A Mindfulness-Based Approach to the Treatment of Obesity and Diabetes

描述（由申请人提供）：在美国，糖尿病患病率的上升与肥胖的上升是同步的，需要在糖尿病患者中使用新的方法来预防体重增加和促进体重减轻，以减少与肥胖相关的发病率和死亡率。肥胖和糖尿病在双向互动中包含多种身心关系，例如高血糖可能对情绪产生不利影响，而情绪低落可能导致不良的饮食习惯、缺乏运动和进一步的体重增加。增强正念自我意识的干预技术可以改善精神和身体健康，并可能改善糖尿病的自我管理和体重控制。因此，本研究的目的是评估以正念冥想为基础的干预与标准糖尿病教育干预对35-65岁超重/肥胖2型糖尿病患者1年的影响（n=70）。参与者将被随机分配到一个为期10周的以小组为基础的治疗方法，该治疗方法侧重于正念冥想、正念饮食、正念身体意识和饱腹感的练习，或者是一个标准的为期10周的以小组为基础的干预，该干预符合糖尿病患者护理的营养标准。干预措施对体重、血糖控制（HbA1c和空腹血糖）、胰岛素敏感性、饮食摄入、体力活动、抑郁、焦虑和自我效能感的影响将在干预后10周、随访1个月和3个月时进行测定和比较。正念冥想在调解结果变化中的作用将被探索。这项研究的发现将使教育工作者和临床医生能够确定潜在的肥胖决定因素和更有效的技术，以加强美国人口中日益增长的一部分的体重控制。公共卫生相关性：正念状态可能有利于改善糖尿病患者的体重和血糖控制，因为压力会导致高血糖和不良的饮食习惯。将以正念为基础的教育项目与标准营养教育项目的效果进行比较和评估。这项研究的发现将使教育工作者和临床医生能够在临床和社区环境中为成人糖尿病患者制定更有效的教育计划。

DESCRIPTION (provided by applicant): The rising prevalence of diabetes parallels the rise in obesity in the U.S. The prevention of weight gain and promotion of weight loss using novel approaches among people with diabetes is needed to reduce the morbidity and mortality associated with obesity. Obesity and diabetes encompass several body-mind relationships in bidirectional interactions such that hyperglycemia may adversely affect mood, and depressed mood may contribute to poor eating habits, physical inactivity, and further weight gain. Intervention techniques that enhance mindful self-awareness improve mental and physical well being and may improve diabetes self- management and weight control. Therefore, the purpose of this study is to evaluate the impact of a mindfulness meditation-based intervention compared to a standard diabetes education intervention among overweight/obese adults aged 35-65 years with type 2 diabetes for e 1 year (n=70). Participants will be randomly assigned to either a 10-week group-based mindful approach to treatment that focuses on mindful meditation, mindful eating, and mindful practice of body awareness and satiety cues or to a standard 10-week, group-based intervention that meets the nutritional standards of care for people with diabetes. The impact of the interventions on weight, glycemic control (HbA1c and fasting plasma glucose), insulin sensitivity, dietary intake, physical activity, depression, anxiety and self-efficacy will be determined and compared at 10-weeks post-intervention and at 1-month and 3-month follow-up. The role of mindful meditation in mediating changes in outcomes will be explored. The findings from this study will enable educators and clinicians to determine potentially modifiable determinants of obesity and more effective techniques for enhancing weight control in a growing segment of the U.S. population. PUBLIC HEALTH RELEVANCE: A state of mindfulness may be beneficial in improving weight and glycemic control in adults with diabetes, since stress can contribute to high blood glucose and poor eating habits. The effect of a mindfulness-based education program compared to a standard nutrition education program will be compared and evaluated. The findings from this study will enable educators and clinicians to develop more effective education programs for adults with diabetes in both clinical and community settings.