Today’s Dietitian
Vol. 27 No. 9 P. 16
In the midst of heightened social and political tension and uncertainty about health care access—replayed continuously in the 24-hour news cycle—collective stress and anxiety levels have increased, for both patients and providers. For patients, psychosocial and emotional stress and anxiety can create barriers to behavioral change. Introducing mindfulness into dietetics practice has long been a valuable adjunct to both MNT and more counseling-focused nutrition interventions, in part because it helps people increase their awareness of what’s happening in the present moment and lessen rumination on unhelpful or distressing thoughts.
However, while helpful for many, mindfulness—specifically mindfulness meditation—is not a universal panacea. It may even have adverse effects for some individuals, including those with certain mental health conditions, or a history of trauma.1 For example, a 2019 study of 1,232 regular meditators found that 25% of them experienced unpleasant meditation experiences—anxiety, fear, distorted emotions or thoughts, altered sense of self or the world—that they thought might have been caused by their meditation practice.2 Additionally, some neurodivergent individuals may find that mindfulness, including mindful eating, is stressful and unpleasant.
Fortunately, mindfulness meditation is one small branch on the tree of what’s broadly known as contemplative practice, sometimes described as incorporating “practical methods to bring about a state of enduring well-being or inner flourishing.”3 This broad range of practices can offer a variety of benefits that may help individuals care for themselves in a meaningful way, which can in turn support adoption of nutrition and lifestyle changes that further improve health and well-being. But what are these practices, and how might they apply to patients for whom traditional mindfulness practice isn’t appropriate or desired?
What Are Contemplative Practices?
While there’s no universal definition of what falls under the umbrella of contemplative practice, it can include physical and mental behaviors that emphasize self-awareness, self-regulation, and/or self-inquiry. In addition to fostering states that promote individual well-being, contemplative practice may enhance traits that can contribute to social welfare through prosociality (helping, sharing, volunteering, empathy), equanimity (a state of calmness and mental composure), altruism (selfless concern for the well-being of others), compassion, and ethics.3
As demonstrated visually on the tree of contemplative practices,4 the roots are communication, connection, and awareness. The branches include the following practices:
- Activist: These combine contemplation with action. Examples include making a pilgrimage to areas where social justice issues are highlighted, volunteering, vigils and marches, and bearing witness.
- Creative: By engaging the mind through arts and expression, creative practices facilitate contemplative experiences through creativity. Examples include contemplative arts, improvisation, journaling, music, and singing.
- Generative: Involves activities such as prayers, visualization, and chanting, with a goal to foster feelings of compassion and devotion. Other examples include beholding, loving-kindness meditation, and Lectio Divinia (divine reading).
- Movement: The body’s movements can become a ground for contemplation, as evidenced by the diverse practices that promote mindfulness through physical activity. Examples include walking meditation, labyrinth walking, yoga, dance, qigong, aikido, and T’ai chi ch’uan.
- Relational: The focus is on cultivating a contemplative presence in interaction with others and the world. Examples include council circles, dialogue, deep listening, and storytelling.
- Ritual/Cyclical: These are periodic activities that connect us with the cycles of nature, life, or liturgical rhythms. Examples include establishing a sacred/personal space, retreats, and ceremonies and rituals based on spiritual or cultural traditions.
- Stillness: These encompass methods aimed at achieving tranquility and focus. Examples include meditation, quieting the mind, silence, and centering.
These practices have origins in a variety of world religious and spiritual traditions, including indigenous systems of healing and health promotion. They largely originated as part of integrated systems intended to help individuals and societies thrive and support health and well-being of all life.5
“Any activity that has us step into the present moment is going to offer us benefit,” says Megrette Fletcher, MEd, RD, CDE, a Seacoast, New Hampshire-based diabetes educator and mindful eating expert. “Whether we’re out in nature, whether we’re drumming, whenever we’re in the present moment, that’s going to offer us benefit.”
Benefits of Contemplative Practices
Richard Davidson, PhD, founder and director of the Center for Healthy Minds at the University of Wisconsin-Madison, wrote the foreword to a 2021 special issue of the journal Psychosomatic Medicine6 that included 16 articles on mindfulness. In that foreword, he issued a plea that “mindfulness be situated within a more expansive framework to cultivate well-being.” He said interventions needed to be appropriately broadened beyond mindfulness to include additional elements that are necessary for human flourishing. He said the cultivation of well-being includes four pillars: awareness, connection, insight, and purpose, and points out that mindfulness is only included in the first pillar.
In response to that plea, a 2022 paper from Standford University’s WELL for Life study5 looked at contemplative practices other than mindfulness meditation on different domains of well-being, including the following areas:
- social connectedness;
- stress and resilience;
- experience of emotions;
- physical health;
- purpose and meaning;
- sense of self;
- financial security and satisfaction;
- spirituality and religiosity; and
- exploration and creativity.
These contemplative practices were designed to be easy to integrate in daily life by pausing routine activities for at least five minutes to engage in activities such as:
- breathing deeply, gently stretching, and noticing the senses;
- observing emotions and thoughts as they arise rather than being caught up in them; and
- observing and modifying thoughts to offer more compassion, love, or kindness to oneself and others.
Among the three groups of study participants—one in California, one in China, and one in Taiwan—researchers found statistically significant positive associations between contemplative practices and well-being, both overall and with each of the constituent domains of wellbeing. Interestingly, these associations were comparable to or stronger than the relationship with physical activity, which was measured as a covariant, across most well-being outcomes.
A 2024 review of research on contemplative practices7 posits that the reason that these practices have been shown to benefit both psychological and physical well-being is that they facilitate a state termed “deep rest” that may be deeply restorative on a cellular level. It also counteracts the fact that most of us spend our waking hours in a state of moderate threat arousal. The authors note that to achieve deep rest, we need to feel safe, and that contemplative practices offer unique opportunities to do that, in part because they are typically conducted in safe spaces and can help reducing distressing thoughts.
Misunderstandings About Mindfulness
The mindfulness “trend” peaked around 2014, with the backlash beginning a few years later, says Jenna Hollenstein, MS, RDN, a Mamaroneck, New York-based Certified Intuitive Eating Counselor, meditation teacher, and author of Intuitive Eating for Life and Eat to Love. She says part of the problem is that mindfulness became portrayed as a tool to perform better at work, to have better sex, to lose weight, even though mindfulness was never intended to be used to obtain something. “There’s a dysfunctional way that people can do mindfulness, and a lot of it has to do with having a sense of virtue from practicing mindfulness,” she says.
Hollenstein also says some people tend to approach things in extreme ways, and that can include mindfulness. “Often I find that it comes from a place of thinking that something about you is broken and so you need to go in deep and hard to fix it.” She gives the example of someone who has never meditated deciding to go on a seven-day silent meditation retreat. “I’m like, can I talk you out of that? And maybe we can address some ways to bring more mindfulness into what you’re working with right now. But really, I think it’s almost like mindfulness as the opposite of compassion sometimes.”
Final Thoughts
Because of this, some patients or clients may find some contemplative practices to be more, or less, culturally appropriate. Dietitians can be supportive of any contemplative practice that resonates for their clients, or for themselves.
“When we’re in the helping professions, helpers tend to see suffering,” Fletcher says. “These contemplative practices are a way for us to see suffering with compassion for ourselves, but also a way to tap into a grounded or rooted practice.”
Hollenstein says that for dietitians who practice mindfulness themselves, it’s worth remembering that they aren’t immune to the very human tendency to get excited about something and start proselytizing. “Maybe some of the more traditional forms of meditation or mindfulness aren’t appropriate for some people. While I think body scans are a wonderful thing, for some people they’re not a good idea, because they’re not safe in their bodies. It’s not that these things aren’t amazing and don’t have great benefit, but just like we would hopefully be tailoring our nutrition recommendations and processes, we can tailor our recommendations about mindfulness-related practices.”
— Carrie Dennett, MPH, RDN, is the nutrition columnist for The Seattle Times, owner of Nutrition By Carrie, and author of Healthy for Your Life: A Non-Diet Approach to Optimal Well-Being.
References
1. Van Dam NT, van Vugt MK, Vago DR, et al. Mind the hype: a critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspect Psychol Sci. 2018;13(1):36-61.
2. Schlosser M, Sparby T, Vörös S, Jones R, Marchant NL. Unpleasant meditation-related experiences in regular meditators: prevalence, predictors, and conceptual considerations. PLoS One. 2019;14(5):e0216643.
3. Davidson RJ, Dahl CJ. Varieties of contemplative practice. JAMA Psychiatry. 2017;74(2):121-123.
4. What is contemplative practice? University of Colorado Boulder, Contemplative Resource Center website. https://www.colorado.edu/center/contemplativeresource/what-contemplative-practice. Accessed September 1, 2025.
5. Rich T, Chrisinger BW, Kaimal R, et al. Contemplative practices behavior is positively associated with well-being in three global multi-regional Stanford WELL for Life cohorts. Int J Environ Res Public Health. 2022;19(20):13485.
6. Davidson RJ. Mindfulness and more: toward a science of human flourishing. Psychosom Med. 2021;83(6):665-668.
7. Crosswell AD, Mayer SE, Whitehurst LN, Picard M, Zebarjadian S, Epel ES. Deep rest: an integrative model of how contemplative practices combat stress and enhance the body’s restorative capacity. Psychol Rev. 2024;131(1):247-270.
