Hatha yoga practices: energy expenditure, respiratory changes and intensity of exercise

Traditional Nostril Yoga Breathing Practices and Oxygen Consumption: A Randomized, Cross-over Study

Background

Traditional yoga texts describe "cross nostril breathing," with inhalation and exhalation through different nostrils. Previous research reported no clear differences in oxygen consumption during uninostril breathing (i.e., inhalation and exhalation through the same nostril), hence not supporting right and left uninostril breathing as activating or relaxing, respectively, with no research on oxygen consumed in "cross nostril breathing."

Methods

Oxygen consumed during "cross nostril breathing" was measured in healthy participants (n = 47, males, 26.3 ± 6.4 years). Five sessions (viz., right nostril inspiration yoga breathing [RNIYB], left nostril inspiration yoga breathing [LNIYB], alternate nostril yoga breathing [ANYB], breath awareness (BAW), and quiet rest (QR) were conducted on separate days in random order. Sessions were 33 min in duration with pre, during, and post states.

Results

Volume of oxygen consumed (VO2) and carbon dioxide eliminated (VCO2) increased during RNIYB (9.60% in VO2 and 23.52% in VCO2), LNIYB (9.42% in VO2 and 21.20% in VCO2) and ANYB (10.25% in VO2 and 22.72% in VCO2) with no significant change in BAW and QR. Diastolic blood pressure decreased during BAW and QR and after all five sessions (P < 0.05; in all cases). All comparisons were with the respective preceding state.

Conclusion

During the three yoga breathing practices, the volume of oxygen consumed increased irrespective of the nostril breathed through, possibly associated with (i) conscious regulation of the breath; (ii) attention directed to the breath, and (iii) "respiration-locked cortical activation." Restriction of the study to males reduces the generalizability of the findings.

Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review

Physical activity has been documented as a foundational approach for weight management and obesity, improving several cardiometabolic and mental health indices. However, it is not clear whether yoga practice can induce beneficial improvements in anthropometric and body composition parameters, performance, metabolic health, and well-being among overweight/obese people. The aim of this topical review was to catalog training studies examining the psychophysiological responses to yoga interventions in order to detect which outcomes have been investigated, the research methods applied, and the conclusions. The inclusion/exclusion criteria were met by 22 published articles involving 1178 (56% female) overweight/obese participants. This brief review on yoga-induced adaptations demonstrates that this widely used meditative movement activity can meaningfully improve the vast majority of the selected markers. These beneficial alterations are focused mostly on various anthropometric and body composition variables, cardiovascular disease risk factors, physical fitness parameters, quality of life, and stress in previously inactive overweight/obese individuals. Instead, yoga-based physical exercise interventions investigating anxiety, depression, mood state, exercise enjoyment, affect valence, and adherence were limited. Further research should focus on the yoga intervention configuration and potential mechanisms behind favorable changes in various psychophysiological indices through large-scale, rigorously designed randomized controlled trials implementing long-term interventions in overweight/obese individuals.

Differences in skeletal growth pattern of yoga practising adolescent girls: A cross-sectional study

Background

Yogasana improves both mental and physical health. There is sparse systematic research on the growth of yogasana practising adolescents.

Objectives

This study aims to assess the differential skeletal growth pattern among pre-adolescent and adolescent girls as a result of yoga practice.

Methods

A cross-sectional anthropometric study was conducted on stature (height), sitting height and leg length of 757 school-going girls (4-15 years old), divided in two groups, Yoga Group (YG) (n=380) and age matched Control Group (CG) (n=377) participants participating in recreational games other than yoga. Descriptive and inferential statistical analyses were applied. Unpaired t-test was performed for assessment of level of significance and Pearson's correlation (r) test was performed to to identify the association between growth pattern of stature and leg length at specific ages.

Results

The physical growth showed an ascending trend in both Yoga group (YG)2 participants and control group (CG)3 . At the onset of adolescence (10–12 years) the mean stature and leg length of YG participants were retarded (p < 0.05). Sitting height in YG was significantly (p < 0.05) low only in 10-year-olds. The similar trends were observed in stature and leg length in YG participants at 10 years (5th and 10th percentile) and 12 years (90th and 95th percentile). There was strong positive relationship between stature and leg length of YG participants (10 years, r = 0.86, p < 0.01; 11 years, r = 0.86, p < 0.01; 12 years, r = 0.72, p < 0.01). The stunted growth in YG participants during adolescence may be related to retarded growth of leg length.

Conclusions

Intense yogasana practice with greater skeletal stress possibly hinders stature in adolescent girls from 10 to 12 years. This may compromise with the natural growth pattern, necessitating special care during yoga training among adolescents while selecting the type, intensity and duration of yogasanas practice.

Potential for integrating yoga within pulmonary rehabilitation and recommendations of reporting framework

There is a rising burden of chronic obstructive pulmonary disease (COPD) in India. Pulmonary rehabilitation (PR), is a universally recommended multidisciplinary therapeutic strategy for the management of COPD; however, its needs are unmet. The diversity in the healthcare systems, availability of PR specialists and sociocultural multiformity requires contextualised and innovative PR models. Culturally sensitive elements, such as yoga, have some evidence of a positive impact in the management of COPD. Yoga and PR are based on similar principles with a holistic approach of involving physical activities, behaviour change techniques and psychological support to improve disease outcomes. Arguably the principles of PR and yoga are complementary but there are some important differences in the intensities of activities, exercise types and inclusion of mindfulness in components that must be considered. Components of PR enable aerobic capacity building, strengthening of muscles of the upper and lower extremities and building awareness towards disease management. Yoga, on the other hand, primarily can focus on core strengthening, breathing control, mindfulness and self-awareness. We discuss the potential of integrating the sociocultural appeal of yoga with PR delivered at international standards, and how an integrated approach may lead to optimal referral, uptake and completion.

Mindfulness intervention improves cognitive function in older adults by enhancing the level of miRNA-29c in neuron-derived extracellular vesicles

Although mindfulness-based stress reduction (MBSR) improves cognitive function, the mechanism is not clear. In this study, people aged 65 years and older were recruited from elderly communities in Chitose City, Japan, and assigned to a non-MBSR group or a MBSR group. Before and after the intervention, the Japanese version of the Montreal Cognitive Assessment (MoCA-J) was administered, and blood samples were collected. Then, neuron-derived extracellular vesicles (NDEVs) were isolated from blood samples, and microRNAs, as well as the target mRNAs, were evaluated in NDEVs. A linear mixed model analysis showed significant effects of the MBSR x time interaction on the MoCA-J scores, the expression of miRNA(miR)-29c, DNA methyltransferase 3 alpha (DNMT3A), and DNMT3B in NDEVs. These results indicate that MBSR can improve cognitive function by increasing the expression of miR-29c and decreasing the expression of DNMT3A, as well as DNMT3B, in neurons. It was also found that intracerebroventricular injection of miR-29c mimic into 5xFAD mice prevented cognitive decline, as well as neuronal loss in the subiculum area, by down-regulating Dnmt3a  and Dnmt3b  in the hippocampus. The present study suggests that MBSR can prevent neuronal loss and cognitive impairment by increasing the neuronal expression of miR-29c.

Metabolic Energy Contributions During High-Intensity Hatha Yoga and Physiological Comparisons Between Active and Passive (Savasana) Recovery

Purpose: The objective of this study was to investigate metabolic energy contributions during high-intensity hatha yoga (HIHY) and to compare changes in physiological variables between active and passive recovery methods.

Methods: The study involved 20 women yoga instructors (n = 20) who performed 10 min of HIHY (vigorous sun salutation). Upon completion, they were randomly assigned to either active (walking; n = 10) or passive (savasana; n = 10) recovery groups for a period of 10 min. During HIHY, physiological variables such as heart rate (HR_peak and HR_mean), oxygen uptake (VO_2peak and VO_2mean), and blood lactate concentrations (peak La⁻) were measured. Energetic contributions (phosphagen; W_PCR, glycolytic; W_Gly, and oxidative; W_Oxi) in kJ and % were estimated using VO₂ and La⁻ data. Furthermore, the metabolic equivalents (METs) of VO_2peak and VO_2mean were calculated. To compare different recovery modes, HR_post, ΔHR, VO_2post, ΔVO₂, recovery La⁻, and recovery ΔLa⁻ were analyzed.

Results: The results revealed that HR_peak, VO_2peak, and peak La⁻ during HIHY showed no differences between the two groups (p > 0.05). Values of HR_peak, HR_mean, METs of VO_2peak and VO_2mean, and La⁻ during HIHY were 95.6% of HR_max, 88.7% of HR_max, 10.54 ± 1.18, 8.67 ±.98 METs, and 8.31 ± 2.18 mmol·L⁻¹, respectively. Furthermore, W_Oxi was significantly higher compared with W_PCR, W_Gly, and anaerobic contribution (W_PCR + W_Gly), in kJ and % (p < 0.0001). VO_2post and recovery ΔLa⁻ were significantly higher in the active recovery group (p < 0.0001, p = 0.0369, respectively). Values of ΔVO₂ and recovery La⁻ were significantly lower in the active group compared with the passive group (p = 0.0115, p = 0.0291, respectively).

Conclusions: The study concluded that high-intensity hatha yoga which was performed for 10 min is a suitable option for relatively healthy people in the modern workplace who may have hatha yoga experience but do not have time to perform a prolonged exercise. Following active recovery, they can participate in further HIHY sessions during short breaks. Furthermore, a faster return to work can be supported by physiological recovery.

Feasibility of Integration of Yoga in a Behavioral Weight-Loss Intervention: A Randomized Trial

OBJECTIVE

This study examined the feasibility and comparison of two styles of yoga within the context of a standard behavioral weight-loss intervention (SBWI).

METHODS

Fifty adults with obesity (BMI: 31.3 ± 3.8 kg/m² ) participated in this 6-month study that included a SBWI and a calorie- and fat-reduced diet. Randomization was to restorative Hatha (SBWI+RES) or Vinyasa (SBWI+VIN) yoga. Yoga was prescribed to increase from 20 to 40 to 60 minutes per session across the intervention. Weight was assessed at baseline and 6 months. Perceptions of yoga were assessed at the completion of the intervention.

RESULTS

Adjusted weight loss was -3.4 kg (95% CI: -6.4 to -0.5) in SBWI+RES and -3.8 kg (95% CI: -6.8 to -0.9) in SBWI+VIN (P < 0.001), with no difference between groups. Of all participants, 74.4% reported that they would continue participation in yoga after the SBWI. Session duration was a barrier as yoga increased from 20 to 40 to 60 minutes per day, with 0%, 7.5%, and 48.8% reporting this barrier, respectively.

CONCLUSIONS

Among adults with obesity, yoga participation, within the context of a SBWI, appears to be feasible, with weight loss not differing by style of yoga. Progressing to 60 minutes per session appears to be a barrier to engagement in yoga in this population.

Energy expenditure during a Vinyasa yoga session

BACKGROUND

Vinyasa yoga has been recently promoted as one of the most popular mindful exercises to improve overall health, including body weight management. The purpose of this study was to determine the metabolic response of 24 moderately trained individuals during a 90-min group Vinyasa yoga routine.

METHODS

Heart rate (HR) time course of 12 males and 12 females (age: 39±7.33 years) was recorded during two group Vinyasa yoga sessions consisted of four sections (warm-up, high-intensity Surya Namaskar (HSN), no Surya Namaskar postures, and cool-down). Maximal oxygen uptake (V̇O<inf>2peak</inf>) and maximum HR had been estimated earlier after a maximal treadmill test. V̇O<inf>2</inf> during Vinyasa yoga sessions was estimated from individual regression equations using the relationship of V̇O<inf>2</inf> and HR values derived from V̇O<inf>2peak</inf> test, while the metabolic rate (kcal/min) was calculated from the relationship of HR and kcal/min. Total session energy consumption was the average value of the two yoga sessions.

RESULTS

The 2 (gender) × 4 (sections) mixed ANOVA revealed no significant interaction between the two factors (P=0.101) for the mean metabolic rate (7.1±2.6 kcal/min). Mean metabolic rate thought was higher (P=0.015) in males compared to females at each section. Also, significant differences were found among the four Vinyasa yoga sections (P<0.001) in the rate of energy expenditure, with HSN presenting the highest mean values (P<0.05).

CONCLUSIONS

It seems that systematic participation in Vinyasa yoga may effectively improve cardiorespiratory fitness and promote body weight loss, as an alternative method to traditional aerobic exercise.

Dynamic brain-body coupling of breath-by-breath O2-CO2 exchange ratio with resting state cerebral hemodynamic fluctuations

BACKGROUND

The origin of low frequency cerebral hemodynamic fluctuations (CHF) in the resting state remains unknown. Breath-by breath O2-CO2 exchange ratio (bER) has been reported to correlate with the cerebrovascular response to brief breath hold challenge at the frequency range of 0.008-0.03Hz in healthy adults. bER is defined as the ratio of the change in the partial pressure of oxygen (ΔPO2) to that of carbon dioxide (ΔPCO2) between end inspiration and end expiration. In this study, we aimed to investigate the contribution of respiratory gas exchange (RGE) metrics (bER, ΔPO2 and ΔPCO2) to low frequency CHF during spontaneous breathing.

METHODS

Twenty-two healthy adults were included. We used transcranial Doppler sonography to evaluate CHF by measuring the changes in cerebral blood flow velocity (ΔCBFv) in bilateral middle cerebral arteries. The regional CHF were mapped with blood oxygenation level dependent (ΔBOLD) signal changes using functional magnetic resonance imaging. Temporal features and frequency characteristics of RGE metrics during spontaneous breathing were examined, and the simultaneous measurements of RGE metrics and CHF (ΔCBFv and ΔBOLD) were studied for their correlation.

RESULTS

We found that the time courses of ΔPO2 and ΔPCO2 were interdependent but not redundant. The oscillations of RGE metrics were coherent with resting state CHF at the frequency range of 0.008-0.03Hz. Both bER and ΔPO2 were superior to ΔPCO2 in association with CHF while CHF could correlate more strongly with bER than with ΔPO2 in some brain regions. Brain regions with the strongest coupling between bER and ΔBOLD overlapped with many areas of default mode network including precuneus and posterior cingulate.

CONCLUSION

Although the physiological mechanisms underlying the strong correlation between bER and CHF are unclear, our findings suggest the contribution of bER to low frequency resting state CHF, providing a novel insight of brain-body interaction via CHF and oscillations of RGE metrics.

Range of Yoga Intensities From Savasana to Sweating: A Systematic Review

Background: There is limited research examining the intensity of yoga and intensity variations between different styles. The purpose of this review is to examine the intensity of yoga based on different physiologic responses both between different yoga styles and within styles of yoga. Methods: Articles were searched for on the PubMed database in early 2019. Inclusion criteria were as follows: (1) written in English, (2) cite a specific style of yoga and include whole yoga session, and (3) measure metabolic or heart rate response. Results: Ten articles were reviewed; articles reported oxygen consumption (n = 1), heart rate (n = 4), or both variables (n = 5). Yoga styles assessed included ashtanga (n = 2), Bikram (n = 3), gentle (n = 1), hatha (n = 3), Iyengar (n = 1), power (n = 1), and vinyasa (n = 1). Oxygen consumption commonly categorized yoga as a light-intensity activity, while heart rate responses classified different yoga into multiple intensities. Conclusion: This review demonstrates that large differences in intensity classifications are observed between different styles of yoga. Furthermore, metabolic and heart rate responses can be variable, leading to inconsistent intensity classifications. This is likely due to their nonlinear relationship during yoga. Thus, it is imperative that the field of yoga research works together to create a standard for reporting yoga.

Yoga Practices as an Alternative Training for Physical Fitness in Children With Visual Impairment

Physical activities provide fundamental benefits to children's health and well-being. They are vital for development and healthy life, but participation of children with visual impairment is limited. Herein, the authors report results of a 16-wk yoga program, evaluating its effects on physical fitness in children with visual impairment. Eighty-three children age 9-16 years (12.37 ± 2.19) participated in a 2-arm, single-blind wait-list-controlled study at a residential school in south India. Participants (yoga group 41, controls 42) were assessed on muscle strength, flexibility, endurance, coordination, and respiratory health. Significant improvements in physical fitness were observed after the yoga intervention (Group × Time interactions for right-hand grip strength, p < .001; sit-up, p < .001; sit and reach, p < .001; bilateral plate tapping, p < .001; and peak expiratory flow rate, p < .001). Left-hand grip strength showed main effects of time, although there were no Group × Time interactions. Results demonstrate yoga's ability to improve a wide range of physical variables in children with visual impairment.

Use of a 'pose rate' to quantify yoga

OBJECTIVE

To develop a method that describes the physical activity completed during yoga, and to use this method to compare three different yoga video categories: weight loss, beginner, and stress relief/meditation.

DESIGN

This study conducted content analysis of commercially available yoga videos in which pre-determined characteristics of yoga routines were recorded. Outcome measures included the yoga routine characteristics of: duration of each yoga routine, number of completed poses, body position of each pose, and pose rate.

RESULTS

Twenty-two routines from yoga videos were analyzed. Duration of routine between the three different categories was not significantly different. There were significant differences between the video categories based on the characteristics of total number of poses and the pose rate, with weight loss routines having the highest values compare to beginner routines and stress relief/meditation (total number of poses: 74.1, 34.3, 25.6 poses, p < 0.05; Pose rate: 2.5m 1.5, 1.1 poses/min, p < 0.05, respectively). Additionally, differences were observed between body postures in poses with weight loss videos including more standing poses (38.8, 17.0, 5.7 poses, p < 0.05, respectively) and a lower percentage of seated (9.9%, 15.8%, 39.0%, p < 0.05, respectively) and supine poses (10.9%, 18.5%, 28.8%, p < 0.05, respectively) compared to the beginner and stress/meditation videos.

CONCLUSIONS

The characteristics of total poses, pose rate, and total standing poses showed significant differences between different styles of yoga. Further research should be conducted to validate these characteristics as an intensity measures and to assess if these characteristics have variations between different yoga styles.

Sexual Activity the Night Before Exercise Does Not Affect Various Measures of Physical Exercise Performance

INTRODUCTION

The idea that sexual activity can affect athletic performance has been a matter of conjecture for the past several decades.

AIM

To provide preliminary data on whether sexual activity the evening before several physical exercise performance tests affects performance the next day.

METHODS

Eight participants (mean age, 28 ± 5 years) underwent several physical exercise performance tests on 3 different mornings, under 3 conditions: (i) no sexual intercourse the night before the tests (control), (ii) sexual intercourse the night before the tests, and (iii) yoga the night before the tests (randomized, single-blinded).

MAIN OUTCOME MEASURES

Physical work capacity, lower body muscular power (standing vertical jump), upper body strength (handgrip strength), reaction time, and upper body musculoskeletal endurance (number of push-ups completed).

RESULTS

All participants experienced orgasm through intercourse. The more pleasurable the orgasm, the lower the systolic blood pressure (SBP) on the day after intercourse (Spearman's rho = -0.86; P = .007). For every 2% increase in the total orgasm score, SBP decreased by 1 mmHg. Intercourse lasted 13 minutes; mean heart rate (HR) and caloric expenditure ranged from 88 to 145 beats/minute and from 53 to 190 kcal, respectively. There were no significant differences in the physical working capacity that elicited an HR of 170 beats/minute, number of push-ups completed, vertical jump height, grip strength, or reaction time across the 3 conditions.

CONCLUSION

Orgasm through sexual activity on the night before physical exercise may reduce SBP; however, we were unable to demonstrate a statistically significant difference in physical exercise performance in any of the 3 conditions. Zavorsky GS, Vouyoukas E, Pfaus JG. Sexual Activity the Night Before Exercise Does Not Affect Various Measures of Physical Exercise Performance. Sex Med 2019;7:235-240.

Heart rate and thermal responses to power yoga

BACKGROUND

and Purpose: Yoga has grown in popularity and may offer a viable alternative form of physical activity. The purpose of this study was to examine heart rate, hydration, and thermal responses to a power yoga sequence.

MATERIALS AND METHODS

Twenty-seven men and women (n = 4/23; Mean ± SD age = 23.3 ± 3.3 years; BMI = 23 ± 3 kg m^-2) underwent ∼45 min of power yoga. Heart rate and skin temperature were recorded. Mass was measured before and after exercise to estimate fluid loss. Time spent in light, moderate, and vigorous heart rate zones was calculated.

RESULTS

Heart rate and skin temperature increased (p < 0.0001). Participants spent more time in moderate and vigorous heart rate zones than in light intensity (p < 0.0001). There was a reduction in body mass (-0.28 ± 0.13 kg, p < 0.0001).

CONCLUSION

Power yoga may be considered moderate-vigorous intensity exercise, based on heart-rate.

Respiratory Training Late After Fontan Intervention: Impact on Cardiorespiratory Performance

Fontan palliation allows patients with "single ventricle" circulation to reach adulthood with an acceptable quality of life, although exercise tolerance is significantly reduced. To assess whether controlled respiratory training (CRT) increases cardiorespiratory performance. 16 Adolescent Fontan patients (age 17. 5 ± 3.8 years) were enrolled. Patients were divided into CRT group (n = 10) and control group (C group, n = 6). Maximal cardiopulmonary test (CPT) was repeated at the end of CRT in the CRT group and after an average time of 3 months in the C group. In the CRT group a CPT endurance was also performed before and after CRT. In the CRT group there was a significant improvement in cardiovascular and respiratory response to exercise after CRT. Actually, after accounting for baseline values, the CRT group had decreased breathing respiratory reserve (- 15, 95% CI -22.3 to - 8.0, p = 0.001) and increased RR peak (+ 4.8, 95% CI 0.7-8.9, p = 0.03), VE peak (+ 13.7, 95% CI 5.6-21.7, p = 0.004), VO₂ of predicted (+ 8.5, 95% CI 0.1-17.0, p = 0.05), VO₂ peak (+ 4.3, 95% CI 0.3 to 8.2, p = 0.04), and VO₂ workslope (+ 1.7, 95% CI 0.3-3.1, p = 0.02) as compared to the control group. Moreover, exercise endurance time increased from 8.45 to 17.7 min (p = 0.01). CRT improves cardiorespiratory performance in post-Fontan patients leading to a better aerobic capacity.

Yoga for Heart Failure: A Review and Future Research

Background:

Complementary and alternative medicine is a rapidly growing area of biomedical inquiry. Yoga has emerged in the forefront of holistic medical care due to its long history of linking physical, mental, and spiritual well-being. Research in yoga therapy (YT) has associated improved cardiovascular and quality of life (QoL) outcomes for the special needs of heart failure (HF) patients.

Aim:

The aim of this study is to review yoga intervention studies on HF patients, discuss proposed mechanisms, and examine yoga's effect on physiological systems that have potential benefits for HF patients. Second, to recommend future research directions to find the most effective delivery methods of yoga to medically stable HF patients.

Methods:

The authors conducted a systematic review of the medical literature for RCTs involving HF patients as participants in yoga interventions and for studies utilizing mechanistic theories of stretch and new technologies. We examined physical intensity, mechanistic theories, and the use of the latest technologies.

Conclusions:

Based on the review, there is a need to further explore yoga mechanisms and research options for the delivery of YT. Software apps as exergames developed for use at home and community activity centers may minimize health disparities and increase QoL for HF patients.

Experiences of hatha yogic exercises among patients with obstructive pulmonary diseases: A qualitative study

BACKGROUND AND AIM

Obstructive pulmonary diseases can involve dyspnea and deconditioning. Hatha yogic exercises are a form of psychophysical attention-based activity. Research of experiences after participating in an adapted hatha yoga (YE) intervention remains limited. The aim of the present study was to explore the experiences of patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary disease) in a 12-week hatha yoga intervention (YE).

METHOD

Fifteen patients (10 women and 5 men, median age = 61, range: 44-76 years) who had participated in YE were interviewed after the intervention. Interview data were analyzed using qualitative content analysis.

RESULTS

Three main categories emerged: "To focus and be aware of oneself", "To gain new knowledge through practice" and "To master one's own situation". The overall theme "From limitation to opportunity - to experience breathing as a tool in daily life" illustrates a learning process on different levels. The participants described improved physical symptoms and breathing techniques, greater energy/stamina and body awareness along with a new sense of control over their breathing in different situations.

CONCLUSIONS

Patients with obstructive pulmonary diseases may strengthen their self-awareness and improve control of symptoms and learning new ways of breathing after practicing YE, which may provide a tool to control disease symptoms in daily life. Trial registration number NCT02233114.

Quality of Life and Breast Cancer: How Can Mind⁻Body Exercise Therapies Help? An Overview Study

Breast cancer survivors experience extensive treatments, threatening their quality of life. Complementary therapies used as a supplement to cancer treatment may control symptoms, enhance quality of life, and contribute to overall patient care. Mind–body exercise therapies might motivate cancer survivors to exercise, and assist them in regaining health. The purpose of this overview study is to study benefits from mind–body exercise of yoga, tai chi chuan and qigong upon quality of life in breast cancer populations. A systematic overview of reviews was applied. Literature search in five electronic databases and in reference lists was performed during April 2017. In addition, experts in the field were consulted. Of 38 identified titles, 11 review articles, including six meta-analyses were found eligible for review. Methodological quality was high for the majority of quality domains. Yoga, the most studied mind–body therapy, was found to benefit breast cancer patients’ psychological quality of life, while less support was established concerning physical quality of life elements. The evidence of improvements of quality of life from tai chi chuan and qigong remains unclear. Breast cancer survivors’ experiences of psychological and social well-being may be enhanced by practicing yoga.

A Systematic Review of the Energy Cost and Metabolic Intensity of Yoga

PURPOSE

With the increasing popularity of Hatha yoga, it is important to understand the energy cost and METs of yoga practice within the context of the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) physical activity guidelines.

METHODS

This systematic review evaluated the energy cost and metabolic intensity of yoga practice including yoga asanas (poses/postures) and pranayamas (breath exercises) measured by indirect calorimetry. The English-speaking literature was surveyed via PubMed using the general terms "yoga" and "energy expenditure" with no date limitations.

RESULTS

Thirteen manuscripts were initially identified with an additional four located from review of manuscript references. Of the 17 studies, 10 evaluated the energy cost and METs of full yoga sessions or flow through Surya Namaskar (sun salutations), eight of individual asanas, and five of pranayamas. METs for yoga practice averaged 3.3 ± 1.6 (range = 1.83-7.4 METs) and 2.9 ± 0.8 METs when one outlier (i.e., 7.4 METs for Surya Namaskar) was omitted. METs for individual asanas averaged 2.2 ± 0.7 (range = 1.4-4.0 METs), whereas that of pranayamas was 1.3 ± 0.3. On the basis of ACSM/AHA classification, the intensity of most asanas and full yoga sessions ranged from light (less than 3 METs) to moderate aerobic intensity (3-6 METs), with the majority classified as light intensity.

CONCLUSION

This review suggests that yoga is typically classified as a light-intensity physical activity. However, a few sequences/poses, including Surya Namaskar, meet the criteria for moderate- to vigorous-intensity activity. In accordance with the ACSM/AHA guidelines, the practice of asana sequences with MET intensities higher than three (i.e., >10 min) can be accumulated throughout the day and count toward daily recommendations for moderate- or vigorous-intensity physical activity.

Effects of yoga (pranayama) on lung function and lactate kinetics in sedentary adults at intermediate altitude

Introducción. La medicina basada en evidencia clínica encuentra cada vez más beneficios del yoga en sus practicantes.Objetivo. Describir los efectos en la función pulmonar y la cinética del lactato ocasionados por la práctica de pranayamas en adultos con apariencia saludable.Materiales y métodos. Se realizó un estudio cuasiexperimental en adultos sedentarios sin experiencia en la práctica de yoga, quienes realizaron un estímulo durante 12 semanas con un frecuencia mínima de dos sesiones por semana. Se dividieron en un grupo de yoga (GY) y un grupo de control (GC). Se determinó composición corporal, presión arterial, frecuencia cardíaca, doble producto (DP), saturación periférica de oxígeno (SpO2), lactato en sangre (Lacts), hematocrito (Htc) por micrométodo, y espirometría previa y posterior a un plan de entrenamiento con pranayamas. Las variables analizadas fueron: capacidad vital forzada (CVF), volumen espiratorio forzado del primer segundo (VEF1) y relación VEF1/CVF.Resultados. Los resultados de la CVF, VEF1 y lactato presentaron diferencias significativas entre el GY y el GC (p<0.05), antes y después del estímulo en el GY (p<0.05). El doble producto mejoró en ambos grupos.Conclusiones. La práctica dirigida de pranayamas durante 12 semanas mejoró la CVF, el VEF1, el doble producto (p<0.05) y la capacidad de producción de lactato (capacidad anaeróbica).

Brief Report on the Psychophysiological Effects of a Yoga Intervention for Chronic Stress

Abstract. This paper evaluates the results of a longitudinal investigation of the potential benefits of yoga in a nonclinical sample of chronically stressed women (N = 116). Women undertook a twice weekly, hour-long yoga class for a period of 2 months, measuring psychological and physical indicators of health periodically. Changes in both areas were compared against a wait-list control group. The reported energy expenditure between groups was estimated to be similar, which suggests that the control group engaged in physical activities other than yoga. Of the six psychological outcomes measured, we found improvements in three. Specifically, those in the practicing yoga group experienced increases in positive affect, decreases in levels of distress and stress, as well as a decrease in waist circumference and increased flexibility. No between-group differences were found in mindfulness, well-being, and negative affect. These findings are generally consistent with an emerging literature, suggesting that yoga may provide both psychological and physiological effects that extend beyond its more obvious physical benefits, and are discussed in terms of the body’s allostatic load. These results should be considered in light of this study’s limitations, which include its small sample size, lack of an “active” control group, and female-only participants.

Differences in energy expenditure during high-speed versus standard-speed yoga: A randomized sequence crossover trial

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.

Associations between yoga/meditation use, body satisfaction, and weight management methods: Results of a national cross-sectional survey of 8009 Australian women

OBJECTIVES

To analyze whether yoga or meditation use is associated with body (dis)satisfaction and weight control methods in Australian women.

METHODS

Women ages 34 to 39 y from the Australian Longitudinal Study on Women's Health were surveyed regarding body satisfaction, weight control behaviors, and yoga and meditation practice. Associations of body satisfaction and weight control methods with yoga/meditation practice were analyzed using chi-squared tests and multiple logistic regression modelling.

RESULTS

Of the 8009 women, 49% were overweight or obese. Sixty-five percent of women with normal body mass index (BMI) and approximately 95% of women with overweight/obesity wanted to lose weight. At least one in four women with normal BMI was dissatisfied with body weight and shape, as were more than two in three women with overweight/obesity. The most common weight control methods included exercising (82.7%), cutting down meal sizes (76.8%), and cutting down sugars or fats (71.9%). Yoga/meditation was practiced frequently by 688 women (8.6%) and occasionally by 1176 women (14.7%). Yoga/meditation users with normal BMI were less likely dissatisfied with body weight and shape. All yoga/meditation users more likely exercised and followed a low glycemic diet or diet books; and women with obesity occasionally using yoga/meditation also more likely used fasting or smoking to lose weight.

CONCLUSION

Yoga/meditation users with normal BMI appear to be more satisfied with their body weight and shape than non-yoga/meditation users. While women with normal BMI or overweight tend to rely on healthy weight control methods, women with obesity occasional using yoga/meditation may more likely utilize unhealthy weight control methods.

A systematic review and meta-analysis on the effects of yoga on weight-related outcomes

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.

Examining the energy cost and intensity level of prenatal yoga

CONTEXT

A popular form of pregnancy physical activity (PA) is prenatal yoga. However, little is known about the intensity and energy cost of this practice.

AIMS

To examine the energy cost and intensity level of prenatal yoga.

METHODS

Pregnant women in a prenatal yoga class (n = 19) wore a Sense Wear Armband during eleven 60 min classes each, and self-reported demographic variables, height and weight, prepregnancy weight, and PA behaviors and beliefs. Sense Wear Armband data included kilocalories, metabolic equivalent (MET) values, and time spent in various intensities. Descriptive statistics and frequencies were utilized to describe energy expenditure and intensity.

RESULTS

Energy expenditure averaged 109 ± 8 kcals, and the average MET value was 1.5 ± 0.02. On average, 93% and 7% of classes were sedentary and moderate intensity PA, respectively.

CONCLUSIONS

Time spent in a prenatal yoga class was considered to be primarily a sedentary activity. Future research should utilize larger samples, practice type, and skill level to increase generalizability.

A self-directed home yoga programme for women with breast cancer during chemotherapy: A feasibility study

Recent studies suggest yoga as a promising approach for improving the cognitive function of cancer survivors. We studied whether a self‐directed home yoga programme was feasible for patients with breast cancer who were undergoing chemotherapy. Participants' preferences for the type of yoga course and the clinical effects of the programme were also assessed.

In this study, 18 women (mean age, 43.9 years) were enrolled (44.7% recruitment rate). Of the participants, 63.6% had stage II cancer and 71.4% received adjuvant chemotherapy. Favourable retention (86%), adherence (94.4%) and acceptability (96.5%) rates were determined. Most (94.4%) of the women practiced the home programme more than twice a week on average. The participants preferred to gradually increase the intensity of the exercises.

We only observed improvements in the cognitive aspects of fatigue. No serious adverse events were encountered during the programme. This self‐directed home yoga programme was safe and feasible for patients with breast cancer undergoing chemotherapy.

Effects of High-Intensity Hatha Yoga on Cardiovascular Fitness, Adipocytokines, and Apolipoproteins in Healthy Students: A Randomized Controlled Study

BACKGROUND

Yoga exercises are often used as a form of body and mind exercise to increase performance. However, knowledge about the physiologic effects of performing high-intensity Hatha yoga exercises over a longer time period remains limited.

OBJECTIVE

To investigate the effects of high-intensity yoga (HIY) on cardiovascular fitness (maximal oxygen consumption, estimated from the Cooper running test), ratings of perceived exertion (RPE), heart rate (HR), heart rate recovery (HRR), blood pressure (BP), adipocytokines, apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and glycosylated hemoglobin (HbA1c) in healthy students.

METHODS

The 44 participants (38 women and 6 men; median age, 25 years [range, 20-39 years]) were randomly assigned to an HIY or a control group. The HIY program was held for 6 weeks (60 minutes once a week). Cardiovascular fitness, RPE, HR, HRR, BP, adipocytokines, HbA1c, ApoA1, and ApoB were measured at baseline and after 6 weeks in both groups.

RESULTS

HIY had no significant effects on cardiovascular fitness (mean dose: 390 minutes [range, 210-800 minutes]), HR, HRR, BP, or any of the blood parameters. However, secondary findings showed that [corrected] ApoA1 (1.47 ± 0.17 to 1.55 ± 0.16 g/L; p = 0.03) and adiponectin (8.32 ± 3.32 to 9.68 ± 3.83 mg/L; p = 0.003) levels increased significantly in the HIY group after 6 weeks.

CONCLUSIONS

Six weeks of HIY did not significantly improve cardiovascular fitness. However, secondary findings showed that [corrected] ApoA1 and adiponectin levels increased significantly in the HIY group. This finding suggests that HIY may have positive effects on blood lipids and an anti-inflammatory effect.

Yoga, bioenergetics and eating behaviors: A conceptual review

Yoga is an ancient oriental discipline that emerged from mystical and philosophical concepts. Today it is practiced in the west, partly due to the promotion of its benefits to improve the lifestyle and overall health. As compared to non-Hatha Yoga (HY) practitioners, healthier and better-eating patterns have been observed in those who practice it. Agreement with the brought benefits, HY can be used as a therapeutic method to correct abnormal eating behaviors (AEB), obesity, and some metabolic diseases. However, the energy expenditure during traditional protocols of HY is not high; hence, it is not very effective for reducing or maintaining body weight or to improve cardiovascular conditioning. Even so, several observational studies suggest significant changes in eating behaviors, like a reduction in dietary fat intake and increments in that of fresh vegetables, whole grains and soy-based products, which in turn may reduce the risk for cardiovascular diseases. Given the inconsistency of the results derived from cross-sectional studies, more case–control studies are needed to demonstrate the efficacy of HY as an alternative method in the clinical treatment of disordered eating and metabolic diseases.

Positive effect of yoga on cardiorespiratory fitness: A pilot study

INTRODUCTION

Cardiovascular disease (CVD) is the leading cause of death in developed countries. An integral part of primary prevention is physical activity. One form of physical activity to be potentially used is yoga, but this activity is associated with lower energy expenditure than that recommended for prevention. The study aimed at assessing the effect of regular yoga sessions on the aerobic capacity of the practitioners and comparing it with the normal population performing physical activity recommended by guidelines.

MATERIALS AND METHODS

Fifty-eight persons (16 males) with a mean age of 50.0 ± 11.06 years comprising the yoga group practiced yoga for at least 1 h a day for over 2 years. They underwent spiroergometry under maximal exercise testing to assess basic performance parameters. Their results were compared with those in 54 age-matched controls (16 males mean age of 48 ± 11.86 years performing a regular aerobic physical activity for at least 7 h a week.

RESULTS

The yoga group had statistically significantly higher maximum performance per kilogram (P = 0.007) and maximum oxygen consumption per kilogram per minute (P = 0.028).

CONCLUSIONS

Despite low energy expenditure, yoga practices are better in some cardiorespiratory fitness parameters than other aerobic activities recommended by current guidelines for CVD prevention.

Moving beyond cardio: the value of resistance training, balance training, and other forms of exercise in the management of diabetes

IN BRIEF Traditionally, aerobic training has been a central focus of exercise promotion for diabetes management. However, people with diabetes have much to gain from other forms of exercise. This article reviews the evidence and recommendations on resistance, balance, and flexibility training, as well as other, less traditional, forms of exercise such as yoga and Tai Chi.

Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors

BACKGROUND

Sixty percent of cancer survivors are 65years of age or older. Cancer and its treatments lead to cancer-related fatigue and many other side effects, in turn, creating substantial global side-effect burden (total burden from all side effects) which, ultimately, compromises functional independence and quality of life. Various modes of exercise, such as yoga, reduce cancer-related fatigue and global side-effect burden in younger cancer survivors, but no studies have specifically examined the effects of yoga on older cancer survivors.

OBJECTIVES

The purpose of this study was to assess the effects of a 4-week yoga intervention (Yoga for Cancer Survivors: YOCAS©®) on overall cancer-related fatigue, and due to its multidimensional nature, the subdomains of cancer-related fatigue (general, physical, emotional, and mental) and global side-effect burden in older cancer survivors.

MATERIALS AND METHODS

We conducted a secondary analysis on data from a multicenter phase III randomized controlled clinical trial with 2 arms (standard care and standard care plus a 4-week YOCAS©® intervention). The sample for this secondary analysis was 97 older cancer survivors (≥60years of age), between 2months and 2years post-treatment, who participated in the original trial.

RESULTS

Participants in the YOCAS©® intervention arm reported significantly lower cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden than participants in the standard care arm following the 4-week intervention period (p<0.05).

CONCLUSIONS

YOCAS©® is an effective standardized yoga intervention for reducing cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden among older cancer survivors.

Effect of 11 months of yoga training on cardiorespiratory responses during the actual practice of Surya Namaskar

Background:

Surya Namaskar (SN), a popular traditional Indian yogic practice, includes practicing 12 physical postures with alternate forward and backward bending movement of the body along with deep breathing maneuvers. The practice of SN has become popular among yoga practitioners and other fitness conscious people. The long-term effect of practicing SN and other yogic practices on cardiorespiratory responses during SN are lacking.

Aim:

The present study was conducted to study the effect of yogic training on various cardiorespiratory responses during the SN practice in yoga trainees after a time interval of 3, 6, and 11 months.

Materials and Methods:

The present study was conducted on 9 healthy male Army soldiers who underwent training in various yoga postures including SN, meditation, and pranayama for 1 h daily for 11 months. First, second, and third phase of the study was conducted in the laboratory after completion of 3, 6, and 11 months of the yoga training. The participants performed SN along with other yogic practices in the laboratory as per their daily practice schedule. The cardiorespiratory responses of the volunteers were recorded during actual practice of SN.

Statistical Analysis:

One-way repeated measure ANOVA followed by Tukey HSD.

Results:

Oxygen consumption and heart rate during actual practice of SN was 0.794 ± 0.252, 0.738 ± 0.229, and 0.560 ± 0.165 L/min and 92.1 ± 11.6, 97.9 ± 7.3 and 87.4 ± 9.2 beats/min respectively at 1^st , 2^nd , and 3^rd phase of yoga training. Minute ventilation and tidal volume also reduced from 19.9 ± 4.65 to 17.8 ± 4.41 L/min and 1.091 ± 0.021 to 0.952 L/breath from 1^st phase to 3^rd phase of yoga training. However, respiratory parameters like breathing rate (f_R) did not show any reduction across the three phases.

Conclusion:

The results of the present study indicated that yogic training caused conditioning of cardiorespiratory parameters except f_R, which did not reduce across three phases of training.

A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial

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.

Effect of regular yogic training on growth hormone and dehydroepiandrosterone sulfate as an endocrine marker of aging

Growth hormone (GH) and dehydroepiandrosterone sulfate (DHEAS) secretion decline with advancing age and are associated with the symptoms of aging. Yogic texts claimed that regular practice of yoga may restore and maintain general endocrinological properties in the human body. Objective of the Study. To observe the effect of yogic training for twelve weeks on basal level of GH and DHEAS in middle aged group. Method. Forty-five untrained volunteers were divided into two groups, that is, yoga practicing (experimental: male 15, age 42.80 ± 7.43 yrs; female 8, age 44.75 ± 8.40 yrs) and waitlisted control group (male 15, age 41.67 ± 7.87 yrs; female 7, age 45.43 ± 7.00 yrs). The experimental group underwent combined yogic practices daily in the morning for 6 days/week for 12 weeks, whereas control group continued their usual routine activities. Standing height, body weight, body mass index, and basal level of GH and DHEAS were measured before commencement and after six and twelve weeks of yogic training period. The repeated measure ANOVA was used for data analysis. Results. 12 weeks of yogic training produces a significant increase in GH and DHEAS for both male and female groups as compared to their baseline data, whereas no as such changes were observed in the control group. Conclusion. Combined approach of graded yogic training may be beneficial for maintaining the basal level of GH and DHEAS in the human body, thus promoting healthy aging.

Oxygen Consumption Changes With Yoga Practices

Oxygen consumption varies with physical and mental activity as well as pathological conditions. Although there is a strong relationship between yoga and metabolic parameters, the relationship between yoga and oxygen consumption has not yet been formally reviewed. This systematic review attempted to include all studies of yoga that also measured oxygen consumption or metabolic rate as an outcome. A total of 58 studies were located involving between 1 and 104 subjects (average 21). The studies were generally of poor methodological quality and demonstrated great heterogeneity with different experimental designs, yoga practices, time periods, and small sample sizes. Studies report yoga practices to have profound metabolic effects producing both increase and decrease in oxygen consumption, ranging from 383% increase with cobra pose to 40% decrease with meditation. Compared to nonpractitioners, basal oxygen consumption is reported to be up to 15% less in regular yoga practitioners, and regular yoga practice is reported to have a training effect with oxygen consumption during submaximal exercise decreasing by 36% after 3 months. Yoga breathing practices emphasize breathing patterns and retention ratios as well as unilateral nostril breathing, and these factors appear critical in influencing oxygen consumption. A number of studies report extraordinary volitional control over metabolism in advanced yoga practitioners who appear to be able to survive extended periods in airtight pits and to exceed the limits of normal human endurance. More rigorous research with standardized practices is required to determine the mechanisms of yoga’s metabolic effects and the relevance of yoga practices in different clinical populations.