From the Beatles' bouts with Transcendental Meditation to brand names such as lululemon and YogaRat, mind-body relaxation methods have long been pop-culture staples. But ongoing studies aim to show that a calmer mind and a more acute awareness of one's surroundings can improve physical health, according to research based at Carnegie Mellon University.
Mindfulness-based stress reduction, a 12-week program developed in the 1970s by Jon Kabat-Zinn at the University of Massachusetts Medical School, uses techniques from Buddhism to train participants in skills they can apply to their everyday lives, to help them deal with stress, pain and illness. The skills involve finely tuned attention to thoughts and emotions and their bodies' reactions to physical sensations.
Loneliness and stress have been found to increase risk for medical conditions such as heart disease and Alzheimer's. Last year, in a published study of 40 healthy adults, mindfulness meditation in the MBSR model seemed to reduce loneliness and stress. In addition, it was linked to reducing inflammation throughout the body, which scientists say promotes the progression of diseases such as cancer and cardiovascular and neurodegenerative diseases.
The loneliness research is among several small studies conducted by Carnegie Mellon assistant professor of psychology J. David Creswell. One study from 2006-08 focused directly on the body's immune response to the human immunodeficiency virus. It indicated that mindfulness meditation could prevent the decline of the type of white blood cell that is specifically targeted and killed by HIV. Known as CD4 cells, they are counted in people infected with HIV to analyze the extent of the disease. They are a type of T-cell, cells that send signals to activate the body's immune response when they detect virus or bacteria infections.
"It was one of the first studies to show that mindfulness meditation could actually have a direct impact on a clinically relevant disease marker," Mr. Creswell said. "In this case it was delaying disease progression in the context of HIV infection."
Conducted in Los Angeles at the University of California and HIV/AIDS clinics around the city, Mr. Creswell recruited for his study through newspapers and community agencies that catered to the city's HIV/AIDS population. The 33 participants all had HIV, but not AIDS. Most were male, African-American, homosexual and low-income. All experienced moderate to high levels of stress in their daily lives, Mr. Creswell said.
In blood tests at the start, each participant had CD4 counts above 200. The HIV virus slowly deteriorates the infected individual's immune system, particularly CD4 cells. Once the CD4 count drops below 200, the infection advances from HIV to AIDS.
For the study, half of the participants were randomly assigned to an eight-week mindfulness meditation program or a similar program condensed to one day. Those assigned to the eight-week program attended weekly classes where they learned meditation practices and were also expected to practice these techniques at home. By contrast, those in the one-day program received the same training, but did not practice meditation regularly. Average age for the eight-week program was 40 and average age for the control group was 42.
Mr. Creswell said the study's results indicated more meditating brought more benefit, what he called a "dose-response effect."
During the eight weeks, two individuals in the control group, which received only one day of mindfulness training, progressed from HIV to AIDS. No one who underwent the eight-week program developed AIDS.
"The more classes you were attending or the more mindfulness meditation home practice you were doing, the better your CD4 T-cell counts were at post-test," Mr. Creswell said. "The more mindfulness practices you were doing, the better your immune outcome is going to be at post-test."
Previously, most mindfulness meditation studies had been conducted among more affluent, female individuals. Mr. Creswell said the results from his study show that mindfulness meditation can also be applied to more "hard-to-reach" populations who also have high amounts of stress.
More recently, a similar study was conducted from 2008-10 in Tehran, Iran, on 173 HIV-positive patients, who were mostly male. The study also found that CD4 counts in participants practicing mindfulness-based stress reduction remained stable over time. Those not practicing MBSR experienced declines in their CD4 count.
The Iranian study, Mr. Creswell said, shows mindfulness meditation has similar effects in a sample from a different population in another country.
Mr. Creswell's latest research is assessing how well people perform in stressful situations after undergoing mindfulness meditation training. In a laboratory, people who have received the training perform tasks such as giving a speech or doing mental math under pressure. The aim is to discern whether or not mindfulness can build resilience in stressful situations.
And yet, according to Carol Schramke, Ph.D., director of behavioral neurology at Allegheny General Hospital, such research is still in the beginning stage.
Ms. Schramke, a clinical psychologist who treats patients with neurological problems, frequently advises different relaxation strategies to patients, including mindfulness meditation. She says it is widely known people need to reduce stress and to relax, but most studies examining the health impacts of relaxation techniques are underpowered and underfunded.
"In a lot of these areas the research is in very preliminary stages, and there haven't been really well-controlled, well-designed studies yet," she said.
She cited the disease multiple sclerosis, which, in contrast to HIV, causes an overactive, rather than underactive, immune system. While there has been research examining the effects of stress in T cells among people with MS, the disease acts over decades, not days or weeks. Consequently, "these things are pretty expensive to study," she said.
But Hilary Tindle, associate professor of medicine at the University of Pittsburgh, believes there is sufficient evidence that mindfulness can improve chronic conditions such as pain, anxiety, depression or addiction. She added, however, that mindfulness is most helpful when used with existing therapies like prescription medications.
Dr. Tindle, who published a book on mindfulness called "Up: How Positive Outlook Can Transform Our Health and Aging" last month, said mindfulness research is spreading throughout the country. She said the majority of mindfulness studies were initially funded by the National Center for Complementary and Alternative Medicine. But the National Cancer Institute and the National Institute on Drug Abuse have since funded additional studies.
Although Dr. Tindle advises mindfulness to patients in her everyday practice, she says they're often resistant. Some people are confused by mindfulness. Others have never heard of it or assume it must be religious, Dr. Tindle said. She said the field can continue to grow by holding larger studies with more funding and more subjects.
"That's when people really start to stand up and notice it because they understand how it may be working," she said. "It ceases to be voodoo."
For phone-based training on mindfulness, go to www.basicmindfulness.org.
For guided mindfulness meditations online, visit marc.ucla.edu/body.cfm?id=22.
Jacob Axelrad: firstname.lastname@example.org or 412-263-1634. Follow on Twitter @jakeaxelrad. Sarah Wiley contributed reporting.