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Liang Z, Zhang M, Wang C, Hao F, Yu Y, Tian S, Yuan Y. The Best Exercise Modality and Dose to Reduce Glycosylated Hemoglobin in Patients with Type 2 Diabetes: A Systematic Review with Pairwise, Network, and Dose-Response Meta-Analyses. Sports Med 2024; 54:2557-2570. [PMID: 38916824 DOI: 10.1007/s40279-024-02057-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications. OBJECTIVE We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes. METHODS A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose-response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels. RESULTS A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = - 0.78% [- 8.50 mmol/mol]; 95% CrI: - 1.04, - 0.51), followed by combined aerobic and resistance exercise (CE) (MD = - 0.54% [- 5.90 mmol/mol]; 95% CrI: - 0.69, - 0.40), yoga (MD = - 0.45% [- 4.92 mmol/mol]; 95% CrI: - 0.77, - 0.13), and continuous aerobic exercise (CAE) (MD = - 0.42% [- 4.58 mmol/mol]; 95% CrI: - 0.54, - 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week. CONCLUSIONS There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose-response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription.
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Affiliation(s)
- Zhide Liang
- School of Sports Science, Qufu Normal University, Qufu, 273165, China
- Cancer Institute of The Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, No. 308 Ningxia Road, Qingdao, 266071, China
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, 266071, China
| | - Meng Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Chuanzhi Wang
- School of Physical Education and Sports Exercise, South China Normal University, Guangzhou, 510006, China
| | - Fengwei Hao
- School of Physical Education and Sports Exercise, South China Normal University, Guangzhou, 510006, China
| | - Yingdanni Yu
- School of Physical Education, Shandong University, Jinan, 250061, China
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, 266071, China
| | - Shudong Tian
- School of Physical Education, Shandong University, Jinan, 250061, China.
| | - Yang Yuan
- School of Sports Science, Qufu Normal University, Qufu, 273165, China.
- Cancer Institute of The Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, No. 308 Ningxia Road, Qingdao, 266071, China.
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Kumar R, Dhamija P, Vardhan G, Kant R, Singh Y, Yadav RK, Rudra B, Pathania M. Evaluating Yoga-Based Intervention Versus the American Diabetes Association Exercise Regimen in Conjunction With Standard Care for Autonomic Neuropathy in Diabetes Mellitus: An Exploratory Clinical Trial. Cureus 2024; 16:e61329. [PMID: 38947647 PMCID: PMC11213716 DOI: 10.7759/cureus.61329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
INTRODUCTION Diabetic autonomic neuropathy (DAN) is a prevalent yet often overlooked complication of diabetes mellitus (DM), impacting multiple organs and substantially elevating the risk of morbidity and mortality. This study aimed to assess the effectiveness of yoga-based intervention (YBI) compared to the American Diabetes Association exercise regimen (ADA Ex. Regime) and standard care for treating autonomic neuropathy in type 2 DM. METHODS This open-label exploratory clinical trial featured two parallel study arms: Group A (Intervention), which received YBI alongside standard care, and Group B, which adhered to the ADA Ex. Regime in conjunction with standard care. A total of 80 participants aged 35-60, diagnosed with type 2 DM and autonomic neuropathy, were equally allocated to both groups. Data collection included nerve conduction velocity (NCV) tests, autonomic function tests (AFTs), as well as evaluations of depression and quality of life. RESULTS YBI demonstrated a drop in parasympathetic tone compared to the ADA Ex. Regime. Following a six-month intervention, the sympathetic activity indicator (SD2) exhibited a significantly lower value in the YBI group than in the ADA Ex. Regime group, indicating a positive effect (p < 0.05), while the ADA Ex. Regime showed more improvement in certain areas of NCV (e.g., left and right peroneal NCV, right and left peroneal F-latency), notable differences were observed in alkaline phosphatase levels, depression scores, and WHO-5 wellness, all reaching statistical significance at p < 0.05. CONCLUSIONS The study findings observed that a 24-week YBI significantly reduced in symptoms of diabetic neuropathy and stress. Although the ADA Ex. Regime demonstrated greater improvement in specific aspects of NCV compared to YBI, YBI outperformed the ADA Ex. Regime in enhancing WHO-5 wellness and reducing depression symptoms.
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Affiliation(s)
- Ramesh Kumar
- Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Puneet Dhamija
- Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Gyan Vardhan
- Pharmacology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Ravi Kant
- General Medicine, All India Institute of Medical Sciences, Rishikesh, IND
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Yogesh Singh
- Physiology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Raj Kumar Yadav
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Rishikesh, IND
| | | | - Monika Pathania
- Internal Medicine, All India Institute of Medical Sciences, Rishikesh, IND
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Zhang F, Lin JJ, Tian HN, Wang J. Effect of exercise on improving myocardial mitochondrial function in decreasing diabetic cardiomyopathy. Exp Physiol 2024; 109:190-201. [PMID: 37845840 PMCID: PMC10988701 DOI: 10.1113/ep091309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
Diabetic cardiomyopathy (DCM) is a significant cause of heart failure in patients with diabetes, and its pathogenesis is closely related to myocardial mitochondrial injury and functional disability. Studies have shown that the development of diabetic cardiomyopathy is related to disorders in mitochondrial metabolic substrates, changes in mitochondrial dynamics, an imbalance in mitochondrial Ca2+ regulation, defects in the regulation of microRNAs, and mitochondrial oxidative stress. Physical activity may play a role in resistance to the development of diabetic cardiomyopathy by improving myocardial mitochondrial biogenesis, the level of autophagy and dynamic changes in fusion and division; enhancing the ability to cope with oxidative stress; and optimising the metabolic substrates of the myocardium. This paper puts forward a new idea for further understanding the specific mitochondrial mechanism of the occurrence and development of diabetic cardiomyopathy and clarifying the role of exercise-mediated myocardial mitochondrial changes in the prevention and treatment of diabetic cardiomyopathy. This is expected to provide a new theoretical basis for exercise to reduce diabetic cardiomyopathy symptoms.
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Affiliation(s)
- Feng Zhang
- Sports Physiology DepartmentBeijing Sport UniversityBeijingChina
| | - Jian jian Lin
- PE Teaching and Research OfficeUniversity of International RelationshipBeijingChina
| | - Hao nan Tian
- Sports Physiology DepartmentBeijing Sport UniversityBeijingChina
| | - Jun Wang
- Sports Physiology DepartmentBeijing Sport UniversityBeijingChina
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Khan AR, Alnoud MAH, Ali H, Ali I, Ahmad S, Ul Hassan SS, Shaikh AL, Hussain T, Khan MU, Khan SU, Khan MS, Khan SU. Beyond the beat: A pioneering investigation into exercise modalities for alleviating diabetic cardiomyopathy and enhancing cardiac health. Curr Probl Cardiol 2024; 49:102222. [PMID: 38000567 DOI: 10.1016/j.cpcardiol.2023.102222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
Patients with preexisting cardiovascular disease or those at high risk for developing the condition are often offered exercise as a form of therapy. Patients with cancer who are at an increased risk for cardiovascular issues are increasingly encouraged to participate in exercise-based, interdisciplinary programs due to the positive correlation between these interventions and clinical outcomes following myocardial infarction. Diabetic cardiomyopathy (DC) is a cardiac disorder that arises due to disruptions in the homeostasis of individuals with diabetes. One of the primary reasons for mortality in individuals with diabetes is the presence of cardiac structural damage and functional abnormalities, which are the primary pathological features of DC. The aetiology of dilated cardiomyopathy is multifaceted and encompasses a range of processes, including metabolic abnormalities, impaired mitochondrial function, dysregulation of calcium ion homeostasis, excessive cardiomyocyte death, and fibrosis. In recent years, many empirical investigations have demonstrated that exercise training substantially impacts the prevention and management of diabetes. Exercise has been found to positively impact the recovery of diabetes and improve several metabolic problem characteristics associated with DC. One potential benefit of exercise is its ability to increase systolic activity, which can enhance cardiometabolic and facilitate the repair of structural damage to the heart caused by DC, leading to a direct improvement in cardiac health. In contrast, exercise has the potential to indirectly mitigate the pathological progression of DC through its ability to decrease circulating levels of sugar and fat while concurrently enhancing insulin sensitivity. A more comprehensive understanding of the molecular mechanism via exercise facilitates the restoration of DC disease must be understood. Our goal in this review was to provide helpful information and clues for developing new therapeutic techniques for motion alleviation DC by examining the molecular mechanisms involved.
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Affiliation(s)
- Ahsan Riaz Khan
- Department of Interventional and Vascular Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Mohammed A H Alnoud
- Cardiovascular Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Hamid Ali
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai Kalan, Islamabad 44000, Pakistan
| | - Ijaz Ali
- Centre for Applied Mathematics and Bioinformatics, Gulf University for Science and Technology, Hawally 32093, Kuwait
| | - Saleem Ahmad
- Cardiovascular Center of Excellence, Louisiana State University Health Sciences Center, New Orleans 70112 LA, USA
| | - Syed Shams Ul Hassan
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310002, China
| | | | - Talib Hussain
- Women Dental College Abbottabad, KPK, 22020, Pakistan
| | - Munir Ullah Khan
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, International Research Center for X Polymers, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Safir Ullah Khan
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, University of Science and Technology of China, Hefei 230027, China
| | - Muhammad Shehzad Khan
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Shatin city, (HKSAR), Hong Kong
| | - Shahid Ullah Khan
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City and Southwest University, College of Agronomy and Biotechnology, Southwest University, Chongqing 400715, China; Department of Biochemistry, Women Medical and Dental College, Khyber Medical University, Abbottabad, 22080, Khyber Pakhtunkhwa, Pakistan.
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Colvin A, Murray L, Noble J, Chastin S. Effects of Breaking Up Sedentary Behavior With Short Bouts of Yoga and Tai-Chi on Glycemia, Concentration, and Well-Being. J Phys Act Health 2024; 21:181-188. [PMID: 37992705 DOI: 10.1123/jpah.2023-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Investigating the effects of breaking up sedentary behavior with short bouts of Yoga and Tai-Chi on glycemic control, concentration, and well-being in healthy individuals. METHODS In this randomized balanced incomplete block study, 15 adults (age = 26 [2.50] y, 8 females) completed 2 of 3 protocols: uninterrupted sitting (Control), sitting interrupted with 3 minutes of Yoga every 30 minutes, or with 3 minutes of Tai-Chi every 30 minutes. Protocols lasted 7.5 hours and included a standardized diet. Glucose was measured every 30 minutes with a glucometer (Abbott FreeStyle Libre). Concentration and well-being were recorded with self-reported ecological momentary assessment. Area under the curve was calculated for glucose data. Statistical analyses were performed as a hierarchical repeated-measures model. RESULTS Glucose area under the curve for the Yoga intervention (34.55 [3.12] mmol/L) was significantly lower than the Control (38.14 [3.18] mmol/L; P < .05). There was a trend toward lower glucose in the Tai-Chi group compared with the Control, but no significant differences were found (AUCTai-Chi = 36.64 [3.11] mmol/L; P = .57). Mean concentration in all groups decreased throughout the day, with the largest decrease in the Control. Well-being for the Yoga and Control groups decreased but increased with Tai-Chi. Concentration and well-being responses were not statistically significant between intervention groups. CONCLUSIONS Breaking up sedentary behavior using 3-minute bouts of Yoga significantly lowers blood glucose in healthy individuals without compromising concentration or well-being. Tai-Chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and well-being. These interventions provide effective ways to combat the deleterious effects of prolonged sedentary time while maintaining concentration and well-being.
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Affiliation(s)
- Alexander Colvin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
- Physiotherapy Department, National Health Service, New Victoria Hospital, Glasgow, United Kingdom
| | - Lynne Murray
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
- Physiotherapy Department, National Health Service, Stobhill Hospital, Glasgow, United Kingdom
| | - Jillian Noble
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
- MSK Physiotherapy Department, National Health Service, South Lanarkshire, United Kingdom
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
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Wong SSS, Liu TW, Ng SSM. Health status of aged women with or without the experience of practicing yoga. BMC Womens Health 2023; 23:524. [PMID: 37794374 PMCID: PMC10552255 DOI: 10.1186/s12905-023-02586-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/02/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Yoga is a popular training practice that enhances women's physical activity level and modifies the major risk factors contributing to noncommunicable diseases. This study aimed to compare general health and cardiovascular health, musculoskeletal health, psychological health, and health-related quality of life between aged women with and without long-term yoga practice. METHODS Thirty-two female yoga practitioners (mean age 56 years) with ≥ 2 years experience in regular yoga practice and 32 age-matched women without yoga experience participated in the study. Between-group comparisons was performed to explore the differences in various health outcomes, including body build indices, exercise endurance, blood pressure, and heart rate variability; hamstring flexibility, upper-limb muscle strength, shoulder range of motion, and upper-limb function; and the symptoms of anxiety and depression, sleep quality, and fatigue. RESULTS Our findings revealed that yoga practitioners demonstrated greater hamstring flexibility, shoulder ROM on the non-dominant side, and hand-grip strength; a higher heart rate variability parameter value (RMSSD); and shorter sleep latency than those who did not practice yoga. CONCLUSIONS In view of the encouraging results of the long-term benefits of yoga practice, it warrants being promoted among aged women to enhance their physical and mental well-being.
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Affiliation(s)
- Sarah Suet Shan Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China.
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
- Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hong Kong (SAR), Hung Hom, Hong Kong (SAR), China.
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Di Murro E, Di Giuseppe G, Soldovieri L, Moffa S, Improta I, Capece U, Nista EC, Cinti F, Ciccarelli G, Brunetti M, Gasbarrini A, Pontecorvi A, Giaccari A, Mezza T. Physical Activity and Type 2 Diabetes: In Search of a Personalized Approach to Improving β-Cell Function. Nutrients 2023; 15:4202. [PMID: 37836486 PMCID: PMC10574038 DOI: 10.3390/nu15194202] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the most widespread diseases worldwide. Lifestyle interventions, including diet and physical activity (PA), are fundamental non-pharmacological components of T2DM therapy. Exercise interventions are strongly recommended for people with or at risk of developing or already with overt diabetes, but adherence to PA guidelines in this population is still challenging. Furthermore, the heterogeneity of T2DM patients, driven by differing residual β-cell functionality, as well as the possibility of practicing different types and intensities of PA, has led to the need to develop tailored exercise and training plans. Investigations on blood glucose variation in response to exercise could help to clarify why individuals do not respond in the same way to PA, and to guide the prescription of personalized treatments. The aim of this review is to offer an updated overview of the current evidence on the effects of different regimens and modalities of PA regarding glucose sensing and β-cell secretory dynamics in individuals with prediabetes or T2DM, with a special focus on β-cell function.
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Affiliation(s)
- Emanuela Di Murro
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Gianfranco Di Giuseppe
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Laura Soldovieri
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Simona Moffa
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Ilaria Improta
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Umberto Capece
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Enrico Celestino Nista
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
- Pancreas Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Francesca Cinti
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Gea Ciccarelli
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Michela Brunetti
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Antonio Gasbarrini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
- Pancreas Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Alfredo Pontecorvi
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Andrea Giaccari
- Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (E.D.M.); (G.D.G.); (L.S.); (S.M.); (I.I.); (U.C.); (F.C.); (G.C.); (M.B.); (A.P.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
| | - Teresa Mezza
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.C.N.); (A.G.)
- Pancreas Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Asiah ASS, Norhayati MN, Muhammad J, Muhamad R. Effect of yoga on anthropometry, quality of life, and lipid profile in patients with obesity and central obesity: A systematic review and meta-analysis. Complement Ther Med 2023; 76:102959. [PMID: 37356673 DOI: 10.1016/j.ctim.2023.102959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to determine the effectiveness of yoga on anthropometry, quality of life, and lipid profiles in patients with obesity and central obesity. METHODOLOGY The Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed (1985-January 2022) and trial registries for relevant randomised clinical trials were used. Relevant and published randomised clinical trials were reviewed and evaluated. The primary outcomes were anthropometry measurements, which were weight, waist circumference, body mass index (BMI), and body fat percentages. The secondary outcomes were changes in quality of life, psychological impact, lipid profile measurement, presence of adverse events, and changes in blood pressure and blood glucose. We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. RESULTS 15 studies are included, involving 1161 participants. The analysis performed is based on three comparisons. For the first comparison between yoga and control, yoga reduces the waist circumference (MD -0.84, 95% CI [-5.12 to 3.44]), while there is no difference in body weight, BMI, or body fat percentages. In the second comparison between yoga and calorie restriction, yoga reduces body weight (MD -3.47, 95% CI [-6.20 to -0.74]), while there is no difference in waist circumference, BMI, or body fat percentage. In the third comparison between yoga and exercise, yoga reduces the body weight (MD -7.58, 95% CI [-11.51 to -3.65]), while there is no difference in waist circumference or BMI. For the secondary outcomes, yoga intervention reduces total cholesterol (MD -17.12, 95% CI [-32.24 to -2.00]) and triglycerides (MD -21.75, 95% CI [-38.77 to -4.73]) compared to the control group, but there is no difference compared to the calorie restriction and exercise group. There is no difference in the rest of the outcomes, which are LDL, HDL, quality of life, psychological impact, adverse events, blood pressure, and blood glucose. However, findings are not robust due to a high risk of bias and low-quality evidence. CONCLUSION From our review, there were methodological drawbacks and very low to moderate quality of evidence across all comparisons, and hence, it is inconclusive to say that yoga can significantly improve anthropometric parameters. More well-designed trials are needed to confirm and support the beneficial effects of yoga.
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Affiliation(s)
- Ahmad Sabri Siti Asiah
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia
| | - Juliawati Muhammad
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia.
| | - Rosediani Muhamad
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia
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Roy J. "Investigating the Brain Activity Correlates of Humming Bee Sound during Bhramari Pranayama". Ann Indian Acad Neurol 2023; 26:364-365. [PMID: 37970262 PMCID: PMC10645273 DOI: 10.4103/aian.aian_648_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Jayanta Roy
- Director of Stroke Program, Institute of Neurosciences, Kolkata, West Bengal, India
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10
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Smit C, Cartwright T. Recommending yoga for health: A survey of perceptions among healthcare practitioners in the UK. Complement Ther Clin Pract 2023; 52:101765. [PMID: 37172418 DOI: 10.1016/j.ctcp.2023.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/14/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Yoga has the potential to support patients across various health conditions. It is slowly being integrated into healthcare worldwide. While healthcare practitioners (HCPs) are critical to integration, there are currently no studies investigating their perceptions of yoga for health, their openness to recommending yoga to patients, and barriers to doing so. This novel UK study aims to address this. METHOD An online survey was conducted among practising UK HCPs. Recruitment was through multi-modal convenience sampling. The COM-B model was used as a framework. Regression analysis examined predictors of HCPs' likelihood to recommend yoga. Open-end responses were analysed through thematic analysis. RESULTS 198 HCPs were included in the analysis, including general practitioners (GPs, 18.8%), psychologists (18.3%), and nurses/health visitors (14.7%). A high proportion (68.8%) practised yoga at least monthly. The likelihood of recommending yoga to patients was high (M = 4.03, SD = 0.94; 5-point scale). Older age, not being a GP, and greater capability and motivation significantly predicted a greater likelihood of recommending yoga, explaining 41.4% of the variance (p < 0.001). Barriers to recommending yoga were mostly related to the lack of opportunity. CONCLUSIONS HCPs in this study had high levels of personal engagement with yoga and were open to recommending yoga to patients, but still faced several barriers. Workplace support, particularly for GPs, and information about how patients can access appropriate and affordable yoga instruction would facilitate referral. Further research with a representative sample is warranted to understand perceptions of HCPs less engaged with yoga.
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Affiliation(s)
- Carryn Smit
- Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, United Kingdom.
| | - Tina Cartwright
- Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, United Kingdom.
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11
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Li M, Jeeyavudeen MS, Arunagirinathan G, Pappachan J. Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:7-15. [PMID: 37313234 PMCID: PMC10258624 DOI: 10.17925/ee.2023.19.1.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/27/2023] [Indexed: 06/15/2023]
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) is steadily rising worldwide due to an increasingly sedentary lifestyle combined with unhealthy food habits. Currently, the burden of diabetes on healthcare systems is unprecedented and rising daily. Several observational studies and randomized controlled trials provide clinical evidence that T2DM remission is possible by adopting dietary interventions and a strict exercise training protocol. Notably, these studies provide ample evidence for remission in patients with T2DM or for prevention in those with risk factors for the disease through various non-pharmacological behavioural interventions. In this article, we present two clinical cases of individuals who showed remission from T2DM/prediabetes via behavioural changes, especially through the adoption of a low-energy diet and exercise. We also discuss the recent advances in T2DM and obesity research, focusing on nutritional interventions and exercise and their benefits for weight loss, improved metabolic profile, enhanced glycaemic control and remission of diabetes.
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Affiliation(s)
- Matthias Li
- The University of Manchester Medical School, Manchester, UK
| | | | | | - Joseph Pappachan
- The University of Manchester Medical School, Manchester, UK
- Lancashire Teaching Hospitals NHS Trust and Manchester Metropolitan University, Manchester, UK
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12
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Sanogo F, Xu K, Cortessis VK, Weigensberg MJ, Watanabe RM. Mind- and Body-Based Interventions Improve Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:69-79. [PMID: 36070591 DOI: 10.1089/jicm.2022.0586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims/Hypothesis: Only 51% of patients with type 2 diabetes achieve the hemoglobin A1c (HbA1c) <7% target. Mind and body practices have been increasingly used to improve glycemic control among patients with type 2 diabetes, but studies show inconsistent efficacy. The authors conducted a systematic review and meta-analysis to assess the association between mind and body practices, and mean change in HbA1c and fasting blood glucose (FBG) in patients with type 2 diabetes. Methods: The authors conducted a literature search of Ovid MEDLINE, Embase, and ClinicalTrials.gov seeking through June 10, 2022, published articles on mind and body practices and type 2 diabetes. Two reviewers independently appraised full text of articles. Only intervention studies were included. Reviewers extracted data for meta-analysis. Restricted maximum likelihood random-effects modeling was used to calculate the mean differences and summary effect sizes. The authors assessed heterogeneity using Cochran's Q and I2 statistics. Funnel plots were generated for each outcome to gauge publication bias. Weighted linear models were used to conduct study-level meta-regression analyses of practice frequency. Results: The authors identified 587 articles with 28 meeting the inclusion criteria. A statistically significant and clinically relevant mean reduction in HbA1c of -0.84% (95% confidence interval [CI]: -1.10% to -0.58%; p < 0.0001) was estimated. Reduction was observed in all intervention subgroups: mindfulness-based stress reduction: -0.48% (95% CI: -0.72% to -0.23%; p = 0.03), qigong: -0.66% (95% CI: -1.18% to -0.14%; p = 0.01), and yoga: -1.00% (95% CI: -1.38% to -0.63%; p < 0.0001). Meta-regression revealed that for every additional day of yoga practice per week, the raw mean HbA1c differed by -0.22% (95% CI: -0.44% to -0.003%; p = 0.046) over the study period. FBG significantly improved following mind and body practices, with overall mean difference of -22.81 mg/dL (95% CI: -33.07 to -12.55 mg/dL; p < 0.0001). However, no significant association was found between the frequency of weekly yoga practice and change in FBG over the study period. Conclusions/Interpretation: Mind and body practices are strongly associated with improvement in glycemic control in patients with type 2 diabetes. The overall mean reduction in HbA1c and FBG was clinically significant, suggesting that mind and body practices may be an effective, complementary nonpharmacological intervention for type 2 diabetes. Additional analyses revealed that the mean decrease in HbA1c was greater in studies requiring larger number of yoga practice sessions each week.
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Affiliation(s)
- Fatimata Sanogo
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Keren Xu
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Victoria K Cortessis
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Obstetrics and Gynecology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Marc J Weigensberg
- USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Richard M Watanabe
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Physiology and Neuroscience, Keck School of Medicine of USC, Los Angeles, CA, USA
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13
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Lu HB, Ma RC, Yin YY, Song CY, Yang TT, Xie J. Clinical Indicators of Effects of Yoga Breathing Exercises on Patients With Lung Cancer After Surgical Resection: A Randomized Controlled Trial. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00105. [PMID: 36716034 DOI: 10.1097/ncc.0000000000001208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cancer itself and surgery pose a heavy burden on adults with lung cancer. Yoga breathing exercises have been proposed as a form of pulmonary rehabilitation exercises to improve these patients' perioperative outcomes. OBJECTIVE To investigate the impact of yoga breathing exercises based on a problem-solving model on dyspnea, exercise capacity, anxiety, depression, and postoperative indwelling time of thoracic drainage tube and compliance in adults with lung cancer undergoing surgery. METHODS One hundred eight lung cancer patients were randomly assigned to receive problem-solving model-based yoga breathing exercises, yoga breathing exercises, or usual care. Outcomes were collected at admission, the day before surgery, and at discharge. RESULTS Patients in the combined intervention group showed a significantly greater improvement in dyspnea, exercise capacity, and anxiety compared with the control group. Yoga breathing training can significantly improve patients' dyspnea and anxiety. Significant difference favoring the combined group was observed in exercise capability and compliance between the 2 intervention groups. However, there was no significant difference in depression or indwelling time of thoracic drainage tube among the 3 groups at any time point. CONCLUSION Findings indicate that yoga breathing exercises are effective in alleviating perioperative symptoms of lung resection patients. Compared with yoga breathing exercises, applying additional problem-solving model may achieve a better effect. IMPLICATIONS FOR PRACTICE Yoga breathing exercises can be considered as a promising pulmonary rehabilitation strategy for lung cancer patients with surgery. The problem-solving model could be integrated into yoga breathing exercises in clinical practice to enhance the rehabilitation effect.
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Affiliation(s)
- Han-Bing Lu
- Author Affiliations: School of Nursing, Jilin University, Changchun, Jilin Province, China
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14
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Effects of Mind-Body Training as a Mental Health Therapy in Adults with Diabetes Mellitus Type II: A Systematic Review. J Clin Med 2023; 12:jcm12030853. [PMID: 36769502 PMCID: PMC9917865 DOI: 10.3390/jcm12030853] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
The increase in the prevalence and disease burden of diabetes has highlighted the need to strengthen a comprehensive care system that includes mental health treatment. A systematic review was carried out to analyze the effectiveness of mind-body training as a therapy for the mental health management of adult patients with type 2 diabetes mellitus (T2DM) following the PRISMA 2020 guidelines. Pubmed, Scopus and Web of Science databases were consulted between November and December 2022. Eight articles were selected according to the inclusion and exclusion criteria. Only randomized controlled trials were included. The interventions focused on mindfulness and yoga with variable durations of between 8 weeks and 6 months. Four of the included studies observed statistically significant changes (p < 0.05) in anxiety. Six articles determined that mind-body training was effective for treating depression. Finally, five articles found favorable effects on stress, while one did not observe changes at 8 weeks of intervention or after 1 year of follow-up. The evidence supports the use of mind-body training to reduce stress, depression, and anxiety levels in the adult population with T2DM, which makes this type of training a valuable intervention to be included in an integral approach to diabetic pathology.
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15
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Chopra D, Stern E, Bushell WC, Castle RD. Yoga and pain: A mind-body complex system. FRONTIERS IN PAIN RESEARCH 2023; 4:1075866. [PMID: 36910253 PMCID: PMC9996306 DOI: 10.3389/fpain.2023.1075866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The human body's response to pain is indicative of a complex adaptive system. Therapeutic yoga potentially represents a similar complex adaptive system that could interact with the pain response system with unique benefits. Objectives To determine the viability of yoga as a therapy for pain and whether pain responses and/or yoga practice should be considered complex adaptive systems. Methods Examination through 3 different approaches, including a narrative overview of the evidence on pain responses, yoga, and complex system, followed by a network analysis of associated keywords, followed by a mapping of the functional components of complex systems, pain response, and yoga. Results The narrative overview provided extensive evidence of the unique efficacy of yoga as a pain therapy, as well as articulating the relevance of applying complex systems perspectives to pain and yoga interventions. The network analysis demonstrated patterns connecting pain and yoga, while complex systems topics were the most extensively connected to the studies as a whole. Conclusion All three approaches support considering yoga a complex adaptive system that exhibits unique benefits as a pain management system. These findings have implications for treating chronic, pervasive pain with behavioral medicine as a systemic intervention. Approaching yoga as complex system suggests the need for research of mind-body topics that focuses on long-term systemic changes rather than short-term isolated effects.
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Affiliation(s)
| | - Eddie Stern
- Vivekananda Yoga University, Los Angeles, CA, United States
| | | | - Ryan D Castle
- Chopra Foundation Institute, Honolulu, HI, United States
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16
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Hirosaki M, Ohira T, Wu Y, Eguchi E, Shirai K, Imano H, Funakubo N, Nishizawa H, Katakami N, Shimomura I, Iso H. Laughter yoga as an enjoyable therapeutic approach for glycemic control in individuals with type 2 diabetes: A randomized controlled trial. Front Endocrinol (Lausanne) 2023; 14:1148468. [PMID: 37065750 PMCID: PMC10102335 DOI: 10.3389/fendo.2023.1148468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Laughter has been reported to have various health benefits. However, data on the long-term effects of laughter interventions on diabetes are limited. This study aimed to investigate whether laughter yoga can improve glycemic control among individuals with type 2 diabetes. METHODS In a single-center, randomized controlled trial, 42 participants with type 2 diabetes were randomly assigned to either the intervention or the control group. The intervention consisted of a 12-week laughter yoga program. Hemoglobin A1c (HbA1c), body weight, waist circumference, psychological factors, and sleep duration were evaluated at baseline and week 12. RESULTS Intention-to-treat analysis showed that participants in the laughter yoga group experienced significant improvements in HbA1c levels (between-group difference: -0.31%; 95% CI -0.54, -0.09) and positive affect scores (between-group difference: 0.62 points; 95% CI 0.003, 1.23). Sleep duration tended to increase in the laughter yoga group with a between-group difference of 0.4 hours (95% CI -0.05, 0.86; P = 0.080). The mean attendance rate for laughter yoga program was high (92.9%). CONCLUSIONS A 12-week laughter yoga program is feasible for individuals with type 2 diabetes and improves glycemic control. These findings suggest that having fun could be a self-care intervention. Further studies with larger numbers of participants are warranted to better evaluate the effects of laughter yoga. CLINICAL TRIAL REGISTRATION http://www.chinadrugtrials.org.cn, identifier UMIN000047164.
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Affiliation(s)
- Mayumi Hirosaki
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
- *Correspondence: Mayumi Hirosaki, ; Tetsuya Ohira,
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- *Correspondence: Mayumi Hirosaki, ; Tetsuya Ohira,
| | - Yawei Wu
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Narumi Funakubo
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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17
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Hou L, Wang Q, Pan B, Li R, Li Y, He J, Qin T, Cao L, Zhang N, Cao C, Ge L, Yang K. Exercise modalities for type 2 diabetes: A systematic review and network meta-analysis of randomized trials. Diabetes Metab Res Rev 2023; 39:e3591. [PMID: 36423199 DOI: 10.1002/dmrr.3591] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/21/2022] [Accepted: 10/15/2022] [Indexed: 11/26/2022]
Abstract
AIMS We aimed to determine the effects of different exercise modalities in patients with type 2 diabetes mellitus (T2DM). METHODS We searched PubMed, Embase, and the Cochrane Library from their inception until July 2020 to identify randomised controlled trials (RCTs) on exercise in adults with T2DM. Paired reviewers independently performed study selection, data extraction, and risk of bias assessment. The certainty of the evidence was assessed using the Confidence in Network Meta-Analysis (CINeMA) framework. RESULTS A total of 106 RCTs that enroled eight exercise modalities with 7438 patients were included. Six exercise modalities, except unsupervised aerobic/resistance exercise, significantly reduced glycosylated haemoglobin (HbA1c), with mean differences (MDs) ranging from 0.71 (95% confidence interval [CI]: 0.34-1.08) to 0.34 (95% CI: 0.17-0.52), low to high certainty, in comparison with no exercise. The evidence of low to moderate certainty showed that supervised aerobic/resistance exercise improved glycaemic control, body weight, blood pressure, and blood lipid profiles compared with no exercise. Flexibility exercise may be associated with glycaemic control (HbA1c: MD = 0.71, 95% CI: 0.34-1.08); fasting plasma glucose (MD = 1.48, 95% CI: 0.78-2.17), and weight loss (MD = 1.80, 95% CI: 0.85-2.75) compared with controls, but not blood pressure and lipid profiles. Balance exercise showed the largest benefit in improving total cholesterol (MD = 52.81, 95% CI: 28.47-77.16) and low certainty. We found no significant differences between exercises and the triacylglycerol (TG) level. CONCLUSIONS Overall, our network meta-analyses support the recommendation for exercise in patients with T2DM, especially supervised exercises. Limited evidence supports the benefits of flexibility and balance exercises. The effectiveness of exercise modalities for TG reduction remains unclear.
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Affiliation(s)
- Liangying Hou
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Qi Wang
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Bei Pan
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Rui Li
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yanfei Li
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Juanjuan He
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Tianzhu Qin
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Liujiao Cao
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Na Zhang
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Changhao Cao
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Long Ge
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
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18
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Amiri S, Fathi-Ashtiani M. Exercise Increasing Health-Related Quality of Life in Type 2 Diabetics: A Meta-Analysis. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2154883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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19
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Childs‐Fegredo J, Fontana E, Moran M, Faulkner P. Yoga‐integrated psychotherapy for emotion dysregulation: A pilot study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Elisa Fontana
- Department of Psychology University of Roehampton London UK
| | - Mary Moran
- Central and North‐West London NHS Foundation Trust London UK
| | - Paul Faulkner
- Department of Psychology University of Roehampton London UK
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20
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Vishnubhotla RV, Wood PL, Verma A, Cebak JE, Hariri S, Mudigonda M, Alankar S, Maturi R, Orui H, Subramaniam B, Palwale D, Renschler J, Sadhasivam S. Advanced Meditation and Vegan Diet Increased Acylglycines and Reduced Lipids Associated with Improved Health: A Prospective Longitudinal Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:674-682. [PMID: 35532984 DOI: 10.1089/jicm.2022.0480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Samyama is an Isha Yoga 8-day residential meditation/yoga retreat combined with 60 days of preparation with vegan diet. We showed earlier Samyama retreat was associated with lower systemic inflammation and favorable lipid profiles along with other physical and mental health benefits. There is no mechanistic study on the impact of an advanced meditative process on multiple blood lipids and their implications on meditation-related improved physical and mental wellbeing. Methods: Sixty-four Samyama participants on vegan diet had blood sampled immediately before and immediately after the 8-day retreat for lipidomic analysis. The complex plasma lipidome was characterized using high-resolution mass spectrometric analysis and tandem mass spectrometry. Results: Pre- and post-Samyama blood samples of 64 Samyama participants were analyzed. Acylglycines (acetyl, propionyl, butyryl, and valeryl) were increased in the plasma post-Samyama compared with pre-Samyama (p < 0.001). Levels of glycerophosphocholines, glycerophosphoethanolamines, di-unsaturated ethanolamine plasmalogens, cholesterol esters, acylcarnitines, and acylgylcerines (triacylglycerols and diacylglycerols) decreased after the Samyama meditation. Plasma levels of glycerophosphoserines or glycerophosphoinositols were unchanged. Conclusion: An 8-day advanced meditation retreat resulted in increased acylglycines, an endocannabinoid-like fatty acid amide associated with increased cellular anandamide levels, anti-inflammation, analgesia, and vascular relaxation. Other serum lipid levels, including some that are associated with increased risk of atherosclerosis, were reduced following the Samyama program. ClinicalTrials.gov Registration: Identifier: NCT04366544.
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Affiliation(s)
- Ramana V Vishnubhotla
- Department of Radiology, Indiana University School of Medicine, Indianpolis, IN, USA
| | - Paul L Wood
- Metabolomics Unit, College of Veterinary Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Ashutosh Verma
- Metabolomics Unit, College of Veterinary Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - John E Cebak
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Sepideh Hariri
- Sadhguru Center for a Conscious Planet, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boson, MA, USA
| | - Mayur Mudigonda
- Redwood Center for Theoretical Neuroscience, University of California, Berkeley, CA, USA
| | - Suresh Alankar
- Vascular Surgery, University of Louisville, Louisville, KY, USA
| | - Raj Maturi
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hibiki Orui
- Sadhguru Center for a Conscious Planet, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boson, MA, USA
| | - Balachundhar Subramaniam
- Sadhguru Center for a Conscious Planet, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boson, MA, USA
| | - Dhanashri Palwale
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Janelle Renschler
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Senthilkumar Sadhasivam
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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21
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Ghazvineh D, Daneshvar M, Basirat V, Daneshzad E. The Effect of Yoga on the Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Nutr 2022; 9:942702. [PMID: 35911119 PMCID: PMC9329825 DOI: 10.3389/fnut.2022.942702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives Yoga is a mind-body stress-relieving exercise that increases mental and physical health, which may have a role in the improvement of metabolic disorders. The present study has reviewed the effect of yoga on lipid profiles as a systematic review and meta-analysis. Methods We evaluated the available randomized controlled trials on the effects of yoga-based programs, and lipid profiles by searching PubMed/Medline, Scopus, Web of Science, and the Cochrane central register of control trials up to January 2022. Both fixed and random effect analyses were used to find the relationships. Subgroup analysis was performed based on the continent, duration of the included studies, gender, and health condition of participants to discover the sources of heterogeneity. Result Fifty-three studies were included in the current systematic review and meta-analysis with a total sample size of 13,191. There was a striking association between yoga and total cholesterol (−10.31 mg/dl; 95% CI: −14.16, −6.45; I2 = 82.5%, P < 0.001), low-density lipoprotein cholesterol (−8.64 mg/dl; 95% CI: −12.03, −5.25; I2 = 75.0%, P < 0.001), high-density lipoprotein cholesterol (1.98 mg/dl; 95% CI: 0.81, 3.14; I2 = 91.6%, P < 0.001), triglycerides (−13.50 mg/dl; 95% CI: −20.09, −6.92; I2 = 90.7%, P < 0.001) and very low-density lipoprotein (−3.94 mg/dl; 95%CI: −6.31, −1.56; I2 = 72.2%, P < 0.001). Conclusion It seems yoga interventions had a substantial effect on lipid profiles, however, more qualified trials or cohort studies are needed to conclude exactly.
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Affiliation(s)
- Dorsa Ghazvineh
- Department of Physical Education, Islamic Azad University of Karaj, Karaj, Iran
| | - Mojtaba Daneshvar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Basirat
- Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran
| | - Elnaz Daneshzad
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Elnaz Daneshzad,
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James-Palmer A, Anderson EZ, Daneault JF. Remote Delivery of Yoga Interventions Through Technology: Scoping Review. J Med Internet Res 2022; 24:e29092. [PMID: 35666562 PMCID: PMC9210204 DOI: 10.2196/29092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The popularity of yoga and the understanding of its potential health benefits have recently increased. Unfortunately, not everyone can easily engage in in-person yoga classes. Over the past decade, the use of remotely delivered yoga has increased in real-world applications. However, the state of the related scientific literature is unclear. OBJECTIVE This scoping review aimed to identify gaps in the literature related to the remote delivery of yoga interventions, including gaps related to the populations studied, the yoga intervention characteristics (delivery methods and intervention components implemented), the safety and feasibility of the interventions, and the preliminary efficacy of the interventions. METHODS This scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Item for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Scientific databases were searched throughout April 2021 for experimental studies involving yoga delivered through technology. Eligibility was assessed through abstract and title screening and a subsequent full-article review. The included articles were appraised for quality, and data were extracted from each article. RESULTS A total of 12 studies of weak to moderate quality were included. Populations varied in physical and mental health status. Of the 12 studies, 10 (83%) implemented asynchronous delivery methods (via prerecorded material), 1 (8%) implemented synchronous delivery methods (through videoconferencing), and 1 (8%) did not clearly describe the delivery method. Yoga interventions were heterogeneous in style and prescribed dose but primarily included yoga intervention components of postures, breathing, and relaxation and meditation. Owing to the heterogeneous nature of the included studies, conclusive findings regarding the preliminary efficacy of the interventions could not be ascertained. CONCLUSIONS Several gaps in the literature were identified. Overall, this review showed that more attention needs to be paid to yoga intervention delivery methods while designing studies and developing interventions. Decisions regarding delivery methods should be justified and not made arbitrarily. Studies of high methodological rigor and robust reporting are needed.
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Affiliation(s)
- Aurora James-Palmer
- Department of Rehabilitation and Movement Sciences, Rutgers University, Newark, NJ, United States
| | - Ellen Zambo Anderson
- Department of Rehabilitation and Movement Sciences, Rutgers University, Newark, NJ, United States
| | - Jean-Francois Daneault
- Department of Rehabilitation and Movement Sciences, Rutgers University, Newark, NJ, United States
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Utilization of Mind–Body Intervention for Integrative Health Care of COVID-19 Patients and Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116618. [PMID: 35682203 PMCID: PMC9180827 DOI: 10.3390/ijerph19116618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Recent findings suggest a correlation between COVID-19 and diabetes, although the underlying causes are still little understood. COVID-19 infection tends to induce severe symptoms in patients with underlying diabetes, increasing their mortality rate. Moreover, COVID-19 itself appears to be a diabetogenic factor. In addition, mental health conditions, such as depression due to lockdown and anxiety about infection, were found to affect glycemic control and immunity, highlighting the importance of mental health care during the pandemic. Mind–Body Intervention (MBI), which includes meditation, yoga, and qigong, has emerged as a tool for mental health management due to its effects on stress reduction and the promotion of mental and physical well-being. Here, we review the latest randomized controlled trials to determine the effects of MBI on glycemic control and the immune system and discuss the underlying mechanisms by which MBI facilitates the virtuous cycle of stress management, glycemic control, and immune modulation. Furthermore, we examine the actual utilization of MBI during the COVID-19 pandemic era through recent studies. With proper online education, non-pharmacological MBI may be more widely used as an important tool for self-health care that complements the usual treatment of COVID-19 patients and survivors.
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Cheshire A, Richards R, Cartwright T. 'Joining a group was inspiring': a qualitative study of service users' experiences of yoga on social prescription. BMC Complement Med Ther 2022; 22:67. [PMID: 35287676 PMCID: PMC8922896 DOI: 10.1186/s12906-022-03514-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Yoga is becoming an increasingly popular holistic approach in the West to manage long-term health conditions. This study presents the evaluation of a pilot yoga intervention, Yoga4Health, that was developed for the NHS to be socially prescribed to patients at risk of developing specific health conditions (risk factors for cardiovascular disease, pre-diabetes, anxiety/depression or experiencing social isolation). The aim of this qualitative study was to explore service users’ experiences of Yoga4Health and the acceptability of the programme. Methods Qualitative data were collected from three sources: 1. Open-ended questions on questionnaires completed by services users at three different time-points (baseline, post intervention and 3 months); 2. Interviews and focus groups with a subset of participants (n = 22); 3. interviews with yoga teachers delivering Yoga4Health (n = 7). Each data source was analysed thematically, then findings were combined. Results Of participants completing baseline questionnaires (n = 240), 82.5% were female, 50% White, with a mean age of 53 (range 23–82) years. Baseline questionnaires revealed key motivations to attend Yoga4Health were to improve psychological and physical health, and believing Yoga4Health would be accessible for people with their health condition. Post-intervention, participants reported a range of benefits across psychological, physical and social domains from Yoga4Health. Increased confidence in self-management of health was also reported, and a number of participants described making positive lifestyle changes after attending the programme. Unanticipated benefits of yoga emerged for participants, such as enjoyment and social connectedness, which facilitated ongoing attendance and practice. Also key to facilitating practice (during and after the intervention) were suitability of the classes for those with health conditions, practising with a group and qualities of the yoga teacher. Home practice was supported by course materials (manual, videos), as well as the teaching of techniques for everyday application that offered immediate benefits, such as breathing practices. Follow-up questionnaires revealed a key challenge was continuation of practice once the intervention had finished, with the structure of a class important in supporting practice. Conclusions Yoga4Health was a highly acceptable intervention to services users, which brought a range of biopsychosocial improvements, suggesting yoga is an appropriate intervention to offer on social prescription. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03514-3.
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Affiliation(s)
- Anna Cheshire
- School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | | | - Tina Cartwright
- School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
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Kanaley JA, Colberg SR, Corcoran MH, Malin SK, Rodriguez NR, Crespo CJ, Kirwan JP, Zierath JR. Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine. Med Sci Sports Exerc 2022; 54:353-368. [PMID: 35029593 PMCID: PMC8802999 DOI: 10.1249/mss.0000000000002800] [Citation(s) in RCA: 224] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT This consensus statement is an update of the 2010 American College of Sports Medicine position stand on exercise and type 2 diabetes. Since then, a substantial amount of research on select topics in exercise in individuals of various ages with type 2 diabetes has been published while diabetes prevalence has continued to expand worldwide. This consensus statement provides a brief summary of the current evidence and extends and updates the prior recommendations. The document has been expanded to include physical activity, a broader, more comprehensive definition of human movement than planned exercise, and reducing sedentary time. Various types of physical activity enhance health and glycemic management in people with type 2 diabetes, including flexibility and balance exercise, and the importance of each recommended type or mode are discussed. In general, the 2018 Physical Activity Guidelines for Americans apply to all individuals with type 2 diabetes, with a few exceptions and modifications. People with type 2 diabetes should engage in physical activity regularly and be encouraged to reduce sedentary time and break up sitting time with frequent activity breaks. Any activities undertaken with acute and chronic health complications related to diabetes may require accommodations to ensure safe and effective participation. Other topics addressed are exercise timing to maximize its glucose-lowering effects and barriers to and inequities in physical activity adoption and maintenance.
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Affiliation(s)
- Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Sheri R Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA
| | | | - Steven K Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ
| | - Nancy R Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | - Carlos J Crespo
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
| | - John P Kirwan
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Juleen R Zierath
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, SWEDEN
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Alzahrani AS, Greenfield SM, Paudyal V. Factors affecting complementary and alternative medicine (CAM) use by adult diabetic patients: A systematic review using the theoretical domains framework (TDF). Res Social Adm Pharm 2022; 18:3312-3322. [DOI: 10.1016/j.sapharm.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/13/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
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Trojian T, Colberg S, Harris G, Oh R, Dixit S, Gibson M, Corcoran M, Ramey L, Berg PV. American Medical Society for Sports Medicine Position Statement on the Care of the Athlete and Athletic Person With Diabetes. Clin J Sport Med 2022; 32:8-20. [PMID: 34930869 DOI: 10.1097/jsm.0000000000000906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/06/2020] [Indexed: 02/02/2023]
Abstract
ABSTRACT The American Medical Society for Sports Medicine (AMSSM) developed this position statement to assist physicians and other health professionals in managing athletes and active people with diabetes. The AMSSM selected the author panel through an application process to identify members with clinical and academic expertise in the care of active patients with diabetes. This article reviews the current knowledge and gaps regarding the benefits and risks of various types of exercise and management issues for athletes and physically active people with diabetes, including nutrition and rehabilitation issues. Resistance exercises seem to be beneficial for patients with type 1 diabetes, and the new medications for patients with type 2 diabetes generally do not need adjustment with exercise. In preparing this statement, the authors conducted an evidence review and received open comment from the AMSSM Board of Directors before finalizing the recommendations.
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Anuradha, Rojaria NS, Kaur J, Saini M. The Effects of Yoga on Cardiovascular Risk Factors among Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis. Int J Yoga 2022; 15:3-11. [PMID: 35444371 PMCID: PMC9015080 DOI: 10.4103/ijoy.ijoy_151_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a fastest evolving metabolic disorder and India houses second highest number of patients with diabetes after China. Cardiovascular diseases are the major cause of mortality among patients with T2DM. Yoga is an ancient Indian practice that proves to be effective for patients with diabetes. The present systematic review and meta-analysis has been conducted to see the benefits of yoga on blood pressure, lipid profile, and anthropometric measures among patients with T2DM. The articles were extracted from three databases - PubMed, The Cochrane library, and Google scholar. Only English language articles, with PEDro score≥6, were included in the current study. The duplicates were removed using Mendeley. Fourteen randomized controlled trials (RCTs) and three 3 non-RCTs were included in the analysis. The meta-analysis was done using Review Manager 5.3. The results reveal that yoga is effect in improving blood pressure (P<0.01), lipid profile (P<0.01) except HDL (P=0.06), and anthropometric measures (P<0.01) except waist-hip ratio (P=0.79). Heterogeneity was also high for most of the variables. It may be concluded from the results that the yoga is effective in improving of blood pressure, lipid profile, and anthropometric measures. However, high heterogeneity sought the need of more high quality RCTs to affirm these findings.
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Affiliation(s)
- Anuradha
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | - Niharika Singh Rojaria
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | - Jaspreet Kaur
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | - Minaxi Saini
- Mother Teresa Saket College of Physiotherapy, Panchkula, Haryana, India,Address for correspondence: Dr. Minaxi Saini, Mother Teresa Saket College of Physiotherapy, Chandi Mandir, Panchkula - 134 107, Haryana, India. E-mail:
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Kaur N, Majumdar V, Nagarathna R, Malik N, Anand A, Nagendra HR. Diabetic yoga protocol improves glycemic, anthropometric and lipid levels in high risk individuals for diabetes: a randomized controlled trial from Northern India. Diabetol Metab Syndr 2021; 13:149. [PMID: 34949227 PMCID: PMC8696241 DOI: 10.1186/s13098-021-00761-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023] Open
Abstract
PURPOSE To study the effectiveness of diabetic yoga protocol (DYP) against management of cardiovascular risk profile in a high-risk community for diabetes, from Chandigarh, India. METHODS The study was a randomized controlled trial, conducted as a sub study of the Pan India trial Niyantrita Madhumeha Bharath (NMB). The cohort was identified through the Indian Diabetes Risk Scoring (IDRS) (≥ 60) and a total of 184 individuals were randomized into intervention (n = 91) and control groups (n = 93). The DYP group underwent the specific DYP training whereas the control group followed their daily regimen. The study outcomes included changes in glycemic and lipid profile. Analysis was done under intent-to-treat principle. RESULTS The 3 months DYP practice showed diverse results showing glycemic and lipid profile of the high risk individuals. Three months of DYP intervention was found to significantly reduce the levels of post-prandial glucose levels (p = 0.035) and LDL-c levels (p = 0.014) and waist circumference (P = 0.001). CONCLUSION The findings indicate that the DYP intervention could improve the metabolic status of the high-diabetes-risk individuals with respect to their glucose tolerance and lipid levels, partially explained by the reduction in abdominal obesity. The study highlights the potential role of yoga intervention in real time improvement of cardiovascular profile in a high diabetes risk cohort. TRIAL REGISTRATION CTRI, CTRI/2018/03/012804. Registered 01 March 2018-Retrospectively registered, http://www.ctri.nic.in/ CTRI/2018/03/012804.
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Affiliation(s)
- Navneet Kaur
- Department of Physical Education, Panjab University, Chandigarh, 160014, India
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Vijaya Majumdar
- Division of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, Karnataka, 560106, India
| | - Raghuram Nagarathna
- Division of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, Karnataka, 560106, India.
| | - Neeru Malik
- Dev Samaj College of Education, Sector 36B, Chandigarh, 160036, India
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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Tolbaños-Roche L, Menon P. Corrigendum: Applying the S-ART Framework to Yoga: Exploring the Self-Regulatory Action of Yoga Practice in Two Culturally Diverse Samples. Front Psychol 2021; 12:778709. [PMID: 34899528 PMCID: PMC8663720 DOI: 10.3389/fpsyg.2021.778709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/19/2021] [Indexed: 12/01/2022] Open
Affiliation(s)
- Laura Tolbaños-Roche
- Department of Clinical Psychology, Psychobiology and Methodology, Section of Psychology, Faculty of Health Sciences, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Praseeda Menon
- Scientific Research Department, Kaivalyadhama Yoga Institute, Lonavala, India
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Sharpe E, Lacombe A, Sadowski A, Phipps J, Heer R, Rajurkar S, Hanes D, Jindal RD, Bradley R. Investigating components of pranayama for effects on heart rate variability. J Psychosom Res 2021; 148:110569. [PMID: 34271528 PMCID: PMC8568305 DOI: 10.1016/j.jpsychores.2021.110569] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Traditional Indian breath control practices of Pranayama have been shown to increase indices of heart rate variability (HRV) that are generally held to reflect parasympathetic nervous system (PNS) tone. To our knowledge, individual components of pranayama have not been separately evaluated for impact on HRV. The objective of this study was to isolate five components of a pranayama practice and evaluate their impact on HRV. METHODS In a crossover clinical trial, 46 healthy adults were allocated to complete five activities in random order, over five separate visits: 1) sitting quietly; 2) self-paced deep breathing; 3) externally-paced deep breathing; 4) self-paced Sheetali/Sheetkari pranayama; and 5) externally paced Sheetali/Sheetkari pranayama RESULTS: Our final sample included 25 participants. There was a significant increase in a time-domain index of HRV, the root mean square successive differences between RR intervals (RMSSD), during the five interventions. The change in logRMSSD ranged from 0.2 to 0.5 (p < .01 in all conditions by paired t-test). Greater increases were evident during externally-paced breathing than during self-paced breathing (mean pre-during logRMSSD change of 0.50 vs. 0.36, p = .02) or sitting quietly (mean, 0.17 ms; p = .005 and 0.02 when comparing Activities 3 and 5 to Activity 1 by random intercept model with Tukey correction for multiple comparisons). Lastly, pre-during increase in RMSSD was greater for Sheetali/Sheetkari vs. deep breathing, when controlling for respiration rate, though not significantly different (p = .07 in random intercept model) CONCLUSIONS: RMSSD increased with paced breathing, deep breathing, and Sheetali/Sheetkari pranayama, reinforcing evidence of a physiologic mechanism of pranayama. TRIAL REGISTRATION NCT03280589 https://www.clinicaltrials.gov/ct2/show/NCT03280589?term=sheetali&draw=2&rank=1.
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Affiliation(s)
- Erica Sharpe
- National University of Natural Medicine, Portland, OR, United States of America; State University of New York at Canton, Canton, NY, United States of America.
| | - Alison Lacombe
- National University of Natural Medicine, Portland, OR,United States Department of Agriculture, Produce Safety Microbiology Research Unit, Albany, CA
| | - Adam Sadowski
- National University of Natural Medicine, Portland, OR, United States of America.
| | - John Phipps
- National University of Natural Medicine, Portland, OR, United States of America.
| | - Ryan Heer
- National University of Natural Medicine, Portland, OR
| | - Savita Rajurkar
- National University of Natural Medicine, Portland, OR, United States of America.
| | - Douglas Hanes
- National University of Natural Medicine, Portland, OR, United States of America.
| | - Ripu D Jindal
- Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Ryan Bradley
- National University of Natural Medicine, Portland, OR, United States of America; University of California, San Diego, La Jolla, CA, United States of America; Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
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Tolbaños-Roche L, Menon P. Applying the S-ART Framework to Yoga: Exploring the Self-Regulatory Action of Yoga Practice in Two Culturally Diverse Samples. Front Psychol 2021; 12:585300. [PMID: 34381394 PMCID: PMC8350561 DOI: 10.3389/fpsyg.2021.585300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 06/09/2021] [Indexed: 11/24/2022] Open
Abstract
Mindfulness practices form the core of numerous therapeutic programs and interventions for stress reduction and the treatment of different health conditions related to stress and life habits. Ways and means to regulate oneself effectively also form the foundation of the path of yoga in the accomplishment of holistic health and well-being. The self-awareness, self-regulation, and self-transcendence (S-ART) model can be considered as an overarching neurobiological framework to explain the self-regulatory mechanisms of well-being present in mindfulness-based practices. The current study, by connecting and applying the S-ART framework to the self-regulatory mechanisms in yoga and generating related hypotheses, provides a theory-led explanation of the action of yoga practices, which is sparse in the literature. Testing the S-ART model in yoga in two culturally diverse samples, assessing the model-mapped psychological mechanisms of action, and exploring the influence of perseverance in yoga practice are the original contributions of this study. The study sample comprised 362 yoga practitioners and non-practitioners (197 Indian and 165 Spanish), who completed four tests of psychological variables indicative of the aforementioned three S-ART abilities. These tests were Multidimensional Assessment of Interoceptive Awareness (MAIA), Experiences Questionnaire-Decentering (EQ-D) subscale, Difficulties in Emotion Regulation Scale (DERS), and Relational Compassion Scale (RCS). The results indicated significantly better self-awareness and self-regulatory abilities in yoga practitioners (Indian and Spanish in a combination) than non-practitioners, reflected in higher levels of interoceptive awareness and decentering abilities. Moreover, perseverance in yoga practice acted as a significant predictor of self-awareness and self-regulation in practitioners. An analysis of each cultural sample revealed some differences. Yoga practice and perseverance in it acted as a significant predictor of interoceptive awareness and decentering in Indian practitioners having more than 1 year of sustained yoga practice, but for the Spanish participants, physical exercise and frequency of yoga practice acted as better predictors of interoceptive awareness and decentering in comparison to yoga practice and perseverance in it. The obtained results suggested that the S-ART model provided preliminary but promising evidence for the self-regulatory mechanisms of action in yoga practice within a culturally diverse sample of yoga practitioners. This study also widens the scope of generating further hypotheses using the S-ART theoretical framework for testing the self-regulatory mechanisms of action in yoga practice.
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Affiliation(s)
- Laura Tolbaños-Roche
- Department of Clinical Psychology, Psychobiology and Methodology, Section of Psychology, Faculty of Health Sciences, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Praseeda Menon
- Scientific Research Department, Kaivalyadhama Yoga Institute, Lonavala, India
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Naturopathy and yoga based lifestyle intervention for type 2 diabetes mellitus – Study protocol for a randomized parallel group trial. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nair RG, Vasudev MM, Mavathur R. Role of Yoga and Its Plausible Mechanism in the Mitigation of DNA Damage in Type-2 Diabetes: A Randomized Clinical Trial. Ann Behav Med 2021; 56:235-244. [PMID: 34180500 DOI: 10.1093/abm/kaab043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although yoga is found to be beneficial in the management of type 2 diabetes (T2D), its mechanism of action is poorly understood. T2D is also known to be associated with increased oxidative stress (OS) and DNA damage. PURPOSE This study examines how yoga modulates OS-induced DNA damage and the efficiency of DNA repair in T2D conditions. METHODS In this assessor-masked randomized clinical trial, T2D subjects (n = 61), aged (Mean ± SD, 50.3 ± 4.2) were randomly allocated into Yoga group (31) that received 10 weeks of yoga intervention and Control (30) with routine exercises. Molecular and biochemical assessments were done before and after the intervention period. Structural Equation Modeling using "R" was used for mediation analysis. RESULTS At the end of the 10th week, Yoga group showed significant reduction in DNA damage indicators like Tail Moment (-5.88[95%CI: -10.47 to -1.30]; P = .013) and Olive Tail Moment (-2.93[95%CI: -4.87 to -1.00]; P < .01), oxidative DNA damage marker 8-OHdG (-60.39[95%CI: -92.55 to -28.23]; P < .001) and Fasting Blood Sugar (-22.58[95%CI: -44.33 to -0.83]; P = .042) compared to Control. OGG1 protein expression indicating DNA repair, improved significantly (17.55[95%CI:1.37 to 33.73]; P = .034) whereas Total Antioxidant Capacity did not (5.80[95%CI: -0.86 to 12.47]; P = 0.086). Mediation analysis indicated that improvements in oxidative DNA damage and DNA repair together played a major mediatory role (97.4%) in carrying the effect of yoga. CONCLUSION The beneficial effect of yoga on DNA damage in T2D subjects was found to be mediated by mitigation of oxidative DNA damage and enhancement of DNA repair. CLINICAL TRIAL INFORMATION (www.ctri.nic.in) CTRI/2018/07/014825.
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Affiliation(s)
- Rajesh G Nair
- Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA, Bangalore, India
| | - Mithila M Vasudev
- Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA, Bangalore, India
| | - Ramesh Mavathur
- Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA, Bangalore, India
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Dutta D, Bhattacharya S, Sharma M, Khandelwal D, Surana V, Kalra S. Effect of yoga on glycemia and lipid parameters in type-2 diabetes: a meta-analysis. J Diabetes Metab Disord 2021; 20:349-367. [PMID: 34178843 PMCID: PMC8212260 DOI: 10.1007/s40200-021-00751-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Prior systematic reviews on yoga and diabetes have given conflicting results. They have been limited by inclusion of uncontrolled unblinded single group observational studies. No reviews are available which have used the Cochrane methodology and GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. This meta-analysis evaluated the efficacy of yoga on glycaemia and lipids in T2DM using the Cochrane methodology and GRADE approach. METHODS Major repositories were searched to pick randomized controlled trials involving T2DM patients receiving yoga. Primary outcome was to evaluate changes in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c). Secondary outcomes were to evaluate changes in post-prandial plasma glucose (PPG), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Sub-group analysis involving people undergoing structured exercise regimen (SER) versus those undergoing standard diabetes care in controls was done. RESULTS Data from 13 studies involving 1440 patients were analysed. Compared to controls, individuals doing yoga had significantly lower FPG [mean difference (MD) -17.22 mg/dl (95% CI: -26.19 - -8.26 mg/dl); p < 0.01; considerable heterogeneity (CH); low certainty of evidence (LCE)], PPG [MD -27.77 mg/dl (95% CI: -35.73 - -19.81 mg/dl); p < 0.01; low heterogeneity; moderate certainty of evidence (MCE)], TC [MD -19.48 mg/dl (95% CI: -31.97 - -6.99 mg/dl); p < 0.01; CH; LCE], triglycerides [MD -12.99 mg/dl (95% CI: -23.74 - -2.25 mg/dl); p < 0.01; CH; LCE], LDL-C [MD -11.71 mg/dl (95% CI: -17.49 - -5.93 mg/dl); p < 0.01; I2 = 69% CH; LCE] and significantly higher HDL-C [MD 4.58 mg/dl (95% CI: 3.98-5.18 mg/dl); p < 0.01; low heterogeneity; MCE]. On sub-group analysis, where yoga was compared to SER, FPG was significantly lower in yoga group. CONCLUSION Yoga improves glycaemia and lipid parameters in T2DM with additional benefits seen both in people doing/not doing structured exercise. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40200-021-00751-0.
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Affiliation(s)
- Deep Dutta
- Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis & Rheumatism (CEDAR) Super-speciality Clinics, Dwarka, New Delhi, 110075 India
| | | | - Meha Sharma
- Department of Rheumatology, CEDAR Superspeciality Clinics, Dwarka, New Delhi, India
| | - Deepak Khandelwal
- Department of Endocrinology, Maharaj Agrasen Hospital, New Delhi, India
| | - Vineet Surana
- Department of Endocrinology, Manipal Hospitals, Dwarka, New Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospitals, Karnal, India
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Chen Z, Ye X, Xia Y, Song H, Wang Y, Guan Y, Shen Z, Chen W, Jiang T, Wu H, Xu X. Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol 2021; 12:641968. [PMID: 34135767 PMCID: PMC8202501 DOI: 10.3389/fphys.2021.641968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The benefits of Pilates for blood glucose and lipids remain unclear. The purpose of this study was to examine the effect of Pilates on their levels. Methods: Searches were conducted in five databases to identify relevant articles published until October 29, 2020. Paired reviewers independently screened the articles and extracted data from each included study. Meta-analysis was performed to assess the effects of Pilates on blood glucose and lipids. Subgroup analyses and sensitivity analyses were conducted to explore heterogeneity. Results: According to the inclusion and exclusion criteria, 15 randomized controlled trials (RCTs) comprising 587 participants were included in the study. Overall, the Pilates group (PG) had a significantly greater reduction in post-prandial blood glucose than the control group (CG) (MD = −22.25 mg/dL, 95% CI: [−28.34, 16.17] mg/dL, P < 0.00001, I2 = 0%); glycated hemoglobin (HbA1c) (MD = −0.78%, 95% CI: [−1.13, −0.42]%, P < 0.0001, I2 = 88%); total cholesterol (TC) (MD = −20.90 mg/dL, 95% CI: [−37.21, −4.60] mg/dL, P = 0.01, I2 = 84%); triglycerides (TG) (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I2 = 86%); and low density lipoprotein cholesterol (LDL-C) (MD = −12.39 mg/dL, 95% CI: [−16.82, −7.95] mg/dL, P < 0.00001, I2 = 45%) compared to CG, whereas no significant difference was detected between the two groups in fasting blood glucose (MD = −7.04 mg/dL, 95% CI: [−17.26, 3.17] mg/dL, P = 0.18, I2 = 93%), insulin (MD = −1.44 μU/mL, 95% CI: [−4.30, 1.41] μU/mL, P = 0.32, I2 = 0%); and high density lipoprotein cholesterol (HDL-C) (MD = −2.68 mg/dL, 95% CI: [−9.03, 3.67] mg/dL, P = 0.41, I2 = 89%). However, by subgroup analysis, we found that compared to the CG, PG showed no significant improvement in blood glucose and lipids levels for non-diabetics, while it presented a significantly greater decrease in post-prandial blood glucose, TC, TG, and LDL-C for diabetic patients. Notably, for diabetic patients, Pilates and medication treatments showed no significant reduction in fasting blood glucose (MD = −7.00 mg/dL, 95% CI: [−26.06, 12.06] mg/dL, P = 0.40) and HbA1c (MD = −0.23%, 95% CI: [−0.58, 0.13]%, P = 0.21, I2 = 0%) than medications treatment used alone, and Pilates combined with medications and dietary treatments presented no significant improvement in fasting blood glucose than a combination of medications and dietary treatments (MD = −10.90 mg/dL, 95% CI: [−32.35, 10.54] mg/dL, P = 0.32, I2 = 94%). Conclusions: Overall, Pilates could improve post-prandial blood glucose, fasting blood glucose, HbA1c, TG, TC, and LDL-C for diabetic patients, which could be influenced by its duration and intensity. Moreover, it had no significant effect on blood glucose and lipids for non-diabetic individuals. However, Pilates, as an adjunctive treatment to medications was not superior to medications used alone in lowering fasting blood glucose and HbA1c. Furthermore, Pilates combined with medications and dietary treatments showed no significant improvement in fasting blood glucose, whereas it had a greater reduction in post-prandial blood glucose and HbA1c for diabetic patients. Systematic Review Registration:https://osf.io/xgv6w.
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Affiliation(s)
- Zehua Chen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yubo Xia
- Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Huiting Song
- Jiangxi Academy of Traditional Chinese Medicine, Nanchang, China
| | - Yi Wang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingxin Guan
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhen Shen
- Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Weijian Chen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tao Jiang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Huai Wu
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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Kurian J, Vijayakumar V, Mooventhan A, Mavathur R. Effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:649-651. [PMID: 33794078 DOI: 10.1515/jcim-2020-0215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/21/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The objective of the study is to evaluate the short-term effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus (T1DM). CASE PRESENTATION A 28-years old female was diagnosed with T1DM at the age of seven. She was under Human Mixtard insulin 30-70, thrice/day for 15-15-15 units. She had a history of poor glycemic control, diabetic ketoacidosis and hypoglycemic shock. At the age of 27, she got admitted with complaints of general weakness, joints stiffness and weight loss in our holistic health centre and underwent two weeks of yoga. Results showed a better reduction in the plasma glucose levels, lipid profile, blood pressure and insulin dose and an increase in hemoglobin levels with no episodes of hypoglycemia after yoga. CONCLUSIONS Yoga might be considered as a safer and effective adjuvant in the management of T1DM.
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Affiliation(s)
- Jintu Kurian
- Division of Yoga and Life Sciences, Department of Molecular Bioscience, S-VYASA Deemed to be University, Bengaluru, Karnataka, India
| | - Venugopal Vijayakumar
- Department of Yoga, Government Yoga and Naturopathy Medical College, Chennai, Tamilnadu, India
| | - A Mooventhan
- Department of Research, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, Tamilnadu, India
| | - Ramesh Mavathur
- Division of Yoga and Life Sciences, Department of Molecular Bioscience, S-VYASA Deemed to be University, Bengaluru, Karnataka, India
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Development of Sham Yoga Poses to Assess the Benefits of Yoga in Future Randomized Controlled Trial Studies. Life (Basel) 2021; 11:life11020130. [PMID: 33562301 PMCID: PMC7915153 DOI: 10.3390/life11020130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Although research has demonstrated the benefits of yoga to people who have been diagnosed with diabetes or at risk of diabetes, studies have not confirmed these effects can be ascribed to the specific features of the traditional postures, called asanas. Instead, the effects of asanas could be ascribed to the increase in cardiovascular activity and expenditure of energy or to the expectation of health benefits. Therefore, to establish whether asanas are beneficial, researchers need to design a control condition in which participants complete activities, called sham poses, that are equivalent to traditional asanas in physical activity and expectation of benefits. Objectives: The aim of this research was to design an appropriate suite of sham poses and to demonstrate these poses and traditional asanas are equivalent in energy expenditure, cardiovascular response, and expectations of health benefits. Methods: Twenty healthy men at medium to high risk of developing diabetes volunteered to partake in the current study. These men completed two sessions that comprised traditional asanas and two sessions that comprised sham poses—poses that utilize the same muscle groups as the asanas and were assigned fictitious Sanskrit labels. Before and after each session, heart rate, blood pressure, blood glucose levels, triglycerides levels, and oxygen saturation were measured to gauge the intensity of exercise. After each session, using a standard measure, participants also indicated the degree to which they expected the poses to improve health. Results: The degree to which the sessions affected the physiological measures (for example, pre-exercise, the heart rate for yoga and sham was 71.06 ± 4.79 and 73.88 ± 6.05, respectively, and post-exercise, the heart rate was 70.19 ± 6.16 and 73 ± 7.55, respectively) and the expectations of health improvements did not differ between the traditional asanas and the sham poses. Likewise, the degree to which each session influenced these physiological measures was negligible in both conditions. Conclusions: This study developed a series of poses that elicit similar physiological and psychological effect as traditional yoga asanas. These poses can be used in an active control group in future randomized trial studies that are designed to assess the benefits of asanas.
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Yang HJ, Koh E, Sung MK, Kang H. Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. Int J Mol Sci 2021; 22:ijms22031317. [PMID: 33525677 PMCID: PMC7865217 DOI: 10.3390/ijms22031317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind-body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.
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Affiliation(s)
- Hyun-Jeong Yang
- Korea Institute of Brain Science, Seoul 06022, Korea; (M.-K.S.); (H.K.)
- Department of Integrative Health Care, University of Brain Education, Cheonan 31228, Korea
- Correspondence:
| | - Eugene Koh
- Temasek Life Sciences Laboratories, Singapore 117604, Singapore;
| | - Min-Kyu Sung
- Korea Institute of Brain Science, Seoul 06022, Korea; (M.-K.S.); (H.K.)
| | - Hojung Kang
- Korea Institute of Brain Science, Seoul 06022, Korea; (M.-K.S.); (H.K.)
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Misra P, Sharma G, Tandon N, Kant S, Sangral M, Rai SK, Yadav K, Vishnubhatla S, Mandal S, Kardam P, Thakur N. Effect of Community-Based Structured Yoga Program on Hba1c Level among Type 2 Diabetes Mellitus Patients: An Interventional Study. Int J Yoga 2021; 14:222-228. [PMID: 35017864 PMCID: PMC8691441 DOI: 10.4103/ijoy.ijoy_150_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/06/2022] Open
Abstract
CONTEXT In view of the rising burden of type 2 diabetes mellitus (DM) cases in India, there is an urgent need for an effective, low-cost, sustainable intervention controlling diabetes thus preventing complications. AIMS This study aimed to assess the effect of structured yoga programs on diabetes. SUBJECTS AND METHODS This was a community-based interventional study that was conducted in an urban resettlement colony of Delhi, India. Known diabetes patients with glycated hemoglobin (Hb1Ac) ≥6.5% were enrolled from 12 randomly selected blocks of the community with a sample size of 192 in each intervention and wait-listed control arm. The intervention was structured yoga of 50 min daily, 2 consecutive weeks in a nearby park and health center followed by twice a week home practice up to the 3rd month. The primary outcome measure was HbA1c% and secondary outcome measures were lipid profile and fasting blood glucose. STATISTICAL ANALYSIS USED Aper-protocol analysis was done. Mean, standard deviation (SD), and 95% confidence interval were estimated. The level of significance was considered for 0.05. RESULTS There was a significant decrease of Hb1Ac (0.5%, SD = 1.5, P = 0.02), total cholesterol (11.7 mg/dl, SD = 40.5, P < 0.01), and low-density lipoprotein (3.2 mg/dl, SD = 37.4, P < 0.01) from baseline to end line in the intervention group. These changes in intervention group were also significantly different from the change in the wait-listed control group. The other variables did not change significantly. CONCLUSIONS It revealed that structured yoga program improved glycemic outcome and lipid profile of individuals in a community-based setting. Yoga can be a feasible strategy to control hyperglycemia, lipid levels, and can help better control type 2 DM.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Dr. Puneet Misra, Room No. 30, Centre for Community Medicine, Old OT Block, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi - 110 029, Delhi, India. E-mail:
| | - Gautam Sharma
- Department of Cardiology, Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Meenu Sangral
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay K Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Suprakash Mandal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Kardam
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishakar Thakur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Gupta U, Gupta Y, Jose D, Mani K, Jyotsna VP, Sharma G, Tandon N. Effectiveness of Yoga-based Exercise Program Compared to Usual Care, in Improving HbA1c in Individuals with Type 2 Diabetes: A Randomized Control Trial. Int J Yoga 2020; 13:233-238. [PMID: 33343154 PMCID: PMC7735507 DOI: 10.4103/ijoy.ijoy_33_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/01/2020] [Accepted: 06/26/2020] [Indexed: 11/04/2022] Open
Abstract
Background: This study was designed to evaluate the effectiveness of a yoga-based exercise program (YBEP) in improving glycemic control in people with type 2 diabetes mellitus. Materials and Methods: Patients on stable oral glucose-lowering agents for at least 3 months and HbA1c 7.5%–10% were randomized in 1:1 ratio. The primary outcome measure was the difference of change in mean HbA1c between groups. Results: The participants (n = 81) had mean (±standard deviation) age of 50.6 (±8.5) years and HbA1c of 8.5 ± 0.7% (68.97 ± 7.42 mmol/mol). The follow-up data were available in 96% (78/81) of participants. Of 40 participants, 25 (62.5%) attended ≥75% (≥10 out of 13) of the sessions in YBEP. On the intention to treat analysis, a favorable reduction (0.21% 95% confidence interval [−0.34, 0.75], P = 0.454) in HbA1c was seen in YBEP group as compared to usual care. The reduction in HbA1c by ≥0.5% was observed in 44.7% of participants in YBEP as compared to 37.5% in usual care arm, respectively. Those who attended ≥75% of the sessions had better HbA1c reduction of 0.3% in comparison to 0.1% reduction seen in those who attended <75% of the sessions. Conclusions: YBEP demonstrated a clinically relevant HbA1c reduction compared to usual care in participants who had attended at least 75% of the yoga sessions. The reduction in HbA1c by >0.5% in 44.7% in the yoga group, suggests, that it can be prescribed as an exercise to individuals who are unable to walk either due to limited joint mobility, adverse weather conditions, lack of space for walking, cultural or religious prohibitions for women for outdoor physical activity, and so on. CTRI registration no: CTRI/2017/05/008564.
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Affiliation(s)
- Uttio Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Yashdeep Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Jose
- Department of Cardiology and All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Viveka P Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Gautam Sharma
- Department of Cardiology and All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Li J, Gao X, Hao X, Kantas D, Mohamed EA, Zheng X, Xu H, Zhang L. Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis. Complement Ther Med 2020; 57:102643. [PMID: 33338581 DOI: 10.1016/j.ctim.2020.102643] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/15/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Yoga has been widely practiced and has recently shown benefits in patients with coronary heart disease (CHD), however, evidence is inconsistent. METHODS We conducted a systematic review and meta-analysis by searching PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Web of Science from inception to May 31, 2020 for randomised controlled trials (RCTs) comparing yoga with usual care or non-pharmacological interventions in patients with CHD. The primary outcomes were all-cause mortality and health related quality of life (HR-QoL). Secondary outcomes were a composite cardiovascular outcome, exercise capacity and cardiovascular risk factors (blood pressure, lipid profiles and body mass index). RESULTS Seven RCTs with a total of 4671 participants were included. Six RCTs compared yoga with usual care and one compared yoga with designed exercise. The mean age of the participants ranged from 51.0-60.7 years and the majority of them were men (85.4 %). Pooled results showed that compared with usual care, yoga had no effect on all-cause mortality (RR, 1.02; 95 % CI, 0.75-1.39), but it significantly improved HR-QoL (SMD, 0.07; 95 % CI, 0.01 - 0.14). A non-significant reduction of the composite cardiovascular outcome was observed (133 vs. 154; RR, 0.63; 95 % CI, 0.15-2.59). Serum level of triglyceride and high density lipoprotein cholesterol, blood pressure and body mass index were also significantly improved. The study comparing yoga with control exercise also reported significantly better effects of yoga on HR-QoL (85.75 vs. 75.24, P < 0.001). No severe adverse events related to yoga were reported. CONCLUSIONS Yoga might be a promising alternative for patients with CHD as it is associated with improved quality of life, less number of composite cardiovascular events, and improved cardiovascular risk factors.
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Affiliation(s)
- Jingen Li
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55902, United States
| | - Xiang Gao
- Internal Medicine Division, Tieying Hospital of Fengtai District, Beijing, 100078, China
| | - Xuezeng Hao
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Dimitrios Kantas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55902, United States
| | - Essa A Mohamed
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55902, United States
| | - Xiangying Zheng
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Hao Xu
- Cardiovascular Diseases Centre, Xiyuan Hospital, China Academy of Chinese Medical Sciences, National Clinical Research Centre for Chinese Medicine Cardiology, Beijing, 100091, China.
| | - Lijing Zhang
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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Thind H, Garcia A, Velez M, Tucker KL. If we offer, will they come: Perceptions of yoga among Hispanics. Complement Ther Med 2020; 56:102622. [PMID: 33227351 DOI: 10.1016/j.ctim.2020.102622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/20/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Yoga is underutilized by the Hispanics. This study examined perceptions of benefits and barriers to yoga among Hispanic adults, to provide information that may increase their participation in this practice. SETTING Participants were recruited from a Community Center serving low-income Hispanics. DESIGN Self-administered cross-sectional questionnaires assessing benefits and barriers to yoga were conducted in Spanish and English. Fisher's exact test was used to examine perceptions of yoga by gender, age, and prior experience. RESULTS Participants (ages 18-85, 65 % women, n = 121) reported several benefits to yoga. Hispanic women, individuals 65 y or older, and those with prior experience, perceived more benefits. Barriers to yoga also differed by demographics. Men reported that time and the perception that they would have to do unrealistic pretzel-like poses as deterrents to yoga practice; younger individuals perceived yoga to be boring, and those with no experience perceived lack of flexibility and feeling like an outsider in class, as barriers to yoga. The most common barrier, across subgroups, was the cost associated with yoga practice. The majority of participants reported being willing to attend yoga classes if offered at a low cost. CONCLUSION Perceived barriers related to yoga reflect a lack of knowledge about yoga and what it entails and the cost of classes. Despite these barriers, Hispanic adults from a low-income population said they would be willing to attend yoga classes if offered at a low cost. Understanding and addressing these barriers can help researchers and health practitioners improve diversity in yoga classes and research.
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Affiliation(s)
- Herpreet Thind
- Department of Public Health, University of Massachusetts Lowell, MA, USA.
| | - Angeline Garcia
- The Center: Seniors, Families, Community; Council on Aging, Lawrence, MA, USA
| | - Martha Velez
- The Center: Seniors, Families, Community; Council on Aging, Lawrence, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, MA, USA
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Chattopadhyay K, Mishra P, Manjunath NK, Harris T, Hamer M, Greenfield SM, Wang H, Singh K, Lewis SA, Tandon N, Kinra S, Prabhakaran D. Development of a Yoga Program for Type-2 Diabetes Prevention (YOGA-DP) Among High-Risk People in India. Front Public Health 2020; 8:548674. [PMID: 33313032 PMCID: PMC7706999 DOI: 10.3389/fpubh.2020.548674] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/02/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction: Many Indians are at high-risk of type-2 diabetes mellitus (T2DM). Yoga is an ancient Indian mind-body discipline, that has been associated with improved glucose levels and can help to prevent T2DM. The study aimed to systematically develop a Yoga program for T2DM prevention (YOGA-DP) among high-risk people in India using a complex intervention development approach. Materials and Methods: As part of the intervention, we developed a booklet and a high-definition video for participants and a manual for YOGA-DP instructors. A systematic iterative process was followed to develop the intervention and included five steps: (i) a systematic review of the literature to generate a list of Yogic practices that improves blood glucose levels among adults at high-risk of or with T2DM, (ii) validation of identified Yogic practices by Yoga experts, (iii) development of the intervention, (iv) consultation with Yoga, exercise, physical activity, diet, behavior change, and/or diabetes experts about the intervention, and (v) pretest the intervention among Yoga practitioners and lay people (those at risk of T2DM and had not practiced Yoga before) in India. Results: YOGA-DP is a structured lifestyle education and exercise program, provided over a period of 24 weeks. The exercise part is based on Yoga and includes Shithilikarana Vyayama (loosening exercises), Surya Namaskar (sun salutation exercises), Asana (Yogic poses), Pranayama (breathing practices), and Dhyana (meditation) and relaxation practices. Once participants complete the program, they are strongly encouraged to maintain a healthy lifestyle in the long-term. Conclusions: We systematically developed a novel Yoga program for T2DM prevention (YOGA-DP) among high-risk people in India. A multi-center feasibility randomized controlled trial is in progress in India.
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Affiliation(s)
- Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
- The Nottingham Centre for Evidence-Based Healthcare: A Joanna Briggs Institute Centre of Excellence, Nottingham, United Kingdom
| | | | | | - Tess Harris
- Population Health Research Institute, St. George's University of London, London, United Kingdom
| | - Mark Hamer
- Division of Surgery and Interventional Science, Institute Sport Exercise and Health, University College London, London, United Kingdom
| | | | - Haiquan Wang
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
- The Nottingham Centre for Evidence-Based Healthcare: A Joanna Briggs Institute Centre of Excellence, Nottingham, United Kingdom
| | - Kavita Singh
- Centre for Chronic Disease Control, New Delhi, India
| | - Sarah Anne Lewis
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Sivapuram MS, Nagarathna R, Anand A, Patil S, Singh A, Nagendra HR. Prevalence of Alcohol and Tobacco Use in India and Implications for COVID-19 - Niyantrita Madhumeha Bharata Study Projections. J Med Life 2020; 13:499-509. [PMID: 33456598 PMCID: PMC7803324 DOI: 10.25122/jml-2020-0079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022] Open
Abstract
Abuse of legal substances in India includes alcohol and tobacco, which are the major risk factors for various non-communicable diseases and deaths. The current pandemic has identified tobacco consumption as a risk factor for COVID-19, highlighting the need to control substance abuse. The objective of this study was to estimate the prevalence of substance abuse in India and discuss the cost-effective public health strategies (such as yoga) to alleviate COVID-related anxiety in order to prevent substance abuse and its associated co-morbidities such as type 2 diabetes mellitus. This study reports the data on tobacco and alcohol abuse from a nationwide randomized two-arm diabetes control trial (Niyantrita Madhumeha Bharata, 2017) conducted by the Indian Yoga Association (IYA) through Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru. Data of 30,354 participants who abuse tobacco and 30,159 participants who abuse alcohol were collected all over India. The prevalence is estimated at around 8.7% for alcohol abuse and 7.9% for tobacco abuse, Arunachal Pradesh state ranking the highest regarding both alcohol and tobacco abuse, while the Tripura state ranked the lowest. School and college-based mandatory yoga programs need to be implemented to prevent the increase of substance abuse in India to alleviate the psychosocial stress of adolescents and college-going students, besides the installation of the mindfulness-based diabetes yoga protocol (DYP) in the wellness centers of Ayushman Bharat.
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Affiliation(s)
- Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, Andhra Pradesh, India
| | - Raghuram Nagarathna
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Suchitra Patil
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Amit Singh
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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Pattnaik SJ, Prasad RK, Jyotirmay, Pani P, Nishant, Kumar S. Yoga as a holistic approach for stress management in Oral Cancer patients. A prospective study. J Family Med Prim Care 2020; 9:4200-4204. [PMID: 33110832 PMCID: PMC7586542 DOI: 10.4103/jfmpc.jfmpc_612_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 12/17/2022] Open
Abstract
Background and Aims: Oral cancer has been ranked as the sixth most common cancer globally. It has been reported to be increasing in incidence especially, in the southern parts of Asia which chiefly includes, India. Diagnosis of oral cancer is followed by a vigorous and highly morbid treatment protocol which drastically impacts the patient's quality of life. This in turn can cause extreme stress in a person. This study aimed to assess the impact of the practice of Yoga on stress levels in cancer patients. Materials and Methods: A total of 200 subjects diagnosed with oral cancer were selected for this study. Their stress levels were scored both before and after initiating the practice of Yogic exercises in a one-month interval using a questionnaire. Obtained scores were entered in Microsoft Excel 2007 worksheet and an unpaired t-test was applied. P values of less than 0.05 and 0.001 were considered statistically significant and extremely significant, respectively. Results: Study results showed a reduction in stress level scores (48 ± 0.99 to 37 ± 5.2) after adopting yoga for one month. An extremely significant P value of less than 0.001 was obtained. Conclusion: It can be concluded from this study that yoga is an effective method in reducing stress levels in individuals diagnosed with oral cancer.
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Affiliation(s)
- Samarjeet J Pattnaik
- Department of Periodontics, Hi Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | | | - Jyotirmay
- Department of Orthodontics, Patna Dental College & Hospital, Bihar, India
| | - Pooja Pani
- Department of Pedodontics and Preventive Dentistry, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Nishant
- Department of Oral and Maxillofacial Surgery, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Swatantra Kumar
- Department of Prosthodontics Crown & Bridge Implantology, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
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Sivapuram MS, Srivastava V, Kaur N, Anand A, Nagarathna R, Patil S, Biman S, Chander I, Jyoti S, Nagendra HR. Ayurveda Body-Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions. Ann Neurosci 2020; 27:214-223. [PMID: 34556962 PMCID: PMC8454998 DOI: 10.1177/09727531211000040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/11/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups (P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha (pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.
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Affiliation(s)
- Madhava Sai Sivapuram
- Department of General Medicine, Dr Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, Andhra Pradesh, India
| | - Vinod Srivastava
- Department of Social Work, College of Health and Behavioral Sciences, Fort Hays State University, Hays, USA
| | - Navneet Kaur
- Department of Physical Education, Panjab University, Chandigarh
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Collaborative Centre for Mind Body Intervention through Yoga, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Cognitive Sciences and Phenomenology, Panjab University, Chandigarh, india
| | - Raghuram Nagarathna
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Suchitra Patil
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Saranga Biman
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | | | - Saras Jyoti
- Department of AYUSH, Haryana Yoga Council, Haryana, India
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Diabetic Cardiomyopathy and Ischemic Heart Disease: Prevention and Therapy by Exercise and Conditioning. Int J Mol Sci 2020; 21:ijms21082896. [PMID: 32326182 PMCID: PMC7215312 DOI: 10.3390/ijms21082896] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome, diabetes, and ischemic heart disease are among the leading causes of death and disability in Western countries. Diabetic cardiomyopathy is responsible for the most severe signs and symptoms. An important strategy for reducing the incidence of cardiovascular disease is regular exercise. Remote ischemic conditioning has some similarity with exercise and can be induced by short periods of ischemia and reperfusion of a limb, and it can be performed in people who cannot exercise. There is abundant evidence that exercise is beneficial in diabetes and ischemic heart disease, but there is a need to elucidate the specific cardiovascular effects of emerging and unconventional forms of exercise in people with diabetes. In addition, remote ischemic conditioning may be considered among the options to induce beneficial effects in these patients. The characteristics and interactions of diabetes and ischemic heart disease, and the known effects of exercise and remote ischemic conditioning in the presence of metabolic syndrome and diabetes, are analyzed in this brief review.
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Arumugam G, Nagarathna R, Majumdar V, Singh M, Srinivasalu R, Sanjival R, Ram VS, Nagendra HR. Yoga-based lifestyle treatment and composite treatment goals in Type 2 Diabetes in a rural South Indian setup- a retrospective study. Sci Rep 2020; 10:6402. [PMID: 32286379 PMCID: PMC7156497 DOI: 10.1038/s41598-020-63133-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/20/2020] [Indexed: 11/14/2022] Open
Abstract
This multicentre retrospective study examined the effects of adjunct yoga-treatment in achieving composite cardiovascular goals for type 2 diabetes (T2D), set forth by the American Diabetes Association (ADA) in rural Indian settings. Records were extracted for 146 T2D patients, aged ≥20–70 years, and treated under the “Apollo Total Health Programme” for rural diabetes management, for the period April 2016 to November 2016. The study cohort comprised of two treatment groups (n = 73 each); non-yoga group (standard of care) and yoga group (adjunct yoga-treatment). Propensity score matching was applied between the study groups to define the cohort. Composite cardiovascular scores were based on the combination of individual ADA goals; A1c < 7%, blood pressure (BP) < 140/90 mmHg, stringent BP (<130/80 mmHg) and lipid, LDL-C < 100 mg/dl [risk factor for atherosclerotic cardiovascular disease]. Logistic regression was used to compare between the two treatment groups. Compared to standard of care, adjunct yoga-treatment was found to significantly facilitate the attainment of ADA composite score by 8-fold; A1c, ~2-fold; LDL-C, ~2-fold; BP < 140/90 mmHg and <130/80 mmHg by ~8-and ~6-fold respectively. This study provides the first evidence for significant efficacy of adjunct yoga-treatment for the attainment of favourable treatment goals for T2D in rural Indian settings. Clinical Trial Registration Number: CTRI/2020/02/0232790
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Affiliation(s)
- Geetharani Arumugam
- Division of Life sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, 560106, Karnataka, India
| | - Raghuram Nagarathna
- Division of Life sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, 560106, Karnataka, India
| | - Vijaya Majumdar
- Division of Life sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, 560106, Karnataka, India.
| | - Mandeep Singh
- Health Programme-Apollo Hospitals Ardhagiri road, Aragonda village, Tavanampalle mandal, Chittoor district, 517129, Andhrapradesh, India
| | - Rambabu Srinivasalu
- Health Programme-Apollo Hospitals Ardhagiri road, Aragonda village, Tavanampalle mandal, Chittoor district, 517129, Andhrapradesh, India
| | - Rajagopal Sanjival
- Health Programme-Apollo Hospitals Ardhagiri road, Aragonda village, Tavanampalle mandal, Chittoor district, 517129, Andhrapradesh, India
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Cartwright T, Mason H, Porter A, Pilkington K. Yoga practice in the UK: a cross-sectional survey of motivation, health benefits and behaviours. BMJ Open 2020; 10:e031848. [PMID: 31932388 PMCID: PMC7044896 DOI: 10.1136/bmjopen-2019-031848] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Despite the popularity of yoga and evidence of its positive effects on physical and mental health, little is known about yoga practice in the UK. This study investigated the characteristics of people who practise yoga, reasons for initiating and maintaining practice, and perceived impact of yoga on health and well-being. DESIGN, SETTING AND PARTICIPANTS A cross-sectional online anonymous survey distributed through UK-based yoga organisations, studios and events, through email invites and flyers. 2434 yoga practitioners completed the survey, including 903 yoga teachers: 87% were women, 91% white and 71% degree educated; mean age was 48.7 years. MAIN OUTCOME MEASURES Perceived impact of yoga on health conditions, health outcomes and injuries. Relationships between yoga practice and measures of health, lifestyle, stress and well-being. RESULTS In comparison with national population norms, participants reported significantly higher well-being but also higher anxiety; lower perceived stress, body mass index and incidence of obesity, and higher rates of positive health behaviours. 47% reported changing their motivations to practise yoga, with general wellness and fitness key to initial uptake, and stress management and spirituality important to current practice. 16% of participants reported starting yoga to manage a physical or mental health condition. Respondents reported the value of yoga for a wide range of health conditions, most notably for musculoskeletal and mental health conditions. 20.7% reported at least one yoga-related injury over their lifetime. Controlling for demographic factors, frequency of yoga practice accounted for small but significant variance in health-related regression models (p<0.001). CONCLUSION The findings of this first detailed UK survey were consistent with surveys in other Western countries. Yoga was perceived to have a positive impact on physical and mental health conditions and was linked to positive health behaviours. Further investigation of yoga's role in self-care could inform health-related challenges faced by many countries.
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Affiliation(s)
- Tina Cartwright
- School of Social Sciences, University of Westminster, London, UK
| | | | - Alan Porter
- School of Social Sciences, University of Westminster, London, UK
| | - Karen Pilkington
- School of Social Sciences, University of Westminster, London, UK
- School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
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