As the life expectancy of individuals with cystic fibrosis (CF) increases, so does the need to further develop psychosocial care, advice and interventions. The need to maintain optimal nutritional status has not been easy for the past decades for clinicians and individuals with CF, contributing to maladaptive nutritional intake for some people. This letter briefly suggests how research and clinical practice that incorporates mindfulness and mindful eating can improve the nutritional well-being of individuals with CF.

Research with regard to generic eating experiences and behaviours within CF populations which could help us understand how eating can be improved to fully achieve the maintenance of a healthy weight is scarce. Nutritional advice derived from clinicians and dieticians is often focused on practical and useful tips (i.e. what to eat, how to prepare meals, amount of calories needed daily), and there is a general consensus that behavioural advice does increase the impact of, and adherence to, nutritional interventions. However, the empirical evidence supporting behavioural interventions is limited, and behavioural advice is somewhat contradictory.

Behavioural advice in the patient information literature is by necessity generic, but also contradictory to contemporary research. For example, to enhance the appetite and consumption among CF patients, the UK CF Trust [1] suggests “limit mealtimes to about 30 min and space mealtimes 3–4 h apart.”, while at a later segment it is suggested that people “Eat food slowly and chew food well” [p. 11]. Eating slowly and chewing well, and consuming a meal within 30 min may be problematic for some people. Longer meal duration was associated with nutritional barriers (such as resistance to eat more) and smaller bodies in toddlers and school-aged children [e.g. 2]. There is a wide body of evidence documenting eating difficulties in childhood, adolescence and adulthood. What is not currently well understood is whether taking a long time to eat a meal signals enjoying meals, or whether individuals may be struggling to eat the amounts required. Suggestions to prolong the meal by chewing slowly and taking your time between mouthfuls may, for people who experience difficulties, increase the levels of distress, unless it constitutes a prototype of attentive or mindful eating.

There are complex issues that may be relevant to mindfulness and mindful eating. Preoccupation with food, exercise and weight are main indicators of (or diagnostic criteria for) eating disorders, but are also elements that are essentially evident and consistently observed in CF patients. For a person with CF, preoccupation with food, compulsively eating calorie-dense foods and restricting intake of other low calorie foods could be considered as adaptive and life enhancing attitudes and behaviours (rather than maladaptive). It seems reasonable to suggest that preoccupation and attentiveness to food, exercise and weight may be one method of being mindful, or may be an attentive method that entails judgement (hence, making it partially mindful or mindless) and this presents an interesting question for future research.

Practising mindfulness entails experiencing the present moment, whether it is pleasant or unpleasant, with qualities of awareness, non-judgement, acceptance and compassion. So, whether prolonging the meal and being attentive is a pleasant or unpleasant experience, mindfulness could help. Attentive and mindful eating or mindfulness-based interventions have been recently explored and found to assist individuals with both weight regulation and eating disorders [e.g. 3]. The assumption is that mindfulness assists in self-regulation by reducing the automatic, emotional and impulsive responses around food, which are primarily responsible for weight difficulties.

The exploration of mindfulness and mindfulness-based interventions and how they may benefit some individuals with CF appears promising. Future research should initially explore mindfulness in relation to physiological health behaviours and outcomes (i.e. eating behaviours and attitudes, smoking, alcohol consumption, medical adherence). Our current research investigates normative or everyday eating behaviours, mindfulness and mindful eating, and aims to develop and evaluate advice and interventions with the support of practitioners and people with CF. Mindfulness and mindfulness-based practices (including compassionate-based interventions or acceptance and commitment therapy) have proven to encompass a plethora of ways of helping people with physical and mental health difficulties and may well be another area of research and practice that will enhance the health and well-being of individuals with CF.