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Mindfulness is Associated with Better Medical Students School Performance

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Mindfulness is Associated with Better Medical Students School Performance

 

By John M. de Castro, Ph.D.

 

“in medical students . . . mindfulness meditation may be used to elicit positive emotions, minimize negative affect and rumination, and enable effective emotion regulation.” –  Michael Minichiello

 

Medical School is challenging both intellectually and psychologically. Stress levels are high, and burnout is common. It’s been estimated that 63% of medical students experience negative consequences from stress while symptoms of severe stress were present in 25% of students. High stress levels lead to lower performance in medical school and higher levels of physical and mental health problems, especially anxiety and depression. Indeed 50% of medical students report burnout and 11% have considered suicide in the last year.

 

Obviously, there is a need to either lower stress levels in medical education or find methods to assist medical students in dealing with the stress. One promising possibility is mindfulness training. It has been shown to reduce stress in students, to help with the negative consequences of stress and to reduce burnout in medical professionals. So, it would seem reasonable to suspect that mindfulness would be helpful in assisting medical students cope with the stress of their training.

 

In today’s Research News article “Mindfulness practice correlates with reduced exam-induced stress and improved exam performance in preclinical medical students with the “acting with awareness”, “non-judging” and “non-reacting” facets of mindfulness particularly associated with improved exam performance.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8864822/ ) Hearn and Stocker recruited undergraduate medical students at the end of their 2nd year of study and measured them 7 days before and immediately before their end-of-year examinations for salivary cortisol levels, perceived stress, mindfulness, and exam performance.

 

They found that just prior to the exams there were, not surprisingly, significant increases in perceived stress and salivary cortisol levels. The greater the increase in salivary cortisol levels the poorer the performance on the exams. In addition, the greater the students’ levels of mindfulness, including the acting with awareness, non-judging, and non-reactivity facet scores, the better the exam performance and the smaller the.increase in salivary cortisol.

 

These findings are correlative. So, causation cannot be determined. But these results suggest that mindfulness is associated with smaller physiological responses to stress and better grades.

 

Hence, the more mindful the students were the better their academic performance.

 

“We all have a need to know ourselves better and to understand our place in the world. That’s the fundamental motivation  for students to not only think of medical training as learning a set of facts and procedures but also paying attention to their evolving relationship to the work that they do. The meaning they derive from that work, and their connection to it.” – Ronald Epstein

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Hearn, J. H., & Stocker, C. J. (2022). Mindfulness practice correlates with reduced exam-induced stress and improved exam performance in preclinical medical students with the “acting with awareness”, “non-judging” and “non-reacting” facets of mindfulness particularly associated with improved exam performance. BMC psychology, 10(1), 41. https://doi.org/10.1186/s40359-022-00754-3

 

Abstract

Background

Medical students demonstrate higher levels of psychological distress compared with the general population and other student groups, especially at exam times. Mindfulness interventions show promise in stress reduction for this group, and in the reduction of cortisol, an established clinical marker of the body’s stress response. This study investigated the relationship of mindfulness to exam-induced stress, salivary cortisol and exam performance in undergraduate medical students.

Methods

A controlled pre-post analysis design with within-groups comparisons. 67 medical students completed the five facet mindfulness questionnaire (FFMQ) and provided saliva samples, from which cortisol was extracted, during group work (control/baseline) and immediately prior to end of year 2 examinations (experimental). Academic performance data was extracted for comparison with measures.

Results

Exam-induced salivary cortisol concentration showed a significant negative relation with exam performance. Total FFMQ score showed a significant positive relation with exam performance and a significant negative relation with exam-induced salivary cortisol. The specific mindfulness facets of acting with awareness, non-judging and non-reacting also showed a positive correlation with exam performance.

Conclusions

This study suggests that there exists an important relationship between mindfulness and the physiological biomarker of stress, cortisol, and this manifests into improved assessment outcomes potentially through healthier, more adaptive coping and stress management strategies. In particular, this study identifies the acting with awareness, non-judging and non-reacting facets of mindfulness to be significantly associated with exam performance suggesting that these may be important facets for clinical educators to target when helping students with mindfulness practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8864822/

 

Improve the Symptoms of Parkinson’s Disease with Long-Term Tai Chi Practice

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Improve the Symptoms of Parkinson’s Disease with Long-Term Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson’s disease, with additional benefits of improved functional capacity and reduced falls.” – Fuzhong Li

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide living with PD. Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. Balance is a particular problem as it effects mobility and increases the likelihood of falls, restricting activity and reducing quality of life.

 

There are no cures for Parkinson’s Disease (PD) or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, combinations of mindfulness and exercise such as Tai Chi and yoga practices have been shown to improve the symptoms of Parkinson’s Disease. The mechanisms of  how Tai Chi practice improves the symptoms of Parkinson’s disease are not known.

 

In today’s Research News article “Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson’s disease patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819852/ ) Li and colleagues recruited early-stage Parkinson’s Disease patients and randomly assigned them to 1 year of no treatment, brisk walking, or Tai Chi practice. They were measured at baseline, 6 months, and 1 year for Parkinson’s Disease symptoms, balance, timed up and go, and gait analysis. They also had blood drawn and analyzed for inflammatory cytokines and protein metabolites. In addition, they had their brains scanned with functional Magnetic Resonance Imaging (fMRI).

 

They found that in comparison with baseline, no treatment, and brisk walking, Tai Chi practice produced significant increases in balance and significant decreases in step width at both 6 and 12 months. In comparison to no treatment Tai Chi practice produced significant decreases in Parkinson’s Disease symptoms, timed up and go, and blood cytokine levels and a significant increase in amino acid metabolism. In addition, improvements in Parkinson’s Disease symptoms were associated with increased connectivity in the brain Default Mode Network, increased amino acid metabolism, and decreased blood cytokine levels.

 

The results suggest that Tai Chi practice over a prolonged period improves the symptoms of Parkinson’s Disease and is superior to brisk walking in doing so. The results also suggest that Tai Chi practice may produce these improvements by altering physiological processes including the brain, inflammatory system, and protein metabolism.

 

So, improve the symptoms of Parkinson’s Disease with long-term Tai Chi practice.

 

“The incorporation of Tai Chi in the daily life of Parkinson’s disease patients allowed them to stay functionally and physically active. Improvement of physical parameters indicated that Tai Chi had the potential to slow down the progression of Parkinson’s disease.” – Allison Rodriquez

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Li, G., Huang, P., Cui, S. S., Tan, Y. Y., He, Y. C., Shen, X., Jiang, Q. Y., Huang, P., He, G. Y., Li, B. Y., Li, Y. X., Xu, J., Wang, Z., & Chen, S. D. (2022). Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson’s disease patients. Translational neurodegeneration, 11(1), 6. https://doi.org/10.1186/s40035-022-00280-7

 

Abstract

Background

Tai Chi has been shown to improve motor symptoms in Parkinson’s disease (PD), but its long-term effects and the related mechanisms remain to be elucidated. In this study, we investigated the effects of long-term Tai Chi training on motor symptoms in PD and the underlying mechanisms.

Methods

Ninety-five early-stage PD patients were enrolled and randomly divided into Tai Chi (n = 32), brisk walking (n = 31) and no-exercise (n = 32) groups. At baseline, 6 months and 12 months during one-year intervention, all participants underwent motor symptom evaluation by Berg balance scale (BBS), Unified PD rating-scale (UPDRS), Timed Up and Go test (TUG) and 3D gait analysis, functional magnetic resonance imaging (fMRI), plasma cytokine and metabolomics analysis, and blood Huntingtin interaction protein 2 (HIP2) mRNA level analysis. Longitudinal self-changes were calculated using repeated measures ANOVA. GEE (generalized estimating equations) was used to assess factors associated with the longitudinal data of rating scales. Switch rates were used for fMRI analysis. False discovery rate correction was used for multiple correction.

Results

Participants in the Tai Chi group had better performance in BBS, UPDRS, TUG and step width. Besides, Tai Chi was advantageous over brisk walking in improving BBS and step width. The improved BBS was correlated with enhanced visual network function and downregulation of interleukin-1β. The improvements in UPDRS were associated with enhanced default mode network function, decreased L-malic acid and 3-phosphoglyceric acid, and increased adenosine and HIP2 mRNA levels. In addition, arginine biosynthesis, urea cycle, tricarboxylic acid cycle and beta oxidation of very-long-chain fatty acids were also improved by Tai Chi training.

Conclusions

Long-term Tai Chi training improves motor function, especially gait and balance, in PD. The underlying mechanisms may include enhanced brain network function, reduced inflammation, improved amino acid metabolism, energy metabolism and neurotransmitter metabolism, and decreased vulnerability to dopaminergic degeneration.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819852/

 

Reduce Burnout in Caregivers for the Elderly with Meditation and Yoga

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Reduce Burnout in Caregivers for the Elderly with Meditation and Yoga

 

By John M. de Castro, Ph.D.

 

“Self-care is very important for preventing caregiver burnout and senior stress, and two of the most effective self-care habits you can start are meditation and yoga.” – Harry Cline

 

There is a tremendous demand for caregiving. It is estimated that over 65 million (29% of the adult population) in the US provides care to someone who is ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost exacting a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving.

 

In today’s Research News article “The effects of yoga and mindful meditation on elderly care worker’s burnout: a CONSORT-compliant randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753257/ ) Kukihara and colleagues recruited adult caregivers for the elderly and randomly assigned them to receive either no-treatment, or 6 weekly 60-minute programs of either yoga or mindful meditation. They were measured before and after treatment for burnout and provided saliva samples for assay for the stress marker α-amylase.

 

They found that in comparison to baseline and the no-treatment control group both the yoga and meditation groups had significant reductions in burnout, particularly emotional exhaustion, and the salivary stress marker α-amylase. There were no significant differences in the benefits of the yoga or the mindful meditation programs.

 

So, practice yoga or meditation to reduce burnout and stress in caregivers for the elderly.

 

“Caregiving for a senior is a wonderful thing to do, but it comes with its difficulties and stresses. Yoga and meditation are two practices that can help seniors and their caregivers lead happier and healthier lives.” – Beverly Nelson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Kukihara, H., Ando, M., & Yamawaki, N. (2022). The effects of yoga and mindful meditation on elderly care worker’s burnout: a CONSORT-compliant randomized controlled trial. Journal of rural medicine : JRM, 17(1), 14–20. https://doi.org/10.2185/jrm.2021-021

 

Abstract

Objectives: This study aims to investigate the effects of mindful meditation and yoga on reducing burnout and stress in care workers who assist elderly individuals. Knowing how to reduce burnout is important because that of care workers is associated with the quality of client care, worker productivity, and job turnover.

Patients and Methods: The participants included 44 care workers who worked for elderly care facilities in rural Fukuoka. They were randomly assigned to one of three intervention groups: control, yoga, or mindfulness. In the yoga intervention group, a certified yoga instructor taught a 60-minute yoga session each week for six weeks. In the mindfulness group, an experienced medical doctor instructed a mindful meditation program for the same length. Participants were asked to complete the Japanese Burnout Scale (JBS), and the research team collected the level of α-amylase in saliva using NIPRO: T-110-N pre- and post-interventions.

Results: MANOVA was performed with each intervention (control, yoga, mindfulness) as the independent variable on the three subscales of the JBS (emotional exhaustion, depersonalization, and personal achievement) and a biomarker of stress level (α-amylase). The results indicated a significant main effect of interventions, and a follow-up ANOVA showed a significant effect of interventions on emotional exhaustion and personal achievement.

Conclusion: The results indicate that practicing mindful meditation or yoga for 60 minutes once a week for six weeks can reduce care workers’ burnout. This study was notable because the biomarker of stress also improved. It is strongly recommended and encouraged that institutions caring for the elderly population provide mindful meditation or yoga intervention to reduce burnout, which benefits not only care workers but also their clients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753257/

 

Increase the Levels of the Anti-Stress Hormone Dehydroepiandrosterone with Mindfulness

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Increase the Levels of the Anti-Stress Hormone Dehydroepiandrosterone with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Best known by researchers as the “longevity molecule” and stress counter-puncher, DHEA is one of the most important hormones in the body. As we get older our DHEA levels decrease year after year, opening us up to disease and accelerated aging. . . Luckily, meditation provides a dramatic boost in DHEA hormone levels.” –  EOC Institute

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress. Stress is accompanied by release of stress-related hormones such as cortisol. But it is also associated with release of the steroid hormone dehydroepiandrosterone (DHEA) which tends to counteract the negative effects of cortisol. This would predict that, mindfulness training would result in an increase in DHEA in stressed individuals. But this prediction has not been assessed.

 

In today’s Research News article “Effect of Mindfulness-Based Stress Reduction on dehydroepiandrosterone-sulfate in adults with self-reported stress. A randomized trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604255/ ) Jørgensen and colleagues recruited adults with self-reported high levels of stress and randomly assigned them to a wait-list control condition, or to receive either weekly 90-minute sessions for 8 weeks of either Local Stress Reduction (LSR) or Mindfulness-Based Stress reduction (MBSR). LSR was based upon Acceptance and Commitment Therapy (ACT) and differed from MBSR in a number of ways but primarily on an emphasis on cognitive behavioral changes. The participants had blood drawn before and after the programs and assayed for dehydroepiandrosterone‐sulfate (DHEAS). They were also measured for resilience, and well-being.

 

They found that in comparison to baseline, the wait-list control group, and the group that received Local Stress Reduction (LSR), the group that received Mindfulness-Based Stress reduction (MBSR) had significantly higher levels of dehydroepiandrosterone‐sulfate (DHEAS), resilience and well-being. A strength of this study was then inclusion of an active control condition, LSR. This eliminates a large number of alternative confounding interpretations of the results and makes the conclusions much stronger of MBSR causing the effects.

 

DHEAS is a hormone that tends to counteract the deleterious effects of stress hormones. Hence, MBSR improved both the psychological and physiological well-being of the high stress participants. High levels of stress are a major source of ill health. So, counteracting the effects of stress may be an important contributor to the health and well-being of the individual. This is particularly important for individual experiencing high levels of perceived stress as in the present study..

 

So, increase the levels of the anti-stress hormone dehydroepiandrosterone with mindfulness.

 

“DHEA is one of the most important hormones in the body. It helps counteract the effects of cortisol as well as provide the raw materials for making other necessary hormones. Low DHEA is linked to increased risk of mortality. Individuals who practice meditation have 43 percent more DHEA than their peers.” –  Renew Youth

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Jørgensen, M. A., Pallesen, K. J., Fjorback, L. O., & Juul, L. (2021). Effect of Mindfulness-Based Stress Reduction on dehydroepiandrosterone-sulfate in adults with self-reported stress. A randomized trial. Clinical and translational science, 14(6), 2360–2369. https://doi.org/10.1111/cts.13100

 

Abstract

Long‐term stress can lead to long‐term increased cortisol plasma levels, which increases the risk of numerous diseases. Dehydroepiandrosterone (DHEA) and its sulfated form dehydroepiandrosterone‐sulfate (DHEAS), together DHEA(S), have shown to counteract some of the effects of cortisol and may be protective during stress. The program “Mindfulness‐Based Stress Reduction” (MBSR) has shown to have positive effects on stress. The present study examined a possible effect of MBSR on DHEAS in plasma compared to a waiting list and a locally developed stress reduction program (LSR) in people with self‐reported stress. The study was a three‐armed randomized controlled trial conducted in a municipal health care center in Denmark. It included 71 participants with self‐reported stress randomized to either MBSR (n = 24) or LSR (n = 23), or a waiting list (n = 24). Blood samples were collected at baseline and at 12 weeks follow‐up to estimate effects of MBSR on DHEAS. The effect of MBSR on DHEAS was statistically significant compared to both the waiting list and LSR. We found a mean effect of 0.70 µmol/L (95% confidence interval [CI] = 0.18–1.22) higher DHEAS in the MBSR group compared with the waiting list group and a mean effect of 0.54 µmol/L (95% CI = 0.04–1.05) higher DHEAS in the MBSR group compared with the LSR group. Findings indicate an effect on DHEAS of the MBSR program compared to a waiting list and LSR program in people with self‐reported stress. However, we consider our findings hypothesis‐generating and validation by future studies is essential.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604255/

Improve Adolescent Psychological Well-Being with Tai Chi or Qigong

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Improve Adolescent Psychological Well-Being with Tai Chi or Qigong

 

By John M. de Castro, Ph.D.

 

“Qigong was able to improve attention in adolescents after 4 weeks of practice, leading us to conclude that it may be a useful tool when integrated into physical education classes.” – Leonel Duarte

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. This can lead to emotional and behavioral problems.

 

Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training in adults has been shown to reduce anxiety and depression levels and improve resilience and emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health.

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park. There has been accumulating research on the effects of Tai Chi and Qigong training on the psychological well-being of adolescents. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “The Effects of Tai Chi and Qigong Exercise on Psychological Status in Adolescents: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.746975/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1784429_a0P58000000G0YfEAK_Psycho_20211202_arts_A  ) Liu and colleagues review, summarize, and perform a meta-analysis of the published controlled research studies effects of Tai Chi and Qigong training on the psychological well-being of adolescents (aged 12 to 18 years).

 

They identified 10 published research studies with a total of 1244 participants. They report that the published research studies found that Tai Chi or Qigong practice produced significant reductions in anxiety, depression, and blood cortisol levels (stress marker) and significant improvements in self-concept and general mental health. Adolescence is a turbulent and stressful time. The published research suggests that practicing Tai Chi or Qigong helps reduce the mental turbulence and may help the youths navigate adolescence and in their transition to adulthood.

 

So, improve adolescent psychological well-being with Tai Chi or Qigong.

 

“Teens . . . who had taken the Tai Chi Chuan classes showed markedly less stress and psychological distress and enjoyed a much better self-image.” – Jeff Paterson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Liu X, Li R, Cui J, Liu F, Smith L, Chen X and Zhang D (2021) The Effects of Tai Chi and Qigong Exercise on Psychological Status in Adolescents: A Systematic Review and Meta-Analysis. Front. Psychol. 12:746975. doi: 10.3389/fpsyg.2021.746975

 

Background: The purpose of this study was to systematically review the effectiveness of Tai Chi and Qigong exercise on adolescents’ symptoms of depression and anxiety, and psychological status based on clinical evidences, and to calculate the pooled results using meta-analysis.

Methods: A systematic search using seven English and three Chinese databases was initiated to identify randomized controlled trials (RCT) and non-randomized comparison studies (NRS) assessing the effect of Tai Chi and Qigong exercise on psychological status among adolescents. Standardized mean differences (SMD) and their 95% confidence intervals (CI) were used to determine the pooled effect of the intervention. Study quality was evaluated using a Checklist to Evaluate a Report of a Non-pharmacological Trial (CLEAR-NPT) designed for non-pharmacological trials.

Results: Four RCTs and six NRS were identified, including 1,244 adolescents. The results suggested a potential beneficial effect of Tai chi and Qigong exercise on reducing anxiety (SMD = 0.386, 95 CI% [0.233, 0.538]) and depression (SMD = 1.937 [95 CI%, 1.392–2.546]) symptoms, and reducing cortisol level (SMD = 0.621 [95 CI%, 0.18–1.062]) in adolescents. Conversely, non-significant effects were found for stress, mood, and self-esteem.

Conclusions: The findings of this review suggest Qigong appears to be an effective therapeutic modality to improve psychological well-being in adolescents. Hope future studies will have rigorously designed, well-controlled randomized trials with large sample sizes in order to confirm these findings.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.746975/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1784429_a0P58000000G0YfEAK_Psycho_20211202_arts_A

 

Decrease the Development of Diabetes in At-risk Patients with Yoga

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Decrease the Development of Diabetes in At-risk Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga can do more than just relax your body in mind — especially if you’re living with diabetes. Certain poses may help lower blood pressure and blood sugar levels while also improving circulation, leading many experts to recommend yoga for diabetes management.” –  Emily Cronkleton 

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes, and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary lifestyle. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes. But it is not known if yoga practice can prevent people at risk for diabetes to actually become diabetic.

 

In today’s Research News article “Effectiveness of a Yoga-Based Lifestyle Protocol (YLP) in Preventing Diabetes in a High-Risk Indian Cohort: A Multicenter Cluster-Randomized Controlled Trial (NMB-Trial).” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231281/ ) Raghuram and colleagues recruited adults at risk for the development of Type 2 diabetes based upon HbA1c levels and randomly assigned them to receive yoga lifestyle training or to a treatment as usual control condition. Lifestyle training occurred in 9 sessions followed by 3 months of daily practice and included postures, breathing exercises, meditation, and relaxation. They were measured before and after training for HbA1c levels, body size, blood pressure, and physical activity.

 

They found that at the end of the yoga lifestyle intervention that significantly fewer of the yoga group transitioned into diabetes (11%) compared to the control condition (32%). In addition, significantly greater number of yoga lifestyle patients transitioned from prediabetes to normoglycemia than the controls. Hence the yoga intervention was successful in making it less likely that patients at risk for diabetes transition to full-fledged diabetes.

 

The weakness in the study was that the control condition did not receive any treatment. This leaves open some confounding interpretations of the results including placebo effects, attentional effects, experimenter bias etc. Future research should use an active control condition such as another exercise or game playing. But previous controlled research has demonstrated that yoga practice improves blood glucose levels and improve the health of patients with diabetes. So, it is likely that yoga and not some confounding factor was responsible for the improvements in the prediabetic patients.

 

So, decrease the development of diabetes in at-risk patients with yoga.

 

“Yoga is considered to be a promising, cost-effective option in the treatment and prevention of diabetes, with data from several studies suggesting that yoga and other mind-body therapies can reduce stress-related hyperglycemia and have a positive effect on blood glucose control.” – Diabetes UK

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Raghuram, N., Ram, V., Majumdar, V., Sk, R., Singh, A., Patil, S., Anand, A., Judu, I., Bhaskara, S., Basa, J. R., & Nagendra, H. R. (2021). Effectiveness of a Yoga-Based Lifestyle Protocol (YLP) in Preventing Diabetes in a High-Risk Indian Cohort: A Multicenter Cluster-Randomized Controlled Trial (NMB-Trial). Frontiers in endocrinology, 12, 664657. https://doi.org/10.3389/fendo.2021.664657

 

Abstract

Introduction

Though several lines of evidence support the utility of yoga-based interventions in diabetes prevention, most of these studies have been limited by methodological issues, primarily sample size inadequacy. Hence, we tested the effectiveness of yoga-based lifestyle intervention against diabetes risk reduction in multicentre, large community settings of India, through a single-blind cluster-randomized controlled trial, Niyantrita Madhumeha Bharat Abhiyan (NMB).

Research Design and Methods

NMB-trial is a multicentre cluster-randomized trial conducted in 80 clusters [composed of rural units (villages) and urban units (Census Enumeration Blocks)] randomly assigned in a 1:1 ratio to intervention and control groups. Participants were individuals (age, 20–70 years) with prediabetes (blood HbA1c values in the range of 5.7–6.4%) and IDRS ≥ 60. The intervention included the practice of yoga-based lifestyle modification protocol (YLP) for 9 consecutive days, followed by daily home and weekly supervised practices for 3 months. The control cluster received standard of care advice for diabetes prevention. Statistical analyses were performed on an intention-to-treat basis, using available and imputed datasets. The primary outcome was the conversion from prediabetes to diabetes after the YLP intervention of 3 months (diagnosed based upon HbA1c cutoff >6.5%). Secondary outcome included regression to normoglycemia with HbA1c <5.7%.

Results

A total of 3380 (75.96%) participants were followed up at 3 months. At 3 months post-intervention, overall, diabetes developed in 726 (21.44%) participants. YLP was found to be significantly effective in halting progression to diabetes as compared to standard of care; adjusted RRR was 63.81(95% CI = 56.55–69.85). The YLP also accelerated regression to normoglycemia [adjusted Odds Ratio (adjOR) = 1.20 (95% CI, 1.02–1.43)]. Importantly, younger participants (≤40 years) were found to regress to normoglycemia more effectively than the older participants Pinteraction<0.001.

Conclusion

Based on the significant risk reduction derived from the large sample size, and the carefully designed randomized yoga-based intervention on high-risk populations, the study is a preliminary but strong proof-of-concept for yoga as a potential lifestyle-based treatment to curb the epidemic of diabetes. The observed findings also indicate a potential of YLP for diabetes prevention in low/moderate risk profile individuals that needs large-scale validation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231281/

 

Reduce Oxidative Stress with Tai Chi

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Reduce Oxidative Stress with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Oxidative stress is an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage. Oxidative stress occurs naturally and plays a role in the aging process.” – Jamie Eske

 

Free radicals are oxidants that need to be balanced with antioxidants. If there is an imbalance in the cells and the blood it produces a condition known as oxidative stress that has been associated with neurodegenerative diseases, gene mutations and cancers, chronic fatigue syndrome, fragile X syndrome, heart and blood vessel disorders, atherosclerosis, heart failure, heart attack and inflammatory diseases. So, there is a need for treatments to reduce oxidative stress. Yoga practice is an exercise and a mindfulness practice that produces a significant increase in blood antioxidants, reducing oxidative stress. Mindful movement practices such as Tai Chi and Qigong are also exercises and mindfulness practices. It is interesting to investigate whether these practices are also effective in reducing oxidative stress.

 

In today’s Research News article “Effect of Tai Chi on Markers of Oxidative Stress: Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037964/ ) Rosado-Pérez and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effects of Tai Chi practice on oxidative stress.

 

They identified 10 published research studies 5 of which were randomized controlled trials. They contained a total of 621 participants. Oxidative stress involves a number of markers in the blood. They report that the published studies found that Tai Chi practice resulted in a significant increase in antioxidant enzymes superoxide dismutase and catalase, and a significant decrease in the levels of lipoperoxides. So, Tai Chi practice reduced oxidative stress.

 

Tai Chi practice is both a mindfulness training and an exercise. The published studies did not compare Tai Chi to other exercises. So, it cannot be determined if the observed reduction in oxidative stress markers produced by Tai Chi practice was due to which component or both. Regardless, it is clear that Tai Chi practice reduces oxidative stress. This may be one of the underlying mechanisms by which Tai Chi improves the health and well-being of practitioners.

 

So, reduce oxidative stress with Tai Chi.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“One year of Tai Chi training has been reported to promote superoxide dismutase activity and lessen lipid peroxidation.” – Chitrawina Mahagita

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Rosado-Pérez, J., Castelán-Martínez, O. D., Mújica-Calderón, A. J., Sánchez-Rodríguez, M. A., & Mendoza-Núñez, V. M. (2021). Effect of Tai Chi on Markers of Oxidative Stress: Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(7), 3458. https://doi.org/10.3390/ijerph18073458

 

Abstract

Background: This study aimed to synthesize the evidence of the effect of practicing Tai Chi on oxidative stress markers (OxSM). Methods: This systematic review and meta-analysis was conducting using the MEDLINE, Cochrane Library, ScienceDirect, Scopus, Epistemonikos, Lilacs, and Ovid databases to identify randomized (RCT) and non-randomized (NRCT) clinical trials that evaluated the Tai Chi effect on OxSM compared to sedentary behavior, walking or yoga. Pooled mean differences (MDs) with 95% confidence intervals (95%CI) were estimated using the inverse variance method to determine the effect of Tai Chi on OxSM. PROSPERO register: CRD42019138362. Results: Five RCT and five NRCT were included. Compared to sedentary behavior, regular Tai Chi practice increases the levels of the enzymes superoxide dismutase (MD = 34.97 U/mL, (95%CI, 9.45 to 60.48), 344 participants) and catalase (MD = 15.63 U/mL, (95%CI, 4.05 to 27.22), 110 participants), as well as reducing the levels of lipoperoxides (MD = −0.02 µmol/L, (95%CI, −0.04 to −0.00), 234 participants). For comparisons with walking or yoga, only one study per activity was identified comparing the effect on OxSM. Conclusions: Regular Tai Chi practice increases the levels of superoxide dismutase and catalase, as well as reducing the levels of lipoperoxides. More studies are necessary to determine the effect of Tai Chi on OxSM when compared to other physical activities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037964/

 

Improve the Mental, Physical, and Emotional Well-Being of Older Adults During Covid-19 Pandemic with Tai Chi

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Improve the Mental, Physical, and Emotional Well-Being of Older Adults During Covid-19 Pandemic with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi Chuan has a potential effect on the prevention, treatment and rehabilitation of COVID-19. Its potential mechanisms include reducing anxiety, relieving depression and stress, enhancing pulmonary and cardiovascular function, enhancing immunity and improving quality of life.” – Chen Xianjian

 

The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress on everyone but particularly the elderly isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress. So, mindfulness training may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic. Tai Chi and Qigong are both mindfulness practices and gentle exercises. They have been shown to be beneficial for the health and well-being of individuals of a variety of ages, but particularly the elderly. So, it would seem reasonable to examine the ability of Tai Chi practice to improve the well-being of older adults during the Covid-19 pandemic.

 

In today’s Research News article “Tai chi improves psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054611/ ) Solianik and colleagues recruited healthy sedentary older adults (over 60 years of age) during the Covid-19 pandemic and randomly assigned them to 10 weeks of twice a week for 60 minute Tai Chi practice or to a no treatment control condition. They were measured before and after training for heart rate, perceived stress, anxiety, depression cognitive performance, and motor performance. In addition, blood was drawn and assayed for brain-derived neurotrophic factor.

 

They found that in comparison to baseline and the control group, the older adults who practiced Tai Chi had significantly higher levels of brain-derived neurotrophic factor, high frequency power in the heart rate, visuospatial performance, response inhibition, and shifting mental set, and significantly lower reaction times, heart rate, perceived stress, and depression.

 

The results must be interpreted with the understanding that the control condition was no treatment in a sedentary group of older adults. So, it cannot be determined if the effects were due to Tai Chi itself or exercise in general. Nevertheless, Tai Chi practice resulted in significant improvements in cardiovascular fitness, brain development, cognitive performance, and psychological health.

 

Tai Chi practice is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate the elderly. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This suggests that during stressful times Tai Chi should be recommended for older adults for their mental, physical, and emotional well-being.

 

So, improve the mental, physical, and emotional well-being of older adults during Covid-19 pandemic with Tai Chi.

 

“Older people should exercise for the entire duration of self-isolation. One large systematic review of falls prevention exercises emphasised the importance of maintaining exercise over time – benefits from Tai Chi were found after 20 weeks.” –  Jamie Hartmann-Boyce

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Solianik, R., Mickevičienė, D., Žlibinaitė, L., & Čekanauskaitė, A. (2021). Tai chi improves psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Experimental gerontology, 150, 111363. https://doi.org/10.1016/j.exger.2021.111363

 

Abstract

The aim of this study was to determine the effect of a 10-week tai chi intervention on psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Participants aged 60–78 years were randomized to either a control group (n = 15) or a tai chi group (n = 15) for a 10-week period. The tai chi group received two, 8-form tai chi classes of 60 min duration per week. Changes in psychoemotional state, cognition, and the learning of fast and accurate reaching movements were assessed. In addition, the potential roles of the autonomic nervous system and brain-derived neurotrophic factor (BDNF) were investigated. Tai chi practice decreased (P < 0.05) perceived stress, whereas no change in autonomic nervous system activity was observed. Improvements in mental switching correlated with decreased depressive symptoms and increased BDNF levels (P < 0.05), whereas improvements in inhibitory control tended to correlate with BDNF levels (P = 0.08). Improvements in visuospatial processing tended to correlate with decreased depressive symptoms (P = 0.07) while improved visuospatial processing correlated with improved motor planning during learning tasks (P < 0.05). This study suggests that tai chi is an effective intervention that can be delivered under pandemic conditions to improve mental and physical function in older adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054611/

 

Hot Yoga is Superior in Improving Cardiovascular Health

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Hot Yoga is Superior in Improving Cardiovascular Health

 

By John M. de Castro, Ph.D.

 

“It might be hard, but hot yoga can help improve strength, flexibility and balance, while helping decrease your risk of conditions such as diabetes and heart disease.” – Lydia Stephens

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. But the safest effective treatments are lifestyle changes. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Other safe and effective treatments are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of lifestyle changes needed such as smoking cessation, weight reduction, and stress reduction.

 

Yoga is a mindfulness practice and exercise that has been shown to improve physical well-being and cardiovascular health. Hot Yoga is somewhat unique yoga practice as it is practiced in a heated environment (105°F, 40.6°C, 40% humidity). The hot environment is thought to soften the muscles making them more pliable and loosen the joints making them more flexible allowing the practitioner to go deeper into poses. The sweating that occurs is thought to help remove toxins and impurities. It is not known if hot yoga is better in improving cardiovascular health than regular yoga.

 

In today’s Research News article “Cardiovascular, Cellular, and Neural Adaptations to Hot Yoga versus Normal-Temperature Yoga.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191229/ ) Bourbeau and colleagues recruited adults and randomly assigned them to either practice normal yoga or hot yoga for 75 minutes 3 times per week for 4 weeks. Both normal and hot yoga sessions followed an identical taped standardized yoga program. The participants were measured before and after training for body size, maximal aerobic capacity (VO2Max), heat tolerance, and perceived stress. In addition, blood was drawn and assayed for adrenocorticotropic hormone, brain-derived neurotrophic factor, and heat shock protein 70.

 

They found that in comparison to baseline the hot yoga group had significant increases in maximal aerobic capacity (VO2Max) and heat shock protein 70, while the normal yoga group did not. Both yoga groups had significant increases in brain-derived neurotrophic factor. Neither yoga practices significantly altered plasma adrenocorticotropic hormone, perceived stress, or heat tolerance.

 

These results suggest that practicing yoga in a hot environment increases its ability to improve cardiovascular fitness (VO2Max) and cellular heat tolerance (Heat shock protein 70). Yoga in either form increase brain development (Brain-derived neurotrophic factor). This suggests for adult patients at risk for or having cardiovascular problems who can also tolerate high temperatures that hot yoga may be an effective treatment to improve cardiovascular function. The results also show as has been shown in multiple previous studies that yoga practice improve the physical well-being of the participants.

 

So, hot yoga is superior in improving cardiovascular health.

 

“hot yoga promises a number of compelling health benefits, alleging to cure everything from back pain to high blood pressure to anxiety.” – Anna Dickens

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Bourbeau, K. C., Moriarty, T. A., Bellovary, B. N., Bellissimo, G. F., Ducharme, J. B., Haeny, T. J., & Zuhl, M. N. (2021). Cardiovascular, Cellular, and Neural Adaptations to Hot Yoga versus Normal-Temperature Yoga. International Journal of Yoga, 14(2), 115–126. https://doi.org/10.4103/ijoy.IJOY_134_20

 

Abstract

Context:

Chronic heat exposure promotes cardiovascular and cellular adaptations, improving an organism’s ability to tolerate subsequent stressors. Heat exposure may also promote neural adaptations and alter the neural–hormonal stress response. Hot-temperature yoga (HY) combines mind–body exercise with heat exposure. The added heat component in HY may induce cardiovascular and cellular changes, along with neural benefits and modulation of stress hormones.

Aims:

The purpose of the present study is to compare the cardiovascular, cellular heat shock protein 70 (HSP70), neural, and hormonal adaptations of HY versus normal-temperature yoga (NY).

Settings and Design:

Twenty-two subjects (males = 11 and females = 11, 26 ± 6 years) completed 4 weeks of NY (n = 11) or HY (n = 11, 41°C, 40% humidity). Yoga sessions were performed 3 times/week following a modified Bikram protocol.

Subjects and Methods:

Pre- and posttesting included (1) hemodynamic measures during a heat tolerance test and maximal aerobic fitness test; (2) neural and hormonal adaptations using serum brain-derived neurotrophic factor (BDNF) and adrenocorticotropic hormone (ACTH), along with a mental stress questionnaire; and (3) cellular adaptations (HSP70) in peripheral blood mononuclear cells (PBMCs).

Statistical Analysis:

Within- and between-group Student’s t-test analyses were conducted to compare pre- and post-VO2 max, perceived stress, BDNF, HSP70, and ACTH in HY and NY groups.

Results:

Maximal aerobic fitness increased in the HY group only. No evidence of heat acclimation or change in mental stress was observed. Serum BDNF significantly increased in yoga groups combined. Analysis of HSP70 suggested higher expression of HSP70 in the HY group only.

Conclusions:

Twelve sessions of HY promoted cardiovascular fitness and cellular thermotolerance adaptations. Serum BDNF increased in response to yoga (NY + HY) and appeared to not be temperature dependent.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191229/

 

Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

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Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Diabetes, like many other chronic diseases, can also affect the mind. Similarly the mind has great power to influence the body.” – Diabetes UK

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Mindful movement practices such as Tai Chi and Qigong  and yoga are mindfulness practices that are also gentle exercises. There is accumulating research on the effectiveness of these mind-body practices for the treatment of Type 2 Diabetes. So, it makes sense to examine what has been learned.

 

In today’s Research News article “Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/ ) Yang and colleagues review and summarize the published research studies of the effects of mind-body practices on the symptoms of Type 2 Diabetes including epigenetic markers.

 

They report that moving meditation practices such as Tai Chi and Qigong  and yoga have been shown to significantly improve blood glucose, HbA1c, postprandial blood glucose, total cholesterol, and both low-density and high-density lipoprotein cholesterol. Mindfulness meditation has been shown to significantly improve HbA1c, diabetes-related distress, depression, and stress. In addition, mind-body interventions produce epigenetic changes reflected in DNA methylation modification. More study is needed but these epigenetic changes may underlie the improvements in Type 2 Diabetes produced by mind-body interventions.

 

Mind-body interventions have been repeatedly demonstrated to significantly reduce depression, anxiety and stress. These psychological states tend to aggravate Type 2 Diabetes. Since mind-mind-body practices reduce depression, anxiety and stress, they produce improvements in the symptoms of diabetes. In addition, mind-body practices produce physiological changes that can improve the symptoms of Type 2 Diabetes. These include activation of the parasympathetic (relaxation) nervous system, lower stress hormone (cortisol) secretion, reduced inflammation, and even reduced age based physiological changes.

 

These are remarkable findings that suggest that mind-body practices are effective in producing psychological and physiological changes that are very beneficial for the relief of the symptoms of Type 2 Diabetes. These benefits are reflected in changes on the epigenetic level that might ultimately be responsible for the benefits. Clearly, mind-body practices should be incorporated into Type 2 Diabetes treatment programs.

 

So, improve psychological, physiological, and epigenetic markers of type 2 diabetes with mind-body practices.

 

“meditation strategies can be useful adjunctive techniques to lifestyle modification and pharmacological management of diabetes and help improve patient wellbeing.” Gagan Priya

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Yang, H. J., Koh, E., Sung, M. K., & Kang, H. (2021). Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. International journal of molecular sciences, 22(3), 1317. https://doi.org/10.3390/ijms22031317

 

Abstract

Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind–body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/