Many folks gain benefits, but some of the claims appear to outstrip the evidence 10/30/2017
People are prone to following fads, and social media fuels that proclivity.
Many fads are as ephemeral as the term implies, but others have staying power.
Yoga and meditation emerged from the counterculture of the late 1960s and early 1970s.
Despite their exotic Asian roots, they’re now almost as American as apple pie, culturally and commercially.
Mindfulness meditation is now billion-dollar industry that includes countless studios and hundreds of smartphone apps – see Mindfulness to Go: Meditation Apps, Appraised.
The practice originated among early Buddhists some 2,500 years, and “mindfulness” simply means judgment-free, moment-to-moment awareness of existence.
The idea is to focus on your breathing, and allow thoughts to pass by without paying them any lingering attention.
And there’s significant evidence suggesting that meditation brings a range of health benefits.
We detailed some of those apparent benefits in these articles from our newsletter:
- Meditation Builds Gray Matter
- Ease Back Pain with Your Mind?
- Meditation May Cut Inflammation
- Can Meditation Yield Lasting Calm?
- Got Pain? Meditation Rivals Morphine
- Meditation Yields Healthy Gene Changes
In addition, there’s some clinical evidence that mindfulness meditation can help reduce stress, boost memory, enhance focus, accelerate thinking speed, reduce mental effort, enhance immune functions, foster cognitive flexibility, improve relationships, and reduce the rumination associated with anxiety and depression.
But leading meditation researchers say that many of the clinical studies lack scientific rigor — so claims should be viewed skeptically unless they're backed by high-quality evidence.
While these doubts warrant attention, it's wise to view them within the context of mindfulness meditation's ancient, durable history.
As James Maddux, professor emeritus of clinical psychology at George Mason University, says, “Mindfulness and meditation have been around for thousands of years, and there's good reason from all this history to suspect that there’s something going on here that’s useful.”
Evidence abounds, but so do doubts
In 2015, The New York Times published an op-ed essay by Professor Adam Grant of the University of Pennsylvania.
Dr. Grant acknowledged meditation's real potential: “Meditation isn't snake oil. For some people, meditation might be the most efficient way to reduce stress and cultivate mindfulness.” However, he expressed concern about hype: “But it isn't a panacea.”
Grant cited evidence that other approaches can also reduce stress and/or its harmful effects: exercise, ample high-quality sleep ... and simply changing the way you think about stress.
This matters in part because for-profit meditation studios have been proliferating, even though mindfulness doesn't appear to require much, if any, “professional” instruction.
Many organizations offer free classes in mindfulness meditation … and there are many instructional websites, DVDs, apps, and books.
It's about as simple as sitting quietly in a comfortable chair — or lotus position if you're limber enough — and focusing on your breathing for 20 minutes once or twice a day.
For example, the website of the UCLA Mindful Awareness Research Center offers free guided meditations.
Last month, leading meditation researchers published a paper in which they echoed Dr. Grant’s concerns about exaggerated or off-target claims for meditation.
Let’s examine the concerns expressed in the paper published last month — and similar conclusions reached in 2014 by the U.S. agency that evaluates medical evidence.
Leading meditation researchers express hype concerns
The new study — titled “Mind the Hype” — was led by Willoughby Britton, Ph.D., director of Brown University's neuroscience laboratory (Van Dam NT et al. 2017).
Her team included scientists from leading centers for meditation research at — among other academic institutions — Harvard, NYU, Stanford, Princeton, and the state universities of California, Massachusetts, and Michigan.
In short, they found little or no high-quality evidence backing many of the health claims made for mindfulness meditation.
Dr. Britton expressed the fear shared by her colleagues: “Meditation researchers are concerned the exaggerated claims of mindfulness benefits will mislead vulnerable people and keep them from receiving evidence-based treatment.”
Her colleagues also decried the lack of an agreed definition of mindfulness — which impairs researchers’ ability to confirm or refute the results of previous clinical trials.
Replication of prior studies is essential to confirming the validity of the outcomes of clinical trials.
And — just as the use of varying forms or doses of nutrients muddies clinical research in that realm — lack of clear definitions can preclude clear confirmation or refutation of prior clinical trials involving meditation.
In addition, much of the clinical research on mindfulness compares regular meditators to non-meditators. But regular meditators may tend to share healthy attributes, such as exercising more, or eating better diets, compared with non-meditators.
There’s also recent evidence that women — at least ones attending college — may respond more to mindfulness meditation, compared with their male peers (Rojiani R et al. 2017).
The shortcomings of many clinical trials led Britton and her 14 expert co-authors to argue that it’s long past time to test claims for mindfulness meditation with greater scientific rigor.
As they wrote, “Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed.”
The team expressed an ambitious agenda: “Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.”
2014 U.S evidence review anticipated the concerns
Dr. Britton and her co-authors noted that similar concerns were raised by a 2014 evidence review from the U.S. Agency for Healthcare Research and Quality (AHRQ).
All of the scientists who conducted the review on behalf of the AHRQ were based at Baltimore's Johns Hopkins University, in the departments of medicine, pediatrics, and psychiatry and behavioral services.
That evidence review encompassed 41 clinical trials with 2,993 participants that met minimum quality standards, although only 10 out of the 41 trials had a “low risk of bias” (Goyal M et al. et al. 2014).
The AHRQ team noticed limitations that included inconsistent study design and inconsistency among the meditation programs, including the amount, frequency, duration, and technique.
They found moderate evidence that mindfulness meditation can improve anxiety, depression, and pain.
But they found little or no evidence that mindfulness helps with substance abuse, poor eating habits, insomnia, or weight control, or that it lifts mood in people who don’t suffer from depression.
These were their specific findings (SOE means “strength of evidence”):
- Moderate SOE for improvement in anxiety, depression, and pain
- Low SOE for improvement in stress/distress and mental health–related quality of life.
- Low SOE of no effect or insufficient SOE of an effect on positive mood, attention, substance use, eating, sleep, and weight.
- No evidence to suggest that mindfulness meditation programs were superior to any alternative therapies to which they were compared.
Nonetheless, the AHRQ team’ conclusion included this positive statement: “Meditation programs, in particular mindfulness programs, reduce multiple negative dimensions of psychological stress.”
But they anticipated the concerns expressed by Dr. Britton’s team: “Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health as well as stress-related behavioral outcomes.”
- de Jong M et al. A Randomized Controlled Pilot Study on Mindfulness-Based Cognitive Therapy for Unipolar Depression in Patients With Chronic Pain. J Clin Psychiatry. 2017 Feb 28. doi: 10.4088/JCP.15m10160. [Epub ahead of print]
- Goyal M et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014 Mar;174(3):357-68. doi: 10.1001/jamainternmed.2013.13018. Review.
- Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav. 2014 Apr;15(2):197-204. doi: 10.1016/j.eatbeh.2014.01.005. Epub 2014 Feb 1. Review.
- Mantzios M, Wilson JC. Mindfulness, Eating Behaviours, and Obesity: A Review and Reflection on Current Findings. Curr Obes Rep. 2015 Mar;4(1):141-6. doi: 10.1007/s13679-014-0131-x. Review.
- O'Reilly GA, Cook L, Spruijt-Metz D, Black DS. Mindfulness-based interventions for obesity-related eating behaviours: a literature review. Obes Rev. 2014 Jun;15(6):453-61. doi: 10.1111/obr.12156. Epub 2014 Mar 18. Review.
- Rojiani R, Santoyo JF, Rahrig H, Roth HD, Britton WB. Women Benefit More Than Men in Response to College-based Meditation Training. Front Psychol. 2017 Apr 20;8:551. doi: 10.3389/fpsyg.2017.00551. eCollection 2017.
- Van Dam NT et al. Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation. Perspect Psychol Sci. 2017 Sep 1:1745691617709589. doi: 10.1177/1745691617709589. [Epub ahead of print]
- Van Dam NT et al. Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl. Perspect Psychol Sci. 2017 Sep 1:1745691617727529. doi: 10.1177/1745691617727529. [Epub ahead of print]