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Kanthi A, Deepeshwar S, Chidananda K, Vidyashree M, Krishna D. Event-Related Potential Changes Following 12-week Yoga Practice in T2DM Patients: A Randomized Controlled Trial. Clin EEG Neurosci 2024:15500594241249511. [PMID: 38689456 DOI: 10.1177/15500594241249511] [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] [Indexed: 05/02/2024]
Abstract
Introduction. Type 2 diabetes patients are more likely to experience cognitive decline (1.5%) and dementia (1.6%) than healthy individuals. Although cognitive impairment adversely affects Type 2 diabetes mellitus (T2DM) patients, it is the least addressed complication of T2DM patients. Objective. The present study attempts to examine the changes in cognitive performance of T2DM patients and the probable factors contributing to the changes following 12-week yoga practice. Methods. The current study is a parallel group randomized controlled trial that compared the outcomes of the participants randomized to a yoga group (YG) (n = 25) and to a wait-list control group (n = 29). The study assessed N200 and N450 event-related potential (ERP) components following the Stroop task, heart rate variability (HRV) and HbA1c before and after the intervention. Results. The mean amplitude of the N200 ERP component showed a significant group difference after the intervention, demonstrating an improved neural efficiency in the process of conflict monitoring and response inhibition. No differences were present for the N450 component. T2DM patients showed reduced heart rate and increased mean RR following yoga practice without any corresponding changes in other HRV parameters, demonstrating an overall improvement in cardiac activity. Along with that yoga practice also reduced HbA1c levels in T2DM patients, indicating improved glycemic control. Moreover, HbA1c levels were negatively correlated with reaction time after the intervention, indicating an impact of glycemic control on cognitive performance. Conclusion. The 12-week yoga practice improved cognitive performance by enhancing the processes of conflict monitoring and response inhibition. Further, improved cognitive performance postintervention was facilitated by improved glycemic control.
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Affiliation(s)
- Amit Kanthi
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | | | - Kaligal Chidananda
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | | | - Dwivedi Krishna
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
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Kaligal C, Kanthi A, Vidyashree M, Krishna D, Raghuram N, Hongasandra Ramarao N, Deepeshwar S. Prefrontal oxygenation and working memory in patients with type 2 diabetes mellitus following integrated yoga: a randomized controlled trial. Acta Diabetol 2023; 60:951-961. [PMID: 37014456 DOI: 10.1007/s00592-023-02085-0] [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: 02/07/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) alters brain functional and structural connectivity leading to cognitive dysfunction. This study examined the effect of a 12-week yoga intervention on prefrontal cortex (PFC) oxygenation and working memory in patients with T2DM. METHODS Fifty participants were randomized into yoga and waitlist control groups. The yoga protocol specific to T2DM was followed. The pre- (day 1), mid- (6 weeks) and post-intervention (12 weeks) assessments included measurement of PFC oxygenation while performing working memory tasks (n-back) using functional near-infrared spectroscopy. RESULTS Following a 12-week intervention, the yoga group showed improved performance in working memory [accuracy (geometric mean difference of 3.15%, 95% CI [2.33,3.96], p = 0.001) and reaction time (mean difference of 100.8 milliseconds,95% CI [- 166.6, - 35.1], p = 0.002] in the high task load (2-back) associated with higher oxygenation in dorsolateral PFC (β coefficient mean difference of 95.6, 95% CI [0.23,191], p = 0.049) and ventrolateral PFC (β coefficient mean difference of 53.4, 95% CI [7.8,98.9], p = 0.018) regions. Higher oxygenation in dorsolateral PFC during 2-back task was positively correlated with accuracy (r(23) = 0.65, p < 0.001) and negatively correlated with reaction time (r(23) = - 0.47,p = 0.017). CONCLUSION Integrated yoga practice may improve working memory performance associated with higher PFC oxygenation in patients with T2DM. As 12 weeks of yoga intervention improved working memory performance, the regular practice of yoga may have the potential to prevent decline of cognitive functions in clinical conditions.
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Affiliation(s)
- Chidananda Kaligal
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Amit Kanthi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - M Vidyashree
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Dwivedi Krishna
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Nagarathna Raghuram
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Nagendra Hongasandra Ramarao
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Singh Deepeshwar
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India.
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Shrimant Kumar S, Santhi Sree M, Manjusha M, Reddy MM, B R, Kishore B, G RS, Mohapatra JJ. Efficacy of Residential, Group-Based, Intensive Holistic Lifestyle Intervention Among Type-2 Diabetes Patients - A Single Group Pre- And Post-intervention Study. Cureus 2022; 14:e22253. [PMID: 35350487 PMCID: PMC8933147 DOI: 10.7759/cureus.22253] [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] [Accepted: 01/25/2022] [Indexed: 11/11/2022] Open
Abstract
Background The present study assessed the efficacy of the residential, group-based, intensive holistic lifestyle intervention on glycaemic control. Materials and methods A one-group pre and post-intervention study was conducted among 145 people with diabetes for a period of one year from February 2019 to January 2020. The study population underwent "Brahma Kumaris Raja Yoga lifestyle" intervention. Outcome variables were changes in HbA1c levels and anthropometric parameters (like weight, BMI, etc.). Paired t-test was used to compare normally distributed numeric variables. Results The mean age was 52.39±5.79 years, with a male-female ratio close to 1:1. Mean HbA1c at baseline was 9.06±2.1%. The mean weight and BMI were 71.03±12.84 kg and 28.28±4.83kg/m2, respectively. Mean HbA1c value had shown a reduction of 1.60% (95%CI 1.17 to 1.90, p <0.001) at three months and 1.58% (95% CI 1.13-1.87, p<0.001) reduction at a six-month follow-up. Between the third and sixth months, there was no significant change in the HbA1c value. Mean weight reduced by 0.79 kg (95% CI 0.08-1.08, p=0.023) at six-month follow-up and mean BMI decreased by 0.31 units from baseline to three months (95% CI 0.05-0.56, p=0.017). A statistically significant reduction was observed in waist circumference at the third month (MD=1.61 95% CI =0.95 to 2.28, P<0.001) and sixth month (MD=1.53, 95% CI 0.82-2.25, p<0.001) follow-up. Conclusion This residential, group-based, intensive holistic lifestyle intervention showed a significant decrease in HbA1c levels and anthropometric parameters at three- and six-months follow-up, thereby improving the overall health and wellbeing of people with diabetes.
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Affiliation(s)
- Sahu Shrimant Kumar
- Diabetology and Holistic Care, J. Watumull Global Hospital and Research Centre, Mount Abu, IND
| | - M Santhi Sree
- Community Medicine, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, IND
| | - Mohandas Manjusha
- Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, IND
| | | | - Ramya B
- Diabetology, Dr. Mohan's Diabetes Specialities Centre, Chennai, IND
| | - Bala Kishore
- Vedic Sciences, MIT Art Design and Technology University, Pune, IND
| | - Rohini Sharma G
- Evidencian Science, Evidencian Research Associates, Bangalore, IND
| | - Jagat Jit Mohapatra
- Diabetology, J. Watumull Global Hospital and Research Centre, Mount Abu, IND
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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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Nagarathna R, Kumar S, Anand A, Acharya IN, Singh AK, Patil SS, Latha RH, Datey P, Nagendra HR. Effectiveness of Yoga Lifestyle on Lipid Metabolism in a Vulnerable Population-A Community Based Multicenter Randomized Controlled Trial. MEDICINES 2021; 8:medicines8070037. [PMID: 34357153 PMCID: PMC8303653 DOI: 10.3390/medicines8070037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/13/2021] [Accepted: 06/29/2021] [Indexed: 01/09/2023]
Abstract
Background: Dyslipidemia poses a high risk for cardiovascular disease and stroke in Type 2 diabetes (T2DM). There are no studies on the impact of a validated integrated yoga lifestyle protocol on lipid profiles in a high-risk diabetes population. Methods: Here, we report the results of lipid profile values of 11,254 (yoga 5932 and control 5322) adults (20–70 years) of both genders with high risk (≥60 on Indian diabetes risk score) for diabetes from a nationwide rural and urban community-based two group (yoga and conventional management) cluster randomized controlled trial. The yoga group practiced a validated integrated yoga lifestyle protocol (DYP) in nine day camps followed by daily one-hour practice. Biochemical profiling included glycated hemoglobin and lipid profiles before and after three months. Results: There was a significant difference between groups (p < 0.001 ANCOVA) with improved serum total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein in the yoga group compared to the control group. Further, the regulatory effect of yoga was noted with a significant decrease or increase in those with high or low values of lipids, respectively, with marginal or no change in those within the normal range. Conclusion: Yoga lifestyle improves and regulates (lowered if high, increased if low) the blood lipid levels in both genders of prediabetic and diabetic individuals in both rural and urban Indian communities.
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Affiliation(s)
- Raghuram Nagarathna
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru 560105, India; (A.K.S.); (S.S.P.); (H.R.N.)
- Correspondence: (R.N.); (A.A.)
| | - Saurabh Kumar
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India;
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India;
- Centre for Mind Body Medicine, PGIMER, Chandigarh 160012, India
- Centre for Cognitive Science and Phenomenology, Panjab University, Chandigarh 160014, India
- Correspondence: (R.N.); (A.A.)
| | - Ishwara N. Acharya
- Central Council for Research in Yoga & Naturopathy (CCRYN), Delhi 110058, India;
| | - Amit Kumar Singh
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru 560105, India; (A.K.S.); (S.S.P.); (H.R.N.)
| | - Suchitra S. Patil
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru 560105, India; (A.K.S.); (S.S.P.); (H.R.N.)
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Nair RG, Vasudev MM, Mavathur R. Role of Yoga and Its Plausible Mechanism in the Mitigation of DNA Damage in Type-2 Diabetes: A Randomized Clinical Trial. Ann Behav Med 2021; 56:235-244. [PMID: 34180500 DOI: 10.1093/abm/kaab043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although yoga is found to be beneficial in the management of type 2 diabetes (T2D), its mechanism of action is poorly understood. T2D is also known to be associated with increased oxidative stress (OS) and DNA damage. PURPOSE This study examines how yoga modulates OS-induced DNA damage and the efficiency of DNA repair in T2D conditions. METHODS In this assessor-masked randomized clinical trial, T2D subjects (n = 61), aged (Mean ± SD, 50.3 ± 4.2) were randomly allocated into Yoga group (31) that received 10 weeks of yoga intervention and Control (30) with routine exercises. Molecular and biochemical assessments were done before and after the intervention period. Structural Equation Modeling using "R" was used for mediation analysis. RESULTS At the end of the 10th week, Yoga group showed significant reduction in DNA damage indicators like Tail Moment (-5.88[95%CI: -10.47 to -1.30]; P = .013) and Olive Tail Moment (-2.93[95%CI: -4.87 to -1.00]; P < .01), oxidative DNA damage marker 8-OHdG (-60.39[95%CI: -92.55 to -28.23]; P < .001) and Fasting Blood Sugar (-22.58[95%CI: -44.33 to -0.83]; P = .042) compared to Control. OGG1 protein expression indicating DNA repair, improved significantly (17.55[95%CI:1.37 to 33.73]; P = .034) whereas Total Antioxidant Capacity did not (5.80[95%CI: -0.86 to 12.47]; P = 0.086). Mediation analysis indicated that improvements in oxidative DNA damage and DNA repair together played a major mediatory role (97.4%) in carrying the effect of yoga. CONCLUSION The beneficial effect of yoga on DNA damage in T2D subjects was found to be mediated by mitigation of oxidative DNA damage and enhancement of DNA repair. CLINICAL TRIAL INFORMATION (www.ctri.nic.in) CTRI/2018/07/014825.
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Affiliation(s)
- Rajesh G Nair
- Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA, Bangalore, India
| | - Mithila M Vasudev
- Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA, Bangalore, India
| | - Ramesh Mavathur
- Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA, Bangalore, India
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Raghuram N, Ram V, Majumdar V, SK R, Singh A, Patil S, Anand A, Judu I, Bhaskara S, Basa JR, Nagendra HR. Effectiveness of a Yoga-Based Lifestyle Protocol (YLP) in Preventing Diabetes in a High-Risk Indian Cohort: A Multicenter Cluster-Randomized Controlled Trial (NMB-Trial). Front Endocrinol (Lausanne) 2021; 12:664657. [PMID: 34177805 PMCID: PMC8231281 DOI: 10.3389/fendo.2021.664657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/23/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Though several lines of evidence support the utility of yoga-based interventions in diabetes prevention, most of these studies have been limited by methodological issues, primarily sample size inadequacy. Hence, we tested the effectiveness of yoga-based lifestyle intervention against diabetes risk reduction in multicentre, large community settings of India, through a single-blind cluster-randomized controlled trial, Niyantrita Madhumeha Bharat Abhiyan (NMB). Research Design and Methods NMB-trial is a multicentre cluster-randomized trial conducted in 80 clusters [composed of rural units (villages) and urban units (Census Enumeration Blocks)] randomly assigned in a 1:1 ratio to intervention and control groups. Participants were individuals (age, 20-70 years) with prediabetes (blood HbA1c values in the range of 5.7-6.4%) and IDRS ≥ 60. The intervention included the practice of yoga-based lifestyle modification protocol (YLP) for 9 consecutive days, followed by daily home and weekly supervised practices for 3 months. The control cluster received standard of care advice for diabetes prevention. Statistical analyses were performed on an intention-to-treat basis, using available and imputed datasets. The primary outcome was the conversion from prediabetes to diabetes after the YLP intervention of 3 months (diagnosed based upon HbA1c cutoff >6.5%). Secondary outcome included regression to normoglycemia with HbA1c <5.7%. Results A total of 3380 (75.96%) participants were followed up at 3 months. At 3 months post-intervention, overall, diabetes developed in 726 (21.44%) participants. YLP was found to be significantly effective in halting progression to diabetes as compared to standard of care; adjusted RRR was 63.81(95% CI = 56.55-69.85). The YLP also accelerated regression to normoglycemia [adjusted Odds Ratio (adjOR) = 1.20 (95% CI, 1.02-1.43)]. Importantly, younger participants (≤40 years) were found to regress to normoglycemia more effectively than the older participants Pinteraction<0.001. Conclusion Based on the significant risk reduction derived from the large sample size, and the carefully designed randomized yoga-based intervention on high-risk populations, the study is a preliminary but strong proof-of-concept for yoga as a potential lifestyle-based treatment to curb the epidemic of diabetes. The observed findings also indicate a potential of YLP for diabetes prevention in low/moderate risk profile individuals that needs large-scale validation. Trial Registration Clinical Trial Registration Number: CTRI/2018/03/012804.
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Affiliation(s)
| | - Venkat Ram
- Apollo Medical College, Hyderabad, India
| | - Vijaya Majumdar
- Division of Life Sciences, Swami Vivekananda Yoga University, Bengaluru, India
| | - Rajesh SK
- Division of Life Sciences, Swami Vivekananda Yoga University, Bengaluru, India
| | - Amit Singh
- Division of Life Sciences, Swami Vivekananda Yoga University, Bengaluru, India
| | - Suchitra Patil
- Division of Life Sciences, Swami Vivekananda Yoga University, Bengaluru, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ilavarasu Judu
- Division of Life Sciences, Swami Vivekananda Yoga University, Bengaluru, India
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8
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Mehra P, Anand A, Nagarathna R, Kaur N, Malik N, Singh A, Pannu V, Avti P, Patil S, Nagendra HR. Role of Mind-Body Intervention on Lipid Profile: A Cross-sectional Study. Int J Yoga 2021; 14:168-172. [PMID: 34188391 PMCID: PMC8191221 DOI: 10.4103/ijoy.ijoy_51_20] [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: 05/15/2020] [Revised: 12/12/2020] [Accepted: 03/23/2021] [Indexed: 11/04/2022] Open
Abstract
Background Yoga is a combination of physical-breathing and meditative techniques that assist in the unification of the mind-body, which improves the quality of life. It was shown that long-term Yoga practitioners had superior control over respiratory rate, reduced stress and anxiety, and a better-controlled lipid profile. Purpose We aimed to investigate the lipid profile of long-term yoga practitioners who were practicing yoga for more than 1 year in comparison with the nonyoga group. Methods A nationwide survey was conducted in which the long-term yoga practitioners (n = 76) and nonyoga practitioners (n = 80) were recruited for assessment for the lipid parameters. Results The mean (standard deviation) values of both groups were within normal range with serum cholesterol at 189.715 ± 20.4 and 180.88 ± 29.7 and triglycerides at 216.72 ± 92.5 and 207.665 ± 88.3, low-density lipoprotein at 126.65 ± 18.5 and 120.775 ± 26.5, and high-density lipoprotein at 47.17 ± 6.6 and 44.99 ± 7.0, respectively, in yoga and no-yoga groups. Conclusion The lipid profile values were similar in yoga and nonyoga practitioners in the 2017 survey.
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Affiliation(s)
- Priya Mehra
- Department of Biotechnology, Panjab University, Post Graduate Institute of Medical Education and Research, Bengaluru, Karnataka, India.,Department of Neurology, Neurosciences Research Lab, Post Graduate Institute of Medical Education and Research, Bengaluru, Karnataka, India
| | - Akshay Anand
- Department of Neurology, Neurosciences Research Lab, Post Graduate Institute of Medical Education and Research, Bengaluru, Karnataka, India.,Centre for Mind Body Medicine, PGIMER, Panjab University, Bengaluru, Karnataka, India.,Centre for Cognitive Sciences, Phenomenology and Philosophy, Panjab University, Bengaluru, Karnataka, India
| | | | - Navneet Kaur
- Department o Physical Education, Panjab University, Post Graduate Institute of Medical Education and Research, Bengaluru, Karnataka, India
| | - Neeru Malik
- Dev Samaj College of Education, Panjab University, Bengaluru, Karnataka, India
| | - Amit Singh
- S-VYASA University, Bengaluru, Karnataka, India
| | - Viraaj Pannu
- Government Medical College Hospital, Post Graduate Institute of Medical Education and Research, Chandigarh, Karnataka, India
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, Karnataka, India
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Rain M, Subramaniam B, Avti P, Mahajan P, Anand A. Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress? Front Psychol 2021; 12:635816. [PMID: 33935886 PMCID: PMC8081973 DOI: 10.3389/fpsyg.2021.635816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 12/19/2022] Open
Abstract
The global impact of Coronavirus Disease 2019 (COVID-19) is tremendous on human life, not only affecting the physical and mental health of population but also impacting the economic system of countries and individual itself. The present situation demands prompt response toward COVID-19 by equipping the humans with strategies to overcome the infection and stress associated with it. These strategies must not only be limited to preventive and therapeutic measures, but also aim at improving immunity and mental health. This can be achieved by yogic breathing techniques. In this perspective, we emphasize the importance of yogic breathing, Simha Kriya and Isha kriya, the simple yet effective breathing techniques.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Balachundhar Subramaniam
- Center for Anesthesia Research Excellence, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Mind Body Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India
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10
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Kumar S, Anand A, Nagarathna R, Kaur N, Sivapuram MS, Pannu V, Pal DK, Malik N, Singh AK, Nagendra HR. Prevalence of prediabetes, and diabetes in Chandigarh and Panchkula region based on glycated haemoglobin and Indian diabetes risk score. Endocrinol Diabetes Metab 2021; 4:e00162. [PMID: 33532605 PMCID: PMC7831224 DOI: 10.1002/edm2.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/17/2020] [Indexed: 01/12/2023] Open
Abstract
There is a rapid increase in the prevalence of diabetes in India. We wanted to review the status of prediabetes and diabetes in the combined population of Chandigarh and Panchkula region based on both Indian Diabetes Risk Score (IDRS) and Glycated Haemoglobin (HbA1c). A total of 1215 subjects were recruited during the screening process, out of which 444 i subjects have been analysed for the current study on the basis of high risk for IDRS (≥60) and their known diabetes status. This study included 431 subjects having high risk for IDRS (≥60) and 13 known subjects with diabetes (IDRS < 60) which were further analysed for biochemical and anthropometric parameters. The prevalence of diabetes was found to be 12.67% and prediabetes 11.69% in the combined population of Chandigarh and Panchkula. There was an increased level of fasting blood glucose (183.12 ± 68.61), postprandial blood glucose (262.57 ± 96.92), triglyceride (193.84 ± 119.88), very low-density lipoprotein (VLDL) (34.87 ± 15.42) and High Density Lipoprotein(HDL) (4.61 ± 1.39) in the said diabetes population. Mean HDL was found to be decreased in subjects having diabetes. Glucose-induced lipid intolerance study revealed significant alteration in triglyceride, HDL and VLDL. The study has revealed that high prevalence of diabetes in the sampled population when compared with the national average of 8.8%.
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Affiliation(s)
- Saurabh Kumar
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | - Akshay Anand
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | | | - Navneet Kaur
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
- Department of Physical EducationPanjab UniversityChandigarhIndia
| | - Madhava Sai Sivapuram
- Department of General MedicineDr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research FoundationChinna‐AvutapalliIndia
| | - Viraaj Pannu
- Government Medical College and Hospital Sector‐32ChandigarhIndia
| | - Deepak Kumar Pal
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | - Neeru Malik
- Dev Samaj College of EducationChandigarhIndia
| | - Amit Kumar Singh
- Swami Vivekananda Yoga Anusandhana Samsthana (S‐VYASA)BengaluruIndia
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Mishra A, Chawathey SA, Mehra P, Nagarathna R, Anand A, Rajesh SK, Singh A, Patil S, Sai Sivapuram M, Nagendra HR. Perceptions of benefits and barriers to Yoga practice across rural and urban India: Implications for workplace Yoga. Work 2020; 65:721-732. [PMID: 32310204 DOI: 10.3233/wor-203126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Even though Yoga is useful for prevention of obesity, diabetes and hypertension it is not universally practiced. The purpose of the study was to determine the benefits and barriers confronted by the community members while incorporating Yoga into routine practice and at workplace. OBJECTIVE This study explored the motivators and barriers to Yoga practice by estimating how these elements can be useful for development and incorporation of Yoga as a workplace activity and as a profession. METHODS A nationwide multi-centered prospective study was conducted recruiting individuals of different age groups and geographical zones in India. Participants of Yoga intervention group were administered a questionnaire with 19 items on benefits (YBS) and 18 items on barriers for Yoga practice (BFYS). Data was analyzed using SPSS v21 software. RESULTS Majority of the participants perceived Yoga improves "physical fitness", "relaxes mind and body", improves "stamina", across age groups. "Lifestyle", "Family commitments", "Physical over-exertion", "No Encouragement from family", "Occupational commitments" and "Few places to do Yoga" were perceived barriers across various geographical zones. Despite knowing the benefits of Yoga, these barriers prevented individuals from integrating it into their daily routine. CONCLUSIONS The present study may be considered as a starting point for development of Yoga as a workplace activity and a profession based on the perceptions of its various benefits and barriers faced by a large study population spanning an entire nation.
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Affiliation(s)
| | | | - Priya Mehra
- Neurosciences Research Lab, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Akshay Anand
- Neurosciences Research Lab, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, India
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Nagarathna R, Bali P, Anand A, Srivastava V, Patil S, Sharma G, Manasa K, Pannu V, Singh A, Nagendra HR. Prevalence of Diabetes and Its Determinants in the Young Adults Indian Population-Call for Yoga Intervention. Front Endocrinol (Lausanne) 2020; 11:507064. [PMID: 33362708 PMCID: PMC7759624 DOI: 10.3389/fendo.2020.507064] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background The young Indian population, which constitutes 65% of the country, is fast adapting to a new lifestyle, which was not known earlier. They are at a high risk of the increasing burden of diabetes and associated complications. The new evolving lifestyle is not only affecting people's health but also mounting the monetary burden on a developing country such as India. Aim We aimed to collect information regarding the prevalence of risk of diabetes in young adults (<35 years) in the 29 most populous states and union territories (7 zones) of India, using a validated questionnaire. Methods A user-friendly questionnaire-based survey using a mobile application was conducted on all adults in the 29 most populous states/union territories of India, after obtaining ethical clearance for the study. Here, we report the estimation of the prevalence of the risk of diabetes and self-reported diabetes on 58,821 young individuals below the age of 35 years. Risk for diabetes was assessed using a standardized instrument, the Indian diabetes risk score (IDRS), that has 4 factors (age, family history of diabetes, waist circumference, and physical activity). Spearman's correlation coefficient was used to check the correlations. Results The prevalence of high (IDRS score > 60), moderate (IDRS score 30-50), and low (IDRS < 30) diabetes risk in young adults (<35 years) was 10.2%, 33.1%, and 56.7%, respectively. Those with high-risk scores were highest (14.4%) in the Jammu zone and lowest (4.1%) in the central zone. The prevalence of self-reported diabetes was 1.8% with a small difference between men (1.7%) and women (1.9%), and the highest (8.4%) in those with a parental history of diabetes. The south zone had the highest (2.5%), and the north west zone had the lowest (4.4%) prevalence. Conclusions Indian youth are at high risk for diabetes, which calls for an urgent action plan through intensive efforts to promote lifestyle behavior modifications during the pandemics of both communicable and noncommunicable diseases.
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Affiliation(s)
| | - Parul Bali
- Department of Biophysics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Srivastava
- College of Social Work, University of Kentucky, Lexington, KY, United States
| | - Suchitra Patil
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Guruprasad Sharma
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Krishna Manasa
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Viraaj Pannu
- Government Medical College and Hospital Sector 32, Chandigarh, India
| | - Amit Singh
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Hongasandra R. Nagendra
- Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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Sivapuram MS, Nagarathna R, Anand A, Patil S, Singh A, Nagendra HR. Prevalence of Alcohol and Tobacco Use in India and Implications for COVID-19 - Niyantrita Madhumeha Bharata Study Projections. J Med Life 2020; 13:499-509. [PMID: 33456598 PMCID: PMC7803324 DOI: 10.25122/jml-2020-0079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022] Open
Abstract
Abuse of legal substances in India includes alcohol and tobacco, which are the major risk factors for various non-communicable diseases and deaths. The current pandemic has identified tobacco consumption as a risk factor for COVID-19, highlighting the need to control substance abuse. The objective of this study was to estimate the prevalence of substance abuse in India and discuss the cost-effective public health strategies (such as yoga) to alleviate COVID-related anxiety in order to prevent substance abuse and its associated co-morbidities such as type 2 diabetes mellitus. This study reports the data on tobacco and alcohol abuse from a nationwide randomized two-arm diabetes control trial (Niyantrita Madhumeha Bharata, 2017) conducted by the Indian Yoga Association (IYA) through Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru. Data of 30,354 participants who abuse tobacco and 30,159 participants who abuse alcohol were collected all over India. The prevalence is estimated at around 8.7% for alcohol abuse and 7.9% for tobacco abuse, Arunachal Pradesh state ranking the highest regarding both alcohol and tobacco abuse, while the Tripura state ranked the lowest. School and college-based mandatory yoga programs need to be implemented to prevent the increase of substance abuse in India to alleviate the psychosocial stress of adolescents and college-going students, besides the installation of the mindfulness-based diabetes yoga protocol (DYP) in the wellness centers of Ayushman Bharat.
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Affiliation(s)
- Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, Andhra Pradesh, India
| | - Raghuram Nagarathna
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Suchitra Patil
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Amit Singh
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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Venkatrao M, Nagarathna R, Majumdar V, Patil SS, Rathi S, Nagendra H. Prevalence of Obesity in India and Its Neurological Implications: A Multifactor Analysis of a Nationwide Cross-Sectional Study. Ann Neurosci 2020; 27:153-161. [PMID: 34556954 PMCID: PMC8455012 DOI: 10.1177/0972753120987465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND India is undergoing a rapid epidemiological transition, from underweight to overweight/obese population. Obesity is a major risk factor in type 2 diabetes and cardiovascular diseases, and is also implicated as a factor in neurological diseases such as Alzheimer's disease. A robust, pan-Indian estimate of obesity is not yet available. PURPOSE This study estimates the pan-Indian prevalence of obesity, stratified across nonmodifiable (age and gender) and modifiable (education and physical activity levels) factors, and across zones and urban/rural. METHODOLOGY Data for 1,00,531 adults from a nationwide randomized cluster sample survey (Niyantrita Madhumeha Bharata 2017, phase 1) were analyzed. Obesity was determined using body mass index, and cross-tabulations were calculated across zones, age, gender, education, physical activity, and area. To determine statistical significance, t-tests were used. The odds of obesity within each category of the various factors were calculated using binary logistic regression. RESULTS Prevalence of obesity in India is 40.3%. Zonal variations were seen as follows: south highest at 46.51% and east lowest at 32.96%. Obesity was higher among women than men (41.88% vs. 38.67%), urban than rural (44.17% vs. 36.08%), and over 40 than under 40 (45.81% vs. 34.58%). More education implied a higher obesity (44.6% college vs. 38% uneducated), as did lowered physical activity (43.71% inactive vs. 32.56% vigorously active). The odds ratio for physical activity was 3.83, stronger than age (1.58), education (1.4), urban (1.3), and gender (1.2). CONCLUSION Obesity levels in India are very high, across all zones. The odds of being obese increases with age, and is higher among women and among urban dwellers. Obesity is the highest among aging urban men and women who are college educated and are sedentary. Physical activity and aging are the strongest determinants of obesity. Given the high cost of obesity in terms of type 2 diabetes, cardiovascular diseases, and Alzheimer's disease, urgent public health measures are necessary to reduce its impact.
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Affiliation(s)
- Murali Venkatrao
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Raghuram Nagarathna
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Vijaya Majumdar
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Suchitra S. Patil
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Sunanda Rathi
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Hongasandra Nagendra
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
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Podder V, Nagarathna R, Anand A, Patil SS, Singh AK, Nagendra HR. Physical Activity Patterns in India Stratified by Zones, Age, Region, BMI and Implications for COVID-19: A Nationwide Study. Ann Neurosci 2020; 27:193-203. [PMID: 34556960 PMCID: PMC8455010 DOI: 10.1177/0972753121998507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022] Open
Abstract
Rationale: India has a high prevalence of noncommunicable diseases (NCDs), which can be lowered by regular physical activity. To understand this association, recent population data is required which is representative of all the states and union territories of the country. Objective: We aimed to investigate the patterns of physical activity in India, stratified by zones, body mass index (BMI), urban, rural areas, and gender. Method: We present the analysis of physical activity status from the data collected during the phase 1 of a pan-India study. This (Niyantrita Madhumeha Bharata 2017) was a multicenter pan-India cluster sampled trial with dual objectives. A survey to identify all individuals at a high risk for diabetes, using a validated instrument called the Indian Diabetes Risk Score (IDRS), was followed by a two-armed randomized yoga-based lifestyle intervention for the primary prevention of diabetes. The physical activity was scored as per IDRS (vigorous exercise or strenuous at work = 0, moderate exercise at home/work = 10, mild exercise at home/work = 20, no exercise = 30). This was done in a selected cluster using a mobile application. A weighted prevalence was calculated based on the nonresponse rate and design weight. Results: We analyzed the data from 2,33,805 individuals; the mean age was 41.4 years (SD 13.4). Of these, 50.6% were females and 49.4% were males; 45.8% were from rural areas and 54% from urban areas. The BMI was 24.7 ± 4.6 kg/m2. Briefly, 20% were physically inactive and 57% of the people were either inactive or mildly active. 21.2% of females were found physically inactive, whereas 19.2% of males were inactive. Individuals living in urban localities were proportionately more inactive (21.7% vs. 18.8%) or mildly active (38.9% vs. 34.8%) than the rural people. Individuals from the central (29.6%) and south zones (28.6%) of the country were also relatively inactive, in contrast to those from the northwest zone (14.2%). The known diabetics were found to be physically inactive (28.3% vs. 19.8%) when compared with those unaware of their diabetic status. Conclusion: 20% and 37% of the population in India are not active or mildly active, respectively, and thus 57% of the surveyed population do not meet the physical activity regimen recommended by the World Health Organization. This puts a large Indian population at risk of developing various NCDs, which are being increasingly reported to be vulnerable to COVID-19 infections. India needs to adopt the four strategic objectives recommended by the World Health Organization for reducing the prevalence of physical inactivity.
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Affiliation(s)
- Vivek Podder
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana, India
| | - Raghuram Nagarathna
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Suchitra S Patil
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Amit Kumar Singh
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
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Sivapuram MS, Srivastava V, Kaur N, Anand A, Nagarathna R, Patil S, Biman S, Chander I, Jyoti S, Nagendra HR. Ayurveda Body-Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions. Ann Neurosci 2020; 27:214-223. [PMID: 34556962 PMCID: PMC8454998 DOI: 10.1177/09727531211000040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/11/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups (P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha (pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.
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Affiliation(s)
- Madhava Sai Sivapuram
- Department of General Medicine, Dr Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, Andhra Pradesh, India
| | - Vinod Srivastava
- Department of Social Work, College of Health and Behavioral Sciences, Fort Hays State University, Hays, USA
| | - Navneet Kaur
- Department of Physical Education, Panjab University, Chandigarh
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Collaborative Centre for Mind Body Intervention through Yoga, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Cognitive Sciences and Phenomenology, Panjab University, Chandigarh, india
| | - Raghuram Nagarathna
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Suchitra Patil
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Saranga Biman
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | | | - Saras Jyoti
- Department of AYUSH, Haryana Yoga Council, Haryana, India
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Nagarathna R, Tyagi R, Battu P, Singh A, Anand A, Nagendra HR. Assessment of risk of diabetes by using Indian Diabetic risk score (IDRS) in Indian population. Diabetes Res Clin Pract 2020; 162:108088. [PMID: 32087269 DOI: 10.1016/j.diabres.2020.108088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/30/2020] [Accepted: 02/18/2020] [Indexed: 01/18/2023]
Abstract
AIMS To screen the Indian population for Type 2 Diabetes Mellitus (DM) based on Indian Diabetes Risk Score. Our main question was; Does Indian Diabetic risk score (IDRS) effectively screen diabetic subjects in Indian population? METHODS Multi-centric nationwide screening for DM and its risk in all populous states and Union territories of India in 2017. It is the first pan India DM screening study conducted on 240,000 subjects in a short period of 3 months based on IDRS. This was a stratified translational research study in randomly selected cluster populations from all zones of rural and urban India. Two non-modifiable (age, family history) and two modifiable (waist circumference & physical activity) were used to obtain the score. High, moderate and low risk groups were selected based on scores. RESULTS In this study 40.9% subjects were detected to be high risk, known or newly diagnosed DM subjects in urban and rural regions. IDRS could detect 78.1% known diabetic subjects as high risk group. Age group 50-59 (17.4%); 60-69 (22%); 70-79 (22.8%); >80 (19.2%) revealed high percentage of subjects. ROC was found to be 0.763 at CI 95% of 0.761-0.765 with statistical significance of p < 0.0001. At >50 cut off, youden index showed the sensitivity of 78.05 and specificity of 62.68. Regression analysis revealed that IDRS and Diabetes are significantly positively associated. CONCLUSIONS Data reveals that IDRS is a good indicator of high risk diabetic subjects.
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Affiliation(s)
| | - Rahul Tyagi
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Priya Battu
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Singh
- Swami Vivekananda Yoga Research Foundation, Bengaluru, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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18
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Venkatrao M, Nagarathna R, Patil SS, Singh A, Rajesh SK, Nagendra H. A composite of BMI and waist circumference may be a better obesity metric in Indians with high risk for type 2 diabetes: An analysis of NMB-2017, a nationwide cross-sectional study. Diabetes Res Clin Pract 2020; 161:108037. [PMID: 32004696 DOI: 10.1016/j.diabres.2020.108037] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/26/2019] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
AIMS Obesity measurement is a vital component of most type 2 diabetes screening tests; while studies had shown that waist circumference (WC) is a better predictor in South Asians, there is evidence that BMI is also effective. Our objective was to evaluate the efficacy of BMIWC, a composite measure, against BMI and WC. METHODS Using data from a nationwide randomized cluster sample survey (NMB-2017), we analyzed 7496 adults at high risk for type 2 diabetes. WC, BMI, and BMIWC were evaluated using Odds Ratio (OR), and Classification scores (Sensitivity, Specificity, and Accuracy). These were validated using Indian Diabetes Risk Score (IDRS) by replacing WC with BMI and BMIWC, and calculating Sensitivity, Specificity, and Accuracy. RESULTS BMIWC had higher OR (2·300) compared to WC (1·87) and BMI (2·26). WC, BMI, and BMIWC were all highly Sensitive (0·75, 0·81, 0·70 resp.). But BMIWC had significantly higher Specificity (0.36) when compared to WC and BMI (0.27 each). IDRSWC, IDRSBMI, and IDRSBMIWC were all highly Sensitive (0·87, 0·88, 0·82 resp.). But IDRSBMIWC had significantly higher Specificity (0·39) compared to IDRSWC and IDRSBMI (0·30, 0·31 resp.). CONCLUSIONS Both WC and BMI are good predictors of risk for T2DM, but BMIWC is a better predictor, with higher Specificity; this may indicate that Indians with high values of both central (high WC) and general (BMI > 23) obesity carry higher risk for type 2 diabetes than either one in isolation. Using BMIWC in IDRS improves its performance on Accuracy and Specificity.
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Affiliation(s)
- Murali Venkatrao
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Raghuram Nagarathna
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Suchitra S Patil
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Amit Singh
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - S K Rajesh
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Hongasandra Nagendra
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India.
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Knowledge, Attitude, and Practice of Yoga in Rural and Urban India, KAPY 2017: A Nationwide Cluster Sample Survey. MEDICINES 2020; 7:medicines7020008. [PMID: 32033426 PMCID: PMC7168227 DOI: 10.3390/medicines7020008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/11/2020] [Accepted: 01/19/2020] [Indexed: 12/04/2022]
Abstract
Background: To examine the knowledge, attitudes, and practice gap of yoga across India based on implicit perceptions. Methods: The present study is a nationwide door-to-door survey conducted using a questionnaire/screening form. The data were collected from a national survey conducted under the Niyantrit Madhumeh Bharat (NMB) program initiated by The Ministry of Ayurveda, Yoga, Unani, Siddha, Homeopathy (AYUSH), Government of India, from all major zones of the country. A total of 162,330 participants who joined the NMB program were recruited in our study. Results: Out of the total respondents to the survey, it was observed that 11.8% [13,336/112,735] practice yoga, which was highest in the north zone [4,567/112,735] and lowest in the east zone [971/112,735]. Out of 101,643 respondents, 94,135 of the individuals who participated in the survey believed that yoga improved their lifestyle, and 90,102/98,518 believed that yoga prevented diabetes, revealing a huge knowledge–practice gap. Conclusions: The scale of the knowledge–practice gap coupled with the general acceptability of yoga calls for a change in the conventional healthcare provisions by its integration with modern medicine. The population-wide positive perceptions about yoga as a preventive health tool can not only catalyze consensus disease-specific yoga modules but also bridge the knowledge–practice gap that exists because of limited yoga centers and professionals.
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Nagarathna R, Kaur N, Anand A, Sharma K, Dada R, Sridhar P, Sharma P, Kumar Singh A, Patil S, Nagendra HR. Distribution of glycated haemoglobin and its determinants in Indian young adults. Diabetes Res Clin Pract 2020; 159:107982. [PMID: 31846666 DOI: 10.1016/j.diabres.2019.107982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/23/2019] [Accepted: 12/12/2019] [Indexed: 01/15/2023]
Abstract
AIM The aim of the present study is to understand the distribution of A1c in four different age groups in young adults and its relation to other co-variants. METHODS The countrywide data was collected in 2017 in Individuals with high risk analysed by Indian Diabetes Risk Score (IDRS) and self-declared diabetics were identified after screening a sample of 240,968 individuals from rural (4 villages of about 500 adults each) and urban (4 census enumeration blocks of about 500 adults each) population spanning 65 districts of 29 states/UTs of Indian subcontinent. Blood tests and other detailed assessments were carried out on this selected group. This study presents the analysis of the A1c values of 2862 young adults (<35 years). RESULTS In the age group of 31-34 years, the proportion of Diabetes (22.36%) and Prediabetes (9.86%) was higher in comparison with younger age groups. Also, Diabetes (7.3%) and Prediabetes (22%) were highest among those who had parental history of DM in both parents as compared to those with Diabetes history in one parent [Diabetes (7.1%) or Prediabetes (19.0%)] and no Diabetes Parental History (Diabetes (7.3%) and Prediabetes (18.3%) cases. BMI was found to play a significant positive correlation with Diabetes and Prediabetes (p < 0.001) with range of A1c. CONCLUSION Age, BMI and parental history were found to be correlated with A1c levels in IDRS screened high-risk population. With increasing age, the proportion of Diabetics and Prediabetics also increased with positive correlation of age with A1c levels.
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Affiliation(s)
| | - Navneet Kaur
- Department of Physical Education, Panjab University Chandigarh, India; Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Kanupriya Sharma
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rima Dada
- Department of Anatomy, Laboratory of Molecular Reproduction & Genetics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Purnendu Sharma
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | | | - Suchitra Patil
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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Nagarathna R, Tyagi R, Kaur G, Vendan V, Acharya IN, Anand A, Singh A, Nagendra HR. Efficacy of a Validated Yoga Protocol on Dyslipidemia in Diabetes Patients: NMB-2017 India Trial. MEDICINES 2019; 6:medicines6040100. [PMID: 31614579 PMCID: PMC6963794 DOI: 10.3390/medicines6040100] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022]
Abstract
Background: Dyslipidemia is considered a risk factor in Type 2 diabetes mellitus (T2DM) resulting in cardio-vascular complications. Yoga practices have shown promising results in alleviating Type 2 Diabetes pathology. Method: In this stratified trial on a Yoga based lifestyle program in cases with Type 2 diabetes, in the rural and urban population from all zones of India, a total of 17,012 adults (>20 years) of both genders were screened for lipid profile and sugar levels. Those who satisfied the selection criteria were taught the Diabetes Yoga Protocol (DYP) for three months and the data were analyzed. Results: Among those with Diabetes, 29.1% had elevated total cholesterol (TC > 200 mg/dL) levels that were higher in urban (69%) than rural (31%) Diabetes patients. There was a positive correlation (p = 0.048) between HbA1c and total cholesterol levels. DYP intervention helped in reducing TC from 232.34 ± 31.48 mg/dL to 189.38 ± 40.23 mg/dL with significant pre post difference (p < 0.001). Conversion rate from high TC (>200 mg/dL) to normal TC (<200 mg/dL) was observed in 60.3% of cases with Type 2 Diabetes Mellitus (T2DM); from high LDL (>130 mg/dL) to normal LDL (<130 mg/dL) in 73.7%; from high triglyceride (>200 mg/dL) to normal triglyceride level (<200 mg/dL) in 63%; from low HDL (<45 mg/dL) to normal HDL (>45 mg/dL) in 43.7% of T2DM patients after three months of DYP. Conclusions: A Yoga lifestyle program designed specifically to manage Diabetes helps in reducing the co-morbidity of dyslipidemia in cases of patients with T2DM.
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Affiliation(s)
| | - Rahul Tyagi
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Gurkeerat Kaur
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Vetri Vendan
- Swami Vivekananda Yoga Research Foundation, Bengaluru 560105, India.
| | - Ishwara N Acharya
- Director, Central Council for Research in Yoga & Naturopathy (CCRYN), Delhi 110058, India.
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Amit Singh
- Swami Vivekananda Yoga Research Foundation, Bengaluru 560105, India.
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