This article is a collaboration between MedPage Today and:

Getting a score on a test measuring mindfulness was associated with better glucose regulation, according to researchers.

Of 400 participants, those who scored highest on a mindfulness test were more likely to have normal plasma glucose levels (prevalence ratio 1.35, 95% CI 1.08-1.87) than those who scored lowest, but there was no statistically significant link between mindfulness and type 2 diabetes (0.83, 95% CI 0.38-1.79) in the study, which was published this week in the American Journal of Health Behavior.

"This study demonstrated a significant association of dispositional mindfulness with glucose regulation, and provided novel evidence that obesity and sense of control may serve as potential mediators of this association," wrote the authors, who were led by Eric Loucks, PhD, at Brown University School of Public Health. "As mindfulness is likely a modifiable trait, this study provides preliminary evidence for a fairly novel and modifiable potential determinant of diabetes risk."

The authors adjusted their findings for age, sex, race, family history of diabetes, and socioeconomic status. In mediation analyses, they found that obesity and sense of control measures explained part of the relationship between glucose levels and mindfulness.

The authors hypothesized that greater dispositional mindfulness -- a trait that allows one to be aware of the present moment even during ordinary tasks -- may lead to a lower likelihood of obesity and a greater sense of control when eating. But they added that "overall, there are a number of particularly plausible psychological and behavioral mechanisms" like craving and stress response that could explain the associations. "However," they wrote, "the mechanisms linking mindfulness to glucose regulation have not been established using modern analytic mediation approaches."

Participants were from the New England Family Study, which tracked the offspring of nearly 18,000 pregnant women. From the Providence, Massachusetts cohort of that study, 1,400 members were randomly selected, most of them white. Researchers contacted members of that cohort and found 400 of them that were willing and able to participate in the study; one participant was later excluded because she was diagnosed with diabetes when she was younger than 20.

Mindfulness was measured by the Mindful Attention Awareness Scale (MAAS), a 15-item questionnaire in which participants indicate, via a 6-point Likert scale, how aware and attentive they are of present experiences and events. Those who get higher MAAS scores tend to be more self-conscious, socially anxious, and ruminative than lower scorers, according to the researchers. In addition, mindfulness is partly heritable, but it can be modified as well.

Five randomized control trials have been done to determine the relationship between glucose levels and mindfulness; three of those studies had a null finding and two showed a positive association, wrote the authors.

Limitations of the study include its cross-sectional design, limiting causal inference. Mindfulness was self-reported, and there's debate about how accurate the self-reported MAAS is, according to the researchers. The researchers performed the mediation analysis on a smaller number of participants (n=331) because of missing data. It's also not clear if the 400 participants that chose to participate were different than the 122 who were contacted but chose not to participate.

"These findings need to be replicated by prospective studies to establish causality and to evaluate potential implications for mindfulness-based interventions to reduce risk of type 2 diabetes," the authors wrote.