Effect of yoga on adipokine levels among overweight and obese people: A systematic review.

BACKGROUND: Adipokines have an important role in the pathophysiology of overweight and obesity and associated inflammatory diseases. OBJECTIVE: The present review aims to evaluate the role of Yoga on adipokines among people with overweight and obesity. METHODS: Authors performed a systematic search for relevant research studies as per the PRISMA guidelines in Google Scholar, Medline/Pubmed, Scopus, Web of Science, PsychInfo electronic databases. Two independent authors conducted the selection of articles, data extraction, assessment of the risk of bias for individual studies. Any disagreements were resolved by discussion with the third author. RESULTS: Eight randomized trials and four uncontrolled trials involving a total of 1054 participants were included. Yoga with varying frequencies was administered for different durations. The studied adipokines among overweight and obese were leptin, adiponectin, interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-α), chemerin, visfatin, plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor-beta (TGF-ß). The methodological quality of the included studies was low to moderate on the Cochrane risk of bias tool and Newcastle-Ottawa Quality Assessment Scale. The higher the frequency and duration of Yoga practice, the more significant changes in the adipokine levels were seen. CONCLUSION: The present review indicates that Yoga practices positively impacts adipokines among people with overweight and obesity. However, the present study precludes the generalizability of results due to the methodological heterogeneity, the type of Yoga intervention, and settings.

Impact of workplace yoga on pain measures, mental health, sleep quality, and quality of life in female teachers with chronic musculoskeletal pain: A randomized controlled study.

BACKGROUND: Chronic pain conditions such as low back pain, knee pain and cervical pain are highly prevalent among female teachers. Chronic pain significantly affects the mental health, sleep and quality of life among teachers. OBJECTIVE: This study is intended to investigate the impact of a workplace yoga intervention on musculoskeletal pain, anxiety, depression, sleep, and quality of life (QoL) among female teachers who had chronic musculoskeletal pain. METHOD: Fifty female teachers aged between 25-55 years with chronic musculoskeletal pain were randomized to either the yoga group (n = 25) or the control group (n = 25). The yoga group received a 60-minute structured Integrated Yoga intervention (IY) four days a week for six consecutive weeks at school. The control group received no intervention. OUTCOME MEASURES: Pain intensity, anxiety, depression, stress, fatigue, self-compassion, sleep quality, and quality of life were assessed at the baseline and six weeks. RESULTS: A significant (p < 0.05) reduction in pain intensity and pain disability in the yoga group was observed after 6-week compared to baseline. Anxiety, depression, stress, sleep scores and fatigues also improved in the yoga group after six weeks. The control group showed no change. Post score comparison showed a significant difference between the groups for all the measures. CONCLUSION: Workplace yoga intervention is found to be effective in improving pain, pain disability, mental health, sleep quality among female teachers with chronic musculoskeletal pain. This study strongly recommends yoga for the prevention of work-related health issues and for the promotion of wellbeing among teachers.

Tele-yoga in the management of ankylosing spondylitis amidst COVID pandemic: A prospective randomized controlled trial.

PURPOSE: Ankylosing spondylitis (AS) signficantly affect day to day activities contributing to signficant disability. Patients with AS often report to have psychological problems and poor quality of life (QoL). This study investigates the effect of a three-month tele-yogic intervention on disease activity, functional index, inflammatory markers, quality of life and mental health measures in patients with AS. METHODS: One hundred and twenty AS patients were assigned to either the yoga intervention group (YG) or the control group (CG). The YG (n = 57) received a 60-min structured yoga module online for 3 months in addition to standard medical care. The CG participants (n = 52) received only standard care during the same period. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis-Quality of Life (ASQOL) and psychological and inflammatory biomarkers were assessed at baseline and after three months. RESULTS: YG showed significant improvement in BASDAI (p = 0.001), anxiety (p = 0.0004), and depression (p = 0.001) at three months compared to baseline. The CG showed no significant change in similar outcome measures. At three months, the intervention resulted in a significant improvement in BASDI (-0.79; 95% CI (-1.3, to -0.29); p = 0.0021), BASFI (-0.86, 95% CI (-1.59, to -0.14); p = 0.0193), anxiety (-0.42, 95% CI (-0.84 to -0.01), p = 0.0468), and AS-QoL (-3.37; 95% CI (-5.21 to 1.53); p = 0.0004) compared to the CG. CONCLUSIONS: The present study suggests that yoga helps improve pain, functional index, and mental health in patients with AS. Tele-yoga intervention is feasible and effective in treating AS.

Prevalence of Non-Communicable Diseases and Its Associated Factors Among Urban Elderly of Six Indian States.

Aims The aim of this study is to investigate the prevalence, impact of health determinants on non-communicable diseases (NCDs), and multimorbidity among urban elderly in India. Methods This is a cross-sectional study involving a total of 1,671 (870 male and 801 female) respondents aged 60-80 years. Multistage sampling was used for the recruitment of the participants. A total of 12 sample areas from 12 cities of six southern states of south India were selected. Through survey form, information regarding demographic characteristics, health-influencing lifestyle factors, and history of nine NCDs was collected. Results The mean age of participants was 68.5 ± 6.01 years.. The prevalence of hypertension was 40.4%, followed by diabetes (31.2%), arthritis (22.1%), sensory impairment (10.1%), heart diseases (7.8%), and dyslipidemia (7.0%). 74.1% of participants had at least one morbidity, and 40.0% of people had multimorbidity. Being overweight is the highest risk health determinant for hypertension, diabetes, heart disease, high cholesterol, stroke, and joint pain. Obese people have 64% more risk of hypertension than people with normal BMI. People with disturbed sleep have increased risk of hypertension, high cholesterol, and joint pain by more than 80% compared to people with proper sleep. Among the modifiable health determinants of obesity, disturbed sleep, constipation, and physical activity up to 30 minutes were positively associated with multimorbidity. Those in the age group of 70 to 80 years have a high risk for NCDs and multimorbidity compared to those in the age group of 60 to 70 years. Conclusions A healthy lifestyle is necessary to reduce the burden of NCDs among the elderly. Developing holistic health policies seems an urgent need.

The Deadly Duo of Hypertension and Diabetes in India: Further Affirmation from a New Epidemiological Study.

INTRODUCTION: Hypertension is highly prevalent in patients with type II diabetes mellitus. India has some of the highest rates of diabetes and hypertension worldwide, but there is a lack of local data on the coexistence of these two risk factors. This study determined the prevalence of hypertension in patients with, or at high risk of, type II diabetes mellitus from across India. METHODS: Data came from a nationwide trial evaluating the effects of yoga-based lifestyle modification for the prevention/management of type II diabetes. Participants were recruited based on randomized house-to-house screening in urban and rural areas from 65 districts of 29 states/union territories. Eligible individuals were aged 20-80 years and had diabetes or were at high risk of diabetes (IDRS ≥ 60). Anthropometric and demographic data were obtained, and resting blood pressure and blood glucose levels were recorded. RESULTS: This analysis included data from 14,135 individuals. Of these, 25% had self-reported diabetes, 19% were diagnosed with diabetes during the trial, and 26.8% were at high risk for type II diabetes. In these three patient groups, hypertension prevalence rates were 58%, 41.0%, and 35.8%, respectively. The prevalence of hypertension was highest in the North East region and lowest in the North West. CONCLUSION: The high prevalence of hypertension in patients with, or at risk of diabetes, highlights the urgent need for policies to manage this population, who are at high risk of cardiovascular disease and death.

A narrative review on yoga: a potential intervention for augmenting immunomodulation and mental health in COVID-19.

BACKGROUND: The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has a significant mortality rate of 3-5%. The principal causes of multiorgan failure and death are cytokine release syndrome and immune dysfunction. Stress, anxiety, and depression has been aggravated by the pandemic and its resultant restrictions in day-to-day life which may contribute to immune dysregulation. Thus, immunity strengthening and the prevention of cytokine release syndrome are important for preventing and minimizing mortality in COVID-19 patients. However, despite a few specific remedies that now exist for the SARS-CoV-2virus, the principal modes of prevention include vaccination, masking, and holistic healing methods, such as yoga. Currently, extensive research is being conducted to better understand the neuroendocrinoimmunological mechanisms by which yoga alleviates stress and inflammation. This review article explores the anti-inflammatory and immune-modulating potentials of yoga, along with its role in reducing risk for immune dysfunction and impaired mental health. METHODS: We conducted this narrative review from published literature in MEDLINE, EMBASE, COCHRANE databases. Screening was performed for titles and abstracts by two independent review authors; potentially eligible citations were retrieved for full-text review. References of included articles and articles of major non-indexed peer reviewed journals were searched for relevance by two independent review authors. A third review author checked the excluded records. All disagreements were resolved through discussion amongst review authors or through adjudication by a fourth review author. Abstracts, editorials, conference proceedings and clinical trial registrations were excluded. OBSERVATIONS: Yoga is a nonpharmacological, cost-effective, and safe intervention associated with several health benefits. Originating in ancient India, this vast discipline consists of postures (asanas), breathing techniques (pranayama), meditation (dhyana/dharana), and relaxation. Studies have demonstrated yoga's ability to bolster innate immunity and to inhibit cytokine release syndrome. As an intervention, yoga has been shown to improve mental health, as it alleviates anxiety, depression, and stress and enhances mindfulness, self-control, and self-regulation. Yoga has been correlated with numerous cardioprotective effects, which also may play a role in COVID-19 by preventing lung and cardiac injury. CONCLUSION AND RELEVANCE: This review paves the path for further research on yoga as a potential intervention for enhancing innate immunity and mental health and thus its role in prevention and adjunctive treatment in COVID-19.

Designing, validation, and feasibility of a yoga module for patients with ankylosing spondylitis.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes significant disability and reduced quality of life. Scientific studies on yoga have revealed its various health benefits in chronic conditions, including autoimmune diseases. However, whether yoga is feasible for AS patients or not is not studied. Further, no validated yoga module is available for AS patients. OBJECTIVE(S): This study intended to develop a yoga module for AS patients and investigated its feasibility of use. MATERIALS AND METHODS: The study was completed in three stages. In Stage I, six yoga experts prepared a list of 64 yoga practices based on the classical and contemporary yogic literature review. Of these practices, 41 were included in the designed yoga module. In Stage II, 41 experts with a minimum of five years of experience in yoga therapy were invited for yoga module validation. The usefulness of the practices was rated by experts on a 3-point scale (1: not at all useful, 2: moderately useful, and 3: very much useful). The Lawshe content validity ratio (CVR) method was used for the content validity of the yoga module. Practices with a CVR score of > 0.3 were retained in the final yoga module. In Stage III, a certified yoga instructor administered the validated yoga module to 19 AS patients (average age: 35.5 ± 10.7 years) thrice weekly for a month. Feasibility was assessed on the basis of the attrition rate, retention rate, attendance of the participants, and the subjective response on practical sessions using a structured checklist. RESULTS: Of the 41 practices in the module, 31 had a CVR score of > 0.3 and were included in the final yoga module. Of the 25 participants, 19 (76%) completed the study while six dropped out (24%). Nineteen patients reported greater improvement in pain and flexibility. They found yoga relaxing and easy to practice. Most participants (65%) were able to practice a minimum of 30 min/day. CONCLUSION: The present study offers a validated yoga module consisting of 31 practices for AS patients. The results of the pilot suggested that the module is feasible, acceptable, and easy to practice for AS patients. We recommend that AS patients should practice this yoga module for a minimum of 30 min every day under the supervision of a yoga expert.

Immediate effect of mind sound resonance technique (MSRT - a yoga-based relaxation technique) on blood pressure, heart rate, and state anxiety in individuals with hypertension: a pilot study.

Background Mind sound resonance technique (MSRT) is a yoga-based relaxation technique. Previous studies on MSRT demonstrated its potential health-benefiting effects in both clinical and nonclinical population. Present study intended to assess the acute effect of MSRT intervention on blood pressure, heart rate (HR), and state anxiety in patients with essential hypertension (HTN). Methods Thirty participants (13 females) with HTN, within the age range 30-60 years (with mean±SD: 57.23±11.3 years), who visited SVYASA University campus to attend 1-week residential yoga program for HTN treatment, were considered for this study based on inclusion and exclusion criteria. All participants received a 4-day MSRT orientation sessions prior to the study. Each participant underwent 30-min session of both MSRT and supine rest (SR) on 2 successive days. Systolic and diastolic blood pressures, pulse rate, and state anxiety were measured before and immediately after both MSRT and SR sessions. Data were analyzed using SPSS version 16. Repeated-measure analysis of variance was applied to assess within-subjects changes. Results After MSRT session, significant decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), HR, and state anxiety was observed compared to baseline. Similarly, after SR session, significant changes were found in HR and state anxiety. No significant change was seen in SBP and DBP following SR compared to SR session; MSRT session showed significantly better improvement in SBP, DBP, HR, and state anxiety. Conclusion Present study demonstrated the usefulness of single session of MSRT in reducing blood pressure, HR, and state anxiety among individuals with HTN as compared to SR. These findings encourage the further studies with larger sample size and long-term intervention with a robust research design.

Effects of a Yoga Program on Mood States, Quality of Life, and Toxicity in Breast Cancer Patients Receiving Conventional Treatment: A Randomized Controlled Trial.

AIMS: The aim of this study is to compare the effects of yoga program with supportive therapy counseling on mood states, treatment-related symptoms, toxicity, and quality of life in Stage II and III breast cancer patients on conventional treatment. METHODS: Ninety-eight Stage II and III breast cancer patients underwent surgery followed by adjuvant radiotherapy (RT) or chemotherapy (CT) or both at a cancer center were randomly assigned to receive yoga (n = 45) and supportive therapy counseling (n = 53) over a 24-week period. Intervention consisted of 60-min yoga sessions, daily while the control group was imparted supportive therapy during their hospital visits. Assessments included state-trait anxiety inventory, Beck's depression inventory, symptom checklist, common toxicity criteria, and functional living index-cancer. Assessments were done at baseline, after surgery, before, during, and after RT and six cycles of CT. RESULTS: Both groups had similar baseline scores. There were 29 dropouts 12 (yoga) and 17 (controls) following surgery. Sixty-nine participants contributed data to the current analysis (33 in yoga, and 36 in controls). An ANCOVA, adjusting for baseline differences, showed a significant decrease for the yoga intervention as compared to the control group during RT (first result) and CT (second result), in (i) anxiety state by 4.72 and 7.7 points, (ii) depression by 5.74 and 7.25 points, (iii) treatment-related symptoms by 2.34 and 2.97 points, (iv) severity of symptoms by 6.43 and 8.83 points, (v) distress by 7.19 and 13.11 points, and (vi) and improved overall quality of life by 23.9 and 31.2 points as compared to controls. Toxicity was significantly less in the yoga group (P = 0.01) during CT. CONCLUSION: The results suggest a possible use for yoga as a psychotherapeutic intervention in breast cancer patients undergoing conventional treatment.

Effects of Mind Sound Resonance Technique (Yogic Relaxation) on Psychological States, Sleep Quality, and Cognitive Functions in Female Teachers: A Randomized, Controlled Trial.

Context • Several studies have revealed a high rate of physical and psychological problems from stress among schoolteachers. Yoga is one of the mind-body interventions known to alleviate stress and effects. The mind sound resonance technique (MSRT), a yoga-based, mindfulness relaxation is recognized as having a positive influence on physical and psychological health. Objectives • The study intended to examine the effects of an MSRT intervention for 1 mo on perceived stress, quality of sleep, cognitive function, state and trait anxiety, psychological distress, and fatigue among female teachers. Design • The study was a randomized, controlled trial. Setting • The study occurred at 2 primary schools in Bangalore City, India. Participants • Sixty female teachers, aged between 30 and 55 y, from the 2 schools were enrolled in the study. Intervention • The participants were randomly divided into an MSRT group (n = 30) and a control group (n = 30). Participants in the MSRT group participated in MSRT for 30 min/d, 5 d/wk, for the duration of 1 mo. The participants in the control group followed their normal daily routines. Outcome measures • Perceived stress, sleep quality, cognitive function, anxiety, psychological distress, fatigue, and self-esteem were assessed using standardized assessment tools at baseline and after 1 mo of the intervention. Results • In the MSRT group, a significant reduction occurred for 5 variables: (1) 47.01% for perceived stress (P < .001), (2) 28.76% for state anxiety (P < .001), (3) 13.35% for trait anxiety (P < .001), (4) 32.90% for psychological distress (P < .001), and (5) 44.79% for fatigue (P < .001). A significant improvement occurred for that group for 2 variables: (1) 44.94% for quality of sleep (P < .001), and (2) 12.12% for self-esteem (P < .001). An 11.88% increase occurred for the group for cognitive function, but the change was not significant (P = .111). On the other hand, the control group showed significant increases in 5 variables: (1) 55.56% for perceived stress (P < .001), (2) 13.32% for state anxiety (P < .001), (3) 21.28% for trait anxiety (P < .001), (4) 20.95% for psychological distress (P = .103), and (5) 16.44% for fatigue (P < .001). The group also showed significant decreases in 3 variables: (1) 3.51% for self-esteem (P < .001), (2) 21.39% for quality of sleep (P = .003), and (3) 17.60% for cognitive function (P = .002). A comparison between the 2 groups showed significant differences in 7 variables: (1) perceived stress (P < .001), (2) quality of sleep (P < .001), (3) state anxiety (P < .001), (4) trait anxiety (P < .001), (5) psychological distress (P = .006), (6) fatigue (P = .005), and (7) self-esteem (P < .001). No significant differences existed between the groups in cognitive function (P = .083). Conclusions • In the current study, the practice of MSRT facilitated a reduction in the levels of stress, anxiety, fatigue, and psychological distress. The relaxation technique also enhanced the levels of self-esteem and quality of sleep among female teachers working in primary schools.

Effect of 6 months intense Yoga practice on lipid profile, thyroxine medication and serum TSH level in women suffering from hypothyroidism: A pilot study.

BACKGROUND: A significant number of women in India are suffering from hypothyroidism. Hypothyroidism is characterized by elevated lipid profiles and thyroid stimulation hormone (TSH). It leads many comorbid conditions such as coronary artery disease, obesity, depression, osteoporosis, sleep apnea, and etc. Yoga is proven to be effective in reducing weight, dyslipidemia, depression and it brings the balance in autonomous nervous system. We aimed to study the effect of 6 months yoga practice on lipid profile, thyroxine requirement and serum TSH in women suffering from hypothyroidism. METHODS: Twenty-two household women suffering from hypothyroidism between the age range of 30 and 40 (mean±SD; 36.7±3.2) years, with average 4±1.12-year history of hypothyroidism were included in this study. Subjects with known cardiac issues, hypertension, history, recent surgery, slip disc and low back pain were excluded from this study. None of the subjects were on any other medication except thyroxine which was kept during the intervention phage (mean 65.78±22.74 mcg). All the subjects underwent 6 months of yoga practice 1 h daily for 4 days a week. Lipid profile, thyroxine dosage and serum TSH level were assessed before and after intervention. Data was analyzed using paired sample t test & Wilcoxon's signed rank test. RESULTS: The paired sample t-test showed significant reduction in total cholesterol (p=0.006; -8.99 %), low-density lipoprotein (LDL) (p=0.002; -9.81 %) and triglycerides (p=0.013; -7.6 %), and there was a significant improvement in high-density lipoprotein (HDL) (p=0.02; +9.65 %) along with nonsignificant reduction in TSH level (p=0.452; -9.72 %). Wilcoxon signed-rank test showed significant reduction in thyroxine medication score (p=0.029; -15.30 %) from. CONCLUSION: 6 months practice of yoga may help in improving cholesterol level, serum TSH, may also help in reducing the thyroxine requirement in female patients suffering from hypothyroidism. However, further randomized controlled studies need to be conducted to confirm the present finding.