, minimizing alcohol intake and monitoring stress reactivity,” he said.

A heart-focused mindfulness program

The mindfulness-based blood pressure reduction program used in the study, which Loucks developed in 2014, trains participants in skills such as meditation, yoga, self-awareness, attention control and emotion regulation. What makes the program unique, he said, is that participants learn how to direct those skills toward behaviors known to lower blood pressure.

The MB-BP plan consisted of a group orientation session, eight 2.5-hour weekly group sessions and one day-long retreat, as well as recommended home practice for 45 minutes, six days a week. The program was led by trained instructors with expertise in cardiovascular disease etiology, treatment and prevention. Classes were held in Providence, R.I., at Brown University and at a health center in a lower-income, urban neighborhood.

The study compared two groups, totaling 201 participants. The 101 people in the test group were a part of the 8-week MB-BP program, which included personalized feedback and education about hypertension risk factors; mindfulness training of participants in relationship to hypertension risk factors (including mindful eating); and behavior change supportThe “usual care” control group received educational brochures on controlling high blood pressure. Both groups received a home blood-pressure monitoring device with usage training, and options for referral to primary care physicians.

The researchers focused on participant adherence to the DASH (Dietary Approaches to Stop Hypertension) program, a balanced eating plan rich in fruits, vegetables, whole grains and low-fat dairy, intended to create a heart-healthy eating style for life. Despite its effectiveness, adherence to the DASH diet is typically low.

After six months, the mindfulness group showed a 0.34-point improvement in the DASH diet score. Loucks explained that this effect can be interpreted as equivalent for a participant shifting from a vegetable intake approaching recommended levels (2-3 servings) to recommended levels (at least 4 servings), or making similar shifts across another component of the DASH score. The control group showed a -0.04-point change in DASH diet score.

The mindfulness group also showed a 0.71-point improvement in the average interoceptive awareness (which is the process of sensing and interpreting signals from one’s own body) score compared to six months prior, which outperformed the control group by a significant 0.54 points.

The authors said the trial results offer evidence that an adapted mindfulness training program for participants with high blood pressure that targets diet and self-awareness significantly improves both.

“The program gives participants the tools to make heart-healthy diet changes that can lower their blood pressure and decrease their risk of cardiovascular disease,” Loucks said.

The researchers are studying different “doses” of the program (for example, shorter program lengths, fewer sessions), as well as factors influencing the implementation of the MB-BP plan in a real-world setting — including eligibility for health insurance coverage, accessibility for different patient groups and flexibility for physicians.

The naturally occurring peptide may tackle obesity-related conditions’ ‘root cause’.

Naturally occurring peptide may tackle the ‘root cause’ of obesity-related conditions
Naturally occurring peptide may tackle the ‘root cause’ of obesity-related conditions

Research shows that a peptide (small protein) called PEPITEM could provide a revolutionary approach to reducing the risk of type 2 diabetes and other obesity-related diseases such as hepatic steatosis (fatty liver). 

The researchers used an animal model of obesity to investigate whether PEPITEM, delivered by a slow-release pump, could prevent or reverse the effects that a high fat diet has on the pancreas.  Excitingly, the results showed that administration of PEPITEM significantly reduced the enlargement of insulin-producing cells in the pancreas and also significantly reduced immune cell migration into various tissues. 

The research team was led by Dr Helen MCGettrick and Dr Asif Iqbal from the University of Birmingham’s Institute of Inflammation and Ageing and Institute of Cardiovascular Sciences.  Dr McGettrick said: “We have found a new therapeutic approach that could provide new drugs to tackle the root cause of obesity-related conditions by preventing the damage caused by systemic inflammation.

PEPITEM was first identified in 2015 by Birmingham researchers who described its role in the adiponectin-PEPITEM pathway, which is involved in controlling the onset and severity of auto-immune and chronic inflammatory diseases. 

Obesity causes complex and dramatic changes in metabolism in adipose (fat) tissue, damage to the pancreas, reduced insulin sensitivity and eventually the hyperglycaemia that underpins type 2 diabetes.  It also causes a low-level inflammatory response across the boyd, encouraging white blood cells to enter into many tissues including the visceral adipose tissue (fat stored deep inside the body wrapped around the organs, including the liver and gut) and peritoneal cavity (a thin membrane that encompasses the gut). 

The latest research, published in Clinical and Experimental Immunology, shows that the adiponectin-PEPITEM pathway also connects obesity, the low-level inflammatory response that is driven by it, and changes in the pancreas that precede diabetes. 

The results showed that dosing with PEPITEM while the mice were on a high fat diet significantly reduced the enlargement of insulin-producing beta cells in the pancreas and the number of white blood cells in the visceral adipose tissue and peritoneal cavity, compared to controls. 

The researchers also looked at the potential of PEPITEM to reverse the changes brought on by obesity, by feeding the animals a high fat diet prior to treating with PEPITEM.  Excitingly, they saw similar results.  Dr Asif Iqbal commented: “Until now we have understood very little about how the inflammation that accompanies obesity drives pathology.  These results show us that PEPITEM can both prevent and reverse the impact that obesity has on metabolism.  The next stage is to translate these exciting results into therapeutics that can be used in humans.”

Professor Ed Rainger from Birmingham’s Institute of Cardiovascular Sciences led the team that first identified PEPITEM.  He commented: “We are all very excited about these latest results.  PEPITEM is a naturally occurring peptide.  We have already shown it has effects on several organs and now for the first time, we have shown that PEPITEM is effective

More evidence that sugary drinks cause weight gain

More evidence that sugary drinks cause weight gain
More evidence that sugary drinks cause weight gain

A review of dozens of studies from the last decade, led by researchers at the University of Toronto and Harvard University, recently found that sugar-sweetened beverages promote weight gain in children and adults.

The review, published in the American Journal of Clinical Nutrition, is the largest and most thorough analysis to date of research on sweetened drinks, and overweight and obesity — both of which heighten risks for diabetes, heart disease, some cancers and other diseases.

Vasanti Malik led the study, with colleagues in Toronto and Boston. Malik is an assistant professor of nutritional sciences at U of T’s Temerty Faculty of Medicine and the Joannah & Brian Lawson Centre for Child Nutrition. She spoke with writer Jim Oldfield about the findings, and take-aways for public policy and personal health.

Why do this study now?

Our last meta-analysis on this topic was 2013. You want to update a meta-analysis every five to 10 years anyway, but especially in this area because there has been so much new research the last decade. Evidence has continued to accumulate showing associations among sugar-sweetened beverages, or SSBs as we call them, and weight and chronic disease. And it’s very important to have an updated synthesis of that evidence, especially for public policy. The Canada Food Guide is clear on the need to limit SSBs and recommends water as the drink of choice, and added sugar intake including SSBs has declined in Canada, in part due to public policies. But levels here are still too high. As well, the USDA Dietary Guidelines for Americans are arguably not as strong, and with U.S. policymakers coming together soon to discuss the 2025 guidelines, our study will be an important piece of evidence to inform their work. 

What did your study show?

We expected to find a positive association between SSBs and weight gain, among adults and children, and in cohort studies and randomized clinical trials. And that was exactly what we found. We analyzed 85 studies, which totalled over half a million participants. In cohort studies, which follow people over long periods of time, each serving-per-day increase in SSBs was associated with a 0.42-kg (almost one-pound) higher body weight in adults. In children, we saw a 0.07-unit higher body-mass index (just under one-twelfth of a BMI unit). Perhaps most striking, findings from our dose-response analysis showed that weight gain increases with increasing levels of SSB intake, in both children and adults. A doseresponse relationship provides strongevidence for a cause-and-effect relationship.  

How much weight gain might one drink a day lead to over time?

Well, we estimated that associated change in body weight over a one-year period. For adults, one additional 12-ounce serving a day was linked to a 0.20-kg higher body weight (about half a pound) in one year. Over 10 years, that could be about five pounds. In children, we observed a 0.03-unit higher BMI for each additional daily serving of SSBs over a one-year period. Although these results may seem modest, weight gain is a gradual process, with adults averaging about one pound (0.45 kg) of weight gain per year. So, limiting SSB consumption could be an effective way to prevent age-related weight gain. Limiting SSB intake among children is also an important strategy to help them develop healthy lifestyle habits and weight trajectories.

How common is excess consumption of these drinks?

It’s very common. Sugar-sweetened beverages include sodas, fruit drinks, sports and energy drinks, and they are the largest source of added sugar in the North American diet. Moreover, the rise in consumption of these drinks has mirrored the epidemic of overweight and obesity. In 2016, almost two billion adults were estimated as having overweight and 650 million had obesity. Even more worrying, the rate of increase in obesity in children and adolescents is now greater than in adults. The prevalence of childhood obesity has increased more than four-fold globally since the 1970s, which is truly alarming.

What are some of the health effects of SSBs?

A typical 12-ounce serving of an SSB contains over 140 calories and more than eight teaspoons of sugar. That nearly reaches the recommended daily limit for added sugar, which is no more than 10 per cent of total calories, or about 200 calories for a 2000-calorie per day diet. These drinks are sugar in liquid form. They’re usually made with table sugar, high-fructose corn syrup or other sweeteners that provide calories, and are digested rapidly, more so than sugar consumed as a solid. This bolus of glucose increases blood sugar levels, which triggers a glycemic response that over time can lead to insulin resistance and diabetes. The fructose component also floods the liver, which can cause lipogenesis (creation of fat), which puts a person on the path to fatty liver and metabolic disease. Fructose also increases uric acid, which contributes to insulin resistance and risk for cardiovascular and other diseases. Insulin spikes from the glycemic response can result in an appetite cascade and over-eating, as can excess insulin in the blood over longer periods. Some evidence shows that SSBs activate the dopaminergic reward system in the brain and encourage addictive behaviour, and that they alter the gut microbiome, but we need more research on those effects.

Are you optimistic, given these effects and the research evidence?  

Intake levels of SSBs have come down in the developed world. We’re still seeing increases in the developing world, but taxes in some of those countries are working. Thailand introduced a tax that has reduced consumption, as has Mexico and South Africa. At least 85 countries now have a tax on SSBs, which in part reflects the World Health Organization’s stand on this issue. In Canada, Newfoundland introduced a tax recently, and several U.S. regions and cities have had a tax for years, in response to public health efforts, more awareness and advocacy. The general effect of these taxes is reduced intake, and the revenues can be put toward further public health measures and health care. Other changes will help in Canada and elsewhere as well, such as limiting marketing to children, and better front-of-pack and nutrition labels. All these efforts will push intake down, but it’s important to remember that as that happens, people need access to clean, safe drinking water as an alternative. That’s an ongoing challenge globally, and in many parts of Canada, that we really need to address.

Vasanti Malik holds a Canada Research Chair in Nutrition and Chronic Disease Prevention at the University of Toronto, and an adjunct position in Nutrition at the Harvard T.H. Chan School of Public Health. Michelle Nguyen, a doctoral student at U of T, conducted the study analysis and wrote the paper.

Time-restricted eating reshapes gene expression throughout the body.

Science image


Time-restricted eating reshapes gene expression throughout the body. In this illustration, the Ferris wheel displays the interconnected organ systems working smoothly during time-restricted eating, represented by the clock in the middle CREDIT Salk Institute

Numerous studies have shown the health benefits of time-restricted eating, including an increase in life span in laboratory studies, and practices like intermittent fasting, a hot topic in the wellness industry. However, how it affects the body on the molecular level and how those changes interact across multiple organ systems has not been well understood. Now, Salk scientists show in mice how time-restricted eating influences gene expression across more than 22 regions of the body and brain. Gene expression is the process through which genes are activated and responds to their environment by creating proteins.

The findings, published in Cell Metabolism on January 3, 2023, have implications for many health conditions where time-restricted eating has shown potential benefits, including diabetes, heart disease, hypertension, and cancer.

“We found that there is a system-wide, molecular impact of time-restricted eating in mice,” says Professor Satchidananda Panda, senior author and holder of the Rita and Richard Atkinson Chair at Salk. “Our results open the door for looking more closely at how this nutritional intervention activates genes involved in specific diseases, such as cancer.”

For the study, two groups of mice were fed the same high-calorie diet. One group was given free access to food. The other group was restricted to eating within a feeding window of nine hours each day. After seven weeks, tissue samples were collected from 22 organ groups and the brain at different times of the day or night and analyzed for genetic changes. Samples included tissues from the liver, stomach, lungs, heart, adrenal gland, hypothalamus, different parts of the kidney and intestine, and different areas of the brain.

The authors found that 70 per cent of mouse genes respond to time-restricted eating.

“By changing the timing of food, we were able to change the gene expression not just in the gut or in the liver, but also in thousands of genes in the brain,” says Panda. 

Nearly 40 per cent of genes in the adrenal gland, hypothalamus, and pancreas were affected by time-restricted eating. These organs are essential for hormonal regulation. Hormones coordinate functions in different body and brain parts, and hormonal imbalance is implicated in many diseases, from diabetes to stress disorders. The results offer guidance on how time-restricted eating may help manage these diseases.

Interestingly, not all sections of the digestive tract were affected equally. While genes involved in the upper two portions of the small intestine—the duodenum and jejunum—were activated by time-restricted eating, the ileum, at the lower end of the small intestine, was not. This finding could open a new line of research to study how jobs with shiftwork, which disrupt our 24-hour biological clock (called the circadian rhythm) impact digestive diseases and cancers. Previous research by Panda’s team showed that time-restricted eating improved the health of firefighters, who are typically shifting workers.

The researchers also found that time-restricted eating aligned the circadian rhythms of multiple body organs.

“Circadian rhythms are everywhere in every cell,” says Panda. “We found that time-restricted eating synchronized the circadian rhythms to have two major waves: one during fasting and another just after eating. We suspect this allows the body to coordinate different processes.”

Next, Panda’s team will take a closer look at the effects of time-restricted eating on specific conditions or systems implicated in the study, such as atherosclerosis, which is a hardening of the arteries that is often a precursor to heart disease and stroke, as well as chronic kidney disease.

Some guts are better than others at harvesting energy

Associate professor Henrik Roager


Associate professor Henrik Roager in the lab. CREDIT University of Copenhagen.

New research from the University of Copenhagen suggests that a portion of the Danish population has a composition of gut microbes that, on average, extracts more energy from food than do the microbes in the guts of their fellow Danes. The research is a step towards understanding why some people gain more weight than others, even when they eat the same.

Unfair as it, some of us seem to put on weight just by looking at a plate of Christmas cookies, while others can munch away with abandon and not gain a gram. Part of the explanation could be related to the composition of our gut microbes. This, according to new research conducted at the University of Copenhagen’s Department of Nutrition, Exercise and Sports.

Researchers studied the residual energy in the faeces of 85 Danes to estimate how effective their gut microbes are at extracting energy from food. At the same time, they mapped the composition of gut microbes for each participant.

The results show that roughly 40 percent of the participants belong to a group that, on average, extracts more energy from food compared to the other 60 percent. The researchers also observed that those who extracted the most energy from food also weighed 10 percent more on average, amounting to an extra nine kilograms.

“We may have found a key to understanding why some people gain more weight than others, even when they don’t eat more or any differently. But this needs to be investigated further,” says Associate Professor Henrik Roager of the University of Copenhagen’s Department of Nutrition, Exercise and Sports.

May increase the risk of obesity

The results indicate that being overweight might not just be related to how healthily one eats or the amount of exercise one gets. It may also have something to do with the composition of a person’s gut microbes. 

Participants were divided into three groups, based on the composition of their gut microbes. The so-called B-type composition (dominated by Bacteroides bacteria) is more effective at extracting nutrients from food and was observed in 40 percent of the participants.

Following the study, the researchers suspect that a portion of the population may be disadvantaged by having gut bacteria that are a bit too effective at extracting energy. This effectiveness may result in more calories being available for the human host from the same amount of food.

“The fact that our gut bacteria are great at extracting energy from food is basically a good thing, as the bacteria’s metabolism of food provides extra energy in the form of, for example, short-chain fatty acids , which are molecules that our body can use as energy-supplying fuel. But if we consume more than we burn, the extra energy provided by the intestinal bacteria may increase the risk of obesity over time,” says Henrik Roager.

Short travel time in the gut surprises

From mouth to esophagus, stomach, duodenum and small intestine, large intestine and finally to rectum, the food we eat takes a 12-to-36-hour journey, passing several stations along the way, before the body has extracted all the food’s nutrients.

The researchers also studied the length of this journey for each participant, all of whom had similar dietary patterns. Here, the researchers hypothesized that those with long digestive travel times would be the ones who harvested the most nutrition from their food. But the study found the exact opposite.

“We thought that there would be a long digestive travel time would allow more energy to be extracted. But here, we see that participants with the B-type gut bacteria that extract the most energy, also have the fastest passage through the gastrointestinal system, which has given us something to think about,” says Henrik Roager.

Confirms previous study in mice

The new study in humans confirms earlier studies in mice. In these studies, it was found that germ-free mice that received gut microbes from obese donors gained more weight compared to mice that received gut microbes from lean donors, despite being fed the same diet.

Even then, the researchers proposed that the differences in weight gain could be attributable to the fact that the gut bacteria from obese people were more efficient at extracting energy from food. This is the theory now being confirmed in the new study by the Department of Nutrition, Exercise and Sports.

“It is very interesting that the group of people who have less energy left in their stool also weigh more on average. However, this study doesn’t provide proof that the two factors are directly related. We hope to explore this more in the future,” says Henrik Roager. 

About gut bacteria:

  • Everyone has a unique composition of gut bacteria – shaped by genetics, environment, lifestyle and diet.
  • The collection of gut bacteria, called the gut microbiota, is like an entire galaxy in our gut, with a staggering 100 billion of them per gram of stool.
  • Gut bacteria in the colon serve to break down food parts that our body’s digestive enzymes can’t, e.g., dietary fibre.
  • Humans can be divided into three groups based on the presence and abundance of three main groups of bacteria that most of us have: B-type (Bacteroides), R-type (Ruminococcaceae) and P-type (Prevotella).