Posted 08.23.2016 | by AMRA

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Studies show that older lesbian and bisexual women are more likely to be overweight than their heterosexual peers, but there is a dearth of reported interventions specific to this population. Ingraham et al. [Women’s Health Issues] investigated whether mindful eating programs specifically designed for older lesbian and bisexual women can improve their physical and emotional health. The researchers also compared the outcomes of these programs with traditional diet-and-exercise programs that were also tailored for this population.

The U.S. Department of Health and Human Services funded five different interventions at five separate locations to gain information about the how to best reduce overweight status. Two of the sites adopted slightly different mindful eating approaches, while three sites opted for variations on traditional diet-and-exercise approaches. Each site designed its own program curriculum based on the concerns and beliefs of the organizations hosting the programs at each site. All five sites recruited lesbian and bisexual participants 40 years of age or older with a BMI ≥ 25 kg/m2. Assignment to groups was based on proximity to sites and was not randomized.

The two different mindful eating interventions were both 12-week group programs employing aspects of Mindfulness-Based Stress Reduction along with the Health At Every Size program’s emphasis on acceptance of body size and shape, and the Intuitive Eating program’s emphasis on attending to hunger and satiety cues. The three traditional diet-and-exercise programs met 12-16 times in weekly support groups and employed techniques such as food logs, recipe handouts, gym memberships, pedometers and personal trainers. There were a total of 160 participants in the mindful eating groups, and 106 in the diet-and-exercise groups.

All participants completed assessments immediately before and after intervention. Self-report measures included a Mindful Eating Questionnaire that measured eating beyond fullness, sensory awareness while eating, and emotionally-triggered eating and a quality of life questionnaire that measured perceptions of physical and mental health. They also completed measures of nutritional intake, physical activity, height, weight, and waist circumference. At baseline, the mindful eating trainees were significantly more likely to be women of color, be more overweight, be older, be less physically active, be disabled, unemployed or retired, and have poorer quality of life than the traditional diet-and-exercise group members.

Mindful eating trainees showed significant, albeit small (6-7%) improvements in mindful eating scores. The women who improved mindful eating scores the most had the largest improvements in physical and mental health quality of life. Women in the upper third of improvement in mindful eating improved their mental health quality of life by 35%, while those in the lower third improved by only 4%. Mindful eating trainees who improved most in mindful eating also showed the largest increases in physical activity and largest decreases in sweetened beverage consumption.

The women showed significant weight losses (1-5 pounds) and reduced waist-to-hip ratios at all five sites, without significant between-group differences. Only mindful eating trainees significantly improved their mental health quality or increased their fruit and vegetable intake, eating an additional 12 servings a month. Diet-and-exercise trainees reported significantly greater increases in weekly physical activity (117 minutes versus 60 minutes) and physical quality of life compared to mindful eating trainees.

Findings from this study show that mindful eating programs tailored to the needs of older, overweight lesbian and bisexual women can lead to improvements in mindful eating and perceived mental health, as well as increased fruit and vegetable consumption. Traditional diet-and-exercise programs faired better at improving physical activity and perceived physical health. Mindful eating programs provide an alternative for women who are ideologically averse to traditional diet-and-exercise programs. The lack of random assignment limits any inferences about between group differences in outcomes.

Reference:

Ingraham, N., Eliason, M. J., Garbers, S., Harbatkin, D., Minnis, A. M., McElroy, J. A., & Haynes, S. G. (2016). Effects of mindfulness interventions on health outcomes in older lesbian/bisexual women. Women’s Health Issues, 26, S53-S62.

[Link to abstract]