Posted 07.17.2018 | by AMRA

Acute respiratory infections including colds and flu affect over 50% of the population annually. Interestingly, our psychological states and behaviors can affect our susceptibility to these infections. People who are under stress or otherwise unhappy are more likely to catch acute respiratory infections, while people who exercise regularly are less likely to catch them.

Barrett et al. [PLOS One] conducted a randomized controlled study to test the effects of Mindfulness-Based Stress Reduction (MBSR) and moderate intensity sustained exercise on the frequency, duration, and severity of colds and flu compared to a control group.

The researchers recruited 413 volunteers (average age = 50 years, 76% female, 85% white, 77% college educated) and randomly assigned them to a MBSR, exercise, or non-active control group. The MBSR and exercise interventions were matched on group size, program length, session frequency, and the amount of home practice (20-45 minutes).

The interventions were conducted in the fall, and participants were monitored for colds and flu from fall through spring. During this time, participants completed weekly health reports. If participants developed an infection, they completed daily reports until symptoms abated.

Additionally, they provided oral and nasal swabs to assess their immune response and identify viruses. Participants completed a variety of mental health and personality measures at baseline and at various points along the study timeline. Absenteeism, the number of respiratory infection-related medical appointments, and illness related costs were also assessed.

The study found that the MBSR and exercise groups both reduced acute respiratory infection incidence, duration, and severity. Compared to controls, the MBSR group showed a 16%, reduction in incidence, a 14% reduction in duration, and a 21% reduction in severity. Compared to controls, the exercise group showed a 10% reduction in incidence, a 16% reduction in duration, and a 31% reduction in severity. All these reductions were statistically significant at p<.05.

Compared to the control group, MBSR and exercise both resulted in significant improvements in a variety of mental health and personality variables including general mental health, perceived stress, sleep quality, depressive symptoms, and self-efficacy. MBSR and exercise groups both improved mindfulness scores on the Mindful Attention Awareness Scale.

In terms of biological measures, the MBSR and exercise group participants who developed an infection both showed a stronger interferon-gamma-induced protein 10 (IP-10) response to infection than the control group participants. IP-10 is part of the body’s response to viral infection and is correlated with reduced viral load and recovery from infection.

The study shows that MBSR and exercise both significantly reduce cold and flu frequency, length, and severity, along with providing general mental health benefits. The authors suggest that the magnitude of MBSR and exercise benefit may be similar to that of other preventative interventions such as flu vaccination.

Depending on the year and the variable under study, the reduction of flu incidence and severity due to vaccination ranges from 13-70%. By way of comparison, MBSR cold and flu incidence, duration, and severity reduction rates in this study and one previous study ranges from 14-60%.


Barrett, B., Hayney, M. S., Muller, D., Rakel, D., Brown, R., Zgierska, A. E., . . . Coe, C. L. (2018). Meditation or exercise for preventing acute respiratory infection (MEPARI-2): A randomized controlled trial. PLoS ONE, 13(6), e0197778.

[Link to abstract]