Plain language summary
Susceptibility to acute respiratory infection (ARI), including the common cold and flu, have been shown to be influenced by psychological, social and behavioural factors. Given these previous associations, the aim of this study was to determine the preventive effects of meditation and exercise on ARI illness. This randomised controlled trial allocated 390 participants to one of three parallel groups either receiving 8-week training in mindfulness-based stress reduction (MBSR), 8-week training in moderate intensity exercise or observational control. ARI symptoms were assessed daily and various psychosocial factors were assessed at baseline and 4 times after the intervention. Blood and nasal wash samples were assessed with each ARI episode as well as at baseline, 1-month and 4-month post-intervention. This study found significant reductions in ARI illness incidence, duration and severity for participants in the MBSR group compared with controls. While this was also true for the exercise group, results were not as significant suggesting a slight advantage of mindfulness over exercise. Based on these results, the authors conclude both mindfulness and exercise should be encouraged and further research be conducted to better understand the benefits of these activities in sick populations.
Abstract
BACKGROUND Practice of meditation or exercise may enhance health to protect against acute infectious illness. OBJECTIVE To assess preventive effects of meditation and exercise on acute respiratory infection (ARI) illness. DESIGN Randomized controlled prevention trial with three parallel groups. SETTING Madison, Wisconsin, USA. PARTICIPANTS Community-recruited adults who did not regularly exercise or meditate. METHODS 1) 8-week behavioral training in mindfulness-based stress reduction (MBSR); 2) matched 8-week training in moderate intensity sustained exercise (EX); or 3) observational waitlist control. Training classes occurred in September and October, with weekly ARI surveillance through May. Incidence, duration, and area-under-curve ARI global severity were measured using daily reports on the WURSS-24 during ARI illness. Viruses were identified multiplex PCR. Absenteeism, health care utilization, and psychosocial health self-report assessments were also employed. RESULTS Of 413 participants randomized, 390 completed the trial. In the MBSR group, 74 experienced 112 ARI episodes with 1045 days of ARI illness. Among exercisers, 84 had 120 episodes totaling 1010 illness days. Eighty-two of the controls had 134 episodes with 1210 days of ARI illness. Mean global severity was 315 for MBSR (95% confidence interval 244, 386), 256 (193, 318) for EX, and 336 (268, 403) for controls. A prespecified multivariate zero-inflated regression model suggested reduced incidence for MBSR (p = 0.036) and lower global severity for EX (p = 0.042), compared to control, not quite attaining the p<0.025 prespecified cut-off for null hypothesis rejection. There were 73 ARI-related missed-work days and 22 ARI-related health care visits in the MBSR group, 82 days and 21 visits for exercisers, and 105 days and 24 visits among controls. Viruses were identified in 63 ARI episodes in the MBSR group, compared to 64 for EX and 72 for control. Statistically significant (p<0.05) improvements in general mental health, self-efficacy, mindful attention, sleep quality, perceived stress, and depressive symptoms were observed in the MBSR and/or EX groups, compared to control. CONCLUSIONS Training in mindfulness meditation or exercise may help protect against ARI illness. LIMITATIONS This trial was likely underpowered. TRIAL REGISTRATION Clinicaltrials.gov NCT01654289.
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