Abstract
We enjoyed reading the recent review article by Blair Kennedy and Resnick 1 discussing the interaction between mindfulness and physical activity. We agree with the authors that mindfulness and mindful activity can have a profound effect on physical and psychological health. We also argue that when these mindful activities are combined with physical activity, the beneficial effects would be greater. As the authors reviewed in the article, a typical approach for studying the mind–body interaction is to focus on the activities that naturally combine mindfulness and physical activity. A lot of traditional activities in existence from the ancient times, including yoga, tai chi, and kouk-sun-do, fall into this category. 2 However, the format and the organization of these mind–body exercises may be too rigid to be adapted by people with different cultures and customs. An alternative approach to study this would be to incorporate a mindful activity into standard exercise programs that have been shown to be effective. One of such examples is Buddhism walking meditation. It incorporates the basic principles of traditional meditation performed in the sitting position, including breathing, awareness, concentration, and relaxation, with rhythmic exercise of standard walking. 3 In a study using depressed elderly, Buddhism walking meditation produced improvements in functional fitness and vascular function that were equivalent to those induced by the traditional walking program. More notably, only the walking meditation resulted in a significant reduction in depression scores and blood concentration of cortisol. 3 This kind of activity is particularly attractive in Thailand where the study was conducted. As 95% of the populations in Thailand practice Buddhism, it can be practiced and accepted by the majority of the population. Poor adherence and compliance to exercise programs have been well known. 4 As Blair Kennedy and Resnick implied, integrating mindfulness is one way to enhance exercise adherence even though currently no such evidence exists. These effects may be greater if religion-based mindful activity was incorporated into standard exercise as the practice in religions is a life-long commitment for most people.
This kind of holistic approach incorporating mind–body exercises is consistent with the current guidelines for lifestyle modifications. The exercise prescription schemes had focused primarily on aerobic exercise in the past. But more recent exercise prescriptions include and target a variety of other fitness components (muscle strength and power, flexibility) as evidenced by the recent popularity of cross-training programs (eg, cross-fit). Time may come in the near future to newly include mindful components into the overall health and fitness promotion. But to do so, we need to accumulate more research evidence to support such practices.