Despite the similarity in names, there are some key differences.
While probiotics rightfully get a lot of praise from health experts, prebiotics are important as well.
So, what are prebiotics, and how can you get more of them?
Keep reading to learn more about the power of prebiotics.
What Are Prebiotics?
Prebiotics are a relatively new discovery in terms of medical science.
They're very different from probiotics, but they work closely with them.
Prebiotics vs. Probiotics
Probiotics are beneficial bacteria that have been linked with a wide range of health benefits, including (1):
- Stronger immune system
- Healthier gut
- Symptom relief from depression and anxiety
- Lower body weight
- Improved heart health
- Cancer prevention
Prebiotics are compounds in foods that feed probiotic bacteria. In doing so, they help beneficial bacteria grow and to work more effectively.
Prebiotic Fiber
All prebiotics are types of fiber (2).
Fibers resist digestion in the stomach and the small intestine. They reach the colon intact, where they're fermented by probiotic bacteria for fuel (3).
During fermentation, prebiotics are broken down into short-chain fatty acids, like butyrate, acetate and propionate.
Some probiotic bacteria can feed off of these. However, these fatty acids are thought to have health benefits beyond feeding beneficial bacteria, including (4):
- improved gut health
- a stronger immune system
- enhanced glucose and dietary fat metabolism
- appetite control.
Bacteria in the colon feed off of prebiotic fiber to form short-chain fatty acids (24).
In short, both prebiotics and their digestive end-products are important to health.
Benefits of Prebiotics
Prebiotics are said to have several health benefits, including:
- A healthier ratio of beneficial to harmful bacteria
- Increased bone health
- Lower risk of allergies
- Reduced intestinal permeability
- A healthier immune system.
Most studies to date, though, show that these benefits aren't from the prebiotics themselves. So far, few studies have directly linked prebiotics to positive health outcomes. Rather, they play an important supporting role by helping probiotics be more effective (5).
Summary: Prebiotics are fibers that help feed probiotics. In doing so, they increase the population of healthy bacteria and help them work more effectively.
Prebiotic Foods
Though all prebiotics are fiber, not all dietary fibers are prebiotics.
The most common prebiotic fibers include:
- Beta-Glucan
- Fructooligosaccharides
- Inulin
- Galactooligosaccharides
- Isomaltooligosaccharides
- Guar gum
- Lactulose
- Resistant Starch, including maltodextrin
- Xylooligosaccharides.
These are found in abundance in plant foods. It's best to eat a variety of prebiotic-rich foods, in order to promote a diverse gut microbiome (5).
Here are a few types of foods that can help nourish your gut bacteria.
Root Vegetables
Onions and garlic can be added to a variety of dishes to boost intake of prebiotics. Jerusalem artichokes and leeks are delicious roasted, while jicama is great raw in salads or baked like French fries.
Human and animal studies have shown that root vegetables can positively impact the gut biome.
One study found that after 40 days pigs fed inulin or Jerusalem artichoke had higher levels of short-chain fatty acids in the colon. The Jerusalem artichoke group also saw increases in beneficial Bifidobacterium spp. bacteria (6).
Also, in one small human study, volunteers who drank juice shots fortified with inulin from Jerusalem artichoke had significantly greater increases in probiotic bacteria than those who drank plain juice (7).
Fruits
Eating fruit every day is recommended as part of a healthy and balanced diet.
Among many other health benefits, certain fruits have positive impacts on the gut biome.
Apples and bananas are particularly rich in prebiotic fibers. Apples are high in pectin, while ripe bananas contain inulin, and unripe bananas also have resistant starch.
In one small study, women who ate two medium bananas per day for 60 days saw modest increases in bifidobacteria (8).
Meanwhile, rodent studies have found that the pectin in apples increases levels of beneficial gut bacteria while decreasing harmful bacterial strains (9).
Spring Vegetables
Spring vegetables are rich in prebiotic fibers, particularly inulin, fructooligosaccharides and xylooligosaccharides (10, 11).
Examples include greens (especially dandelion greens), peas, corn, leeks and asparagus.
Greens can be used in salads, but soaking or sautéing dandelion greens can reduce their bitterness. Other spring vegetables are highly versatile and can be incorporated into a number of dishes.
Cocoa
Would it surprise you to know that chocolate can help promote a healthy gut biome?
Cocoa beans contain fibers that can be fermented by probiotics. They also contain antioxidants called polyphenols, which can help beneficial bacteria grow in the gut (12).
Animal studies and small human studies have found that cocoa powder promotes a healthy ratio of good to bad bacteria in the bowel (12, 13).
Just keep in mind that not all chocolate is created equal. Look for a dark chocolate with few additives, or stir pure cocoa powder into yogurt, smoothies, oats or baked goods.
Lentils
Lentils are legumes, which means they grow in a pod.
Prebiotic fiber content varies depending on the type of lentil. Some types are rich in resistant starches, while others are higher in fructooligosaccharides or sugar alcohols (14).
Animal studies have found that lentil-based diets promote a favorable balance of healthy to unhealthy gut bacteria. However, limited data are available in humans (15).
Nonetheless, lentils have many health benefits, and it makes sense to include them in the diet as tolerated. They're great in soups, curries, salads or on their own.
Whole Grains
Wheat is the most abundant source of prebiotics in the Western diet (16).
Wheat and other whole grains contain various types of prebiotic fiber. For example, barley and oats are high in beta-glucan. Others contain resistant starch or other fibers.
In one small human study, consumption of 48 grams of a whole grain breakfast per day for three weeks resulted in significant increases in bifidobacteria and lactobacilli (17).
Also, in one lab study, beta-glucan from oats showed greater prebiotic activity than other prebiotic foods, including corn and sugar beets (18).
You can maximize the prebiotic benefit by experimenting with a variety of whole grains. Whole wheat bread, rice and pasta are great, but don't overlook less popular grains like barley, rye, farro and quinoa.
Nuts
Most nuts and seeds contain some prebiotic fiber, though walnuts are among the richest sources.
In one human study with 135 healthy adult volunteers, daily walnut consumption positively altered the gut biome by significantly increasing the abundance of Ruminococcaceae and Bifidobacteria, and significantly decreasing levels of Clostridium sp. bacteria.
Volunteers in this study ate 43 grams per day (a little over 1/3 cup chopped) of walnuts. Participants reduced calories from fat or carbohydrates due to the high calorie content of walnuts (19).
Summary: The best way to consume adequate prebiotic fibers is to eat a variety of plant foods. Aim for 5-9 servings of fruits and vegetables per day and round out your plate with whole grains, legumes and nuts. Feel free to indulge in pure cocoa for dessert.
Prebiotic Supplements
There's a growing market for prebiotic supplements with sales expected to reach $7.5 billion by 2023 (5).
A large selection of prebiotic supplements are available online, many of which contain inulin as an active ingredient. Some popular ones include:
- Dr. Tobias GutMeiser Ultimate Prebiotic
- Prebio Thrive
- Biohm Super Greens
- Uplift Food Daily Uplifter.
Unfortunately, few studies have specifically examined prebiotic supplements. Most have focused on animals or human infants, while others have looked at synbiotic supplements, which include both prebiotics and probiotics (20).
These supplements are probably safe for most adults, but we don't know enough to say if they're effective (21).
Summary: Prebiotic supplements have been very popular, and many options are available online. The research hasn't caught up to the demand yet, at least in human adults. While they won't likely harm you, there's not enough evidence to say if they work.
Are Prebiotics Right for Everyone?
Prebiotics are safe for most people.
However, some people with irritable bowel syndrome or other digestive issues are intolerant to certain prebiotic fibers. This is because many prebiotics are high in FODMAPs.
FODMAPs are fibers that undergo fermentation in the colon, just like prebiotics. In fact, certain prebiotic foods are also high in FODMAPs.
Reaction to FODMAPs in the gut.
Some people are especially sensitive to FODMAPs and experience pain, bloating, gas, diarrhea and abdominal distention when they eat high-FODMAP foods.
A diet that temporarily restricts foods high in FODMAPs may be helpful for people who frequently experience this type of discomfort (22).
That's not to say that you should give up prebiotics altogether, though. Doing so alters the composition of beneficial gut bacteria, many of which lower gastrointestinal distress.
Even on a FODMAP elimination diet, prebiotic foods that are high in FODMAPs should be reintroduced gradually as tolerated (23).
A free 7-day low-FODMAP starter plan is available here.
Summary: Some prebiotic fibers are high in FODMAPs, which can cause gastrointestinal issues in people who are sensitive. A diet that temporarily restricts then reintroduces high-FODMAP foods may be helpful. The reintroduction phase is important, because unnecessarily restricting prebiotic foods will limit the effectiveness of gut-friendly probiotics.
Some Final Thoughts on Prebiotics
No studies to date have directly linked prebiotics to positive health outcomes.
But that's not to diminish their importance. Prebiotics feed probiotics and allow them to work more effectively.
As such, they play a secondary role in many important bodily functions.
There are many supplements on the market, but research hasn't caught up to consumer demand.
For now, the best way to obtain prebiotics is to eat a diet with a wide variety of fibrous plant foods.
Do your best to incorporate whole grains, root vegetables, spring vegetables (when available), fruits, legumes and nuts.
A bit of high-quality dark chocolate won't hurt, either.
Reposted with permission from our media associate Diet vs Disease.
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This is the idea behind the flexitarian diet, which reduces meat intake instead of avoiding it altogether.
This article discusses the potential benefits and risks of following a flexitarian diet to help you decide if it's a good plan for you.
What is a Flexitarian Diet?
"Flexitarianism" is essentially what it sounds like: a flexible vegetarian diet.
A person who identifies as flexitarian might eat meat occasionally, but does not include it as a regular part of their normal diet.
Most often, those who prefer not to eat meat do so for health or ethical reasons (or both). The same can be said for flexitarians looking to improve their overall health and lessen their impact on the environment.
Summary: Flexitarianism means eating a flexible vegetarian diet, which reduces meat intake instead of completely cutting it out. This may be a decision based on health or ethical reasons (or both).
Will a Flexitarian Diet Promote Weight Loss and Improve Overall Health?
In short, yes, if we first look at the benefits of a vegetarian diet.
Studies have found that those who eat a vegetarian diet are more likely to have a body mass index (BMI) that falls within the normal range.
This may be because vegetarians are likely to consume more fruit and vegetables, which are low in calories and high in fiber—two major components in promoting weight loss.
Additionally, vegetarians tend to have an increased life expectancy compared with meat-eaters. Several studies have found that people who eat a diet high in fruit, vegetables, nuts and whole grains have a lower risk of both cardiovascular disease and cancer—two of our biggest killers (1, 2).
This is likely due to the high amount of antioxidants, vitamins, minerals, fiber, phytochemicals and plant protein found in such foods (3, 4).
Meanwhile, observational studies indicate that eating red meat may lead to an increase risk of cancers, including colorectal cancer. Avoiding or limiting red meat can help reduce this risk (5).
That said, compared to a vegetarian, a flexitarian will benefit from getting important nutrients—such as protein, vitamin B12, and iron—that are highly concentrated in meat.
Interestingly, among diabetics, eating a diet low in red meat has also been shown to improve blood sugar levels (6, 7, 8). But at the same time, a low carb diet can help diabetics too.
So it seems a flexitarian eating pattern can be healthy for a range of people. As you'd expect, those who eat a semi-vegetarian diet tend to have lower BMIs, lower risk of breast cancer and lower blood glucose levels compared to those who eat meat often (9).
Summary: Flexitarians may experience similar benefits as vegetarians, who typically weigh less and have higher life expectancies. Eating a diet low in meat is also linked to lower risk of cardiovascular disease and cancer.
Health Risks of Flexitarianism
Changing your diet in any way may come with some unexpected risks.
As mentioned above, meat is an excellent source of dietary protein, as well as zinc, iron and vitamins like B1, B2, B3 and B12.
This means flexitarians need to be sure they're getting these nutrients from other sources when cutting down on meat.
For example, limiting red meat may increase your risk of iron deficiency anemia. Flexitarians may want to increase their intake of plant foods like soybeans, chickpeas, quinoa and lentils—all good sources of iron (9).
You'll also want to seek out high-protein plant foods, such as nuts, seeds, lentils, tofu and beans. This graph gives you an idea of the protein content of many plant foods:
Summary: Eating a flexitarian diet may lead to deficiency in iron, as well as other essential nutrients like protein, zinc and B12. Flexitarians need to be sure they're getting these nutrients from both meat and plant sources.
Who Should (and Shouldn't) Consider a Flexitarian Diet?
If you are overweight, at increased cardiovascular risk (including those with high blood pressure, high cholesterol, type 2 diabetes or people with a family history of metabolic health issues) or have ethical concerns about eating meat, you may benefit from adopting a flexitarian lifestyle.
However, you should discuss this diet with your doctor or dietitian if you have:
- Iron deficiency or any other type of anemia
- Dietary allergies or intolerances that limit your intake of non-meat foods
- A history of eating disorders or drastically restricting your diet (10).
Summary: Those who are overweight or at increased cardiovascular risk may benefit from following a flexitarian diet. Anyone with existing health problems should discuss the decision with their doctor or dietitian first.
How to Become Flexitarian
If you currently eat meat, it's best to make small, gradual changes to your diet.
Consider tracking your meat intake for one week. Write down every portion of meat consumed for seven days.
The following week, aim to reduce meat intake by around one serving (approximately 85 grams or 3 ounces). Continue doing this week by week until your weekly meat intake equates to less than five servings per week.
It's useful to observe when your largest intake of meat is likely to occur. For most people, this will be dinner. Replace meat in the evening meal with vegetarian options or meat substitutes.
Because the flexitarian diet is, by definition, flexible, you can choose how much meat you wish to consume. Continue to gradually lessen your meat consumption until you reach a point that feels right to you.
See below for ways to incorporate this idea into a meal plan.
Summary: To adopt a flexitarian lifestyle, gradually reduce meat intake by cutting out one serving a week.
2-Day Sample Flexitarian Diet Plan
Day 1
Breakfast: Omelette with eggs, cheese and selected vegetables as desired (e.g. mushrooms, tomatoes, bell peppers)
Lunch: Sandwich on wholegrain bread with cottage cheese, lettuce, tomato, grated carrot, cucumber
Dinner: Pasta with vegetarian sauce
Snacks: Fruit, nuts, yogurt
Day 2
Breakfast: Rolled oats with milk and berries
Lunch: Sandwich on wholegrain bread with egg, cheese, lettuce, tomato, alfalfa sprouts, beetroot
Dinner: Roast vegetables with tofu and couscous
Snacks: Fruit, nuts, yogurt.
Is a Flexitarian Diet Right for You?
There is no one perfect diet.
In fact , the best diet for you may very well be different to me.
What I like about the flexitarian diet is that it allows for flexibility.
This places the diet among the more sensible and sustainable methods of eating (unlike the ketogenic diet) as it doesn't require strict dietary restriction.
Overall, reducing meat intake may offer many health benefits, particularly if you are already overweight or experience metabolic health issues. Meat is high in calories so reducing your intake will be beneficial.
To start, try cutting out one serving of meat (about 3 ounces) every week. But note that those with existing health problems, including iron deficiency or other anemias, should talk to their doctor or a dietitian first.
Making these types of slow, gradual changes to your diet will lead to longer lasting changes and hopefully a beautiful relationship with food and your health.
Reposted with permission from our media associate Diet vs Disease.
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This article explores the health conditions and diseases it may help with.
What is Mindfulness Meditation?
Meditation is the ancient practice of connecting the body and mind to become more self-aware and present (1).
There is a range of different meditation styles, but the most popular are:
- Focused Attention (Vipassana)
- Transcendental
- Mindfulness
Most techniques emerged from a religious or spiritual context, but most now practice outside of these traditional settings.
Mindfulness is a specific approach that can be used alone or with other meditation techniques.
It's most commonly defined as "paying attention in a particular way, on purpose, in the present moment, non-judgmentally."
Mindfulness meditation is the most well-studied in health research. Scientific literature may also refer to it as Mindfulness-Based Stress Reduction or Mindfulness-Based Cognitive Therapy, which are types of mindfulness training.
I'll refer to it as mindfulness in this article from here on.
Summary: Mindfulness is a form of meditation that is the most well-studied in health literature. It's an ancient practice that emphasizes presence of mind and focus.
Reducing Stress is the Secret Sauce
Mindfulness appears helpful in a wide spectrum of health conditions.
It's not understood why, but stress reduction appears to be the common link.
Stress is associated with decreased activity in the prefrontal cortex, thought to be problematic. Mindfulness allows for conscious thinking in the prefrontal cortex, which may reverse this pattern of brain activity under stress (2).
Under high stress there are high levels of catecholamine release in brain, which weaken prefrontal cortex function. National Center for Biotechnology Information
It makes sense then that those who regularly practice mindfulness tend to have lower levels of the stress hormone cortisol. At least, that's what early research indicates (3, 4).
For these reasons most experts suspect the ability of mindfulness to reduce stress is the key reason to its benefits.
Summary: Mindfulness appears to reduce stress and markers of stress. This is important as many health conditions are worsened by stress.
Mindfulness Meditation For Anxiety and Depression
Mindfulness has a direct effect on mental health.
Evidence is strongest for anxiety (General Anxiety Disorder) and depression, two of the most common mental health conditions worldwide.
Anxiety
Anxiety causes chronic, excessive, and often uncontrollable worry.
Unfortunately up to 60% of patients do not improve with conventional treatment, such as medications and psychotherapy(5).
Studies show mindfulness can help.
In one clinical trial of 89 patients with anxiety, one group undertook an 8-week Mindfulness-Based Stress Reduction program (MBSR), while the other group received 8 weeks of stress management education.
Members of both groups who participated in just one or more sessions showed symptom improvement, assessed by the Hamilton Anxiety Scale.
However, the MBSR group showed much greater improvement than the stress management group when additional anxiety symptom scales were used (5).
Change in symptom scores for three anxiety measures after Mindfulness-Based Stress Reduction. The lower the number the better.
Other studies have found similar benefits, particularly when mindfulness is used alongside anxiety medication (6).
Depression
Clinical depression is complex disorder characterized by low mood and avoidance of usual activities.
Conventional care includes medication and psychotherapy. Unfortunately, many patients relapse with this protocol or are do not comply with medication regimens (7).
Research suggests that mindfulness can help prevent relapse for those who do not wish to use maintenance antidepressants.
In one study (7):
- One group of 28 patients with major depressive disorder in remission received maintenance antidepressants.
- The second group of 26 patients gradually discontinued antidepressants while receiving an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program.
- The third group of 30 patients gradually discontinued medications while receiving placebo pills under clinical supervision.
Compared to the placebo group, the mindfulness and antidepressant groups showed equally reduced likelihood of relapse. Keep in mind the mindfulness group were weaned off antidepressants.
Proportion of unstable remitters who survived without relapse during maintenance/follow up. M-ADM = maintenance antidepressant pharamacotherapy, MBCT = taper + Mindfulness Based Cognitive Therapy and PLA+CLIN = taper + pill placebo and clinical management.
Data from several studies suggests mindfulness and antidepressants are comparable for treating mild to moderate symptoms of depression (8).
This certainly does not suggest those with depression should discontinue medications. However, mindfulness does show promise as an alternative, and certainly as therapy alongside antidepressants.
Summary: Studies indicate it's useful for managing anxiety compared to conventional stress management practices. It may also be an effective alternative to antidepressants for those at risk of depression relapse.
Mindfulness Meditation and Weight Loss
Obesity rates worldwide have more than doubled in the past 36 years.
Research is now heavily focused on prevention and treatment strategies.
Mindfulness is promising as it has been shown to help limit stress and stress-related overeating (10, 11).
It can also increase awareness of hunger and satiety cues, a concept known as mindful eating (12).
A very large observational study showed a relationship between mindfulness and reduced risk of being overweight or obese. Although it was not able to prove that mindfulness causes lower body weight (13).
Results from smaller clinical trials are promising, but we can't make solid conclusions yet (14, 15).
Average weight change by group condition among overweight versus obese participants. Mindfulness dramatically reduced cortisol awakening response in obese but not overweight subjects.
It makes sense that mindful eating is beneficial for weight loss given our modern, fast-paced, fast food lifestyles.
Summary: Research has shown a link between mindfulness and healthy body weight, but more research is needed.
Mindfulness Meditation and Metabolic Risk Factors
Metabolic syndrome is a group of symptoms that raise risk for cardiovascular disease and diabetes.
You are considered to have metabolic syndrome if you have three or more of the following symptoms:
- A waist circumference greater than 102 cm (40 inches) in men and greater than 88 cm (35 inches) in women.
- High triglycerides
- Low HDL cholesterol
- Elevated fasting glucose (sugar)
- High blood pressure.
Observational studies have shown that metabolic syndrome is less common among those who use mind-body practices, including mindfulness (16).
Smaller clinical studies have explored the cause-effect relationships between mindfulness and metabolic risk. Interestingly, improvements to metabolic risk were seen in studies that showed no significant reduction in body weight (15).
In one study of 194 obese adults, the first group received diet and exercise advice, and the second received that same advice plus an all-day mindfulness retreat.
Compared to the first group, the mindfulness group showed significantly improved cholesterol and triglycerides after 12 months, and better fasting glucose levels after 18 months (15).
Changes in weight, fasting glucose, and triglyceride/HDL ratio for mindfulness and control groups from baseline to 18 months. Lower values are better for all 3 measures.
Other studies have shown mindfulness may improve blood pressure in those with hypertension, as well as exercise capacity and heart rate in those with heart disease (17, 18).
The mechanism for these changes is still unknown, but it's suspected that mindfulness can alter the autonomic nervous system, which regulates blood pressure, breathing, and heart rate (17).
Summary: Mindfulness appears to improve certain metabolic risk factors, even without weight loss. In particular triglycerides, cholesterol ratios, blood sugar levels and blood pressure.
Mindfulness Meditation and the Gut Microbiome
The human body is full of bacteria.
These bacteria make up the human microbiome, mostly located in the large intestine or "gut."
Alterations and imbalances in the microbiome may contribute to inflammation, weakened immunity, and maybe even weight gain(19).
Very small, early studies on humans have shown a correlation between psychological stress, stress hormones, and changes in microbial composition (20).
In theory then, mindfulness based stress reduction could be a way to help prevent negative changes in the microbiome.
This has so far been tested in rodent studies designed to place mice in stressful situations (19, 21).
Increased stress seems to dramatically alter the types of bacteria in a mouse's gut, which has been observed multiple times.
Interestingly, this shift in bacteria does indeed increase inflammatory marker levels in the blood, which has huge implications for many common health conditions.
Summary: Research has linked psychological stress to changes in the microbiome, which could theoretically contribute to illness. But more human studies are needed to determine if mindfulness can help maintain a healthy microbiome.
Mindfulness Meditation and Irritable Bowel Syndrome (IBS)
The exact causes of IBS are unknown, but it's likely multifactorial. Gut microbiome imbalance, stress and other psychological issues are suspected triggers (19, 23, 24, 25).
Considering the potential benefits of mindfulness on each of those triggers, it makes sense it helps with IBS management.
In one study of 43 IBS patients, the group who received mindfulness training showed significantly greater reductions in IBS symptoms than the group who received standard medical care (26).
These benefits were still noticeable after 6-months.
Other small studies have shown 30 minutes of mindfulness activity per day to help with IBS symptoms, although these weren't well-designed (27, 28).
Summary: Small studies indicate that mindfulness may help relieve IBS symptoms. This makes sense given the suspected triggers of IBS are stress and psychological-related.
Mindfulness Meditation and Pregnancy
Stress during pregnancy has been associated with negative health outcomes, including preeclampsia, hypertension, and low birth weight (29, 30, 31).
Small studies have shown that mindfulness may lessen pregnancy-related stress.
In one study of 74 pregnant Indian women, participants who received twice-weekly mindfulness sessions for 5 weeks showed significantly reduced perceived stress than the control group (32).
This suggests mindfulness could very well be beneficial in reducing day-to-day perceived stress during pregnancy, but much more research is needed.
Summary: A small study shows that mindfulness reduces perceived stress in pregnant moms at 12 weeks gestation. More research is needed though.
Mindfulness Meditation and Cancer
In 2012, there were 14.1 million new cases of cancer worldwide.
The number of new cases per year is expected to increase 68% by 2030.
Mindfulness has been shown to significantly improve symptoms and side effects from cancer and its treatment. This includes stress, anxiety, depression, vitality, fatigue, and sleep levels (33, 34, 35, 36, 37).
Newer studies suspect that mindfulness may also help to treat cancer progression in the first place. In particular, markers of cancer activity in breast cancer.
The mechanism for this is still under investigation, but stress reduction appears to play a key role (38, 39).
In one study of 128 stage I to III breast cancer patients who had completed standard medical treatment:
- One group of 53 patients attended eight, 90-minute mindfulness-based educational sessions, plus a 6-hour mindfulness retreat.
- The second group of 49 patients attended a 90-minute group supportive-expressive therapy (SET) sessions once a week for 12 weeks.
- The third control group of 26 patients attended single 6-hour stress management session.
Compared to the mindfulness and SET groups, the control group had significantly shorter telomeres following the intervention.
Telomeres protect the structure of DNA. Shorter telomeres have been linked to disease progression and mortality in breast cancer and leukemia (39, 40).
Although it could have exciting implications for cancer treatment, it's important to remember this is an emerging area of research. Mindfulness should not replace standard cancer care, but instead be used alongside it.
Summary: There is potential that mindfulness can positively influence cancer progression, or at least breast cancer. At a minimum, mindfulness appears to improve certain cancer symptoms and treatment side effects.
Mindfulness Meditation For Beginners
The potential health benefits of mindfulness meditation are very impressive.
It's a harmless practice that can only be good for us.
If you are a beginner looking to explore the benefits of mindfulness, many free resources are available online.
I personally use Headspace, which is a guided meditation app for beginners available on iPhone and android. It's free for 10 sessions, and is a great way to understand what it's all about.
Feeling stressed?
Trouble sleeping?
Craving sugar and gaining weight?
Some may diagnose this cluster of symptoms as Adrenal Fatigue … but is it actually a real condition?
This is a sales-free look at the facts.
What is Adrenal Fatigue and the Function of Adrenal Glands?
Adrenal fatigue refers to a cluster of common symptoms one might experience when under long-term mental or emotional stress.
It's also known as Adrenal Fatigue Syndrome, HPA Axis Disregulation or Hypoadrenalism.
The concept was introduced in 1998 by chiropractor and naturopath James Wilson. Since then it has become very popular among alternative health practitioners.
The adrenal glands—small organs above the kidneys that produce certain hormones—help to manage stress. But they are said to grow tired or fatigued when overworked for a long period of time.
As a result they produce inadequate amounts of hormones that influence stress, such as cortisol. At least, that's the theory.
In the medical community adrenal fatigue is not recognized. In fact, the Endocrine Society (which represents more than 18,000 endocrinologists in 122 countries) says:
"Adrenal fatigue is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional or physical stress drains the adrenal glands and causes many common symptoms."
So there is clearly a divide in opinion between alternative and conventional medicine.
Summary: Adrenal fatigue is a condition said to be caused by long-term stress. However, it is not recognized in the medical community.
Adrenal Fatigue vs. Adrenal Insufficiency
It's important not to get these confused.
Adrenal insufficiency is a serious disorder, characterized by adrenal glands that produce insufficient hormones. Addison's disease is the name of autoimmune adrenal insufficiency.
It's quite rare, affecting 11 out of every 100,000 people. But rates are on the rise, particularly in women (1, 2).
Much like Hashimoto's disease it cannot be treated with diet and lifestyle alone. Without proper hormone replacement medication, adrenal insufficiency is life-threatening.
Adrenal fatigue, if it exists, is not immediately dangerous.
Summary: Adrenal fatigue should not be mixed up with adrenal insufficiency, which is a rare yet serious condition treated with strong hormone medication.
Adrenal Fatigue Symptoms Are Subjective
It's human nature to try and make sense of patterns and clusters.
Clusters of symptoms are no exception and we often give them a non-scientific name, like Leaky Gut Syndrome.
Adrenal fatigue is another example. These are several symptoms listed on James Wilson's AdrenalFatigue.org website:
- Always tired
- Feeling stressed
- Struggling to keep up with daily tasks
- Reliance on caffeine through the day
- Strong cravings for sugar or salt
- Low libido
Immediately it's clear how broad and unspecific symptoms are. No doubt they are real, but they easily overlap with other known medical issues.
The real issue is that the symptoms are not objective, nor measurable. That is, there is no validated symptom score to assess how mild or severe a case may be.
Summary: Symptoms of adrenal fatigue are real, but so broad that they overlap with other medical issues.
Adrenal Fatigue Tests Are Not Accurate
Proponents claim existing blood tests are not sensitive enough to detect small declines in adrenal function.
So the only criteria for diagnosing adrenal fatigue are the non-specific symptoms.
Therefore it's not actually possible for health practitioners to determine what classifies as adrenal fatigue and what doesn't, assuming it is a real condition.
Some practitioners claim it can be measured and diagnosed using salivary cortisol. This is a way to measure the HPAA adaptation to stress and is useful for helping to diagnose adrenal insufficiency.
But researchers note salivary cortisol is not necessarily representative of blood cortisol. Numerous other factors including adrenal sensitivity, cortisol binding, estrogens and HPAA responsivity influence the saliva reading. This makes it an unreliable stress biomarker on its own (3).
Additionally, treatment endpoints are as non-specific as the diagnosis.
In other words, without measurements there is no way to confirm when a patient's adrenals are corrected or "cured." It's the reason why studies must use adrenal fatigue questionnaires to measure results instead of testing physical or chemical changes (4).
If this were the case for other common medical conditions, like type 2 diabetes or high blood pressure, the doctor would never know when to increase, decrease or stop medication.
Summary: There is no way to accurately test or measure adrenal fatigue. Therefore practitioners cannot actually prove who has it, nor when it has been corrected.
Adrenal Fatigue Supplements
Few medical conditions are broad and unmeasurable.
Fibromyalgia is one of them, perhaps adrenal fatigue is another.
Despite this, supplements for adrenal fatigue and associated natural remedies are more common than ever. Even the creator of adrenal fatigue, James Wilson, sells his own line of supplements online.
Keep in mind that given the non-specific nature of adrenal fatigue, there is no way to develop a supplement to specifically treat it. Nor a way to test if that supplement is effective.
Nutrition supplements should be used to supplement deficiencies linked with a particular condition. However, only a handful of studies even mention adrenal fatigue let alone have tested for associated nutrient deficiencies.
There are also many hormone supplements available that promise to treat this condition. But these can do more harm than good if they aren't required.
Adrenal Crisis is not uncommon in patients receiving inappropriate adrenal hormone treatment.
Summary: Adrenal fatigue supplements are sold by many alternative health practitioners, including the creator of adrenal fatigue. However, it's not possible to develop or test a supplement's effectiveness without a way to measure the problem condition first.
Adrenal Fatigue Treatment and Diet Changes Do Help
Many claim that adrenal fatigue "treatment" restored their health.
They lost weight, have more energy and feel fantastic. Of course this is great to hear, but actually not surprising.
The typical adrenal fatigue treatment protocol includes eating more fruits and vegetables, cutting out sugar-laden and starchy junk food, exercising more, improving sleep quality and taking measures to reduce stress.
These recommendations address the fundamental aspects of good health, also known as the pillars of health. Anyone who improves one or more of these diet and lifestyle aspects will feel better to some degree.
But whether adrenal gland function actually shifts as a result of these changes is debatable and not possible to prove from observation.
Summary: An adrenal fatigue diet and treatment protocol may help improve an individual's health. But this is because it encourages important diet and lifestyle improvements, rather than a boost to adrenal gland function.
Could Adrenal Fatigue Be Subclinical Adrenal Insufficiency?
Some proponents claim adrenal fatigue is a mild or early form of adrenal insufficiency and should be formally recognized as such.
Much in the same way as subclinical hypothyroidism is to hypothyroidism.
But in cases of subclinical hypothyroidism, doctors are able to measure a patient's blood TSH levels. This provides an objective measurement used to determine diagnosis and treatment efficacy.
As this isn't possible with adrenal fatigue it's difficult to confirm this theory, though it is interesting.
Is Adrenal Fatigue Real?
It's frustrating if you constantly feel unwell to have a doctor that seems unable or unwilling to discover the true problem.
I understand that, because the symptoms are very real. It's the reason adrenal fatigue has become such a popular alternative approach to this type of scenario.
However, there is no scientific evidence to validate the concept. Without any reliable method of measuring adrenal fatigue it's near impossible to make the "diagnosis."
That said, believing one has adrenal fatigue can sometimes be beneficial. It provides a "physical" reason for individuals to take action and improve their diet and reduce stressors. This is why so many experience improvements.
But if the real problem is more sinister than poor diet and high stress, accepting adrenal fatigue as the root cause can be dangerous. It only prolongs the time required to discover what's really causing symptoms.
Add to that the unproven adrenal fatigue supplements pushed on desperate customers and you start to question how helpful or ethical this diagnosis is.
In the end it's clear that taking measures to improve your diet and better manage the stressors in your life is key to getting your health back … Whether adrenal fatigue exists or not.
Reposted with permission from our media associate Diet vs Disease.