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Ahuja N, Bhardwaj P, Pathania M, Sethi D, Kumar A, Parchani A, Chandel A, Phadke A. Yoga Nidra for hypertension: A systematic review and meta-analysis. J Ayurveda Integr Med 2024; 15:100882. [PMID: 38484438 PMCID: PMC10950755 DOI: 10.1016/j.jaim.2023.100882] [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: 05/19/2023] [Revised: 10/05/2023] [Accepted: 12/15/2023] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Hypertension is a prevalent chronic condition that affects a substantial proportion of the world's population. Medications are commonly prescribed for hypertension management, but non-pharmacological interventions like yoga are gaining popularity. OBJECTIVE The purpose of this systematic review and meta-analysis is to assess the efficacy of Yoga Nidra (YN) for the management of hypertension. METHODS A systematic review and meta-analysis of clinical trials, i.e., non-randomized and randomized controlled trials (RCTs) was conducted to investigate the effects of YN on hypertension. PubMed, the Cochrane Library, SCOPUS, and EBSCO were searched for relevant studies published up to September 2022. The quality of the included studies was assessed using the Cochrane risk of bias tool. The primary outcome measure was the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after YN intervention, analyzed as weighted mean difference (WMD), in comparison to control groups. The random-effects model was used for the meta-analysis. Risk of bias was assessed for RCTs and non-RCTs using Cochrane's RoB-2 and ROBINS-I tools, respectively. RESULTS Five RCTs and three Non-RCTs involving a total of 482 participants (239 for YN vs 243 for controls) were included in this review. The meta-analysis indicated that YN significantly reduced SBP (WMD = 12.03 mm Hg, 95% CI [7.12, 16.93], Z = 4.80, p < 0.00001) and DBP (WMD = 6.32 mm Hg, 95% CI [3.53, 9.12], Z = 4.43, p < 0.00001) compared to control groups. The overall risk of bias for the three RCTs was high, whereas for the five non-RCTs, one had an overall moderate risk while the other four had an overall serious risk of bias. DISCUSSION This systematic review and meta-analysis provides evidence supporting the efficacy of YN as a complementary therapy for hypertension management. YN is a safe, cost-effective, and easily accessible intervention that primarily relies on interoception and induces a deep relaxation response in practitioners, aiding them in coping with various components of high blood pressure, such as stress, vascular inflammation, peripheral vascular resistance, etc. Our understanding of the mechanisms of YN is constantly evolving, and there is a need for further research to fully explore and appreciate the significance of this ancient science and its potential efficacy on BP. Considering the results and the multifactorial role of YN, it can act as a safe and reliable adjuvant therapy to complement the pharmacological treatment of hypertension. However, further studies with larger sample sizes, longer follow-up periods, and homogenous populations are warranted. CONCLUSION This meta-analysis suggests that YN is effective in reducing SBP and DBP, particularly in individuals with hypertension. The results highlight the potential of YN as a complementary therapy for hypertension management. Healthcare providers may consider recommending YN to patients with hypertension as an adjuvant therapy to medication. Further studies are required to identify standardized optimal forms and durations of YN best suited for hypertension management.
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Affiliation(s)
- Navdeep Ahuja
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praag Bhardwaj
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
| | - Dilasha Sethi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana - SVYASA, Bangaluru, Karnataka, India
| | - Arjun Kumar
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashwin Parchani
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Akshita Chandel
- Dept. of General Medicine, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Aashish Phadke
- Division of Endocrine and Metabolic Disorders - Lifestyle Modulations and Yoga Modules, Kasturba Health Society - Medical Research Centre, Mumbai, Maharashtra, India
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Raman M, Vishnubhotla R, Ramay HR, Gonçalves MCB, Shin AS, Pawale D, Subramaniam B, Sadhasivam S. Isha yoga practices, vegan diet, and participation in Samyama meditation retreat: impact on the gut microbiome & metabolome - a non-randomized trial. BMC Complement Med Ther 2023; 23:107. [PMID: 37020274 PMCID: PMC10074366 DOI: 10.1186/s12906-023-03935-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Growing evidence suggests a role for gut bacteria and their metabolites in host-signaling responses along the gut-brain axis which may impact mental health. Meditation is increasingly utilized to combat stress, anxiety, and depression symptoms. However, its impact on the microbiome remains unclear. This study observes the effects of preparation and participation in an advanced meditation program (Samyama) implemented with a vegan diet including 50% raw foods, on gut microbiome and metabolites profiles. METHODS There were 288 subjects for this study. Stool samples were collected at 3-time points for meditators and household controls. Meditators prepared for 2 months for the Samyama, incorporating daily yoga and meditation practices with a vegan diet including 50% raw foods. Subjects were requested to submit stool samples for 3 time points - 2 months before Samyama (T1), right before Samyama (T2), and 3 months following Samyama (T3). 16 s rRNA sequencing was used to study participants' microbiome. Alpha and beta diversities along with short-chain fatty acid (SCFA) were assessed. Metabolomics were performed on a mass spectrometer coupled to a UHLPC system and analyzed by El-MAVEN software. RESULTS Alpha diversity showed no significant differences between meditators and controls, while beta diversity showed significant changes (padj = 0.001) after Samyama in meditators' microbiota composition. After the preparation phase, changes in branched short-chain fatty acids, higher levels of iso-valerate (padj = 0.02) and iso-buytrate (padj = 0.019) were observed at T2 in meditators. Other metabolites were also observed to have changed in meditators at timepoint T2. CONCLUSION This study examined the impact of an advanced meditation program combined with a vegan diet on the gut microbiome. There was an increase in beneficial bacteria even three months after the completion of the Samyama program. Further study is warranted to validate current observations and investigate the significance and mechanisms of action related to diet, meditation, and microbial composition and function, on psychological processes, including mood. TRIAL REGISTRATION Registration number: NCT04366544 ; Registered on 29/04/2020.
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Affiliation(s)
- Maitreyi Raman
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ramana Vishnubhotla
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hena R Ramay
- International Microbiome Centre, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maria C B Gonçalves
- Department of Anesthesia, Critical Care and Pain Medicine, Sadhguru Center for a Conscious Planet, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andrea S Shin
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dhanashri Pawale
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Balachundhar Subramaniam
- Department of Anesthesia, Critical Care and Pain Medicine, Sadhguru Center for a Conscious Planet, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Senthilkumar Sadhasivam
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Moser B, Moore D, Khadka B, Lyons C, Foxall T, Andam CP, Parker CJ, Ochin C, Garelnabi M, Sevigny J, Thomas WK, Bigornia S, Dao MC. Association between inflammation, lipopolysaccharide binding protein, and gut microbiota composition in a New Hampshire Bhutanese refugee population with a high burden of type 2 diabetes. Front Nutr 2023; 9:1059163. [PMID: 36687728 PMCID: PMC9852993 DOI: 10.3389/fnut.2022.1059163] [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: 10/01/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction South Asian refugees experience a high risk of obesity and diabetes yet are often underrepresented in studies on chronic diseases and their risk factors. The gut microbiota and gut permeability, as assessed through circulating lipopolysaccharide binding protein (LBP), may underlie the link between chronic inflammation and type 2 diabetes (T2D). The composition of the gut microbiota varies according to multiple factors including demographics, migration, and dietary patterns, particularly fiber intake. However, there is no evidence on the composition of the gut microbiota and its relationship with metabolic health in refugee populations, including those migrating to the United States from Bhutan. The objective of this study was to examine glycemic status in relation to LBP, systemic inflammation fiber intake, and gut microbiota composition in Bhutanese refugee adults residing in New Hampshire (n = 50). Methods This cross-sectional study included a convenience sample of Bhutanese refugee adults (N = 50) in NH. Established bioinformatics pipelines for metagenomic analysis were used to determine relative genus abundance, species richness, and alpha diversity measures from shallow shotgun sequences. The relationships between inflammatory markers, gut microbiota composition, dietary fiber, and glycemic status were analyzed. Results We identified a substantial chronic disease burden in this study population, and observed a correlation between glycemic status, LBP, and inflammation, and a correlation between glycemic status and gut microbiome alpha diversity. Further, we identified a significant correlation between proinflammatory taxa and inflammatory cytokines. SCFA-producing taxa were found to be inversely correlated with age. Conclusion To date, this is the most comprehensive examination of metabolic health and the gut microbiome in a Bhutanese refugee population in NH. The findings highlight areas for future investigations of inflammation and glycemic impairment, in addition to informing potential interventions targeting this vulnerable population.
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Affiliation(s)
- Brandy Moser
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Dustin Moore
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Bishnu Khadka
- Building Community in New Hampshire, Manchester, NH, United States
| | - Carrie Lyons
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Tom Foxall
- Department of Biological Sciences, University of New Hampshire, Durham, NH, United States
| | - Cheryl P. Andam
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH, United States,Department of Biological Sciences, University at Albany, Albany, NY, United States
| | - Cooper J. Parker
- Department of Biological Sciences, University of New Hampshire, Durham, NH, United States
| | - Chinedu Ochin
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Mahdi Garelnabi
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Joseph Sevigny
- Department of Molecular, Cellular, and Biomedical Sciences, Hubbard Center for Genome Studies, University of New Hampshire, Durham, NH, United States
| | - W. Kelley Thomas
- Department of Molecular, Cellular, and Biomedical Sciences, Hubbard Center for Genome Studies, University of New Hampshire, Durham, NH, United States
| | - Sherman Bigornia
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Maria Carlota Dao
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States,*Correspondence: Maria Carlota Dao,
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