PMID- 31165653
OWN - NLM
STAT- MEDLINE
DCOM- 20191211
LR  - 20200309
IS  - 1552-695X (Electronic)
IS  - 1534-7354 (Print)
IS  - 1534-7354 (Linking)
VI  - 18
DP  - 2019 Jan-Dec
TI  - Mindfulness-Oriented Recovery Enhancement Restructures Reward Processing and 
      Promotes Interoceptive Awareness in Overweight Cancer Survivors: Mechanistic 
      Results From a Stage 1 Randomized Controlled Trial.
PG  - 1534735419855138
LID - 10.1177/1534735419855138 [doi]
LID - 1534735419855138
AB  - INTRODUCTION: The primary aims of this Stage I pilot randomized controlled trial 
      were to establish the feasibility of integrating exercise and nutrition 
      counseling with Mindfulness-Oriented Recovery Enhancement (MORE), a novel 
      intervention that unites training in mindfulness, reappraisal, and savoring 
      skills to target mechanisms underpinning appetitive dysregulation a pathogenic 
      process that contributes to obesity among cancer survivors; to identify potential 
      therapeutic mechanisms of the MORE intervention; and to obtain effect sizes to 
      power a subsequent Stage II trial. METHODS: Female overweight and obese cancer 
      survivors (N = 51; mean age = 57.92 +/- 10.04; 88% breast cancer history; 96% 
      white) were randomized to one of two 10-week study treatment conditions: ( a) 
      exercise and nutrition counseling or ( b) exercise and nutrition counseling plus 
      the MORE intervention. Trial feasibility was assessed via recruitment and 
      retention metrics. Measures of therapeutic mechanisms included self-reported 
      interoceptive awareness, maladaptive eating behaviors, and savoring, as well as 
      natural reward responsiveness and food attentional bias, which were evaluated as 
      psychophysiological mechanisms. RESULTS: Feasibility was demonstrated by 82% of 
      participants who initiated MORE receiving a full dose of the intervention. Linear 
      mixed models revealed that the addition of MORE led to significantly greater 
      increases in indices of interoceptive awareness, savoring, and natural reward 
      responsiveness, and, significantly greater decreases in external eating behaviors 
      and food attentional bias-the latter of which was significantly associated with 
      decreases in waist-to-hip ratio. Path analysis demonstrated that the effect of 
      MORE on reducing food attentional bias was mediated by increased zygomatic 
      electromyographic activation during attention to natural rewards. CONCLUSIONS AND 
      IMPLICATIONS: MORE may target appetitive dysregulatory mechanisms implicated in 
      obesity by promoting interoceptive awareness and restructuring reward 
      responsiveness.
FAU - Thomas, Elizabeth A
AU  - Thomas EA
AD  - 1 University of Tennessee, Knoxville, TN, USA.
FAU - Mijangos, Jennifer L
AU  - Mijangos JL
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
FAU - Hansen, Pamela A
AU  - Hansen PA
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
FAU - White, Shelley
AU  - White S
AUID- ORCID: 0000-0003-2315-9498
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
FAU - Walker, Darren
AU  - Walker D
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
FAU - Reimers, Celestial
AU  - Reimers C
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
FAU - Beck, Anna C
AU  - Beck AC
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
FAU - Garland, Eric L
AU  - Garland EL
AUID- ORCID: 0000-0003-2891-857X
AD  - 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
LA  - eng
GR  - R01 DA042033/DA/NIDA NIH HHS/United States
GR  - R61 AT009296/AT/NCCIH NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Integr Cancer Ther
JT  - Integrative cancer therapies
JID - 101128834
SB  - IM
MH  - Adult
MH  - Aged
MH  - Body Mass Index
MH  - Cancer Survivors/*psychology
MH  - Counseling/methods
MH  - Exercise/psychology
MH  - Feeding Behavior/psychology
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Mindfulness/methods
MH  - Nutritional Status/physiology
MH  - Obesity/*psychology
MH  - Overweight/*psychology
MH  - Pilot Projects
MH  - Reward
MH  - Weight Loss/physiology
PMC - PMC6552347
OTO - NOTNLM
OT  - attentional bias
OT  - interoceptive awareness
OT  - obesity
OT  - savoring
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2019/06/06 06:00
MHDA- 2019/12/18 06:00
PMCR- 2019/06/05
CRDT- 2019/06/06 06:00
PHST- 2019/06/06 06:00 [entrez]
PHST- 2019/06/06 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2019/06/05 00:00 [pmc-release]
AID - 10.1177_1534735419855138 [pii]
AID - 10.1177/1534735419855138 [doi]
PST - ppublish
SO  - Integr Cancer Ther. 2019 Jan-Dec;18:1534735419855138. doi: 
      10.1177/1534735419855138.