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Mindfulness research: separating the hype from the science

The observed benefits for some conditions, particularly anxiety and depression, are “significant and measurable” and worth further study, says researcher Timothy Caulfield.

The study found no evidence “that meditation programs were better than any active treatment” like exercise.
REUTERS/Edgard Garrido

Is all the recent hype about the health benefits of mindfulness meditation justified?

That’s the question Timothy Caulfield, a health law and policy researcher at the University of Alberta (and author of the new book “Is Gwyneth Paltrow Wrong About Everything? When Celebrity Culture and Science Clash”), thoughtfully explores in a recent online commentary for the journal Policy Options, which is published by the Canadian Institute for Research on Public Policy.

“Is mindfulness a science-based approach to health and wellbeing or a philosophy about how we should live?” he asks. “If the former, what does the good science actually say about the benefits? If the latter, does it matter what the science says, and what, then, is its place in an (allegedly) evidence-based health care system? And, perhaps most challenging, can it be both?”

‘No firm conclusions’

Caulfield notes that, despite the fact that celebrities, sports stars and business leaders have enthusiastically endorsed claims for the physical and mental benefits of mindfulness meditation, the scientific evidence “is far less definitive.”

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He explains:

A rigorous 2014 systematic review of available evidence on the impact of meditation on stress and well-being, published in JAMA Internal Medicine, reviewed over 18,000 citations and found 47 randomized clinical trials worthy of consideration. Using only these high-quality studies, it concluded there is moderate evidence to support the benefits associated with anxiety and depression and either insufficient evidence or evidence of no effect “on positive mood, attention, substance use, eating habits, sleep, and weight.”

More importantly, the study also found no evidence “that meditation programs were better than any active treatment.” Mindfulness was not better than, for example, exercise. In part, this may be because many of the studies on mindfulness and meditation are, from a methodological perspective, less than ideal.

A 2007 review done for the US Department of Health and Human Services by the University of Alberta Evidence-based Practice Center came to a similar conclusion, finding that most studies on meditation were “of a poor methodological quality” and that no “firm conclusions on the effects of meditation practices” can be made.

“These are pretty underwhelming conclusions for an approach that has received so much attention,” Caulfield concludes. 

Big business

Still, Caulfield stresses that he’s not out to “bash meditation.” The observed benefits for some conditions, particularly anxiety and depression, are “significant and measurable” and worth further study, he points out.

Timothy Caulfield
Timothy Caulfield

But we must conduct and interpret those studies with our eyes wide open. Caulfield warns that mindfulness and meditation research is often tainted by “white hat bias” — bias that leads to a “distortion of information in the service of what might be perceived to be righteous ends.”

He also notes that mindfulness has become a multibillion-dollar business. That means “that the potential for profit will, inevitably, further twist what we hear about the value of the practice ” — just as it does with other products and services offered by various corners of the health-related industry, both alternative and mainstream.

So, suggests Caulfield, “let’s tone down the hype and study mindfulness in a rigorous manner, looking at both benefits and possible harms. We should strive to do it in the same critical and dispassionate manner that good science demands for all areas of research.”

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“If we want to use science to justify the use of mindfulness,” he adds, “we must play by the rules of science.”

You can read Caulfield’s article on the Policy Options website.