The Role of Interoception in Lifestyle Factors: A Systematic Review

BackgroundInteroception, the perception of the internal state of the body, offers an underrepresented and intriguing potential avenue for altering lifestyle-related behaviors. Interoception is intrinsically related to maintaining homeostasis and the flexible allostatic regulation of complex demands. Internal bodily states may also be influenced by lifestyle factors and related problems. This systematic review aimed to provide insight into the current state of evidence about the role of interoception in lifestyle factors. MethodsStudies from three databases (PubMed, Embase, and Web of Science) were screened for eligibility based on two inclusion criteria: 1) at least one measure of interoception (e.g., interoceptive accuracy, attention, or awareness), and 2) at least one measure of a lifestyle factor (i.e., alcohol consumption, cognitive leisure and relaxation activities, eating behavior, exercise, sleep, or smoking). Risk of bias was assessed using an adjusted quality score checklist, consisting of five items related to study design, population size, exposure measurement, outcome measurement, and adjustment for confounders. ResultsThe review included 73 studies. Out of the included studies, 51 measured interoceptive accuracy and 36 measured interoceptive attention. Six studies quantified interoceptive awareness. In terms of lifestyle factors, 26 studies on cognitive leisure and relaxation activities, 19 studies on eating behavior, 12 studies focused on alcohol consumption, 10 studies on exercise, five studies on smoking, and four studies on sleep were identified. Findings show positive relations between interoception and cognitive leisure and relaxation activities, eating behavior, and exercise. Conversely, the consumption of alcohol is negatively related to interoception. Studies in the smoking and sleep lifestyle factors were sparse and of varying methodological quality. DiscussionThe findings of this review show that interoceptive domains are associated with various lifestyle factors, but the quality of the evidence is limited. Future longitudinal studies with more objective measures of interoception are needed in order to better understand the interrelations between interoception and lifestyle factors. HighlightsO_LIStrong support for importance of mindfulness in interoception C_LIO_LILess strong positive relations between interoception, eating behavior, and exercise C_LIO_LILess strong negative relation between interoception and alcohol consumption C_LIO_LIResults show lack of articles using objective interoceptive attention measures C_LIO_LIResults show lack of quantification of interoceptive awareness C_LI