A Literature Review of the Role of Mindfulness Practices in Nutrition for Mothers and Their Children

Abstract

Nutrition-related problems have been increasingly prevalent among children and adults nationally and globally. Pregnant women and children are particularly susceptible to nutrition-related concerns. Mindfulness-based programs have demonstrated favorable outcomes for lifestyles and behaviors and may, therefore, assist in nutrition-related concerns. This column focuses on existing literature that focuses on the way mindfulness practices improve eating and nutrition outcomes for mothers. The synthesized findings of this review provide support for the effectiveness of mindfulness practices of mothers affecting improved nutrition for their children.

‘ . . . a model of mindful parenting emphasized the importance of demonstrating intentionality and incorporating moment-to-moment awareness in parent-child relationships.’

Introduction

US adults suffer from a number of nutrition-related problems. Obesity in adults is also a major public health problem. ¹ In 2015-2016, 39.8% of American adults were affected by obesity. Inadequate fruit and vegetable intake have been expressed as a nutritional concern. Approximately 12.2% of adults meet the recommended daily intake of fruit, and even less (9.3%) consume the recommended amount of vegetables. ² Although healthy nutrition and adequate diet is important throughout the life span, healthy nutrition during pregnancy is of significance because of the development of the expecting mother and child during pregnancy. ³ Throughout pregnancy, nutritional needs increase, including the increased need for micronutrients and macronutrients. Healthy weight gain has also been given increased attention, with guidelines of a healthy weight gain ranging between 25 and 35 pounds for mothers of normal weight. ⁴

Nutritional needs during childhood are also important to consider given the energy and nutrient needs of this developmental time period. In the United States, numerous nutrition-related concerns have been identified among children. The Centers for Disease Control and Prevention reported that 18.5% of children 2 to 19 years old were affected by obesity in 2014, and this number has only increased in the past few years. ⁵ Inadequate fruit and vegetable intake is also a concern among children because only 9% of children eat the recommended daily amount of fruit, with 2% eating the recommended daily amount of vegetables. ² Nutrient deficiencies are also of concern. For instance, iron deficiencies are seen in about 7.1% of children 1 to 5 years of age in the United States. ⁶

Increased attention has focused on the benefits of mindfulness and the role mindfulness may have in nutrition. Mindfulness stems from Buddhist teachings and may be defined as the “moment-by-moment” state of awareness. ⁷ Mindfulness has been increasingly popularized in research and practice because of the multitude of benefits associated with it. A bulk of the literature examines the benefits of mindfulness in relation to emotional and affective well-being. ⁸ More recently, however, the literature has expanded on these benefits and demonstrates positive links between mindfulness and other health benefits and behaviors related to good nutrition.

Increased attention has also been given to mindful parenting and its benefits on parenting interventions and positive youth development. In an article published in 2009, a model of mindful parenting emphasized the importance of demonstrating intentionality and incorporating moment-to-moment awareness in parent-child relationships. ⁹

Because of the overwhelming amount of literature that highlights the benefits of mindfulness, this column aimed to review existing studies and interventions that explored the role mindfulness and mindful parenting may have in nutrition. Mindfulness practices have been utilized for eating awareness and eating programs. Such programs have been useful in making individuals conscious of their food choices and eating practices, leading to weight loss and healthy lifestyles. This literature review specifically explored the impacts of mindfulness and nutrition programs for mothers.

Methods

A literature search was completed through the PubMed and PsycInfo databases to identify peer-reviewed journal articles published in the past 5 years that focused on mindfulness and nutrition programs for mothers. The following terms were searched: mindfulness AND nutrition AND mother or mothers. The search was completed by 2 reviewers who agreed on inclusion and exclusion criteria. A total of 10 articles were found through PubMed, and 4 articles were found through PsycInfo.

Each reviewer individually reviewed the abstract of all 14 articles. Following abstract review, reviewers came to consensus on the eligibility of each article. Articles were excluded if they did not include mindfulness practices and nutrition implications. Articles excluded from PubMed included 2 based on substance use, 1 duplicate, 1 not yet published, and 1 study focused on mindlessness instead of mindfulness. Articles excluded from PsycInfo included 1 based on substance use and 1 duplicate article. The final review comprised 7 articles, including 3 general studies and 4 interventions.

Results

In general, the 7 articles explored the association of mindful parenting and/or mindful eating practices and nutrition among pregnant women/mothers and their children. Interventions found positive outcomes, and general studies found positive associations between mindful parenting and/or mindful eating and nutrition-related outcomes.

Mindfulness Studies

Mindfulness helped improve eating and nutrition-related outcomes among mothers.^10-12 For example, scholars Gouveia et al ¹⁰ demonstrated that mindful parenting was significantly associated with lower levels of emotional distress among children, which has implications for coping with (or regulating) emotions through eating. Laraia et al ¹¹ found that the association of mindful parenting, specifically the dimension of compassion, is indirectly related to adolescents’ emotional eating behaviors. Mothers who are mindful of their eating behaviors are also mindful of their child feeding practices. For example, Tylka et al, ¹² in 2013, found that mothers who identified eating for physical reasons, rather than emotional reasons, are more likely to monitor food intake in children, whereas mothers who engage in contextual skills, such as mindfulness, are more likely to engage in shared feeding responsibilities. ¹² These studies have implications for child feeding practices, which can lead to childhood obesity and other chronic diseases.

Mindfulness Programs

The review includes 4 programs of mindfulness and nutrition. These programs helped improve eating and nutrition-related skills (ie, overeating) and childhood feeding practices. In particular, the Slow Down Program and the program by Tylka et al ¹² found that acquiring and practicing mindfulness skills helps mothers with stress management and overeating. ¹³ Additionally, researchers from the Mindful Moms Training program found that the mindfulness component of the program reduced stress and depressive symptoms, improved eating behaviors, and was effective in decreasing experiential avoidance among pregnant women. ¹¹ These interventions have implications for mothers who are overweight or obese during pregnancy. Practicing mindful eating practices could improve the health of mothers who influence their children’s feeding and eating practices.

Other Implications of Mindfulness

In addition to the favorable outcomes for nutrition-related variables, mindfulness was also shown to have favorable outcomes for nonnutrition variables. As mentioned above, mindfulness and mindful parenting has been shown to have favorable outcomes for affective and mental well-being.^8,9 Therefore, it was not surprising that the mindfulness studies demonstrated favorable outcomes for the emotional and mental well-being of mothers and children. For children, mindfulness and mindful parenting displayed by mothers were associated with lower levels of emotional distress in children, increased inclusion of involving children in feeding responsibilities, and decreased likelihood of children or adolescents engaging in emotional eating.^10,12 Similar findings were observed in the mindfulness interventions. In the article that compared a mindfulness intervention (Mindful Moms Training) to an emotional brain training, the mindfulness intervention demonstrated more favorable outcomes toward coping strategies identified by mothers. ¹¹ Although not included in this review, recent studies have also explored the way mindfulness parenting interventions may address concerns related to drug use, including opioid use, and may effectively serve as a basis for a drug treatment program.^14,15

General Discussion

There is a growing body of evidence to show that mindfulness practices improve eating and nutrition outcomes for mothers. The synthesized findings of this review provide support for the effectiveness of mindfulness practices of mothers having an impact on improved nutrition for their children. Additionally, mindfulness may help lifestyles of mothers by promoting better health while decreasing stress. Stress has been found to lead to gestational diabetes and endocrine function over the life course for pregnant mothers,^16,17 which could affect the health and well-being of their children. Stress management and mindful parenting can play a crucial role in lowering levels of emotional distress among children. ¹⁰ Mothers who practice mindful eating behaviors might influence their children’s eating and feeding practices, with implications for reducing and/or preventing childhood overweight and obesity. Although the focus of this study was on mindfulness and nutrition among mothers, other researchers have explored the way mindlessness may affect feeding practices and, thus, nutrition of children. ¹⁸ Thus, the alternative, mindfulness practices, should be considered to address the major public health concern of childhood obesity in the United States.

Limitations and Strengths

The authors acknowledge limitations of this review. Non–English language articles were not included in the review, which might have minimized the relevant literature. Other databases might have posed relevant literature to mindfulness and nutrition of mothers. Furthermore, this review is not based on an exhaustive search of the literature because it does not include gray literature.

Nevertheless, this review highlights key components of health initiatives that emphasize mindfulness in nutrition. Practicing mindfulness in parenting and nutrition has been shown to improve health outcomes of mothers and their children; however, there is still a need to understand how mindfulness and nutrition performs in vulnerable populations and among unique cultures.