Mindfulness Training and Physical Health: Mechanisms and Outcomes

Abstract

Objective: There has been substantial research and public interest in mindfulness interventions, biological pathways, and health for the past two decades. This article reviews recent developments in understanding relationships between mindfulness interventions and physical health.

Methods: A selective review was conducted with the goal of synthesizing conceptual and empirical relationships between mindfulness interventions and physical health outcomes.

Results: Initial randomized controlled trials in this area suggest that mindfulness interventions can improve pain management outcomes among chronic pain populations, and there is preliminary evidence for mindfulness interventions improving specific stress-related disease outcomes in some patient populations (i.e., clinical colds, psoriasis, irritable bowel syndrome, posttraumatic stress disorder, diabetes, HIV). We offer a stress-buffering framework for the observed beneficial effects of mindfulness interventions and summarize supporting biobehavioral and neuroimaging studies that provide plausible mechanistic pathways linking mindfulness interventions with positive physical health outcomes.

Conclusions: We conclude with new opportunities for research and clinical implementations to consider in the next two decades.

Conflict of interest statement

Conflict of Interest Disclosure: The authors declare no financial conflicts of interest but disclose that David Creswell’s lab received research funding from the mindfulness company Headspace for conducting a mindfulness training study in 2018.

Figures

Figure 1.

Plausible pathways linking mindfulness interventions with physical health. Mindfulness interventions, which train skills in monitoring present-moment experience with an orientation of acceptance, are proposed to impact physical health primarily among high-stress populations. Stress-buffering pathways in the brain, peripheral physiology, and subjective experience are posited to increase coping resources, which buffer recurrent, exaggerated, or dysregulated biological stress responses and negative health behaviors. Specifically, mindfulness interventions increase activity and connectivity in regulatory prefrontal cortex brain regions (the top-down regulatory pathway) and decrease reactivity and connectivity in regions that gate the body’s fight-or-flight stress response (the bottom-up reactivity pathway). These neural changes alter stress appraisals, decrease physiological stress reactivity in the sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis, and impact coping and health behaviors. Together, changes in neural and physiological stress responding, stress appraisals, coping, and health behaviors may be important mechanisms for improvements in stress-related disease outcomes observed following mindfulness interventions. Pathways outlined in dotted gray lines represent theorized mechanisms for future research.