Effect of yoga based lifestyle intervention on subjective well-being.

Yoga is assuming importance in improving mental health and quality of life in the treatment of a number of psychiatric and psychosomatic disorders. The present study was a prospective controlled study to explore the short-term impact of a comprehensive but brief lifestyle intervention, based on yoga, on subjective well being levels in normal and diseased subjects. Normal healthy individuals and subjects having hypertension, coronary artery disease, diabetes mellitus or a variety of other illnesses were included in the study. The outcome measures were 'subjective well being inventory' (SUBI) scores, taken on the first and last day of the course. The inventory consists of questions related to one's feelings and attitude about various areas of life, such as happiness, achievement and interpersonal relationship. There was significant improvement in the subjective well being scores of the 77 subjects within a period of 10 days as compared to controls. These observations suggest that a short lifestyle modification and stress management educational program leads to remarkable improvement in the subjective well being scores of the subjects and can therefore make an appreciable contribution to primary prevention as well as management of lifestyle diseases.

Role of temporalis muscle over activity in chronic tension type headache: effect of yoga based management.

The role of central versus peripheral mechanisms has always been questioned while explaining the etiopathogenesis of chronic tension type headache (CTTH). The following study was done to study the role of muscle spasm in CTTH. 15 patients of CTTH and 7 age matched controls were included in the study and their m. temporalis EMG was recorded for one minute each during rest, mental activity and maximal voluntary contraction and subjective pain scoring was done by visual analogue scale. The results revealed significant overactivity of m.temporalis in CTTH patients at rest when compared with control subjects (P = 0.01 and 0.03 left and right side respectively). After respective interventions namely non steroidal anti inflammatory drugs, botulinum toxin injections and yogic life style course, the EMG records revealed decrease in the mean EMG amplitude of m. temporalis during rest and mental activity more significantly after yoga based interventions (P = 0.03) and subjective pain scores decreased from 7.00 +/- 2.10 to 2.00 +/- 1.26 (P = 0.02) supporting the beneficial effect of such non invasive techniques.

Effect of yoga based lifestyle intervention on state and trait anxiety.

Considerable evidence exists for the place of mind body medicine in the treatment of anxiety disorders. Excessive anxiety is maladaptive. It is often considered to be the major component of unhealthy lifestyle that contributes significantly to the pathogenesis of not only psychiatric but also many other systemic disorders. Among the approaches to reduce the level of anxiety has been the search for healthy lifestyles. The aim of the study was to study the short-term impact of a comprehensive but brief lifestyle intervention, based on yoga, on anxiety levels in normal and diseased subjects. The study was the result of operational research carried out in the Integral Health Clinic (IHC) at the Department of Physiology of All India Institute of Medical Sciences. The subjects had history of hypertension, coronary artery disease, diabetes mellitus, obesity, psychiatric disorders (depression, anxiety, 'stress'), gastrointestinal problems (non ulcer dyspepsia, duodenal ulcers, irritable bowel disease, Crohn's disease, chronic constipation) and thyroid disorders (hyperthyroidism and hypothyroidism). The intervention consisted of asanas, pranayama, relaxation techniques, group support, individualized advice, and lectures and films on philosophy of yoga, the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The outcome measures were anxiety scores, taken on the first and last day of the course. Anxiety scores, both state and trait anxiety were significantly reduced. Among the diseased subjects significant improvement was seen in the anxiety levels of patients of hypertension, coronary artery disease, obesity, cervical spondylitis and those with psychiatric disorders. The observations suggest that a short educational programme for lifestyle modification and stress management leads to remarkable reduction in the anxiety scores within a period of 10 days.

An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects.

The study was conducted to examine the hypothesis that yogasanas help in the treatment of diabetes mellitus by releasing insulin from the pancreas. Twenty healthy young voluntees (17 male, 3 female; age 19-31 years) participated in the study. Each volunteer performed four sets of asanas in random order for 5 consecutive days each with a 2-day gap between consecutive sets of asanas. The four sets of asanas were: (I) dhanurasana + matsyendrasana, (II) halasana + vajrasana, (III) naukasana + bhujangasana, and (IV) setubandhasana + pavanamuktasana. Blood samples were collected on days 4 and 5 of each set of asanas for measurement of glucose and insulin levels before the asanas, within 10 min after performing the asanas, and 30 min after ingestion of 75 g glucose, which in turn was ingested immediately after the second blood sample. A standard 75 g oral glucose tolerance test (OGTT) was also done before and after the study. On the days of the pre-study or post-study OGTT, no asanas were done. The serum insulin levels after the asanas were lower (P<0.05) than those before the asanas. However, the serum insulin level 0.5 h after the post-asana oral 75 g-glucose challenge was higher (P<0.05) in Set IV than the 0.5 h postprandial insulin level in the pre-study OGTT; the same trend was observed in other sets as well although statistically not significant. The observations suggest that the performance of asanas led to increased sensitivity of the B cells of pancreas to the glucose signal. The increased sensitivity seems to be a sustained change resulting from a progressive long-term effect of asanas. The study is significant in that it has for the first time attempted to probe the mechanism by which yogasanas help diabetes mellitus.

Serum lipid response to introducing ghee as a partial replacement for mustard oil in the diet of healthy young Indians.

Ghee (clarified butter) has generally been assumed to be hypercholesterolaemic on the basis of its composition but there is hardly any study to support or refute the assumption. The present study was conducted on sixty-three healthy, young, physically active adult volunteers (52 male, 11 female). The study design was that of a randomized controlled trial with a parallel design. After a lead-in period of 2 wk, the subjects were randomly divided into two groups, Group A (n = 30; 25 male, 5 female) and Group B (n = 33; 27 male, 6 female). Group A (experimental) consumed for 8 wk a diet in which ghee provided 10% of the energy intake. The only other visible fat in the diet was mustard oil, and total energy from fats was 25% of the energy intake. Group B (control) consumed for 8 wk a similar diet except that all visible fat came from mustard oil. The serum total cholesterol level showed a significant rise in the experimental group at 4 wk; the rise persisted at 8 wk. A similar rise was also seen in HDL cholesterol. Hence the total cholesterol/HDL cholesterol ratio did not show any significant change. In the control group, there was a trend towards a fall in LDL cholesterol but the change was not significant. The study does not indicate any adverse effect of ghee on lipoprotein profile. However, more studies are needed on older subjects, hyperlipidaemic subjects, and on subjects following less healthy lifestyles before the results of this study can be extrapolated to the general population.

The effect of ingestion of egg on the serum lipid profile of healthy young Indians.

Thirty four healthy young volunteers (22 men, 12 women; age 25.7 +/- 5.8 years; BMI 20.8 +/- 2.3 kg/m2) participated in a randomized controlled cross-over trial on the effect of consuming one boiled egg every day for 8 wk on the serum lipid profile. The only significant change after 8 wk of egg consumption was an elevation of the total cholesterol/HDL cholesterol ratio. However, scrutiny of individual responses revealed that twelve of the subjects (10 men, 2 women) had a greater than 15% rise in the LDL cholesterol level after 8 wk of egg consumption. These subjects, considered hyperresponders, showed significant increases (P < 0.025) at both 4 wk and 8 wk after egg consumption in total cholesterol and LDL cholesterol levels, and at 8 wk in total cholesterol/HDL cholesterol ratio. The remaining 22 hyporesponders showed no change in any of the variables measured at 4 wk or 8 wk after egg consumption. In view of the high nutritional value of eggs, a blanket ban on eggs is not justified. However, since up to one-third of the population may be hyperresponders, knowing the response of an individual is important before making the egg a regular item of the diet.

Short-term physical training alters cardiovascular autonomic response amplitude and latencies.

This study reports the results of 15 days of exercise training in 25 adult males on cardiovascular autonomic response amplitude and latencies. A standard battery of autonomic function tests including both activity (tone) and reactivity was used. Parasympathetic activity as evaluated from Heart rate variability (HRV) showed no statistically significant change in both time and frequency domain measures, similarly Sympathetic activity as measured by QT/QS2 ratio showed no statistically significant change, but there was a trend of a decrease in sympathetic activity and an increase in parasympathetic activity. There were no changes in the parameters measuring parasympathetic reactivity. Sympathetic reactivity as evaluated by diastolic blood pressure responses to hand grip test (HGT) and cold pressor test (CPT) showed significant decreases. Time domain assessment of autonomic responses was done by measuring tachycardia and bradycardia latencies during Valsalva maneuver (VM) and lying to standing test (LST). Physical training resulted in a decrease in tachycardia latency during LST and a decrease in bradycardia latency during VM. We conclude from the present study that 15 days of physical training is not enough to alter autonomic activity and PNS reactivity but can result in changes in SNS reactivity and latency parameters. We hypothesize that a decrease in bradycardia latency during VM signifies a faster recovery of heart rate during VM and a decrease in tachycardia latency during LST denotes a delayed activation of the system both of which are favorable cardiovascular responses.

The effect of ingestion of egg on serum lipid profile in healthy young free-living subjects.

Egg is a major source of dietary cholesterol. Previous studies on the effect of egg on serum lipid profile have given conflicting results. Further, the serum lipid response to egg shows marked individual variation. Since the variation is at least partly genetically determined, and the response depends partly on the overall diet, studies on different ethnic groups are important. There is hardly any study on the subject available on Indians. In the present investigation, eighteen healthy young volunteers (7 male, 11 female) on a lacto-vegetarian diet were given one boiled egg per day for 8 wk in a randomized controlled cross-over study. Compared to the values obtained after 8 wk of egg-free period, the mean serum total cholesterol, LDL cholesterol, HDL cholesterol, total cholesterol/HDL ratio, VLDL cholesterol and triglycerides were not significantly different after 8 wk of egg consumption. However, the serum total cholesterol after 4 wk of egg consumption was significantly higher than the control values. Further, seven subjects out of 18 had an appreciable elevation of serum total cholesterol or LDL cholesterol, or both, after 8 wk of egg consumption. The study suggests that in young healthy Indian subjects on a vegetarian diet, consuming one egg per day raises serum cholesterol levels at 4 wk but in the majority baseline values are restored by 8 wk. However, some hyper-responders continue to have elevated serum cholesterol even at 8 wk. Knowing the response of an individual may be important before making egg consumption a regular habit.

Treadmill training accelerates restoration of locomotion after complete spinal cord transection in the rat.

This short communication is devoted to the problem of the effect of the regular treadmill training on the restoration of motor function after spinal cord interruption. Experiments were carried out on the full spinalized rats. One group of the operated rats (n = 5) received regular treadmill training and another group (n = 5) did not receive any training. Motor behavior and activity were investigated weekly up to week 9 after spinalization. It was observed that trained rats restarted motor behavior earlier and demonstrated locomotor hindlimbs movements, and were more active than untrained rats.

Effect of partial replacement of visible fat by ghee (clarified butter) on serum lipid profile.

A randomised controlled trial with a parallel design was conducted on 24 healthy young volunteers who were divided into two groups. After a lead-in period of 2 wk, the experimental group (n = 11; 9 male, 2 female) had for 8 wk a lactovegetarian diet providing about 25% of the energy intake in the form of fat, of which ghee provided 10 en% and the remaining fat energy came from mustard oil and invisible fat. The control group (n = 13; 8 male, 5 female) had a similar diet except that all visible fat was in the form of mustard oil. In neither group was there any significant change in the serum lipid profile at any point in time. At 8 wk, 2 volunteers in the experimental group, and 1 volunteer in the control group had more than 20% rise in serum total cholesterol as compared to their 0 wk values. There was also an appreciable increase in HDL cholesterol at 8 wk in the experimental group, but it was not statistically significant. Consuming ghee at the level of 10 en% in a vegetarian diet generally has no effect on the serum lipid profile of young, healthy, physically active individuals, but a few individuals may respond differently.

Effect of Chyawanprash and vitamin C on glucose tolerance and lipoprotein profile.

Chyawanprash is an ancient Indian dietary supplement containing vitamin C (34 mg/100 g) derived from amla (Emblica officinalis). In addition, Chyawanprash also contains several other herbal products. The present study was designed to compare the effects of vitamin C with those of Chyawanprash. Ten normal healthy adult male volunteers (age 20-32 years) participated in the 16-week study. They were placed randomly in either the Chyawanprash group (n = 5) or vitamin C group (n = 5). Those in the former received 15 g/d of Chyawanprash while those in the latter received 500 mg/d vitamin C during the first 8 weeks of the study. For the next 8 weeks, no supplement was given. For each individual, an oral glucose tolerance test was performed, and lipoprotein profile in peripheral serum samples was determined at 0 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks. In the Chyawanprash group, the 8 weeks Vs 0 weeks value (mean +/- S.D.) respectively for various indices which were significantly different were fasting plasma glucose (100.2 +/- 5.58 mg/dl vs 116.2 +/- 11.6 mg/dl), area under 2-h plasma glucose curve (245.9 +/- 15.13 mg.dl-1.h vs 280.8 +/- 37.09 mg.dl-1.h), HDL cholesterol (53.2 +/- 4.56 mg/dl vs 42.7 +/- 7.17 mg/dl), LDL cholesterol (82.4 +/- 8.80 mg/dl vs 98.26 +/- 12.07 mg/dl), LDL/HDL ratio (1.56 +/- 0.28 vs 2.38 +/- 0.63). In the Vitamin C group, only the LDL/HDL ratio was significantly lower at 8 weeks than at 0 weeks (1.99 +/- 0.44 vs 2.29 +/- 0.43). All the variables that changed significantly were no longer significantly different from the 0 weeks value at 16 weeks. Chyawanprash reduces postprandial glycemia in the oral glucose tolerance test and reduces blood cholesterol level to a significantly greater extent than vitamin C.

Retardation of coronary atherosclerosis with yoga lifestyle intervention.

BACKGROUND: Yoga has potential for benefit for patients with coronary artery disease though objective, angiographic studies are lacking. MATERIAL AND METHODS: We evaluated possible role of lifestyle modification incorporating yoga, on retardation of coronary atherosclerotic disease. In this prospective, randomized, controlled trial, 42 men with angiographically proven coronary artery disease (CAD) were randomized to control (n = 21) and yoga intervention group (n = 21) and were followed for one year. The active group was treated with a user-friendly program consisting of yoga, control of risk factors, diet control and moderate aerobic exercise. The control group was managed by conventional methods i.e. risk factor control and American Heart Association step I diet. RESULTS: At one year, the yoga groups showed significant reduction in number of anginal episodes per week, improved exercise capacity and decrease in body weight. Serum total cholesterol, LDL cholesterol and triglyceride levels also showed greater reductions as compared with control group. Revascularisation procedures (coronary angioplasty or bypass surgery) were less frequently required in the yoga group (one versus eight patients; relative risk = 5.45; P = 0.01). Coronary angiography repeated at one year showed that significantly more lesions regressed (20% versus 2%) and less lesions progressed (5% versus 37%) in the yoga group (chi-square = 24.9; P < 0.0001). The compliance to the total program was excellent and no side effects were observed. CONCLUSION: Yoga lifestyle intervention retards progression and increases regression of coronary atherosclerosis in patients with severe coronary artery disease. It also improves symptomatic status, functional class and risk factor profile.

Gastro-intestinal effects of Indian spice mixture (Garam Masala).

Spices are a part of diet all over the world but the variety and quantity consumed in tropical countries is particularly significant. The intestinal transit time of Indians is shorter, and their stool weight larger than that of Europeans on a comparable fibre intake. Ingestion of chilli is associated with a faster whole gut transit time. There is hardly any human work on the effects of spices on intestinal transit or gastric emptying. To explore the effects of spices on gastro intestinal transit this study was conducted on 18 well nourished healthy human adult volunteers using Radiolabelled Idli with or without Garam Masala. On gastric scintigraphy the gastric emptying time was much faster in subjects when spicy meal was given. The t1/2 of the spicy meal, 40.09 +/- (p < 0.05) thus implying a faster transit through the stomach. In 17 out of the 18 subjects t1/2 of the spicy meal was consistently lower than that of spicefree meal. The lag phase of gastric emptying showed no significant difference. There was a tendency towards slower gastrocolic transit with Spicefree meal but more subjects need to be done to confirm this.

Lowered sympathetic reactivity in patients with non-bleeding duodenal ulcers.

BACKGROUND: Autonomic dysfunction has been associated with duodenal ulcer. We assessed autonomic reactivity in patients with duodenal ulcer. METHODS: Ten patients with non-bleeding active duodenal ulcers and ten age- and sex-matched healthy subjects were investigated for parasympathetic reactivity (heart rate response to deep breathing, Valsalva maneuver and head-up tilt test) and sympathetic reactivity (blood pressure response to hand grip, head-up tilt and cold pressor test). Anxiety status was measured by evaluating responses to a questionnaire. RESULTS: The duodenal ulcer patients showed normal parasympathetic reactivity, lowered sympathetic reactivity and high anxiety score. When compared to control subjects, they had significantly lower diastolic blood pressure change in response to hand grip (median [range]; difference in values 12 [4-16] mmHg vs 16 [10-22] mmHg) and head up tilt (1 [-6-4] vs 6 [2-10] mmHg). CONCLUSIONS: Patients with duodenal ulcer have lowered sympathetic reactivity; this may be involved in causation by decreasing mucosal protection.

Glycaemic and insulinaemic responses to natural foods, frozen foods and their laboratory equivalents.

Glycaemic response to a food is determined by a large number of factors, of which composition is only one. The present study was designed to study the effect of composition and overnight refrigeration on the glycaemic response. The study involved determination of the glycaemic and insulinaemic response of healthy human volunteers to rice or potato, and to meals equivalent to these foods in terms of carbohydrate, protein, fat and fibre content; but made up of cornflour, casein, corn oil and cellulose. Further, each of these meals was served either freshly cooked, or after overnight storage in a refrigerator and rewarming. The natural foods led to a higher postprandial glycaemia than their respective equivalents, and the freshly cooked foods led to a higher glycaemic response than the refrigerated and rewarmed forms of the corresponding foods. No such consistent differences were observed in case of the insulinaemic responses. The difference in the glycaemic response to foods and their laboratory equivalents may be due to the unique physical arrangement of nutrients within the food or due to specific chemical differences in terms of macro-or micro-nutrients, non-nutrients or anti-nutrients. The difference in the glycaemic response to freshly cooked and refrigerated foods may be due to the formation of resistant starch during cold storage.

Massive upper gastrointestinal haemorrhage due to direct visceral erosion of splenic artery aneurysm.

Six male patients (age group: 30-60 years) with aneurysm of the splenic artery presented with massive upper gastrointestinal tract hemorrhage. Five patients presented with hematemesis and one with melena. Chronic pancreatitis was noted in all the patients, four of whom were chronic alcoholics. Endoscopy was not useful in diagnosis. Bleeding through the Ampulla of Vater was seen in the patient with melena. Angiography was diagnostic in all. Pancreatic resection including the aneurysm(2), and bipolar ligation with underrunning of the aneurysm (3) were the operative procedures. Distal pancreatectomy with pancreatogastrostomy was carried out in the patient with hemosuccus pancreaticus. If endoscopy is inconclusive, angiography and early intervention is recommended to reduce the high mortality associated with conservative management.