Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model

E Epel, B Laraia, K Coleman-Phox, C Leung, C Vieten, L Mellin, J L Kristeller, M Thomas, N Stotland, N Bush, R H Lustig, M Dallman, F M Hecht, N Adler, E Epel, B Laraia, K Coleman-Phox, C Leung, C Vieten, L Mellin, J L Kristeller, M Thomas, N Stotland, N Bush, R H Lustig, M Dallman, F M Hecht, N Adler

Abstract

Background: Stress can lead to excessive weight gain. Mindfulness-based stress reduction that incorporates mindful eating shows promise for reducing stress, overeating, and improving glucose control. No interventions have tested mindfulness training with a focus on healthy eating and weight gain during pregnancy, a period of common excessive weight gain. Here, we test the effectiveness of such an intervention, the Mindful Moms Training (MMT), on perceived stress, eating behaviors, and gestational weight gain in a high-risk sample of low income women with overweight/obesity.

Method: We conducted a quasi-experimental study assigning 115 pregnant women to MMT for 8 weeks and comparing them to 105 sociodemographically and weight equivalent pregnant women receiving treatment as usual. Our main outcomes included weight gain (primary outcome), perceived stress, and depression.

Results: Women in MMT showed significant reductions in perceived stress (β = - 0.16) and depressive symptoms (β = - 0.21) compared to the treatment as usual (TAU) control group. Consistent with national norms, the majority of women (68%) gained excessive weight according to Institute of Medicine weight-gain categories, regardless of group. Slightly more women in the MMT group gained below the recommendation. Among secondary outcomes, women in MMT reported increased physical activity (β = 0.26) and had lower glucose post-oral glucose tolerance test (β = - 0.23), being 66% less likely to have impaired glucose tolerance, compared to the TAU group.

Conclusion: A short-term intervention led to significant improvements in stress, and showed promise for preventing glucose intolerance. However, the majority of women gained excessive weight. A longer more intensive intervention may be needed for this high-risk population. Clinical Trials.gov #NCT01307683.

Keywords: Depression; Gestational weight gain; Insulin resistance; Mindfulness; Pregnancy; Stress.

Conflict of interest statement

No authors have declared to have any conflicts of interest.

Figures

Fig. 1
Fig. 1
Theoretical model (reprinted from Vieten et al., [43])
Fig. 2
Fig. 2
Screening, enrollment, and follow-up of study sample

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