Imagine HEALTH: Changes in diurnal salivary cortisol patterns following a 12-week guided imagery RCT lifestyle intervention in predominantly Latino adolescents

Imagine HEALTH: Changes in diurnal salivary cortisol patterns following a 12-week guided imagery RCT lifestyle intervention in predominantly Latino adolescents

Alterations in diurnal salivary cortisol patterns have been linked to adverse metabolic health outcomes. We have previously shown that stress-reduction guided imagery (GI) can reduce salivary cortisol levels acutely. We now ask whether addition of GI into a 12-week lifestyle intervention designed to...

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Bibliographic Details
Published in:Psychoneuroendocrinology Vol. 151; p. 106053
Main Authors: Weigensberg, Marc J., Wen, Cheng KF, Sanogo, Fatimata, Toledo-Corral, Claudia, Ding, Li
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01-05-2023
Subjects:
Adolescent
Adolescents
Circadian Rhythm - physiology
Cortisol
Exercise
Guided imagery
Hispanic or Latino
Humans
Hydrocortisone - analysis
Imagery, Psychotherapy - methods
Latino
Life Style
Obesity
Saliva - chemistry
Stress reduction
Obesity
GI
RCT
C
LS
SRGI
Cortisol
Guided imagery
PSS
Stress reduction
CAR
DCS
Latino
HPA
LBGI
Adolescents
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Summary:Alterations in diurnal salivary cortisol patterns have been linked to adverse metabolic health outcomes. We have previously shown that stress-reduction guided imagery (GI) can reduce salivary cortisol levels acutely. We now ask whether addition of GI into a 12-week lifestyle intervention designed to improve eating and physical activity behaviors can alter diurnal salivary cortisol patterns and perceived stress. 232 adolescent participants (ages 14–17 years) were cluster randomized by school into one of four intervention arms: non-intervention Control (C; n = 51), Lifestyle (LS; n=61), Stress-Reduction GI (SRGI; n = 55), and Lifestyle Behavior GI (LBGI; n = 65). LS group received one nutrition and one physical activity class per week after-school for 12 weeks. SRGI and LBGI groups received same LS classes plus an additional weekly GI session. Salivary cortisol was assessed pre- and post-intervention on 3 days, 3 times daily, at awakening, 30-minutes post-awakening, and in the evening to determine Cortisol Awakening Response (CAR) and Diurnal Cortisol Slope (DCS). Perceived Stress Scale (PSS) was administered pre- and post-intervention. Mixed effects modeling was used for intent-to-treat analysis and sensitivity analysis was used for those participants adherent to intervention protocol. Analysis of 208 subjects with complete data showed a small between-group increase in CAR in LBGI vs C (p = 0.045, d=0.24), with no significant group differences among other intervention arms. There were no between group differences in change in DCS or change in PSS after 12-weeks. Amongst adherent participants, LBGI showed a small-moderate increase in CAR (p = 0.03, d=0.37), and moderate-large reduction in PSS (p = 0.02, d=−0.66) compared to C. There were no other between group differences in CAR, DCS, or PSS. LBGI led to an increase in CAR, and in adherent subjects, a decrease in PSS, suggesting GI may be a mind-body intervention that can affect both objective and subjective measures of the stress response. Whether changes in cortisol patterns in this population affect measures of mental or physical health remains to be determined. •Chronic stress and altered salivary cortisol patterns are linked to poor metabolic health outcomes.•Guided imagery lifestyle intervention in adolescents led to changes in salivary cortisol patterns.•These changes may promote health in an adolescent population with known health disparities.
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ISSN:0306-4530
1873-3360
DOI:10.1016/j.psyneuen.2023.106053