Increasing evidence suggests that chronic stress in our society is a contributing factor to the behaviors and risk factors that have accelerated the increase in numerous disease states. We propose to evaluate the influence of a modified mindfulness-based stress reduction (MBSR-ld) to decrease biologic markers of stress and chronic inflammation which are risk factors for the diseases of aging. Participants will be selected with upper tertile values of the inflammatory marker C-reactive protein (CRP), a risk factor for cardiovascular disease. We will use a two group single blinded randomized parallel design to assess the effect of MBSR-ld on psychological, biological and resiliency measures among subjects aged 35-60 years. We will compare 90 subjects on this program with 90 subjects from a lifestyle education control group without mindfulness training. Prior to randomization, a two week computerized daily diary program designed to evaluate stress and resiliency (recovery of homeostasis following stressful events) will be administered for two weeks before and after the intervention. During the diary weeks salivary cortisol will be obtained (4 times throughout the day) to provide a physiologic stress measure. The subjects will then be randomized to a control or mindfulness group. They will be blinded as to the content of the other stress reduction program. The MBSR-ld and lifestyle education participants will involve one hour of instruction weekly and 20 minutes of mindfulness or lifestyle education practice daily for 8 weeks. Both groups will receive questionnaires evaluating perceived stress, sleep quality, anxiety, depression, and mindfulness, as well as blood work for stress and inflammatory markers at baseline and 2 months after the interventions. The two week diaries and weekly cortisol sampling will be repeated 2 months post intervention. The primary specific aim of this proposal is to determine if MBSR-ld can produce greater decreases in biologic measures of chronic inflammation and stress (CRP, IL-6 and cortisol) when compared to a standard stress reduction protocol. A secondary specific aim is to determine if MBSR-ld can better improve measures of mindfulness, resiliency, perceived stress, sleep quality, anxiety and depressive symptoms when compared to a lifestyle education protocol. Public Health Relevance: In spite of recent medical advances, the US is experiencing epidemics of various chronic medical conditions. Stressful lifestyle and poor health behaviors are major contributors to this health crisis. We will examine the role of mindfulness meditation, a relatively low cost program, in reducing biologic markers of stress and inflammation which are risk factors for the diseases of aging.
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