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Srivastava K, Rathod H, Borgaonkar C, Rathi M, R A, Sujanyal S. Effectiveness of Multifaceted Lifestyle Interventions in Prediabetic Adults: A Field Study in an Urban Slum Population of Pune, India. Cureus 2024; 16:e68635. [PMID: 39371832 PMCID: PMC11451425 DOI: 10.7759/cureus.68635] [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: 07/11/2024] [Accepted: 09/04/2024] [Indexed: 10/08/2024] Open
Abstract
Introduction Adults with diabetes have an increased risk of hypertension, heart attack, and stroke than those without diabetes. Diagnosing prediabetes at an early stage can significantly reduce the risk of diabetes through simple interventions such as lifestyle modifications. Lifestyle modifications such as weight loss combined with regular physical exercise and a healthy diet can help delay or prevent the progression of diabetes. This study aims to estimate the prevalence of prediabetes among the urban slum population and to assess the effect of lifestyle modifications on blood sugar levels, glycated hemoglobin (HbA1c), and lipid profile among the participants. Methods A quasi-experimental field study was conducted among the urban slum population. Participants were randomly selected from previous health screening data. Pre-intervention blood evaluations were performed, and those who fulfilled the criteria were enrolled for interventions. The follow-up period lasted three months and included telephonic and in-person meetings for support and motivation. All variables were reevaluated at the end of the follow-up period. Results Out of 34 participants included in the study, 20 completed the three-month follow-up. Statistically significant changes were observed after three months of intervention in weight, fasting blood sugar, HbA1c, BMI, triglycerides, and high-density lipoprotein (HDL) cholesterol levels. However, decreases in systolic blood pressure (BP), diastolic BP, total cholesterol, and low-density lipoprotein (LDL) cholesterol were not statistically significant. Conclusion The study revealed that lifestyle intervention programs promoting healthy diets, physical activity, and body weight reduction can prevent or delay the onset of diabetes among high-risk populations. The effectiveness of interventions across community settings depends on delivery formats, implementers, and the level of motivation of participants.
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Affiliation(s)
- Kajal Srivastava
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Hetal Rathod
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Chaitali Borgaonkar
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Manisha Rathi
- Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Akhil R
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Saurabh Sujanyal
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
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Luo J, Tao Y, Xu Y, Yang L, Zhang H, Chen Y, Liu X, Zhang Y, Lan R, Chen Y, Liu B, Deng T. Global comparison of the effect of non-pharmacological interventions on glycemic control in patients with type 2 diabetes: A network meta-analysis from 107 randomized controlled trials. J Diabetes Complications 2023; 37:108518. [PMID: 37267719 DOI: 10.1016/j.jdiacomp.2023.108518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/24/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the effectiveness of non-pharmacological interventions (NPIs) on glycemic control in patients with type 2 diabetes (T2D) and to provide guidance for clinical healthcare-giver. DESIGN Network meta-analysis (NMA). SETTING AND PARTICIPANTS Randomized controlled trials comparing the effect of NPIs with usual care, waitlist, or other NPIs on glycemic control in patients with T2D. METHODS This NMA was guided by frequentist framework. PubMed, Embase, the Cochrane Library Central Register of Controlled Trials, Cumulated Index to Nursing and Allied Health Literature, and Web of Science were searched from their inception until January 2023. The primary outcome was HbA1c and secondary outcomes were cardiovascular risk scores and related psychosocial scores. Mean differences and standardized mean differences were pooled using NMA. Study quality was assessed with the Confidence in Network Meta-analysis. RESULTS A total of 107 studies (10,496 participants) were included. The median sample size of the included studies was 64 (range, 10-563) and the median duration was 3 months (range, 1-24). Compared to usual care, all NPIs except acupuncture (MD: -0.28; 95 % CI: -1.02, 0.26) and psychological therapy (MD: -0.29; 95 % CI: -0.66, 0.08) showed significantly differences in improving glycemic control in patients with T2D. And according to the results of surface under the cumulative ranking analysis and Cluster ranking, meditation therapy was considered to the best choice when balancing the efficacy of glycemic control with self-efficacy and diabetes related problems, while nutrition therapy was considered to the best choice when balancing quality of life with risk of cardiovascular complications. CONCLUSIONS These findings validate the efficacy of NPIs for glycemic control in patients with T2D and suggest that healthcare-giver should consider both the efficacy of interventions and the psychosocial needs of patients when developing NPIs programs.
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Affiliation(s)
- Jingsong Luo
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Yanmin Tao
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yaxin Xu
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; School of Nursing, Tongji University, Shanghai 200000, China
| | - Liping Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Han Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Yufei Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Xingting Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yunwu Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Ruixi Lan
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yuxin Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Beijia Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Tingting Deng
- Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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Sharma S, Bhardwaj S, Gupta A, Katoch VM, Sharma KK, Gupta R. Influence of 24-Week Yoga Intervention on Cardiovascular Risk Factors and Inflammatory Markers in Type 2 Diabetes. Int J Yoga 2023; 16:27-33. [PMID: 37583542 PMCID: PMC10424277 DOI: 10.4103/ijoy.ijoy_176_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/27/2023] [Accepted: 04/04/2023] [Indexed: 08/17/2023] Open
Abstract
Background and Aims Persistent hyperglycemia, dyslipidemia, inflammation, and oxidative stress are important in cardiovascular risk in type-2 diabetes mellitus (DM). To evaluate the effect of 24-week yoga intervention on anthropometry and biochemical markers in DM patients, we performed a study. Methods A hospital-based prospective randomized study in 104 participants with DM divided into control (n = 52) and intervention (n = 52) groups was performed. Patients in the intervention group performed 40 min of multifaceted individualized yoga exercises 5 days/week for 24 weeks. Anthropometric measurements and biochemical analysis were performed at baseline and after 24 weeks in both groups. Descriptive statistics are reported. Results Baseline characteristics were similar in both groups. At 24 weeks, participants in the intervention versus controls had lower body mass index (25.6 ± 2.9 vs. 28.0 ± 3.2 kg/m2), waist-hip ratio (0.94 ± 0.06 vs. 0.99 ± 0.05), systolic blood pressure (121.2 ± 11.7 vs. 139.3 ± 19.1 mmHg), fasting glucose (142.7 ± 45.3 vs. 175.7 ± 45.4 mg/dL), glycated hemoglobin (7.2 ± 1.8 vs. 9.4 ± 1.9%), low-density lipoprotein cholesterol (167.5 ± 38.1 vs. 192.2 ± 51.4 mg/dL), nonhigh-density lipoprotein cholesterol (136.8 ± 35.3 vs. 158.6 ± 47.2 mg/dL), interleukin-6 (32.0 ± 21.5 vs. 43.5 ± 34.3 pg/mL), and high-sensitivity C-reactive protein (5.1 ± 3.7 vs. 9.5 ± 15.6 mg/L) (P ≤ 0.05). In the intervention group, higher levels of high-density lipoprotein cholesterol (49.2 ± 15.0 vs. 40.4 ± 7.2 mg/dL) and serum total antioxidants (1.9 ± 0.4 vs. 1.4 ± 0.4 mmol/L) were observed (P < 0.001). Conclusion A short-term yoga intervention led to reduced glycemia, dyslipidemia, and inflammatory markers and increased antioxidant status in patients with type-2 DM.
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Affiliation(s)
- Sonali Sharma
- Department of Biochemistry, RUHS College of Medical Sciences, Jaipur, Rajasthan, India
| | - Sonal Bhardwaj
- Department of Biochemistry, RUHS College of Medical Sciences, Jaipur, Rajasthan, India
| | - Arvind Gupta
- Department of Medicine, Rajasthan Hospital, Jaipur, Rajasthan, India
| | - Vishwa Mohan Katoch
- Public Health Research, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | | | - Rajeev Gupta
- Academic Research Development Unit, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
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Corgatelli C, Dodge E, Bernstein J, Kruk J, Aboul-Enein BH. A comparative review of nutrition education intervention duration and impact on reduction of prediabetes or Type 2 diabetes mellitus among adults aged 45 years or older. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3733-e3745. [PMID: 36151760 DOI: 10.1111/hsc.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/06/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Prediabetes and Type 2 diabetes mellitus (T2DM) is increasingly prevalent and both conditions have a variety of comorbidities. There are many programs aimed at the reduction or prevention of prediabetes and/or T2DM. However, only a few studies have evaluated the effect of intervention duration and evidence-based frameworks on specific populations at risk for prediabetes or T2DM. This review evaluated evidence-based lifestyle intervention programs to determine whether the duration of programming relates to the efficacy of evidence-based lifestyle change interventions. The aim was to assess relevant outcomes of these interventions in prediabetic or T2DM individuals aged 45 and older. The PRISMA framework was followed. Searches systematically screened and evaluated 2654 articles. Thirteen articles met the inclusion/exclusion criteria. Databases searched included: PubMed; SCOPUS; ProQuest; Biomed Central; SpringerLink; ScienceDirect; EBSCOHost; JSTOR; Taylor & Francis; Wiley Online; BioOne; CINAHL; SAGE Journal; and Google Scholar (2009-2022). Identifying the most effective timeframe for lifestyle intervention programming to reduce the risks associated with prediabetes/T2DM can help providers develop appropriate educational initiatives for patients at risk for pre-diabetes and/or T2DM. After screening, there were 13 studies which met the review criteria. All of the studies included in this comparative review used evidence-based interventions. Evidence-based lifestyle intervention programs that are ≥12 months produced significant and consistent results in mediating outcomes related to prediabetes/T2DM than <12-month programs in adults aged 45 years and older.
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Affiliation(s)
- Christa Corgatelli
- College of Graduate and Professional Studies, University of New England, Portland, Maine, USA
| | - Elizabeth Dodge
- College of Graduate and Professional Studies, University of New England, Portland, Maine, USA
| | - Joshua Bernstein
- Doctor of Education in Health Professions Department, College of Graduate Health Studies, A.T. Still University of Health Sciences, Kirksville, Missouri, USA
| | - Joanna Kruk
- Faculty of Physical Culture and Health, University of Szczecin, Szczecin, Poland
| | - Basil H Aboul-Enein
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island, USA
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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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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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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Dhungana RR, Khatiwoda SR, Gurung Y, Pedišić Ž, de Courten M. Yoga for hypertensive patients: a study on barriers and facilitators of its implementation in primary care. Glob Health Action 2021; 14:1952753. [PMID: 34323666 PMCID: PMC8330799 DOI: 10.1080/16549716.2021.1952753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background International guidelines for hypertension treatment recommend the use of yoga, particularly among low-risk patients. However, evidence is lacking on the implementation potential of health-worker-led yoga interventions in low-resource, primary care settings. Objective To assess barriers to and facilitators of the implementation of a yoga intervention for hypertensive patients in primary care in Nepal. Methods The study was conducted using focus group discussions, in-depth interviews, key informant interviews, and telephone interviews. Data were collected from the ‘Yoga and Hypertension’ (YoH) trial participants, YoH intervention implementers, and officials from the Ministry of Health and Population in Nepal. Results Most YoH trial participants stated that: (1) it was easy to learn yoga during a five-day training period and practise it for three months at home; (2) practising yoga improved their health; and (3) group yoga sessions in a community centre would help them practise yoga more regularly. Most YoH intervention implementers stated that: (1) they were highly motivated to implement the intervention; (2) the cost of implementation was acceptable; (3) they did not need additional staff to effectively implement the intervention; (4) providing remuneration to the staff involved in the intervention would increase their motivation; and (5) the yoga programme was ‘simple and easy to follow’ and ‘easily performed by participants of any age’. The government officials stated that: (1) yoga is considered as a key health promotional activity in Nepal; and (2) the integration of the yoga intervention into the existing health care programme would not be too challenging, because the existing personnel and other resources can be utilised. Conclusion While there is a good potential that a yoga intervention can be implemented in primary care, capacity development for health workers and the involvement of community yoga centres in the delivery of the interventions may be required to facilitate this implementation.
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Affiliation(s)
- Raja Ram Dhungana
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Shiva Ram Khatiwoda
- Patanjali Ayurveda Medical College and Research Center, Dhulikhel, Kathmandu, Nepal
| | - Yadav Gurung
- Child and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand
| | - Željko Pedišić
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology. Biomolecules 2021; 11:biom11050708. [PMID: 34068722 PMCID: PMC8151888 DOI: 10.3390/biom11050708] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped. Studies show that women's brains are more sensitive to factors affecting mental health such as depression and stress than men's brains. In women, poor mental health increases the risk of cardiovascular disease, and conversely, cardiovascular disease increases the incidence of mental illness such as depression. In connection with mental health and cardiovascular health, the presence of gender differences in brain activation, cortisol secretion, autonomic nervous system, vascular health and inflammatory response has been observed. This connection suggests that strategies to manage women's mental health can contribute to preventing cardiovascular disease. Mind-body interventions, such as meditation, yoga and qigong are forms of exercise that strive to actively manage both mind and body. They can provide beneficial effects on stress reduction and mental health. They are also seen as structurally and functionally changing the brain, as well as affecting cortisol secretion, blood pressure, heart rate variability, immune reactions and reducing menopausal symptoms, thus positively affecting women's cardiovascular health. In this review, we investigate the link between mental health, brain activation, HPA axis, autonomic nervous system, blood pressure and immune system associated with cardiovascular health in women and discuss the effects of mind-body intervention in modulating these factors.
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Sarika KS, Kumar H, Balakrishnan V, Sundaram KR. Impact of Integrated Amrita Meditation ® technique on stress in type 2 diabetic patients. Indian J Med Res 2021; 152:508-514. [PMID: 33707393 PMCID: PMC8157888 DOI: 10.4103/ijmr.ijmr_2109_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & objectives: Several studies on mind-body relaxation techniques have demonstrated a reduction in psychological stress levels. Implementation of such cost-effective, persons suffering from chronic disorders would be beneficial for the diabetic population. This study was undertaken to understand the effect of Integrated Amrita Meditation® technique (IAM®) technique on stress and its benefit in attaining a better glycaemic control. Methods: Thirty type 2 diabetic patients aged between 30 and 65 yr were consecutively recruited for the study. They were randomly allocated to IAM® and control groups. Weight, body mass index (BMI), fasting blood glucose (FBG), glycated haemoglobin (HbA1c) and perceived stress scale (PSS) were the variables assessed pre- and post-intervention during the three-month study period. Results: The mean changes between baseline and three months in the experimental group showed statistically significant decrease in HbA1c (P=0.018) as well as psychological stress (P<0.001), whereas an increase in weight (P=0.046) and FBG (P=0.029) was observed in the control group. When the pre- and post-mean changes of the study variables were assessed between the two groups, the differences obtained were statistically significant for weight (P=0.048), BMI (P=0.055), HbA1c (P=0.034) and PSS (P≤0.001). Interpretation & conclusions: The findings suggest that stress is an important risk factor hindering the glycaemic control of diabetic patients. Through reduction of psychological stress by IAM® practice, diabetic patients can attain a better glycaemic control along with the usual treatment regimens.
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Affiliation(s)
- K S Sarika
- Department of Physiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Harish Kumar
- Department of Endocrinology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Vandana Balakrishnan
- Department of Physiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - K R Sundaram
- Department of Biostatistics, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Sridhar GR. On Psychology and Psychiatry in Diabetes. Indian J Endocrinol Metab 2020; 24:387-395. [PMID: 33489842 PMCID: PMC7810053 DOI: 10.4103/ijem.ijem_188_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/08/2020] [Accepted: 06/06/2020] [Indexed: 12/16/2022] Open
Abstract
Managing diabetes requires dealing with diet, medications, and self-monitoring, besides other pressures of daily living. It, therefore, requires collaboration among individuals with diabetes, their families, and significant others including the social milieu in which they reside. Psychological stress plays critical role in the cause and course of diabetes, particularly in mastering various self-management skills, which are essential for adequate management of diabetes. It is possible to measure and to resolve such stressors. Besides the patient and the family, the built environment which the person occupies must be conducive for healthy living. This is a key component in providing an appropriate physical and psychosocial environment. Lacunae in any of the built environmental parameters compromise social and psychological well-being. Psychiatric conditions are also common in diabetes. Both depression and distress are bi-directionally associated with diabetes. The presence of one condition increases the risk of developing the other. In addition, medications used for the treatment of psychiatric conditions have adverse effects on body weight and insulin sensitivity. One must carefully weigh the risk and benefit of the drug class with potential adverse effects. Therefore, identification and management of psychological and psyciatric aspects in subjects with diabetes is an integral and critical component in treating subjects with diabetes.
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11
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Singh VP, Khandelwal B. Effect of Yoga and Exercise on Glycemic Control and Psychosocial Parameters in Type 2 Diabetes Mellitus: A Randomized Controlled Study. Int J Yoga 2020; 13:144-151. [PMID: 32669769 PMCID: PMC7336951 DOI: 10.4103/ijoy.ijoy_45_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/12/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022] Open
Abstract
CONTEXT BACKGROUND Type 2 diabetes has been strongly associated with psychosocial factors such as stress, anxiety, depression, and quality of life (QOL). There is not much evidence whether yoga can improve these factors and motivate individuals to engage in active lifestyle. AIMS This study aims to evaluate the effect of yoga and exercise over glycemic control, anxiety, depression, exercise self-efficacy (ESE), and QOL after 3-month program. METHODS Two hundred and twenty-seven individuals were randomly allocated to yoga group (YG) and exercise group. YG practiced yoga for 2 weeks under supervision and then carried out practice at home for 3 months. The exercise group practiced 30 min of brisk walking for 5 days a week. RESULTS On comparison among the groups, in YG, there was a mean change of 0.47 in glycated hemoglobin which was greater than mean reduction of 0.28 in the exercise group with P < 0.05. State anxiety reduced by 7.8 and trait anxiety reduced by 4.4 in YG (P < 0.05) in 3 months as compared to nonsignificant reductions of 3 and 1 in mean of state and trait anxiety scores in the exercise group (P > 0.05). There was a statistically significant reduction in depression score in both the groups, 8.6 in yoga and 4.0 in exercise, which was greater in YG. ESE improved by 19.2 in YG (P < 0.05), whereas it improved only 2.2 in the exercise group (P > 0.05). QOL improved by 23.7 in YG and 3.0 in the exercise group which was nonsignificant in the exercise group as compared to YG. CONCLUSIONS Yoga is superior to exercise alone as a lifestyle modification program in improving glycemic control, anxiety, depression, and QOL as well as ESE.
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Affiliation(s)
- Vijay Pratap Singh
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Bidita Khandelwal
- Professor of Medicine, Sikkim Manipal University, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
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Xia T, Yang Y, Li W, Tang Z, Huang Q, Li Z, Guo Y. Meditative Movements for Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:5745013. [PMID: 32089725 PMCID: PMC7016481 DOI: 10.1155/2020/5745013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/28/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Physical activity plays a specific role in the fundamental aspect of diabetes care. It is necessary to develop exercise programs for these patients. The aim of this systematic review is to summarize current evidence regarding the effectiveness of meditative movement in patients with type 2 diabetes. METHODS The following databases were searched: PubMed, CENTRAL, Web of Science, Ovid LWW, and EMBASE. Two independent investigators searched and screened the studies by finding duplications, excluding irrelevant titles and abstracts, and then selecting eligible studies by reviewing full texts. 21 studies fulfilled the inclusion criteria. Meta-analyses were performed on glycated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI). RESULTS Meta-analyses showed that meditative movements significantly improved FBG, HbA1c, PPBG, TC, LDL-C, and HDL-C. No improvement was found in BMI. CONCLUSIONS The results demonstrated a favorable effect or tendency of meditative movements to improve blood glucose and blood lipid levels in patients with type 2 diabetes mellitus. The special effects of meditative movements in type 2 diabetes mellitus patients need further research.
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Affiliation(s)
- Tingwei Xia
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Yue Yang
- Department of TCM, Qingyang District People's Hospital, Chengdu, Sichuan Province, China
| | - Weihong Li
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Zhaohui- Tang
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Qingsong Huang
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Zongrun Li
- Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Yongsong Guo
- Chengdu University of TCM, Chengdu, Sichuan Province, China
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Ramamoorthi R, Gahreman D, Skinner T, Moss S. The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: A systematic review and meta-analysis. PLoS One 2019; 14:e0221067. [PMID: 31618207 PMCID: PMC6795440 DOI: 10.1371/journal.pone.0221067] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/29/2019] [Indexed: 12/15/2022] Open
Abstract
A systematic review and meta-analysis was conducted to investigate the effects of yoga on glycemic control, lipid profiles, body composition and blood pressure in people in the pre-diabetic state. Studies on the effectiveness of yoga on population groups under high risk for diabetes, called prediabetic or suffering from metabolic syndromes were extracted from a thorough search of PubMed, Scopus, Cochrane Library, EBSCO and IndMED databases. Both Randomised Controlled Trial (RCT) and non-RCT studies were included in the systematic review and meta-analysis. Studies published between Jan 2002 and Dec 2018 were included. Studies were considered for evaluation if they investigated a yoga intervention to prevent T2DM, against a control group, while also reporting glycemic control and other health parameters of T2DM management. Summary effect sizes and 95% confidence intervals (CI) were calculated using the Comprehensive Meta-Analysis software in addition to publication bias. Of the 46,500 identified studies, 14 studies with 834 participants of whom were 50% women, were found to be eligible for inclusion in our systematic review. Our quantitative synthesis included 12 randomized control trials and 2 non-randomized control trials, with the follow-up period ranging from 4 to 52 weeks. Compared to controls, yoga intervention improved fasting blood glucose (FBG) [Standard Mean Difference (SMD -0.064 mg/dL (95% CI -0.201 to 0.074)]; low density lipoprotein (LDL) [SMD-0.090 mg/dL (95% CI -0.270 to 0.090)]; triglycerides [SMD -0.148 mg/dL (95% CI -0.285 to -0.012)]; total cholesterol [SMD -0.058 mg/dL (95% CI -0.220 to 0.104)] and systolic blood pressure [SMD -0.058 mm Hg (95% CI -0.168 to 0.053)]. This meta-analysis uncovered clinically improved effects of yoga intervention on glycemic control, lipid profiles and other parameters of T2DM management in prediabetic population. These results suggest that yoga intervention may be considered as a comprehensive and alternative approach to preventing T2DM. Further adequately powered, well designed RCTs are needed to support our findings and investigate the long-term effects of yoga in T2DM patients.
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Affiliation(s)
- Ramya Ramamoorthi
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Daniel Gahreman
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Timothy Skinner
- Københavns Universitet, Institut for Psykologi, Center for Sundhed og Samfund, Københavns Universitet, København K, Denmark
| | - Simon Moss
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
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Azami M, Hafezi Ahmadi MR, YektaKooshali MH, Qavam S. Effect of Yoga on Lipid Profile and C-reactive Protein in Women. Int J Prev Med 2019; 10:81. [PMID: 31198516 PMCID: PMC6547799 DOI: 10.4103/ijpvm.ijpvm_487_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 02/01/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few scientific studies have been conducted about the effect of yoga on biochemical variables such as total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and C-reactive protein (CRP) to lay a scientific foundation regarding benefits of yoga, but its effect is not clearly detected yet. This study was conducted to assess the effect of yoga on lipid profile and CRP in women. METHODS This research was designed as an interventional study. After reviewing inclusion and exclusion criteria, selected biochemical variables such as TC, HDL-C, LDL-C, TG, and CRP were measured for each participant. Yoga instruction was done three times a week for 26 weeks by an experienced yoga instructor. After 26 weeks of yoga intervention, the above-mentioned dependent variables were assessed. SPSS Ver. 16 was used for data analysis. RESULTS After a 26-week follow-up for participants, only 24 women had the necessary criteria to be included in the study. The mean TG was 157.33 ± 68.416 mg/dL and 134.33 ± 58.80 mg/dL before and after the intervention (P = 0.108), respectively. The mean TC was 234.83 ± 48.47 mg/dL and 183.33 ± 55.09 mg/dL before and after the intervention (P = 0.014), respectively. The mean HDL-C was 31.58 ± 14.22 mg/dL and 38.25 ± 13.5 mg/dL before and after the intervention (P = 0.118), respectively. The mean LDL-C was 171.75 ± 42.69 mg/dL and 142.91 ± 36.4 mg/dL before and after the intervention (P = 0.030), respectively. The mean CRP was 0.57 ± 0.22 mg/L and 0.71 ± 0.77 mg/L before and after the intervention (P = 0.779), respectively. CONCLUSIONS The result showed that yoga reduced TC and LDL-C significantly, but had no significant effect on TG, HDL-C, and CRP.
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Affiliation(s)
- Milad Azami
- Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Mohammad Hossein YektaKooshali
- Student Research Committee, School of Nursing, Midwifery and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Samiramis Qavam
- Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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Kacker S, Saboo N, Sharma S, Sorout J. Quasi Prospective Comparative Study on Effect of Yoga among Prediabetics on Progression of Cardiovascular Risk Factors. Int J Yoga 2019; 12:114-119. [PMID: 31143018 PMCID: PMC6521758 DOI: 10.4103/ijoy.ijoy_49_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Prediabetic patients have higher risk for cardiovascular diseases, which further increases the rate of mortality. Reason for the rate of increase may be lack of observation, follow-up programs, and self-awareness about the conditions of disease. Lifestyle interventions such as yoga can prove to be a beneficial nonpharmacologic intervention in preventing progression of prediabetes to type 2 diabetes. This study highlights importance of short-term intervention, i.e., yoga in prediabetic patients and use it as a tool for primary prevention of diabetes. METHODS This was an interventional study among adults aged 30-50 years in RUHS college of Medical Sciences and Associated Rukmani Devi Beni Prasad Jaipuria Hospital in Jaipur city. The design of study was quasi prospective comparative study. A total of 102 prediabetic patients of age group 30-50 years were recruited from Jaipuria Hospital. These were divided into two groups: study group (Group A, n = 51) were engaged in yoga session and control group (B, n = 51) not performed any yoga session. RESULTS Yoga intervention resulted in a significant decline in blood glucose (P < 0.001), glycated hemoglobin (P < 0.01), lipid profile cholesterol (P < 0.01), triglyceride (P < 0.01), and low-density lipoprotein (P < 0.01), but high-density lipoprotein (P < 0.02) and very low-density lipoprotein increase (P < 0.03) but not statistically significant relative to the control group. CONCLUSION Short-term yoga intervention is helpful in the control of glycemic parameters like blood glucose, glycated hemoglobin and lipid profile in prediabetic patients. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for prediabetics performing yoga.
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Affiliation(s)
- Sudhanshu Kacker
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Neha Saboo
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Sonali Sharma
- Department of Biochemistry, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Jitender Sorout
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
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Wu Y, Johnson BT, Acabchuk RL, Chen S, Lewis HK, Livingston J, Park CL, Pescatello LS. Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis. Mayo Clin Proc 2019; 94:432-446. [PMID: 30792067 DOI: 10.1016/j.mayocp.2018.09.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/22/2018] [Accepted: 09/19/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the efficacy of yoga as antihypertensive lifestyle therapy and identify moderators that account for variability in the blood pressure (BP) response to yoga. METHODS We systematically searched 6 electronic databases from inception through June 4, 2018, for articles published in English language journals on trials of yoga interventions that involved adult participants, reported preintervention and postintervention BP, and had a nonexercise/nondiet control group. Our search yielded 49 qualifying controlled trials (56 interventions). We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analysis following random-effects assumptions, and (3) generated additive models that represented the largest possible clinically relevant BP reductions. RESULTS On average, the 3517 trial participants were middle-aged (49.2±19.5 years), overweight (27.9±3.6 kg/m2) adults with high BP (systolic BP, 129.3±13.3 mm Hg; diastolic BP, 80.7±8.4 mm Hg). Yoga was practiced 4.8±3.4 sessions per week for 59.2±25.0 minutes per session for 13.2±7.5 weeks. On average, yoga elicited moderate reductions in systolic BP (weighted mean effect size, -0.47; 95% CI, -0.62-0.32, -5.0 mm Hg) and diastolic BP (weighted mean effect size, -0.47; 95% CI, -0.61 to -0.32; -3.9 mm Hg) compared with controls (P<.001 for both systolic BP and diastolic BP). Controlling for publication bias and methodological study quality, when yoga was practiced 3 sessions per week among samples with hypertension, yoga interventions that included breathing techniques and meditation/mental relaxation elicited BP reductions of 11/6 mm Hg compared with those that did not (ie, 6/3 mm Hg). CONCLUSION Our results indicate that yoga is a viable antihypertensive lifestyle therapy that produces the greatest BP benefits when breathing techniques and meditation/mental relaxation are included.
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Affiliation(s)
- Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT.
| | - Blair T Johnson
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Rebecca L Acabchuk
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Shiqi Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Holly K Lewis
- Department of Physical Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, PA
| | - Jill Livingston
- Homer Babbidge Library, Health Sciences, University of Connecticut, Storrs, CT
| | - Crystal L Park
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT
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Rioux J, Howerter A. Outcomes from a Whole-Systems Ayurvedic Medicine and Yoga Therapy Treatment for Obesity Pilot Study. J Altern Complement Med 2019; 25:S124-S137. [PMID: 30870013 PMCID: PMC6446167 DOI: 10.1089/acm.2018.0448] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To determine the feasibility and acceptability of an Ayurveda/Yoga intervention for weight loss, using dual-diagnosis inclusion criteria, dual-paradigm outcomes, and a semistandardized protocol with tailoring according to the Ayurvedic constitution/imbalance profile of each participant. DESIGN Seventeen participants enrolled in a weekly intervention for 3 months. Outcome measurements were performed at baseline, postintervention, and 3 and 6 months follow-up. SETTING The intervention was conducted through the University of Arizona, Department of Family and Community Medicine from April through December 2012. SUBJECTS Participants included 2 men and 15 women recruited from the community of Tucson, AZ using flyers and hospital message boards. Seventeen enrolled and 12 participants provided complete follow-up data. INTERVENTION Participants met with an Ayurvedic practitioner twice monthly (six times) and followed semistandardized dietary guidelines with individual tailoring to address relevant psychophysiological imbalances obstructing weight loss and a standardized protocol of therapeutic yoga classes three times weekly with recommended home practice of two to four additional sessions. OUTCOME MEASURES Primary outcome was weight loss. Other biomedical outcomes included body mass index, body fat percentage, waist and hip circumference, waist to hip ratio, and blood pressure. Unique instruments were designed to collect data on outcomes associated with the Ayurvedic medical paradigm, including dietary changes by food qualities, mood/affect, relationships, and changes in Ayurvedic imbalance profiles. RESULTS Participants lost an average of 3.5 kg during the 3-month intervention. Weight loss at 3 and 6 months postintervention increased to an average of 5.6 kg and 5.9 kg, respectively. Participants who lost 3% of their body weight during the 12 week intervention, lost on average an additional 3% during the follow-up period. Psychosocial outcomes also improved. No additional services were provided to participants during the follow-up period. CONCLUSIONS A whole-systems Ayurvedic medicine and Yoga therapy approach provides a feasible promising noninvasive low-cost alternative to traditional weight loss interventions with potential added benefits associated with sustainable holistic lifestyle modification and positive psychosocial changes.
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Affiliation(s)
- Jennifer Rioux
- Department of Family & Community Medicine, University of Arizona, Tucson, AZ
| | - Amy Howerter
- Department of Family & Community Medicine, University of Arizona, Tucson, AZ
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Thind H, Fava JL, Guthrie KM, Stroud L, Gopalakrishnan G, Sillice M, Gidron N, Bock BC. Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and in Control (HA1C) Study. Int J Yoga Therap 2018; 28:123-132. [PMID: 30130144 DOI: 10.17761/2018-00026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Diabetes is the seventh leading cause of death in the United States. For most patients, medication alone is not sufficient to achieve glycemic control; attention must also be paid to multiple healthy behaviors including diet, regular physical activity, and stress management. Yoga, a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, may have special relevance to people with type 2 diabetes mellitus (T2DM). Yoga practice may positively affect stress and other self-care tasks that will contribute to improved glycemic control. The Healthy, Active, and in Control (HA1C) study is designed to examine the feasibility and acceptability of yoga among adult patients with T2DM. In this pilot randomized controlled trial, adults with T2DM were randomly assigned to either a 12-week Iyengar Yoga intervention given twice weekly, or a twice-weekly 12-week program of traditional exercise (e.g., walking, stationary cycling). Assessments are conducted at the end of treatment (12 weeks) and at 3 and 6 months postintervention. The HA1C study will assess feasibility and acceptability (e.g., attendance/retention rates, satisfaction with program), glycemic outcomes (e.g., HbA1c, fasting blood glucose, postprandial blood glucose), and changes in physiological (e.g., salivary cortisol) and behavioral factors (e.g., physical activity, diet) relevant to the management of T2DM. Focus groups are conducted at the end of the intervention to explore participants' experience with the program and their perception of the potential utility of yoga for diabetes management.
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Affiliation(s)
- Herpreet Thind
- 1. Assistant Professor, Department of Public Health, University of Massachusetts, Lowell, Mass
| | - Joseph L Fava
- 2. Research Associate, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Kate M Guthrie
- 3. Associate Professor of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Laura Stroud
- 3. Associate Professor of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Geetha Gopalakrishnan
- 4. Associate Professor of Medicine, The Warren Alpert Medical School of Brown University, Lifespan Center for Diabetes and Endocrinology, East Providence, R.I
| | - Marie Sillice
- 5. Postdoctoral Fellow, The Warren Alpert Medical School of Brown University, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, R.I
| | - Naama Gidron
- 6. Certified Iyengar Yoga Instructor, and Director, Motion Center Yoga Collective, Pawtucket, R.I
| | - Beth C Bock
- 7. Professor of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, The Miriam Hospital, Providence, R.I
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Behjati Ardakani A, Qassemian A, Koushki M, Shakour E, Mehrez A. The Effect of a Resistance Training Course on Blood Pressure and Nitric Oxide Levels in Elderly Women. SALMAND 2018. [DOI: 10.21859/sija.13.1.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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20
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Whitebird RR, Kreitzer MJ, Vazquez-Benitez G, Enstad CJ. Reducing diabetes distress and improving self-management with mindfulness. SOCIAL WORK IN HEALTH CARE 2018; 57:48-65. [PMID: 29064772 PMCID: PMC9083374 DOI: 10.1080/00981389.2017.1388898] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Stress associated with diabetes makes managing diabetes harder. We investigated whether mindfulness-based stress reduction (MBSR) could reduce diabetes distress and improve management. We recruited 38 participants to complete an MBSR program. Surveys and lab values were completed at baseline and post-intervention. Participants showed significant improvement in diabetes-related distress (Cohen's d -.71, p < .002), psychosocial self-efficacy (Cohen's d .80, p < .001), and glucose control (Cohen's d -.79, p < .001). Significant improvements in depression, anxiety, stress, coping, self-compassion, and social support were also found. These results suggest that MBSR may offer an effective method for helping people better self-manage their diabetes and improve mental health.
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Affiliation(s)
- Robin R. Whitebird
- School of Social Work, University of St Thomas, 2115 Summit Ave SCB #106, St Paul, MN 55105, 651-962-5867
| | - Mary Jo Kreitzer
- Center for Spiritualty & Healing, University of Minnesota, C510 Mayo Memorial Bldg., MMC 505, 420 Delaware Street SE, Minneapolis, MN 55455, 612-625-3977,
| | | | - Chris J. Enstad
- HealthPartners Institute, PO Box 1524, MS 21111R, Minneapolis, MN 55440-1524, 952-967-5007,
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Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology 2017; 86:152-168. [PMID: 28963884 DOI: 10.1016/j.psyneuen.2017.08.008] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Practices that include yoga asanas and mindfulness-based stress reduction for the management of stress are increasingly popular; however, the neurobiological effects of these practices on stress reactivity are not well understood. Many studies investigating the effects of such practices fail to include an active control group. Given the frequency with which people are selecting such interventions as a form of self-management, it is important to determine their effectiveness. Thus, this review investigates the effects of practices that include yoga asanas, with and without mindfulness-based stress reduction, compared to an active control, on physiological markers of stress. MATERIALS AND METHODS A systematic review and meta-analysis of randomised controlled trials published in English compared practices that included yoga asanas, with and without mindfulness-based stress reduction, to an active control, on stress-related physiological measures. The review focused on studies that measured physiological parameters such as blood pressure, heart rate, cortisol and peripheral cytokine expression. MEDLINE, AMED, CINAHL, PsycINFO, SocINDEX, PubMed, and Scopus were searched in May 2016 and updated in December 2016. Randomised controlled trials were included if they assessed at least one of the following outcomes: heart rate, blood pressure, heart rate variability, mean arterial pressure, C-reactive protein, interleukins or cortisol. Risk of bias assessments included sequence generation, allocation concealment, blinding of assessors, incomplete outcome data, selective outcome reporting and other sources of bias. Meta-analysis was undertaken using Comprehensive Meta-Analysis Software Version 3. Sensitivity analyses were performed using 'one-study-removed' analysis. Subgroup analysis was conducted for different yoga and control group types, including mindfulness-based stress reduction versus non-mindfulness-based stress reduction based interventions, different populations, length of intervention, and method of data analysis. A random-effects model was used in all analyses. RESULTS Forty two studies were included in the meta-analysis. Interventions that included yoga asanas were associated with reduced evening cortisol, waking cortisol, ambulatory systolic blood pressure, resting heart rate, high frequency heart rate variability, fasting blood glucose, cholesterol and low density lipoprotein, compared to active control. However, the reported interventions were heterogeneous. CONCLUSIONS Practices that include yoga asanas appear to be associated with improved regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system in various populations.
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Affiliation(s)
- Michaela C Pascoe
- Department of Cancer Experiences, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia.
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3000, Australia.
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia.
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Keerthi GS, Pal P, Pal GK, Sahoo JP, Sridhar MG, Balachander J. Effect of 12 Weeks of Yoga Therapy on Quality of Life and Indian Diabetes Risk Score in Normotensive Indian Young Adult Prediabetics and Diabetics: Randomized Control Trial. J Clin Diagn Res 2017; 11:CC10-CC14. [PMID: 29207699 DOI: 10.7860/jcdr/2017/29307.10633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/23/2017] [Indexed: 01/27/2023]
Abstract
Introduction India has become the epicentre for diabetes, a stress-related disorder affecting the working skills and day-to-day lifestyle management of younger population. Most of the studies have reported the effect of yoga on improving Quality of Life (QoL) in diabetic patients with other comorbidities. Till date, no randomized control trial reports are available to show the effect of yoga therapy on QoL and Indian Diabetes Risk Score (IDRS) in normotensive prediabetic and diabetic young individuals. Aim To determine the effect of 12 weeks of yoga therapy on QoL and IDRS among normotensive prediabetic and diabetic young Indian adults. Materials and Methods A randomized control trial was conducted in Endocrinology Outpatient Department (OPD). Normotensive participants (n=310) aged 18-45 years were divided into healthy controls (n=62), prediabetics (n=124) and diabetics (n=124). Study group subjects were randomly assigned to Group II (n=62, prediabetes-standard treatment), Group III (n=62, prediabetes-standard treatment + yoga therapy), Group IV (n=62, diabetes-standard treatment) and Group V (n=62, diabetes-standard treatment + yoga therapy). Flanagan QoL scale, IDRS questionnaire, Fasting Plasma Glucose (FPG) and insulin were assessed pre and post 12 weeks of intervention. Statistical analysis was done using Student's paired t-test and one-way ANOVA. Results Pre-post intervention analysis showed significant improvement in QoL scale with p<0.01 in Group II and Group IV; p<0.001 in Group III and Group V respectively. There was significant reduction in IDRS in Group II (p<0.05); p<0.001 in Group III, Group IV and Group V respectively. Significant difference (p<0.001) in QoL scale and IDRS were found when study groups with standard treatment along with yoga therapy were compared to standard treatment alone. Conclusion Yoga therapy along with standard treatment for 12 weeks improved QoL and attenuated the diabetes risk among Indian prediabetics and diabetics compared to standard treatment alone.
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Affiliation(s)
- Gorantla Shravya Keerthi
- PhD Scholar, Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Pravati Pal
- Professor, Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Gopal Krushna Pal
- Professor and Dean (JIPMER, Karaikal), Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jaya Prakash Sahoo
- Associate Professor, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Magadi Gopalakrishna Sridhar
- Senior Professor, Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jayaraman Balachander
- Senior Professor and Medical Superintendent, Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Potiaumpai M, Martins MCM, Wong C, Desai T, Rodriguez R, Mooney K, Signorile JF. Difference in muscle activation patterns during high-speed versus standard-speed yoga: A randomized sequence crossover study. Complement Ther Med 2017; 30:24-29. [PMID: 28137523 DOI: 10.1016/j.ctim.2016.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To compare the difference in muscle activation between high-speed yoga and standard-speed yoga and to compare muscle activation of the transitions between poses and the held phases of a yoga pose. DESIGN Randomized sequence crossover trial SETTING: A laboratory of neuromuscular research and active aging Interventions: Eight minutes of continuous Sun Salutation B was performed, at a high speed versus a standard-speed, separately. Electromyography was used to quantify normalized muscle activation patterns of eight upper and lower body muscles (pectoralis major, medial deltoids, lateral head of the triceps, middle fibers of the trapezius, vastus medialis, medial gastrocnemius, thoracic extensor spinae, and external obliques) during the high-speed and standard-speed yoga protocols. MAIN OUTCOME MEASURES Difference in normalized muscle activation between high-speed yoga and standard-speed yoga. RESULTS Normalized muscle activity signals were significantly higher in all eight muscles during the transition phases of poses compared to the held phases (p<0.01). There was no significant interaction between speed×phase; however, greater normalized muscle activity was seen for highspeed yoga across the entire session. CONCLUSIONS Our results show that transitions from one held phase of a pose to another produces higher normalized muscle activity than the held phases of the poses and that overall activity is greater during highspeed yoga than standard-speed yoga. Therefore, the transition speed and associated number of poses should be considered when targeting specific improvements in performance.
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Affiliation(s)
- Melanie Potiaumpai
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Maria Carolina Massoni Martins
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Claudia Wong
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Trusha Desai
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Roberto Rodriguez
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Kiersten Mooney
- Green Monkey Yoga, 1430 S Dixie Highway, #116, Miami, Coral Gables, FL 33146, United States.
| | - Joseph F Signorile
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States; Miller School of Medicine, Center on Aging, University of Miami, 1695 N.W. 9th Avenue, Suite 3204, Miami, FL 33136, United States.
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McNamara C, Johnson M, Read L, Vander Velden H, Thygeson M, Liu M, Gandrud L, McNamara J. Yoga Therapy in Children with Cystic Fibrosis Decreases Immediate Anxiety and Joint Pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:9429504. [PMID: 28077950 PMCID: PMC5204083 DOI: 10.1155/2016/9429504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/12/2016] [Accepted: 11/21/2016] [Indexed: 12/17/2022]
Abstract
This study was designed to determine whether yoga might alleviate symptoms of pain, sleep disturbance, anxiety, and depression in children with cystic fibrosis (CF). CF is the most common genetic, life-limiting chronic disease among Caucasian populations. It primarily affects the lungs but also many other secretory organs and consequently leads to significant morbidities. Research has shown that children with CF have significantly increased depression, anxiety, and pain compared to their healthy counterparts. Subjects participated in six one-on-one sessions over a 10-week period with a certified instructor who designed each yoga practice based on a preestablished list of 30 yoga asanas. Questionnaires evaluating pain, sleep disturbance, sustained anxiety, immediate anxiety, and depression were administered. Differences between premeasures and postmeasures were evaluated using a two-sided test. Twenty subjects were assessed (12 females/8 males), median age of 11 (7-20) years. Mean immediate anxiety scores decreased (before session to after session 29 to 23.6, respectively, p < 0.001). Joint pain improved (3.25 to 3.65, p = 0.028). CFQ-R emotion subscale improved from 79.2 to 85 (p = 0.073), and the respiratory subscale improved from 66.7 to 79.2 (p = 0.076). Other results were less notable. We conclude that yoga may reduce immediate anxiety and joint pain in patients with CF.
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Affiliation(s)
| | - Mahrya Johnson
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Lisa Read
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | | | - Megan Thygeson
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Meixia Liu
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Laura Gandrud
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - John McNamara
- Children's Respiratory and Critical Care Specialists, PA, Minneapolis, MN, USA
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Potiaumpai M, Martins MCM, Rodriguez R, Mooney K, Signorile JF. Differences in energy expenditure during high-speed versus standard-speed yoga: A randomized sequence crossover trial. Complement Ther Med 2016; 29:169-174. [PMID: 27912943 DOI: 10.1016/j.ctim.2016.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To compare energy expenditure and volume of oxygen consumption and carbon dioxide production during a high-speed yoga and a standard-speed yoga program. DESIGN Randomized repeated measures controlled trial. SETTING A laboratory of neuromuscular research and active aging. INTERVENTIONS Sun-Salutation B was performed, for eight minutes, at a high speed versus and a standard-speed separately while oxygen consumption was recorded. Caloric expenditure was calculated using volume of oxygen consumption and carbon dioxide production. MAIN OUTCOME MEASURES Difference in energy expenditure (kcal) of HSY and SSY. RESULTS Significant differences were observed in energy expenditure between yoga speeds with high-speed yoga producing significantly higher energy expenditure than standard-speed yoga (MD=18.55, SE=1.86, p<0.01). Significant differences were also seen between high-speed and standard-speed yoga for volume of oxygen consumed and carbon dioxide produced. CONCLUSIONS High-speed yoga results in a significantly greater caloric expenditure than standard-speed yoga. High-speed yoga may be an effective alternative program for those targeting cardiometabolic markers.
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Affiliation(s)
- Melanie Potiaumpai
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Maria Carolina Massoni Martins
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Roberto Rodriguez
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States.
| | - Kiersten Mooney
- Green Monkey Yoga, 1430 S Dixie Highway, #116, Coral Gables, Miami, FL 33146, United States.
| | - Joseph F Signorile
- Laboratory of Neuromuscular Research and Active Aging, University of Miami, Department of Kinesiology and Sports Sciences, 1507 Levante Avenue, #123, Coral Gables, FL 33146, United States; Miller School of Medicine, Center on Aging, University of Miami, 1695 N.W. 9th Avenue, Suite 3204, Miami, FL 33136, United States.
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Lauche R, Langhorst J, Lee MS, Dobos G, Cramer H. A systematic review and meta-analysis on the effects of yoga on weight-related outcomes. Prev Med 2016; 87:213-232. [PMID: 27058944 DOI: 10.1016/j.ypmed.2016.03.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/26/2016] [Accepted: 03/17/2016] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Overweight and obesity are among the most important modifiable risk factors for chronic diseases and premature death. The aim of this review was to systematically assess and analyze the effects of yoga on weight-related outcomes. METHODS Medline/PubMed, Scopus, and the Cochrane Library were screened through March 2015 for randomized controlled trials on yoga for weight-related outcomes in the general population or overweight/obese individuals. Risk of bias was assessed using the Cochrane risk of bias tool on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias. RESULTS Out of 445 records identified during literature search, 30 trials with a total of 2173 participants were included. No effects on weight, body mass index, body fat percentage or waist circumference were found. In studies with healthy adult participants an effect of yoga compared to usual care was found regarding waist/hip ratio (SMD=--1.00; 95% CI=--1.44, -0.55; p<0.001). In studies with overweight/obese participants only, effects relative to usual care were found for body mass index (SMD=-0.99; 95% CI=-1.67, -0.31; p=0.004). Effects however were not robust against selection bias; and publication bias could not be ruled out. No intervention-related adverse events were reported. CONCLUSIONS Despite methodological drawbacks, yoga can be preliminarily considered a safe and effective intervention to reduce body mass index in overweight or obese individuals.
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Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Myeong Soo Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia.
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Cramer H, Lauche R, Langhorst J, Dobos G. Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials. Complement Ther Med 2016; 25:178-87. [DOI: 10.1016/j.ctim.2016.02.015] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 02/18/2016] [Accepted: 02/18/2016] [Indexed: 12/20/2022] Open
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Ruddy J, Emerson J, McNamara S, Genatossio A, Breuner C, Weber T, Rosenfeld M. Yoga as a Therapy for Adolescents and Young Adults With Cystic Fibrosis: A Pilot Study. Glob Adv Health Med 2015; 4:32-6. [PMID: 26665020 PMCID: PMC4653591 DOI: 10.7453/gahmj.2015.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Rationale: Yoga has been shown to improve outcomes in patients with asthma but has not been investigated in cystic fibrosis (CF) patients. Methods: This was a prospective pilot study to evaluate the safety of a standardized yoga program among CF patients aged 12 to 25 years. Participants engaged in a 50-minute yoga session twice weekly for 8 weeks conducted by a certified yoga instructor using a standardized program designed to be safe for health-compromised individuals. Yoga sessions were individual to avoid transmission of infections. Primary outcome was safety and tolerability. Secondary outcome measures included respiratory symptoms, the Cystic Fibrosis Quality of Life instrument (CFQ-R), lung function, Ease of Breathing Score (measure of exercise tolerance), and weight. Results: Eleven participants were enrolled, and 10 completed the study. Adherence was very good; the mean (SD) number of sessions completed was 14.2 (1.3) out of 16 sessions. Eight patients reported 25 adverse events. The most common was cough, reported in 7. Two events were possibly related to study procedures: calf pain and headache. There were no significant changes in dyspnea or pain scales. The mean (SD) CFQ-R respiratory domain score increased from screening to end of study: 67.9 (11.4) to 82.1 (9.9), P=.04. There were no significant changes in the other outcome measures. Conclusions: In this pilot study, a standardized 8-week yoga program was safe and well tolerated among adolescent and young adult CF patients with mild to moderate lung disease. This study may be helpful to yoga instructors who are interested in working with CF patients. Larger controlled trials are warranted to determine further benefits.
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Affiliation(s)
- Jennifer Ruddy
- Department of Pediatrics, ProMedica Toledo Children's Hospital, Ohio (Dr Ruddy), United States
| | - Julia Emerson
- Department of Pediatrics, Seattle Children's Hospital, University of Washington (Dr Emerson), United States
| | - Sharon McNamara
- Department of Pediatrics, Seattle Children's Hospital, University of Washington (Dr McNamara), United States
| | - Alan Genatossio
- Department of Pediatrics, Seattle Children's Hospital, University of Washington (Mr Genatossio), United States
| | - Cora Breuner
- Department of Pediatrics, Seattle Children's Hospital, University of Washington (Dr Breuner), United States
| | - Tracy Weber
- Whole Life Yoga, Seattle, Washington (Ms Weber), United States
| | - Margaret Rosenfeld
- Department of Pediatrics, Seattle Children's Hospital, University of Washington (Dr Rosenfeld), United States
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Cramer H, Ward L, Saper R, Fishbein D, Dobos G, Lauche R. The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Epidemiol 2015; 182:281-93. [PMID: 26116216 DOI: 10.1093/aje/kwv071] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/16/2015] [Indexed: 12/27/2022] Open
Abstract
As yoga has gained popularity as a therapeutic intervention, its safety has been questioned in the lay press. Thus, this review aimed to systematically assess and meta-analyze the frequency of adverse events in randomized controlled trials of yoga. MEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through February 2014. Of 301 identified randomized controlled trials of yoga, 94 (1975-2014; total of 8,430 participants) reported on adverse events. Life-threatening, disabling adverse events or those requiring intensive treatment were defined as serious and all other events as nonserious. No differences in the frequency of intervention-related, nonserious, or serious adverse events and of dropouts due to adverse events were found when comparing yoga with usual care or exercise. Compared with psychological or educational interventions (e.g., health education), more intervention-related adverse events (odds ratio = 4.21, 95% confidence interval: 1.01, 17.67; P = 0.05) and more nonserious adverse events (odds ratio = 7.30, 95% confidence interval: 1.91, 27.92; P < 0.01) occurred in the yoga group; serious adverse events and dropouts due to adverse events were comparable between groups. Findings from this review indicate that yoga appears as safe as usual care and exercise. The adequate reporting of safety data in future randomized trials of yoga is crucial to conclusively judge its safety.
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Yang K, James KA. Yoga, as a transitional platform to more active lifestyle: a 6-month pilot study in the USA. Health Promot Int 2014; 31:423-9. [DOI: 10.1093/heapro/dau108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Affiliation(s)
- Viveka P. Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Park CL, Groessl E, Maiya M, Sarkin A, Eisen SV, Riley K, Elwy AR. Comparison groups in yoga research: a systematic review and critical evaluation of the literature. Complement Ther Med 2014; 22:920-9. [PMID: 25440384 DOI: 10.1016/j.ctim.2014.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Comparison groups are essential for accurate testing and interpretation of yoga intervention trials. However, selecting proper comparison groups is difficult because yoga comprises a very heterogeneous set of practices and its mechanisms of effect have not been conclusively established. METHODS We conducted a systematic review of the control and comparison groups used in published randomized controlled trials (RCTs) of yoga. RESULTS We located 128 RCTs that met our inclusion criteria; of these, 65 included only a passive control and 63 included at least one active comparison group. Primary comparison groups were physical exercise (43%), relaxation/meditation (20%), and education (16%). Studies rarely provided a strong rationale for choice of comparison. Considering year of publication, the use of active controls in yoga research appears to be slowly increasing over time. CONCLUSIONS Given that yoga has been established as a potentially powerful intervention, future research should use active control groups. Further, care is needed to select comparison conditions that help to isolate the specific mechanisms of yoga's effects.
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Affiliation(s)
- Crystal L Park
- Department of Psychology, University of Connecticut Storrs, CT, United States.
| | - Erik Groessl
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States; The Health Services Research Center, University of California San Diego, La Jolla, CA, United States
| | - Meghan Maiya
- Health Services Research Center, University of California San Diego, La Jolla, CA, United States
| | - Andrew Sarkin
- Health Services Research Center, University of California San Diego, La Jolla, CA, United States
| | - Susan V Eisen
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford MA United States; Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, United States
| | - Kristen Riley
- Department of Psychology, University of Connecticut Storrs, CT, United States
| | - A Rani Elwy
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford MA United States; Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, United States
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Cramer H, Lauche R, Dobos G. Characteristics of randomized controlled trials of yoga: a bibliometric analysis. Altern Ther Health Med 2014; 14:328. [PMID: 25183419 PMCID: PMC4161862 DOI: 10.1186/1472-6882-14-328] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/19/2014] [Indexed: 12/18/2022]
Abstract
Background A growing number of randomized controlled trials (RCTs) have investigated the therapeutic value of yoga interventions. This bibliometric analysis aimed to provide a comprehensive review of the characteristics of the totality of available randomized yoga trials. Methods All RCTs of yoga were eligible. Medline/PubMed, Scopus, the Cochrane Library, IndMED, and the tables of content of yoga specialty journals not listed in medical databases were screened through February 2014. Bibliometric data, data on participants, and intervention were extracted and analyzed descriptively. Results Published between 1975 and 2014, a total of 366 papers were included, reporting 312 RCTs from 23 different countries with 22,548 participants. The median study sample size was 59 (range 8–410, interquartile range = 31, 93). Two hundred sixty-four RCTs (84.6%) were conducted with adults, 105 (33.7%) with older adults and 31 (9.9%) with children. Eighty-four RCTs (26.9%) were conducted with healthy participants. Other trials enrolled patients with one of 63 varied medical conditions; the most common being breast cancer (17 RCTs, 5.4%), depression (14 RCTs, 4.5%), asthma (14 RCTs, 4.5%) and type 2 diabetes mellitus (13 RCTs, 4.2%). Whilst 119 RCTs (38.1%) did not define the style of yoga used, 35 RCTs (11.2%) used Hatha yoga and 30 RCTs (9.6%) yoga breathing. The remaining 128 RCTs (41.0%) used 46 varied yoga styles, with a median intervention length of 9 weeks (range 1 day to 1 year; interquartile range = 5, 12). Two hundred and forty-four RCTs (78.2%) used yoga postures, 232 RCTs (74.4%) used breath control, 153 RCTs (49.0%) used meditation and 32 RCTs (10.3%) used philosophy lectures. One hundred and seventy-four RCTs (55.6%) compared yoga with no specific treatment; 21 varied control interventions were used in the remaining RCTs. Conclusions This bibliometric analysis presents the most complete up-to-date overview on published randomized yoga trials. While the available research evidence is sparse for most conditions, there was a marked increase in published RCTs in recent years. Electronic supplementary material The online version of this article (doi:10.1186/1472-6882-14-328) contains supplementary material, which is available to authorized users.
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McDermott KA, Rao MR, Nagarathna R, Murphy EJ, Burke A, Nagendra RH, Hecht FM. A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:212. [PMID: 24980650 PMCID: PMC4096416 DOI: 10.1186/1472-6882-14-212] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 06/23/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Type 2 diabetes is a major health problem in many countries including India. Yoga may be an effective type 2 diabetes prevention strategy in India, particularly given its cultural familiarity. METHODS This was a parallel, randomized controlled pilot study to collect feasibility and preliminary efficacy data on yoga for diabetes risk factors among people at high risk of diabetes. Primary outcomes included: changes in BMI, waist circumference, fasting blood glucose, postprandial blood glucose, insulin, insulin resistance, blood pressure, and cholesterol. We also looked at measures of psychological well-being including changes in depression, anxiety, positive and negative affect and perceived stress. Forty-one participants with elevated fasting blood glucose in Bangalore, India were randomized to either yoga (n = 21) or a walking control (n = 20). Participants were asked to either attend yoga classes or complete monitored walking 3-6 days per week for eight weeks. Randomization and allocation was performed using computer-generated random numbers and group assignments delivered in sealed, opaque envelopes generated by off-site study staff. Data were analyzed based on intention to treat. RESULTS This study was feasible in terms of recruitment, retention and adherence. In addition, yoga participants had significantly greater reductions in weight, waist circumference and BMI versus control (weight -0.8 ± 2.1 vs. 1.4 ± 3.6, p = 0.02; waist circumference -4.2 ± 4.8 vs. 0.7 ± 4.2, p < 0.01; BMI -0.2 ± 0.8 vs. 0.6 ± 1.6, p = 0.05). There were no between group differences in fasting blood glucose, postprandial blood glucose, insulin resistance or any other factors related to diabetes risk or psychological well-being. There were significant reductions in systolic and diastolic blood pressure, total cholesterol, anxiety, depression, negative affect and perceived stress in both the yoga intervention and walking control over the course of the study. CONCLUSION Among Indians with elevated fasting blood glucose, we found that participation in an 8-week yoga intervention was feasible and resulted in greater weight loss and reduction in waist circumference when compared to a walking control. Yoga offers a promising lifestyle intervention for decreasing weight-related type 2 diabetes risk factors and potentially increasing psychological well-being. TRIAL REGISTRATION ClinicalTrials.gov Identified NCT00090506.
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Hartley L, Dyakova M, Holmes J, Clarke A, Lee MS, Ernst E, Rees K. Yoga for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2014; 2014:CD010072. [PMID: 24825181 PMCID: PMC10075056 DOI: 10.1002/14651858.cd010072.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A sedentary lifestyle and stress are major risk factors for cardiovascular disease (CVD). Since yoga involves exercise and is thought to help in stress reduction it may be an effective strategy in the primary prevention of CVD. OBJECTIVES To determine the effect of any type of yoga on the primary prevention of CVD. SEARCH METHODS We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 11) in The Cochrane Library; MEDLINE (Ovid) (1946 to November Week 3 2013); EMBASE Classic + EMBASE (Ovid) (1947 to 2013 Week 48); Web of Science (Thomson Reuters) (1970 to 4 December 2013); Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database and Health Economics Evaluations Database (Issue 4 of 4, 2013) in The Cochrane Library. We also searched a number of Asian databases and the Allied and Complementary Medicine Database (AMED) (inception to December 2012). We searched trial registers and reference lists of reviews and articles, and approached experts in the field. We applied no language restrictions. SELECTION CRITERIA Randomised controlled trials lasting at least three months involving healthy adults or those at high risk of CVD. Trials examined any type of yoga and the comparison group was no intervention or minimal intervention. Outcomes of interest were clinical CVD events and major CVD risk factors. We did not include any trials that involved multifactorial lifestyle interventions or weight loss. DATA COLLECTION AND ANALYSIS Two authors independently selected trials for inclusion, extracted data and assessed the risk of bias. MAIN RESULTS We identified 11 trials (800 participants) and two ongoing studies. Style and duration of yoga differed between trials. Half of the participants recruited to the studies were at high risk of CVD. Most of studies were at risk of performance bias, with inadequate details reported in many of them to judge the risk of selection bias.No study reported cardiovascular mortality, all-cause mortality or non-fatal events, and most studies were small and short-term. There was substantial heterogeneity between studies making it impossible to combine studies statistically for systolic blood pressure and total cholesterol. Yoga was found to produce reductions in diastolic blood pressure (mean difference (MD) -2.90 mmHg, 95% confidence interval (CI) -4.52 to -1.28), which was stable on sensitivity analysis, triglycerides (MD -0.27 mmol/l, 95% CI -0.44 to -0.11) and high-density lipoprotein (HDL) cholesterol (MD 0.08 mmol/l, 95% CI 0.02 to 0.14). However, the contributing studies were small, short-term and at unclear or high risk of bias. There was no clear evidence of a difference between groups for low-density lipoprotein (LDL) cholesterol (MD -0.09 mmol/l, 95% CI -0.48 to 0.30), although there was moderate statistical heterogeneity. Adverse events, occurrence of type 2 diabetes and costs were not reported in any of the included studies. Quality of life was measured in three trials but the results were inconclusive. AUTHORS' CONCLUSIONS The limited evidence comes from small, short-term, low-quality studies. There is some evidence that yoga has favourable effects on diastolic blood pressure, HDL cholesterol and triglycerides, and uncertain effects on LDL cholesterol. These results should be considered as exploratory and interpreted with caution.
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Affiliation(s)
- Louise Hartley
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryWarwickshireUKCV4 7AL
| | - Mariana Dyakova
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryWarwickshireUKCV4 7AL
| | | | - Aileen Clarke
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryWarwickshireUKCV4 7AL
| | - Myeong Soo Lee
- Korea Institute of Oriental MedicineMedical Research Division461‐24 Jeonmin‐dong, Yuseong‐guDaejeonKorea, South305‐811
| | - Edzard Ernst
- Peninsula Medical School, University of ExeterComplementary Medicine DepartmentExeterUK
| | - Karen Rees
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryWarwickshireUKCV4 7AL
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Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis. Int J Cardiol 2014; 173:170-83. [DOI: 10.1016/j.ijcard.2014.02.017] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 01/28/2014] [Accepted: 02/13/2014] [Indexed: 01/20/2023]
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Kanaya AM, Araneta MRG, Pawlowsky SB, Barrett-Connor E, Grady D, Vittinghoff E, Schembri M, Chang A, Carrion-Petersen ML, Coggins T, Tanori D, Armas JM, Cole RJ. Restorative yoga and metabolic risk factors: the Practicing Restorative Yoga vs. Stretching for the Metabolic Syndrome (PRYSMS) randomized trial. J Diabetes Complications 2014; 28:406-12. [PMID: 24418351 PMCID: PMC4004660 DOI: 10.1016/j.jdiacomp.2013.12.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 12/20/2022]
Abstract
AIMS Intensive lifestyle change prevents type 2 diabetes but is difficult to sustain. Preliminary evidence suggests that yoga may improve metabolic factors. We tested a restorative yoga intervention vs. active stretching for metabolic outcomes. METHODS In 2009-2012, we conducted a 48-week randomized trial comparing restorative yoga vs. stretching among underactive adults with the metabolic syndrome at the Universities of California, San Francisco and San Diego. We provided lifestyle counseling and a tapering series of 90-min group classes in the 24-week intervention period and 24-week maintenance period. Fasting and 2-h glucose, HbA1c, triglycerides, HDL-cholesterol, insulin, systolic blood pressure, visceral fat, and quality of life were assessed at baseline, 6- and 12-months. RESULTS 180 participants were randomized and 135 (75%) completed the trial. At 12 months, fasting glucose decreased more in the yoga group than in the stretching group (-0.35 mmol/L vs. -0.03 mmol/L; p=0.002); there were no other significant differences between groups. At 6 months favorable changes within the yoga group included reductions in fasting glucose, insulin, and HbA1c and an increase in HDL-cholesterol that were not sustained at 1 year except changes in fasting glucose. The stretching group had a significant reduction in triglycerides at 6 months which was not sustained at 1 year but had improved quality of life at both time-points. CONCLUSIONS Restorative yoga was marginally better than stretching for improving fasting glucose but not other metabolic factors.
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Affiliation(s)
| | | | | | | | | | | | | | - Ann Chang
- University of California, San Francisco
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Hunter SD, Tarumi T, Dhindsa MS, Nualnim N, Tanaka H. Hatha yoga and vascular function: results from cross-sectional and interventional studies. J Bodyw Mov Ther 2012; 17:322-7. [PMID: 23768276 DOI: 10.1016/j.jbmt.2012.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 09/21/2012] [Accepted: 10/09/2012] [Indexed: 11/25/2022]
Abstract
The aim of this study was to determine the effect of hatha yoga on arterial elasticity and endothelial function. First, a cross-sectional study was performed to determine whether yoga practitioners would demonstrate greater arterial compliance and endothelium-dependent vasodilation than their sedentary peers. Second, an intervention study involving 13 sedentary middle-aged and older adults (51 ± 7 years) was performed to determine whether 12 weeks of hatha yoga would elicit increases in arterial compliance and endothelial function. In the cross-sectional study involving a total of 34 subjects, there were no group differences in body fatness, blood lipid and lipoprotein concentrations, carotid artery compliance or brachial artery flow-mediated dilation (FMD). Hemoglobin A1c was lower in yoga practitioners than in sedentary adults (P < 0.05). Total cholesterol and hemoglobin A1c decreased after the intervention (P < 0.05) while carotid artery compliance and brachial artery FMD did not change. The results of both cross-sectional and interventional studies indicate that regular practice of hatha yoga is not associated with improvements in vascular functions.
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Affiliation(s)
- Stacy D Hunter
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, TX 78712, USA.
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Balaji PA, Varne SR, Ali SS. Physiological effects of yogic practices and transcendental meditation in health and disease. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2012; 4:442-8. [PMID: 23112963 PMCID: PMC3482773 DOI: 10.4103/1947-2714.101980] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Yoga is an ancient Indian way of life, which includes changes in mental attitude, diet, and the practice of specific techniques such as yoga asanas (postures), breathing practices (pranayamas), and meditation to attain the highest level of consciousness. Since a decade, there has been a surge in the research on yoga, but we do find very few reviews regarding yogic practices and transcendental meditation (TM) in health and disease. Keeping this in view, a Medline search was done to review relevant articles in English literature on evaluation of physiological effects of yogic practices and TM. Data were constructed; issues were reviewed and found that there were considerable health benefits, including improved cognition, respiration, reduced cardiovascular risk, body mass index, blood pressure, and diabetes. Yoga also influenced immunity and ameliorated joint disorders.
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Affiliation(s)
- P A Balaji
- Department of Physiology, Dr. B R Ambedkar Medical College, Bangalore, Karnataka, India
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Sharma M, Knowlden AP. Role of Yoga in Preventing and Controlling Type 2 Diabetes Mellitus. J Evid Based Complementary Altern Med 2012. [DOI: 10.1177/2156587212438899] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Yoga has been suggested as a complementary and alternative treatment for type 2 diabetes mellitus. The purpose of this study was to review studies using yoga in preventing or controlling diabetes. Inclusion criteria were as follows: (1) conducted between 1993 and September 2011; (2) published in the English language; (3) used yoga asanas, pranayama, or dhyana as intervention; (4) involved diabetic patients and healthy volunteers, with insulin or glucose levels as outcomes, or individuals at risk for diabetes; (5) used any quantitative design; and (6) had biochemical, physiological, anthropometric, or clinical outcomes. A total of 17 studies met the inclusion criteria. Of these studies, 15 used yoga asanas, 12 used pranayama, and 1 each used shatkriyas (cleansing exercises) and yoga nidra (relaxation). Of the 11 studies that measured changes in fasting blood glucose, 9 showed significant decrease. Limitations include lack of theory-based approach, small sample sizes, and inability to gauge adherence.
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Affiliation(s)
- Manoj Sharma
- University of Cincinnati, Health Promotion and Education Program and Public Health Sciences, Cincinnati, OH, USA
| | - Adam P. Knowlden
- University of Cincinnati, Health Promotion and Education Program and Public Health Sciences, Cincinnati, OH, USA
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Castro-Sánchez AM, Moreno-Lorenzo C, Matarán-Peñarrocha GA, Feriche-Fernández-Castanys B, Granados-Gámez G, Quesada-Rubio JM. Connective tissue reflex massage for type 2 diabetic patients with peripheral arterial disease: randomized controlled trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:804321. [PMID: 19933770 PMCID: PMC3145465 DOI: 10.1093/ecam/nep171] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 10/02/2009] [Indexed: 12/11/2022]
Abstract
The objective of this study was to evaluate the efficacy of connective tissue massage to improve blood circulation and intermittent claudication symptoms in type 2 diabetic patients. A randomized, placebo-controlled trial was undertaken. Ninety-eight type 2 diabetes patients with stage I or II-a peripheral arterial disease (PAD) (Leriche-Fontaine classification) were randomly assigned to a massage group or to a placebo group treated using disconnected magnetotherapy equipment. Peripheral arterial circulation was determined by measuring differential segmental arterial pressure, heart rate, skin temperature, oxygen saturation and skin blood flow. Measurements were taken before and at 30 min, 6 months and 1 year after the 15-week treatment. After the 15-week program, the groups differed (P < .05) in differential segmental arterial pressure in right lower limb (lower one-third of thigh, upper and lower one-third of leg) and left lower limb (lower one-third of thigh and upper and lower one-third of leg). A significant difference (P < .05) was also observed in skin blood flow in digits 1 and 4 of right foot and digits 2, 4 and 5 of left foot. ANOVA results were significant (P < .05) for right and left foot oxygen saturation but not for heart rate and temperature. At 6 months and 1 year, the groups differed in differential segmental arterial pressure in upper third of left and right legs. Connective tissue massage improves blood circulation in the lower limbs of type 2 diabetic patients at stage I or II-a and may be useful to slow the progression of PAD.
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Martarelli D, Cocchioni M, Scuri S, Pompei P. Diaphragmatic breathing reduces exercise-induced oxidative stress. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:932430. [PMID: 19875429 PMCID: PMC3139518 DOI: 10.1093/ecam/nep169] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 10/02/2009] [Indexed: 01/16/2023]
Abstract
Diaphragmatic breathing is relaxing and therapeutic, reduces stress, and is a fundamental procedure of Pranayama Yoga, Zen, transcendental meditation and other meditation practices. Analysis of oxidative stress levels in people who meditate indicated that meditation correlates with lower oxidative stress levels, lower cortisol levels and higher melatonin levels. It is known that cortisol inhibits enzymes responsible for the antioxidant activity of cells and that melatonin is a strong antioxidant; therefore, in this study, we investigated the effects of diaphragmatic breathing on exercise-induced oxidative stress and the putative role of cortisol and melatonin hormones in this stress pathway. We monitored 16 athletes during an exhaustive training session. After the exercise, athletes were divided in two equivalent groups of eight subjects. Subjects of the studied group spent 1 h relaxing performing diaphragmatic breathing and concentrating on their breath in a quiet place. The other eight subjects, representing the control group, spent the same time sitting in an equivalent quite place. Results demonstrate that relaxation induced by diaphragmatic breathing increases the antioxidant defense status in athletes after exhaustive exercise. These effects correlate with the concomitant decrease in cortisol and the increase in melatonin. The consequence is a lower level of oxidative stress, which suggests that an appropriate diaphragmatic breathing could protect athletes from long-term adverse effects of free radicals.
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Affiliation(s)
- Daniele Martarelli
- Department of Experimental Medicine and Public Health, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Macerata, Italy
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Evans S, Moieni M, Subramanian S, Tsao JCI, Sternlieb B, Zeltzer LK. "Now I see a brighter day": expectations and perceived benefits of an Iyengar yoga intervention for young patients with rheumatoid arthritis. ACTA ACUST UNITED AC 2011; 1. [PMID: 23145356 DOI: 10.4172/2157-7595.1000101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic disease characterized by inflammation of joints and associated fatigue, deteriorated range of motion, and impaired psychosocial functioning. Young adults with RA are at a particular risk for compromised health-related quality of life, and there is a need for safe, effective complementary treatment in addition to traditional medical approaches. The aim of the present study was to use face-to-face participant interviews, conducted before and after an Iyengar yoga (IY) program, to examine mechanisms through which yoga may be beneficial to young adults with RA.This pilot study utilized a single-arm design where all participants received the intervention. Classes were taught twice per week (1.5 hours each) for 6 weeks by an IY teacher qualified in therapeutics. Interview themes included participants' baseline expectations about yoga and viewpoints as to how their functioning had been impacted by the IY intervention were examined. Five young adults with RA aged 24-31 years (mean = 28; 80% female) completed the yoga intervention. Participants consistently reported that yoga helped with energy, relaxation and mood and they discussed perceived mechanisms for how yoga impacted well-being. Mechanisms included physical changes such as range of motion and physiological awareness, and psychospiritual developments such as acceptance, coping, self-efficacy and mindfulness. Though the study is limited, participants' responses provide compelling evidence that IY for RA patients is an intervention worthy of further exploration. The mechanisms and outcomes reported by participants support a biopsychosocial model, which proposes that yoga benefits patients through both physiological and psychospiritual changes.
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Affiliation(s)
- Subhadra Evans
- Pediatric Pain Program, Department of Pediatrics at the David Geffen School of Medicine, University of California, Los Angeles, USA
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Alexander GK, Innes KE, Brown CJ, Kulbok P, Bourguignon C, Bovbjerg VE, Taylor AG. "I could move mountains": adults with or at risk for type 2 diabetes reflect on their experiences with yoga practice. DIABETES EDUCATOR 2010; 36:965-75. [PMID: 20847193 DOI: 10.1177/0145721710381802] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to describe firsthand experiences with yoga as shared by adults with or at risk for type 2 diabetes and to examine their beliefs regarding maintenance of yoga practice over time. METHODS In this qualitative study, 13 adults with or at risk for type 2 diabetes described their experiences with yoga and their beliefs regarding maintenance of yoga practice over time. Semistructured interviews occurred 16 to 20 months after completion of an 8-week yoga-based clinical trial. RESULTS Themes of readiness for continuing yoga, environmental support for yoga, and integrating yoga emerged through data analysis. CONCLUSIONS Findings indicate that yoga is appealing to some individuals with diabetes, but maintaining yoga practice over time is a challenge. Diabetes educators may be able to support maintenance by discussing specific strategies with individuals who express interest in yoga practice.
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Affiliation(s)
- Gina K Alexander
- The Center for the Study of Complementary and Alternative Therapies, University of Virginia School of Nursing, Charlottesville, Virginia (Dr Alexander, Dr Bourguignon, Dr Taylor)
| | - Kim E Innes
- The Department of Community Medicine, West Virginia University School of Medicine, Morgantown, West Virginia (Dr Innes)
| | | | - Pamela Kulbok
- Department of Family, Community & Mental Health Systems, University of Virginia School of Nursing, Charlottesville, Virginia (Dr Kulbok)
| | - Cheryl Bourguignon
- The Center for the Study of Complementary and Alternative Therapies, University of Virginia School of Nursing, Charlottesville, Virginia (Dr Alexander, Dr Bourguignon, Dr Taylor)
| | - Viktor E Bovbjerg
- The Department of Public Health, Oregon State University, Corvallis, Oregon (Dr Bovbjerg)
| | - Ann Gill Taylor
- The Center for the Study of Complementary and Alternative Therapies, University of Virginia School of Nursing, Charlottesville, Virginia (Dr Alexander, Dr Bourguignon, Dr Taylor)
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