Derek Watson, Herald Scotland: When I was a wee girl my daddy used to cajole me and my brother and sisters into finishing our meals by playing a game in which we were to imagine each forkful going to a different part of our bodies. Beef and potato, for instance, would be mashed up and formed into a pie shape, which we took great delight in dividing into wedges. On dad’s instruction we’d scoop up each piece and as we swallowed we’d imagine it going to, say, our left knee or our right pinky toe or a bicep or an eye. We imagine …
So I have survived one month of mentorship through my own programme of ‘Eight Step Recovery.’ I’ve relapsed twice, and am back on track with three days of abstinence. I tried harm reduction and it didn’t work for me. Told myself I will eat a handful of raw cashews a day. I even left them out on the kitchen counter so my hosts could share them with me too. But once they were finished, I went out bought a 500 gram packet and proceeded to eat them for my lunch, during a period of three hours. Now you may think: ‘Get over it, you don’t have an addiction. It’s not a matter of life and death. You’re hardly going to wreck the family, or cause any great harm’.
While I do have a mild allergy to nuts, I can’t claim that if I carried on eating them that they would kill me, but I do know that consuming them stunts my emotional growth. Why? Because the nuts have replaced the cigarette I once used to put in my mouth, it has replaced the gum I used to chew obsessively, the food I used to binge on and purge, the substances I used to consume.
Although I’m not in the throes of a life threatening addiction and admittedly avoiding my direct experience has lessened, I still at times turn away from my direct experience enough to disturb my peace of mind. Every time I turn away or avoid, I am resisting and triggering the urges to pick up. These urges manifest into the mental proliferation and mental obsessing, multiplying my initial experience of discomfort several fold. ‘Now I must eat those cashews because it has become too overwhelming.’
I took the opportunity to reflect on my attachment to raw cashew nuts and I wrote this to my sponsor.
‘I’m on the bus licking my wounds and thought I could email you from my phone. As I walked today I realized I do not want to let go of cashews and that is my problem. I know I need to and that I should do as it is a neurotic behaviour that usurps my equilibrium. After that thought, I found myself buying cashews and ate them all over the next two hours not a huge amount but now I feel sick and wish I could turn the clocks back but I can’t. I can see I was turning away from the discomfort of knowing I don’t want to stop. So the question is how do I move from not wanting to let go or knowing I need to let go, to wanting to let go?’ I know eating them in small doses does not work as I end up bingeing as I did today’.
“What I recommend for you is to meditate and reflect on what you are believing about this behavior that is not true. Usually we are believing an untruth. And usually its a variation on ‘it will be okay this time’ (in spite of what has always happened in the past) or ‘even if it’s not okay, it will be worth it’. These are the lies that we most often keep on deluding ourselves with. Another common one is that: ‘I just can’t do this and I might as well give up’. It may be as simple as ‘it will make me feel better’, which of course is not true, because it never does. So there’s your challenge, to bring awareness to your unspoken beliefs, and then to investigate them for current validity. Uncover the lie that you’re believing.
Most of these bad habits did actually have a valid coping function at one point in our lives, before they became debilitating addictions. They did help us cope. But now we have to uncover the dynamics, and ask ourselves ‘what did this do for me in the past?’, ‘what is it doing for me now?’, and ‘what is it doing TO me now?’. But mindfulness of the inner dynamics is a prerequisite. Then we can face our issues instead of having them ambush from behind.”
Great advice for somebody who has co-created Mindfulness Based Addiction Recovery MBAR course. While delivering the training the trainer MBAR course this weekend, I could not help realize, that I had few thoughts about eating cashews over the three days.
I realized that I have needed the dharma, the mindfulness teachings, rather than actually wanting them. It’s a subtle and gross difference. Nothing wrong in needing the teachings, but what does one do once they have been rescued by the teachings? Often go back to their ways.
If I want the dharma enough, I will wholeheartedly place positive values at the centre of my life moment by moment. I did this while delivering the training. I needed to, to deliver the course, but now the course is over, can I want the dharma enough to go for refuge to the Buddha, Dharma, Sangha, effectively and absolutely. This is step six. More about this step next month.
For a free sample of the book study and 21 meditations of Eight Step Recovery – Using The Buddha’s Teachings To Overcome Addiction please email: firstname.lastname@example.org
I decided it was about time I make some more effort at walking my talk. So what better opportunity do I have but to work through the 8 steps that I co-founded to take me out of my misery? Although many of the teachings I speak about in the book, were inspirations for me to change my life. I’ve not surrendered to a mentor/sponsor to take me systematically through the set of 8 steps.
While writing the notes on 8 step meetings, which I should say I attended daily while working in India for the month of January, and also writing on how to mentor someone in the program, I thought wouldn’t it be great for somebody to mentor me. So I wrote to my sponsor a long time 12 stepper in several programs and asked: ‘Will you sponsor me?’
He emailed me back: ‘Hahaha, interesting, you know. The idea of taking the woman who wrote the book through them is just kind of topsy-turvy. Anyway, sure I’d be glad to do that. It would be good for me too. I’ve been looking forward to an opportunity to do something like this with someone, to explore the steps myself with someone, and you’re the first person to turn up. And naturally I’m confident that you won’t give up or do it on a shallow level.’
Well it’s kinda topsy turvy for me too. Surrendering to my own work. But I realize more and more as I mentor people through this program, and read the emails sent to me, that I need to keep on walking my talk. Those of you who are familiar with food addiction will know, that it is non stop work, and if we are not mindful grey areas do arise.
So I thought I would work on my relationship to cashew nuts, You may laugh, everybody else does, or they tell me: ‘It’s healthy, you’re a vegan—eat away’. But I can’t kid myself, I know that I have a neurotic relationship with them. I know that, because if you told me today I could never eat cashews again, I would cry (metaphorically), and find it incredibly challenging. It’s not so much the behaviour it is the volition behind the behaviour. Still holding to a past that can drive a behaviour.
My trip to India put me in my uncomfortable zone, I was powerless over the foods I could eat. I had no choice but forced into renunciation of my green smoothies, my marmite and tahini, my rice cakes, for a diet of rice and oily vegetable curries three times a day. While I loved the food, I knew I could not keep such a diet. I was shocked to realize that I had a huge fear of becoming bigger. This fear was behind my neurotic eating of cashews, the only food I could cling onto, while away from my familiar environment.
While working with people who are struggling in their addictions, I often say: ‘You have to be abstinent’. I’ve forgotten how painful it is to let go and be abstinent, as there are so many things I have chosen to live without in my life. And I also remember that harm reduction can be a way to go, if abstinence is the place we truly want to land upon, and even that at times may not be perfect.
So I wanted to investigate, why is it so hard to let go of a habit, a behaviour that causes us stress, unsatisfactoriness and can never be permanent in our lives?
So I’m in the hot house. Join me in doing one meditation a day from the 21 meditations for recovery. Check in daily. Email for a copy of the 8 step book study, mentoring and meetings.
For a free sample of the book study and 21 meditations of Eight Step Recovery – Using The Buddha’s Teachings To Overcome Addiction please email: email@example.com
We know that before Shakyamuni became a Buddha (waking up to the truth of reality) that he tried extreme self-discipline that included abstaining from all forms of indulgence, which was called the practice of asceticism. His self-mortification included eating just one grain of rice a day, and sometimes walking around with one arm in the air for weeks. In his search for an end to suffering, Gautama became like an addict to asceticism. Like today’s addicts, he had learned how to master pain, or so he thought. He grew as thin as a skeleton, and did not budge from his addiction. Still he did not find an end to suffering. Until one day he realized he was getting nowhere.
It is believed that when he became a Buddha his first teaching to his disciples referred to addiction. He says:
“There is addiction to indulgence of sense-pleasures, which is low, coarse, the way of ordinary people, unworthy, and unprofitable; and there is addiction to self-mortification, which is painful, unworthy, and unprofitable. Avoiding both these extremes, the Tathagata (The Perfect One) has realized the Middle Path; it gives vision, gives knowledge, and leads to calm, to insight, to enlightenment and to Nibbana.”
There are many stories about the Buddha encountering different people during his travels. There was a King Pasenadi from Kosala who consulted him on many aspects of life. One such story tell us that King Pasenadi who was addicted to eating. One day after eating a bucket full of rice and curries, he was fortunate to have an encounter with the Buddha. The Buddha advised that the King begin to reduce his intake, and recite this sutta
“When a man is always mindful,
Knowing moderation in the food he eats,
His ailments then diminish,
He ages slowly, guarding his life.”
But the king lamented ‘how’. And then he had an idea. I will pay for someone to help me.
It’s said he paid a young Brahmin to watch over him every time he had a meal. The Brahmin would snatch a fistful of food, and recite the sutta. The next day the King was only allowed to eat the amount he consumed the day before, and then the Brahmin would snatch another fistful. And the Brahmin continued to recite the sutta, reduce the King’s food intake until he ate only a pin pot amount and was relieved of his addiction. The Buddha’s method here was harm reduction, with the intention of skilfully leading the King to abstinence.
In the introduction of our book we talk about the Buddha being in recovery. We suggest the following questions for you to work through after reading the introduction.
- What does addiction mean to you?
- What does Recovery mean to you?
- Share your personal story of addiction from the perspective of what was it that got you clean and thinking about the spiritual path
- When you read the Buddha was in recovery what thoughts arise?
- What would it mean if you were to wake up from your present life?
- The Buddha taught the middle way – what would the middle way look like in your life?
- How can this book be for you?
Eight Step Recovery is out now: Eight Step Recovery – Order your book now
Or try a free sample – For a free sample chapter of Eight Step Recovery – Using The Buddha’s Teachings To Overcome Addiction please email: firstname.lastname@example.org
Title: No Ordinary Apple: A Story About Eating Mindfully
Author: Sara Marlowe, Philip Pascuzzo (illus.)
Publisher: Wisdom Publications
Available from: Wisdom Publications, Amazon.co.uk, and Amazon.com.
No Ordinary Apple is a variation on the famous “raisin exercise” that’s so popular in meditation classes. (If you’re not familiar with the raisin exercise it’s where we mindfully eat a single raisin, thoroughly exploring it with our senses.) But No Ordinary Apple is, of course, a children’s book — and a very welcome addition to the growing body of meditation resources for children.
The fruit is question is an apple rather than a raisin and the mindful eater of this apple is a young boy called Elliot, who is waiting at his adult neighbor Carmen’s house between school and his parents getting home.
Elliot is hungry and asks for a snack. Carmen counters with an offer of an apple: a suggestion that is none too popular with Elliot, who wants candy.
Carmen is a good saleswoman, though. Or perhaps she teaches meditation. At any rate, she persuades Elliot that this is no ordinary apple, but tells him that he’ll have to find out for himself why this is the case.
Carmen guides an excited Elliot through an exploration of the apple using all of his senses. He moves from having a stereotypical view of an apple as “red” to recognizing the many colors that it contains. He touches the apple and explores its textures. He smells it. He even listens to the “thwap” it makes as he tosses it from hand to hand. And of course he eventually bites into it, chews it, and swallows it — all the time exploring the apple mindfully.
Of course Elliot realizes that this is indeed no ordinary apple, but it has to be pointed out to him that it’s not the apple that’s special — it’s the attention that he gave to it that created a special experience. And Carmen helps him to see that anything he eats — even candy! and perhaps even food he doesn’t like — will be extra-special when eaten with mindfulness.
No Ordinary Apple is a lovely book. The illustrations are larger-thank life and they do in fact make the experience of eating an apple look special. The story is fun, and children will feel like they’re learning something rather than being preached at.
My daughter, who’s six, was very excited about the prospect of us doing this exercise together, and she even set aside some apples on top of the refrigerator, awaiting the perfect moment (the kids had to be in need of a snack, and we needed some uninterrupted time). When the right time arrived, both my kids (I also have a five-year-old son) enjoyed the exercise, although the youngest had some trouble restraining himself from eating the apple during the looking-feeling-smelling-listening stage, and once we were tasting our apples he couldn’t stop himself from swallowing it. But he had fun. My daughter, who’s almost two years older, really enjoyed the exercise and was old enough to restrain herself. Actually, when I’ve done the raisin exercise with adults there have been a few who’ve had no more discipline than my son!
The principles outlined in the story can very easily be translated into practice, both for encouraging children to eat mindfully, and for encouraging parents to do likewise! Trying to teach a child to eat mindfully is going to be more successful if the parents exemplify mindful eating.
Forbes recently released an article highlighting a Brooklyn-based start-up that is concerned with the psychology of well-being and a mindfulness approach to the culinary experience, an effort praised by chef and restaurateur Geoffrey Cambal. The article begins by discussing the project called Windowfarms, and how the start-up is interested in “making food choices that can help you flourish and thrive.”
The report defines culinary mindfulness as the eating, “cooking, shopping, sharing, remembering, and even talking about food. The purpose is to build awareness of increasing well-being in all the food choices one makes, to accrue mental wealth from every aspect of one’s calories.” The article mentions that the company sells what its name suggests: “hydroponic systems for growing food in windows, be they in small apartments, big houses, or even the lobby of the Museum of Natural History where an impressive Windowfarms display is exhibited as part of the ‘Our Global Kitchen: Food, Culture, Nature’ show.”
Renowned chef and gardener Geoffrey Cambal weighs in on the new window-farming project and the benefits of just-picked foods. “From the standpoint of a culinary professional and a personal gardener in my spare time, I completely agree that anyone who eats vegetables should consider growing them at home,” he said. “Even semi-successful vegetable gardens are better sources of produce than what you may find at the supermarket, not to mention it’s cost-efficient.”
The article highlights the pleasure and positive emotions that can come from growing your Windowfarms, making for mindfulness approach to the culinary experience. “Just picked – and I mean within moments – greens, lettuces, herbs, strawberries, and even cherry tomatoes have flavors and textures that you can astound, if you savor them…” Geoffrey earnestly responds to the contributing writer’s sentiments, noting that “a salad from your own garden has a plethora of experiential opportunities, unlike what you may find in processed systems.” The article adds that “the more you mindfully savor, the more satisfied you feel.”
Geoffrey Cambal aims to adopt this approach in his own restaurant as well as his home, creating a culinary experience for a diverse range of guests. He places high value on preparation when it comes to culinary success and mindfulness, noting that presentation is key.
“I enjoy watching the looks of delight on their faces when customers bite into freshly-cut vegetables and aesthetically pleasing food,” he said. The article continues on with the idea of presentation, mentioning that Windowfarms “takes the positive emotions generated one-step further: their system is gorgeous industrial design unlike any other, at least to my eye. Putting one in your window provides visual pleasure.” The highly-acclaimed chef comments on the concept of beauty in food. “My staff constantly strives to make our dining experience a meaningful activity. You can’t achieve a reputation of culinary mindfulness without paying close attention to the details,” said Geoffrey Cambal.
This book landed on my doormat from Bodhipaksa at an extremely opportune moment: the holiday period between Christmas and the New Year. The clean fresh cover was enticing enough to encourage me to start reading straight away. I’m sure if I hadn’t started reading “Eating Mindfully” there and then a fair few more chocolate truffles would have found their way mindlessly into my tummy. With this book in hand when I did eat the odd chocolate truffle I found myself savouring its taste and texture. So nice timing — thanks Bodhipaksa and Susan Albers!
Susan Albers is a US-based psychologist specialising in mindful eating. This book explores ways to “end emotional eating and savor every bite” in cultivating mindful eating. It encourages us to put an end to mindless eating and to enjoy a balanced relationship with food. It is clearly and simply structured around the Buddha’s traditional formulation of the ‘four foundations of mindfulness’. Albers outlines these in non-traditional order as the mindfulness of the mind, body, feelings and thoughts. In the fifth and final section she explores mindful eating motivations. The book is easy to navigate and structured in ‘bite sized’ subsections. It ends with a comprehensive listing of useful organisations and websites.
Title: Eating Mindfully:How to End Mindless Eating and Enjoy a Balanced Relationship with Food
Author: Susan Albers
Publisher: New Harbinger Publications
Available from: Amazon.co.uk, and Amazon.com.
This is a beautifully produced little book, hence my interest in reading it as soon as it had arrived. It has a clean, simple, attractive cover and immediately put me in mind of Susie Orbach’s “On Eating” — another book well worth reading on this theme. The book was a pleasure to read and to hold. Now I don’t normally make such a big deal about book covers — particularly bearing in mind the old adage that you can’t tell a book by its cover — but in the area of eating I think it’s very important that books are produced in a way which is both inviting, beautiful and practical, encouraging the reader to open and make use of the book again and again.
In my experience, and from my professional experience as a therapist working with people who have difficult associations with eating, the area of eating and nourishment can be highly charged. Very often food and diet books seem to fuel that charge with catchy titles, loud covers and/or promising subheadings. The simple, attractive cover reflects the contents of this book — you can tell this book from its cover. It is refreshing in offering a grounded approach to eating based upon wisdom which has spanned more than two millennia, avoiding the sometimes gimmicky feeling of the self-help book.
Albers’ tone is warm, clear, direct, and intelligent. She invites readers to learn the art of mindful eating. She points out how ‘mindful eating is radically different’ and how the book’s emphasis is about being healthy rather than being thin or losing weight — a refreshing departure from many books about food and diet. She points out how diets tend to cut us off from our experience, whereas mindful eating tunes us inwards in using our intuitive wisdom in re-learning a healthy relationship with food.
I celebrate this emphasis upon turning inwards and listening to and learning from our embodied experience in understanding our relationship with food and eating. The book goes on to explore this turning inwards in order to understanding how and why we eat what we do, based upon the four foundations of mindfulness. As a practising Buddhist, it’s great to see the four foundations applied to the everyday activity of eating.
What most struck me in reading this book is that Albers really ‘gets’ mindfulness, recounting the first time she encountered it in Japan. She gives the impression of living mindfully herself and of wishing to share that experience, rather than applying mindfulness purely as a technique. She makes the point that it can sound very easy to just “be more aware” of what you eat, when, in fact, mindfulness is complex and sophisticated.
I particularly valued this aspect of “Eating Mindfully”: the recognition that mindfulness is a lifelong practice which can be applied to any and every activity in parallel with her very helpful suggestions, examples, anecdotes and “skill builder” exercises. I found her tone enabling and helpful rather than using the blaming and shaming language which is often found in books on eating; sending readers deeper into a counter-productive cycle of shame and mindless eating.
I also respected Albers’ suggestion early on and throughout this book to find support in learning to eat mindfully — from a friend, co-worker or therapist.
I have to admit that if anything, there is just too much content in this book and it would be quite a long-haul to work though every chapter un-aided. But approached with patience, care and mutual support, this book has the potential for lasting transformation.
I have some minor criticisms of “Eating Mindfully”. I appreciate in her Foreword that Lilian Cheung acknowledges that many of us in post-industrial societies are living in a toxic food environment and a toxic media environment. Personally I would have liked to have seen Albers take that theme a little further in including in the Introduction or early in the book the societal, systemic dimension of mindless eating and, in fact, mindlessness in many things which characterise the status quo.
Of course we individually choose what we put in our mouths hour by hour, day by day, but this choosing and individual responsibility is shaped by the complex conditions in which we have been born and raised. Cheung is absolutely spot on in identifying our toxic media and food environments, so I would have appreciated from Albers a greater acknowledgment of the counterbalance between individual responsibility and healthy communities in understanding our relationship with food, living as we do with the hungry gravitational pull of our consumerist society.
Another criticism is the problem I encounter frequently. In presenting Buddhist teachings in a secular (“self-help”) context, the whole notion of Buddhism being a tool for enlightenment gets lost or at least severely obscured. The Dharma — the teachings of the Buddha — simply becomes a tool to help one become a bit happier, more contented, and in this case, healthier in eating more mindfully.
Personally, I would have appreciated Albers making clear the far-reaching nature of contemplating the four foundations. It’s also unclear as to why she decided to present the four foundations in a non-traditional order. This points to my periodic un-ease with the wave of popularity around mindfulness. Of course it’s great that mindfulness practice helps to ease depression, anxiety, pain and mindless eating. It’s also important that mindfulness is practised in its wholeness and that its context is not overlooked, with the danger of mindfulness becoming diluted or divorced from its origins, running the risk of taking the shape of another quick fix technique.
However, Albers is writing a book about mindful eating for popular appeal, not a book on Buddhist teachings, so I wouldn’t want this criticism to put off those who are interested in mindful eating. The great attraction of this book is that I have not doubt it will help many people eat more mindfully. I wouldn’t be surprised, given the skill and care with which Albers presents this material, if readers might become interested in other aspects of Buddhism which help us to live life fully and creatively.
It’s Day 45 of our 100 Day Meditation Challenge.
After I’d asked one of my meditation students to try a mindful eating exercise, she wrote about how during the exercise the food became “her everything” and said that this reminded her “of how life looks when I am able to shut out the whirring thoughts and just pay attention to the now — the big, loud, present, bright world comes forth when before it was in the background.”
Her mentioning how “the big, loud, present, bright world comes forth when before it was in the background” reminds me of times that I’ve been reading outdoors, and after a period of complete immersion in the world of words I’ll come back to sensory reality and find myself astonished by how bright, and vivid, and rich, and fascinating everything is.
Now I love reading, and I consider myself to have a rich inner world, but there’s just a huge difference in sensory bandwidth between the world of thought and the world of sensory experience.
I notice this as well when I’m moving from distracted thought to being present. I’ll be driving, say, and realize that I’ve drifted into rumination, and when I come back the real world just seems so vivid. I also have a strong sense of the thought-world involving qualities of heaviness and tightness, compared to a relative lightness and open relaxation in the sensory realm.
I notice the same thing when I’m walking, and I switch from thinking to being aware of my body and the world through which it’s moving.
I think it’s worth noticing these contrasts and allowing ourselves to be fascinated by them. It’s also worth valuing and rejoicing in the richness and fullness of the sensory world, and developing the intention to keep revisiting it as often as possible. Often we get so caught up in thinking for so long that we almost forget how to be aware of our sensory experience.
I’ve been a vegetarian for over 30 years now, ever since I visited a slaughterhouse as part of my veterinary studies and saw an animal being slaughtered. I didn’t consciously decide to become vegetarian. It was as if the decision was made for me, deep down, and I just had to go along with it. And in 30 years I’ve never once been tempted to lapse.
And I’ve tried being vegan several times, sometimes lasting for a few years. It’s a natural and logical extension of vegetarianism. Really, there isn’t a lot of different between eating eggs and eating a chicken. In both cases a chicken dies, but in one case the chicken lays lots of eggs first. But I’ve found it harder to sustain.
There was the usual tussle between ethics on the one hand, and convenience and laziness and craving on the other. So ethics was outnumbered.
Anyway, we were discussing the Buddhist first precept (not causing harm) in an online Dharma study group that I lead, and mentioned my unease about eating eggs and dairy, and my faltering desire to be vegan again. Someone in the group connected veganism with my “getting myself on the cushion mantra.” This is an affirmation that I’ve been using to make sure I meditate every day: “I meditate every day; it’s what I do; it’s just part of who I am.” This has really worked for me. And when Chris connected that mantra with veganism, I realized I had the tool I needed to give ethics the upper hand over the other three.
So this Wednesday, the day after the study group, was the first day I had an opportunity to put my vegan “mantra” into practice. It went well until dinnertime, when I discovered that some cornbread that my six-year-old daughter had made (all by herself!) contained an egg. It was my bad: I hadn’t had a chance to talk to my wife about the vegan thing. So I’m counting that as Day Zero:
Day One went well. I’d talked to my wife — who also wants to be vegan — and since I was cooking that evening there were no problems anyway. When I was our for a coffee with a friend, I became aware that my local cafe has nothing vegetarian (apart from oatmeal!) but I’ve suggested to them that they make a vegan carrot cake. And an online friend suggested that I carry around snacks. He takes some emergency Clif Bars with him for times he can’t get a vegan snack.
So it’s been sinking in that this is just what I do now, and from now on. There will be slips. My father-in-law invites us round for dinner from time to time, and his culinary skills are very limited. Basically he can make pizza. So every couple of months I’ll have some pizza. I’m not going to ask him to change his ways. In the past that’s tripped me up, because I’ve gotten caught up in all-or-nothing thinking, where I’ll regard eating Lou’s pizza as me having crossed back from veganism to non-veganism, and then I think there’s no point carrying on with it. I’m not going to do that this time.
For protein this week, in the three meals I’ll be cooking at home, I’ll be having tofu, seitan, and tempeh. I’ve also ordered a book, Artisan Vegan Cheese, by Miyoko Schinner. I’m looking forward to trying it out.
Anyway, this is the start of Day Two. Going public about this will help me stay on track, as will counting the days (although don’t worry — I’m not going to do a daily post on the subject).
I’m looking forward to my first anniversary as a vegan!
Eating mindfully is just as effective as adhering to nutrition-based guidelines in reducing weight and blood sugar levels in adults with Type 2 diabetes, a new study at Ohio State University suggests.
In a comparison study of the effectiveness of the two types of behavioral interventions, participants lost about the same amount of weight – an average of between 3 1/2 and 6 pounds – and lowered their long-term blood sugar levels significantly after three months.
One treatment group followed an established diabetes self-management education program, with a strong emphasis on nutrition information. The other group was trained in mindful meditation and a mindful approach to food selection and eating. Both interventions, involving weekly group meetings, also recommended physical activity.
“The more traditional education program includes general information about diabetes, but with more emphasis on nutrition and food choice: What are different types of carbohydrates and fats and how many am I supposed to have? What should I look for when I read a food label? What are healthy options when dining out? That was the traditional diabetes education program,” said Carla Miller, associate professor of human nutrition at Ohio State University and lead author of the study.
“We compared it to an intervention where mindful meditation was applied specifically to eating and food choices. This intervention group did not receive specific nutrition goals. We said we want you to really tune into your body before you eat. Take a few minutes to assess how hungry you are and make conscious choices about how much you’re eating. Stop eating when you’re full.
“We studied two very different approaches, and we found they both worked. This means people with diabetes have choices when it comes to eating a healthy diet,” Miller said.
The research is published in the November issue of the Journal of the Academy of Nutrition and Dietetics.
Participants were adults between age 35 and 65 years and had been diagnosed with Type 2 diabetes for at least one year. To be eligible, they had to have a body mass index, a measure of weight relative to height, of 27 or more, indicating they were overweight, and a hemoglobin A1c (HbA1c) reading of at least 7 percent. HbA1c measures blood glucose levels in the previous two to three months; normal HbA1c is 5.6 percent or lower.
Study participants were randomly assigned to a treatment group. Twenty-seven completed the mindful eating program, and 25 completed the traditional diabetes self-management program called “Smart Choices.” Each intervention involved eight weekly and two biweekly 2 ½-hour sessions with trained facilitators.
Trainers of the mindfulness program encouraged participants to cultivate “inner wisdom,” or mindful awareness related to eating, and “outer wisdom,” which referred to personal knowledge of optimal nutrition choices for people with diabetes. Each session included guided meditation oriented toward participants’ experiences and emotions associated with food. Participants received CDs for help with home meditation practice.
“We have so many environmental cues to eat in America that we’ve tuned out our normal physiological signals to eat. Being mindful means stopping long enough to become aware of these physiological cues,” Miller said. “We also tried to generate awareness, staying in the moment, and living and eating in response to hunger instead of habits and unconscious eating.”
The mindful intervention also included basic information about what is known as medical nutrition therapy: the relationships among calories consumed, carbohydrate and fat intake, weight regulation and high blood sugar.
In contrast, the Smart Choices program focused specifically on the condition of diabetes itself, including factors that can lead to the diagnosis, common complications (which include heart disease, kidney and nerve damage, eye problems and stroke), the importance of blood sugar control, and appropriate food choices when blood sugar levels spike. Every session included a medical nutrition therapy discussion such as calorie-intake goals, percentages of carbohydrates and fats in an ideal diet, and portion control. Many sessions included a 15- to 20-minute walk to further emphasize the recommendation for regular physical activity. Problem-solving regarding choosing healthy foods in high-risk situations, such as the holidays, were a focus of the program.
The interventions took place over three months. Researchers assessed participants’ health measures and dietary habits immediately after the programs concluded and then again three months later at the study’s end.
Miller said that because nutrition education is particularly important to people with a new diabetes diagnosis, she sees the mindful meditation and eating option as a potential supplement to basic diabetes education that patients need.
She also said that participants adapted well to the concept of mindfulness even though it is generally considered an alternative health practice.
“One of the things we were evaluating was how well this was accepted by people who had no experience with it. It was very well accepted by participants in that group,” she said. “And this tells us that people with diabetes have choices.
“The fact that both interventions were equally effective suggests that we should let people choose. If mindful meditation is appealing and people think that approach is effective, then it very well could be the best choice for them.”