Table 2.

Meta and Reviews

	Study Design	Biomarker	Purpose	Intervention	Search Terms	Outcome Conclusions
Black, 2016	Systematic Review RTCs	Circulating and stimulated inflammatory proteins, cellular transcription factors and gene expression, immune cell count, immune cell aging, and antibody response	A comprehensive review of randomized controlled trials examining the effects of mindfulness meditation on immune system parameters.	Mindfulness based	Immune, inflammation, cytokine, proinflammatory, biomarker, blood, saliva, urine, telomere, and infection.	Effects on specific markers of inflammation, cell-mediated immunity, and biological aging.
Bower, 2016	Qualitative Review	Circulating, cellular, and genomic markers of inflammation	To describe the effects of mind-body therapies (MBTs) on circulating, cellular, and genomic markers of inflammation.	MBTS: Mind-body therapies (Tai Chi, Qigong, yoga, and meditation).	Mind-body therapies, tai chi, qigong, meditation, mindfulness, or yoga; and inflammation, cytokines, or proinflammatory.	Decreased expression of inflammation-related genes and reduced signaling through the proinflammatory transcription factor NF-κB.
Bushell, 2020	Qualitative Review	Unspecified testing	Explore pioneering studies in stem cell and regenerative biology, associated with Meditation.	Cognitive behavioral practices	Unspecified	Downregulated substances are proinflammatory cytokines (IL-1β, IL-6, TNF-α) and transforming growth factor (TGF-β).
Buric, 2017	Systematic review	Gene expression involved in inflammatory reactions	To examine changes in gene expression that occur after MBIs and to explore how these molecular changes are related to health.	MBIs (ie, mindfulness, yoga, Tai Chi, Qigong, relaxation response, and breath regulation)	Meditation OR mindfulness OR relaxation response OR yoga OR tai chi OR Qigong) and (gene expression OR microarray OR transcriptome.	Downregulation of nuclear factor kappa B pathway; this is the opposite of the effects of chronic stress on gene expression and suggests that MBI practices may lead to a reduced risk of inflammation-related diseases.
Chen, 2012	Systematic review and meta-analysis	Unspecified	The efficacy of meditation for anxiety specifically.	Meditative techniques	RCTs: various, unspecified types of meditation and anxiety.	Twenty-five of 36 (70%) of studies reported statistically superior outcomes in the meditation group compared to control. No adverse effects were reported.
Cramer, 2012	Systematic review (US National Health Interview Survey (NHIS) data)	Self Report: QOL, Mental Health	To determine the popularity of meditation is increasing, little is known about the prevalence, patterns, and predictors of meditation use in the general population.	Meditation	NHIS Community Sample (4525 adults).	Meditation was mainly used for general wellness (76.2%), improving energy (60.0%), and aiding memory or concentration (50.0%). Anxiety (29.2%), stress (21.6%), and depression (17.8%) were the top health problems for which people used meditation; 63.6% reported that meditation had helped a great deal with these conditions.
Dunn, 2022	Meta	RCTs: biomarkers were selected for this meta-analysis: CD4+, CRP, IL-6, NF-κB, TL, TA	Mindfulness-based interventions (MBIs) may offer a salutogenic effect on somatic disorders is by enhancing immune function.	Mindfulness-based interventions (MBIs)	RCTs examining the effect of MBIs on three immune parameters: inflammation (C-reactive protein, interleukin-6, nuclear factor-κB), infection response (CD4+ cells), and biological ageing (telomere length, telomerase activity) at post-intervention and follow-up.	Pooled effect sizes indicated a reduction in C-reactive protein (SMCD = −0.14, 95% CI [−.26 – −0.01]) and interleukin-6 (SMCD = −0.35, 95% CI [−.67 – −0.03]), and an increase in CD4+ (SMCD = 0.09, 95% CI [−.05 – 0.22]), telomere length (SMCD = 0.12, 95% CI [0.00 – 0.24]) and telomerase activity (SMCD = 0.81, 95% CI [0.17–1.46]) at post-intervention. At follow-up, results showed a reduction in interleukin-6 (SMCD = −0.13, 95% CI [−.29 – 0.03]) and C-reactive protein (SMCD = −0.39, 95% CI [−.68 – −0.10]) and increase in CD4+ (SMCD = 0.22, 95% CI [−.08 – 0.52]). Meta-regression results showed that some heterogeneity in effect size could be accounted for by intervention dosage, study population, and study design. Our findings quantify MBIs’ potential for improving immune function and thus impacting somatic disorders.
Goldberg, 2022	Meta	A wide range of populations, problems, interventions, comparisons, and outcomes (PICOS)	To evaluate the scientific basis for mindfulness-based interventions (MBIs).	Mindfulness-based interventions (MBIs).	RCTs: effect sizes based on four or more trials that did not combine passive and active controls.	MBIs were similar or superior to specific active controls and evidence-based treatments. MBIs showed superiority to passive controls across most PICOS (ds = 0.10–0.89).
Dalpati, 2022	Review	A variety of immune markers	Summarise the effect of COVID 19 lockdowns and positive impacts of yoga and meditation on various psychological, emotional, and immunological parameters.	Summarise the available evidence on the effect of yoga and meditation on various psychological, emotional, and immunological parameters.	Unspecified	Improved respiratory health, reduced inflammation, better innate and adaptive immune cell function, reduced inflammatory cytokines.
Goleman, 2017	Book: Qualitative Review	EEG and other neurological markers	To evaluate the claims about the efficacy of mindfulness and meditation.	Meditation	Unspecified	“Quickie, one-time interventions”—like a weekend meditation course—are unlikely to make a lasting difference”; The amygdala, a key node in the brain’s stress circuitry, shows dampened activity from a mere 30 or so hours of MBSR practice; Long-term practice was associated with greater functional connectivity between the prefrontal areas that manage emotion and the areas of the amygdala that react to stress, resulting in less reactivity; an improved ability to regulate attention accompanies some of the beneficial impact of meditation on stress reactivity.
Jiang, 2021	Meta	Self Report: Sleep Quality from Pre- to Post-intervention	To evaluate the effect of virtual mindfulness-based interventions (MBIs) on sleep quality.	Virtual mindfulness-based interventions (MBIs)	Online OR internet OR digital OR m-health OR e-health OR computer* OR web* OR app OR smartphone OR mobile application) AND (mindful* OR meditate* OR Vipassana OR “acceptance and commitment therapy”) AND (sleep [TIAB] OR insomnia [TIAB]	Virtual MBIs are more effective at improving sleep quality than usual care controls and waitlist controls. Studies provide preliminary evidence that virtual MBIs have a long-term effect on sleep quality.
Khanpour, 2021	Systematic Review	Self Report: Signs and symptoms of ME/CFS and QOL	To systematically review studies using MBIs for the treatment of ME/CFS symptoms.	Mind-Body (MBIs): mindfulness-based stress reduction and mindfulness-based cognitive therapy, relaxation, Qigong, and yoga.	ME/CFS: Various	Fatigue severity, mental functioning and anxiety/depression improved when compared to the control group.
Linardon, 2020	Systematic review and meta-analysis	Outcome measure of acceptance, mind- fulness, or self-compassion	To examine whether principles of acceptance, mindfulness, and self-compassion can be learned through smartphone apps.	Smartphone-Based Meditation App.	Smartphone* OR “mobile phone” OR “cell phone” OR “mobile app*” OR iphone OR android OR mhealth OR m-health OR “cellular phone” OR “mobile device*” OR mobile-based OR “mobile health” OR tablet-based AND random* OR trial* OR allocat* AND mindful* OR accept* OR ACT OR meditate* OR compass*.	Smartphone apps also resulted in significantly lower levels of psychological distress than comparisons (k=22; g=−0.32; 95% CI=−0.48, −0.16). Meta-regression revealed a negative relationship between the effect sizes for mindfulness/acceptance and the effect sizes for distress. Smartphone apps produced significantly greater increases in self-compassion than comparisons (k=9; g=0.31; 95% CI=0.07, 0.56)
Pascoe, 2017	Meta	Neurobiological effects	To investigate the effects of focused attention, open monitoring and automatic self-transcending subtypes, compared to an active control, on markers of stress.	Mindfulness-Based Interventions (MBIs).	Unspecified	When all meditation forms were analysed together, meditation reduced cortisol, C - reactive protein, blood pressure, heart rate, triglycerides and tumour necrosis factor-alpha. Overall, meditation practice leads to decreased physiological markers of stress in a range of populations.
Rathore, 2018	Systematic Review	Telomere Stability	To investigate telomere stability and its implication from the point of view of asana, pranayama, and meditation.	Pranayama Yoga and Meditation.	“telomere length” AND “yoga.”	The results of this review highlight the positive effects of yoga intervention on telomere length. The study suggests that the impact is mediated through upregulation of enzymes that degrades ROS and thereby prevents the accumulation of ROS in cells. ROS is produced as a normal product of cellular metabolism.
Sanada, 2020	Meta	Measurements were collected from the outcomes of such indices as adrenocorticotropic hormone (ACTH), cortisol (area under the curve or AUC, awakening response or CAR, and diurnal slope), cytokines (IL-6, IL-8 and TNF-α), nuclear factor enhancer of the kappa light chains of activated B cells (NF-kB), high-sensitive CRP (hsCRP) and epidermal growth factor (EGF)	To examine the effects of MBIs on biomarkers in psychiatric illness used to summarise the effects of low-grade inflammation.	Mindfulness-Based Interventions (MBIs).	Extensive: psychiatric disorders“[All Fields] OR “psychiatric disturbances”[All Fields] OR “psychiatric”[All Fields]) AND (“mindfulness”[MeSH Terms] OR “mindfulness”[All Fields] OR mbct[tiab] OR mbsr[tiab] OR “Mindfulness-Based Cognitive Therapy”[tiab] OR “Mindfulness Based Stress… Etc.	MBIs showed significant improvements in the event-related potential amplitudes in attention-deficit hyperactivity disorder, the methylation of serotonin transporter genes in post-traumatic stress disorder, the salivary levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) in depression, and the blood levels of adrenocorticotropic hormone (ACTH), IL-6, and TNF-α in generalised anxiety disorder. MBIs showed significant effects on health status related to biomarkers of low-grade inflammation (g = −0.21).
Schlechta Portella, 2021	Evidence Map of Systematic Reviews	Physical and Metabolic Effects; Mental Health; Vitality, Well-Being, and Quality of Life	To addressed the effects of meditation on various clinical and health conditions.	Meditation types based on open state practices accounted for the highest number of results (390 results), followed by mixture of techniques (93 results), mantra-focused practices (15 results), state-focused practices (8 results), and focused mindfulness practices.	Extensive: MH:Meditation OR TI:Meditation OR TI:Meditação OR TI:Meditacion OR TI:Mindfulness OR Cogitat* OR Pranayam* OR kapalabhati OR TI:zen OR TI:transcendental OR “M-Sidhi” OR mahayana OR hiniyana OR theravada* OR vajrayana OR vipassana OR… Etc.	Physical and Metabolic outcomes presents a total of 87 results. The effect of meditation was positive in 41 results, potentially positive in 29 results, inconclusive in 15 results, and with no effects in two results. The most common outcomes were improvements regarding high blood pressure, general cancer symptoms, and chronic pain.
Schutte, 2013	Meta	Telomerase activity	To determine the effect of mindfulness meditation on telomerase.	Mindfulness-based interventions (MBIs)	Various: Mindfulness meditation leads to increased telomerase activity in peripheral blood mononuclear cells.	Effect size of d=0.46 indicated that mindfulness meditation leads to increased telomerase activity in peripheral blood mononuclear cells.
Venditti, 2020	Systematic Review	DNA Methylation; molecular and epigenetic mechanisms influenced by different mindful practices	To uncover the molecular and epigenetic mechanisms influenced by different mindful practices.	Mindfulness meditation, Vipassana, Yoga, Tai Chi, and Quadrato Motor Training.	Unspecified	Meditation practices act on the same gene targets, such as FKBP5, SLC6A4, and BDNF, and promote endocrinal, neuronal, and behavioral functions. This suggests that the achievement of a state of inner silence through the practice of meditation can prevent or reverse the detrimental effects of a stressful environment.
Whitfield, 2021	Meta	Cognition	To review objective cognitive outcomes across multiple domains from randomized MBP studies.	Mindfulness-based interventions (MBIs)	Mindfulness-based programs (MBPs) on cognitive functioning and objective cognitive outcomes.	Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only.
Zhang, 2021	Review	Unspecified	To provide an overall review on mindfulness-based interventions (MBIs).	Mindfulness-based interventions (MBIs)	Various: ‘mindfulness’, “meditation”, and “review”, “meta-analysis” or their variations.	MBIs are effective for improving many biopsychosocial conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms and prosocial behaviours.