Role of Mind-Body Intervention on Lipid Profile: A Cross-sectional Study.

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.

Impact of Yoga on Mental Health and Sleep Quality Among Mothers of Children With Intellectual Disability.

OBJECTIVES: Caring for a child with Intellectual Disability Disorder (IDD) is a tremendously stressful task for any mother, leading to poor mental health and compromised quality of life. Anxiety, depression, stress, and poor sleep quality are frequently observed in mothers with Intellectual Disability Disorder child. This study assessed the impact of a 1-month yoga intervention on anxiety, depression, stress and sleep quality in mothers of children with intellectual disabilities. METHODS: We selected 53 mothers of children with intellectual disabilities between the age of 30 and 50 years (mean age, 40.2 ± 7.1 years). Of these mothers, 28 received 1.5 hours of integrated yoga practice consisting of physical postures, breathing techniques, relaxation techniques and meditation every other day for 1 month. The remaining 25 mothers, who served as the control group, participated in a group discussion session twice a week for 1 month. MAIN OUTCOME MEASURES: All mothers were assessed for anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), stress with the Perceived Stress Scale (PSS), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI) at baseline and at 1 month. RESULTS: Significant improvements in anxiety (-24.8%; P < .001), depression (-15.9%; P < .001), sleep quality (-25.1%; P < .05) and stress (-11.4%; P < .001) were observed after 1 month compared with baseline in the yoga group. In a similar fashion, a significant decrease in anxiety (-12.3%; P < .001), depression (-8.6%; P < .001) and sleep quality (-5.6%; P < .001) was seen in the control group as well. The between-group comparison of post-intervention scores revealed a significantly better improvement in anxiety (P <.001), depression (P < .001), perceived stress (P < .001) and sleep quality (P = .012) in the yoga group compared with the control group. CONCLUSIONS: Our study indicates that yoga can be used as an effective intervention to improve psychopathology and sleep quality in mothers of children with intellectual disabilities. We recommend future randomized controlled trials with larger sample sizes and of longer duration to study the long-term effects of yoga.

A Perspective on Yoga as a Preventive Strategy for Coronavirus Disease 2019.

The pandemic outbreak of coronavirus disease 2019 (COVID-19) infection caused by severe acute respiratory syndrome-coronavirus 2 has led to profound public health crisis. In particular, individuals with preexisting conditions of heart disease, diabetes, cerebrovascular diseases and the elderly are most vulnerable to succumb to this infection. The current COVID-19 emergency calls for rapid development of potential prevention and management strategies against this virus-mediated disease. There is a plethora of evidence that supports the add-on benefits of yoga in stress management, as well as prevention and management of chronic noncommunicable diseases. There are some studies on the effect of yoga in communicable diseases as well but very few for acute conditions and almost none for the rapidly spreading infections resulting in pandemics. Based on the available scientific evidences on yoga in improving respiratory and immune functions, we have formulated very simple doable integrated yoga modules in the form of videos to be practiced for prevention of the disease by children, adults, and the elderly.

Development and Testing of an Audio-Visual Self-Help Yoga Manual for Indian Caregivers of Persons with Schizophrenia Living in the Community: A Single-Blind Randomized Controlled Trial.

BACKGROUND: To test the feasibility and effectiveness of an audio-visual self-help audio-visual yoga manual on burden of Indian caregivers of persons with schizophrenia, living in the community. METHODS: An earlier developed yoga program for caregivers of schizophrenia was remodeled into an audio-visual self-help manual in three languages and validated by mental health and yoga experts. 48 consenting primary family caregivers of outpatients with schizophrenia were screened, recruited, and allotted randomly to Yoga or Care as Usual Group. Participants in Yoga group were taught yoga from the self-help manual (1 session of 1 h every month for 5 months). The caregivers were asked to follow the manual for the remaining month at home. Assessments of burden, perceived stress, quality of life, and anxiety-depression were conducted by a rater blind to the group status at baseline and at the end of every month. RESULTS: Post factoring for missing data, Repeatedmeasure ANOVA was conducted; which showed that there was no significant difference between the group that practiced the selfhelp yoga manual and the care as usual group. The caregivers who practiced yoga at home maintained an average of 50% attendance and "very well" level of yoga performance. CONCLUSION: The audio-visual self-help yoga manual was found to be feasible to use by the caregivers even though its effectiveness could not be ascertained due to high attrition.

Is the Indian Dietary Pattern Associated WithType 2 Diabetes? A Pan-India Randomized Cluster Sample Study.

BACKGROUND: Diabetes is associated strongly with many neurodegenerative diseases and is also a lifestyle disorder. A good glycemic status depends on diet management and physical activity. There are several studies available on the relationship between diet habits and impact on diabetes. PURPOSE: The objective of this study was to check the association of different dietary factors with glucose levels and lipid values in type 2 diabetes from a part of a large nationwide trial. METHODS: This was the data fromapan-India multicentered cluster randomized controlled study covering 60 states and 4 union territories; 17,285 individuals were surveyed for dietary factors. Amongst them, data of 12,500 individuals were analyzed.Males were 54% and 60% individuals were from urban areas. RESULTS: The analysis of the results showed that consumption (usual/often) of milk(odds ratio, OR = 7.180), meat (OR = 6.81), less fiber (OR = 17.77), and less fruits (OR = 14.71) was strongly and positively associated with fasting blood glucose (P<.001). The postprandial blood glucose (PPBG) in diabetes individuals also had a strong positive association (P<.001) with consumption (usual/often) of meat (OR = 22.82) and milk (OR = 17.19). In prediabetes individuals, milk was significantly (P<.001) associated with fasting blood glucose (OR = 2.74). In nondiabetes individuals also, milk was significantly associated with postprandial blood glucose (OR = 2.56). Consumption of meat was associated with high cholesterol (OR = 1.465).Consumption of junk food was associated significantly (P <.001)with the status of known diabetes (OR = 1.345) and known hypertension (OR = 1.247). CONCLUSION: Consumption of milk, meat, less vegetables, less fruits, and junk food has a significant effect on the glycemic status and cholesterol levels, and also on the status of known diabetes and hypertension.

Depression in High-Risk Type 2 Diabetes Adults.

BACKGROUND: Patients suffering from diabetes mellitus are two to three times more vulnerable to develop depressive symptomatology. PURPOSE: To report the association between depression and high-risk diabetes in India. METHODS: A total of 1,606 adults were recruited for the study. A patient health questionnaire was used to determine the depression on the basis of score. A statistical analysis was done using analysis of covariance (ANCOVA) and binary logistic regression to determine the association between diabetes categories and four degrees of depression. RESULTS: Out of 1,606 participants, 52.6% were males and 47.4% were females, 56.4% belonged to the urban area and 43.6% to the rural area. However, 19.5% (314) had diabetes; 29.1% of diabetes individuals had minimal depression, 38.7% had mild, 17.2% moderate, 12.0% moderately severe, and 3.1% had severe depression. In the self-reported diabetic participant group (N = 142), there was a significantly higher degree of severe depression (3.3%) in the uncontrolled group (HbA1c >7%) as compared to the well-controlled diabetes group (HbA1c <7%). ANCOVA in gender differences in the uncontrolled diabetes group showed that male gender had significantly (P = -.02) higher mean scores of depression. CONCLUSION: This study found that there is a positive association between depression and uncontrolled diabetes in male gender.

Niyantrita Madhumeha Bharata 2017, Methodology for a Nationwide Diabetes Prevalence Estimate: Part 1.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) poses an ever-increasing threat to people's health worldwide. India has reported high rates of incidence of T2DM. The dangers make accurate assessment of its burden and intervention of lifestyle change, an urgent necessity. AIMS AND OBJECTIVES: The aim of the study was to estimate the nationwide prevalence of prediabetes and diabetes, followed by a translational lifestyle trial. METHODOLOGY: The Indian Yoga Association was commissioned in 2016-2017 by the Government of India to conduct this study which was undertaken in two phases: Phase 1 was to estimate the prevalence of prediabetes and diabetes across the country, and Phase 2 was to conduct a randomized controlled trial using a validated yoga lifestyle protocol. This paper highlights the unique methodology of Phase 1 of the study. The first stage was screening (February to April 2017) for adults (>20 years) with high risk for diabetes on Indian diabetes risk score (IDRS) on mobile app, using a random cluster sampling survey method. All households in the rural (4 villages with about 500 adult population/village) and urban (2 census enumeration blocks [CEBs] of about 1000 adult population/block) sectors of 65 districts (one per ten districts in the entire country) from 29 out of 35 states of India were approached. In the second stage, detailed assessments (sociodemographic, clinical details, A1c, lipid profile, body mass index, stress, and tobacco) were carried out on those with high risk on IDRS and on all self-reported diabetes individuals. RESULTS: In the first stage of door-to-door visit, 240,968 adults in all households of the selected clusters of villages and CEBs were approached. Of these, 162,330 responded. The respondents in the second stage for detailed assessments in the selected cohort were 50,199 (48% rural and 52% urban) adults. Of these, 7472 were self-reported known diabetes adults and the remaining were 42,737. Prevalence estimates for the country will follow in the future publications. CONCLUSION: This rapid survey completed within 3 months in the entire country using trained volunteers offers the methodology to obtain a quick estimate of diabetes and high-risk population to implement any lifestyle program.

Methodology of Niyantrita Madhumeha Bharata Abhiyaan-2017, a Nationwide Multicentric Trial on the Effect of a Validated Culturally Acceptable Lifestyle Intervention for Primary Prevention of Diabetes: Part 2.

BACKGROUND: The rapidly increasing diabetes burden, reaching epidemic proportions despite decades of efforts, reflects our failure to translate the proven evidence for prevention of diabetes. Yoga, with its holistic approach, alters the habituated patterns of lifestyles and behaviour. Motivated by the accumulating evidence, the Government of India funded a large randomized controlled trial. AIMS AND OBJECTIVES: The twin objectives were: (a) estimate the prevalence of prediabetes and diabetes through a parallel multisite stratified cluster sampling method and (b) implement NMB 2017 (niyantrita madhumeha bharata abhiyaan), a randomized control trial using yoga based lifestyle program. MATERIALS AND METHODS: Screening for Indian Diabetes Risk score(IDRS) was conducted in randomly selected clusters in all 7 zones (65 districts from 29 states/union territories) of India. This was followed by detailed assessments in those with known diabetes and high risk (≥60) on IDRS. Those who satisfied the selection criteria and consented were recruited for the two armed waitlisted randomized control trial. A validated remedial diabetesspecific integrated yoga lifestyle module was taught to the experimental arm by certified volunteers of Indian Yoga Association. Followup assessments were done after 3 months in both groups. In this article, we report the methodology of the trial. RESULTS: Response to door to door visits (n-240,968 adults >20yrs) in randomly selected urban and rural households for screening was 162,330; detailed assessments (A1c, lipid profile, BMI, stress, tobacco etc) were performed on 50,199 individuals. Of these 12466 (6531 yoga 5935 control) consented and for the RCT; 52% females, 48% males; 38% rural, 62% urban; BMI 21.1 ± 3.8; waist circumference 91.7 ± 11.9. A1c in diabetes subjects in yoga group was 7.63 ± 2.17 and 7.86 ± 2.13 in control group. CONCLUSION: This unique methodology provides the evidence to implement a validated yoga life style module using yoga volunteers in all parts of the country which is an urgent need to prevent India from becoming the global capital for diabetes.

Effect of anapanasati meditation on verbal aggression: A randomized controlled trial.

BACKGROUND AND PURPOSE: Aggression is increasing in society, leading to health hazards. The aim of the present study is to investigate the effect of anapanasati meditation on verbal aggression in healthy individuals. MATERIALS AND METHODS: In this randomized controlled trial, 140 participants were screened and 90 participants were randomly allocated to experimental and control groups, with 45 participants in each group. The Verbal Aggressiveness Scale (VAS) was used to assess the verbal aggression score, and anapanasati meditation was given as an intervention. The experimental group practiced anapanasati meditation every day for 6 months, and the control group did not receive any intervention. RESULTS: The experimental group showed a significant reduction in VAS (p < 0.01) score after the intervention, whereas the reduction was not significant in the control group. CONCLUSION: This study showed that after a 6-month intervention, verbal aggression decreased significantly in the experimental group compared with the control group.

Effect of Residential Yoga Camp on Psychosocial Fitness of Adolescents.

BACKGROUND: Adolescence is a key phase of socialization, where improved psychosocial fitness helps to promote socioeconomic productivity in societies. Psychosocial fitness also has an impact on the academic performance, overall health, and quality of life, throughout life. The present study evaluates the effect of yoga intervention on psychosocial fitness among adolescents. MATERIALS AND METHODS: A single group, pre and post yoga interventional study was carried out in three independent cohorts (batches 1, 2, and 3), having sample size of 148, 167, and 195 respectively. A 7-day integrated yoga intervention was given in a residential setting. Psychosocial assessments included social competence, empathy, altruism, parent relationship, and peer friendship. Data were collected from the participants and their parents using respective versions of the scales. While pre- and post-data were collected from all the adolescent participants, pre- and post-data from parents were collected for 340 and 43 parents only. The objective of the analyses was to evaluate the effect of the yoga program and check the consistency of these effects. RESULTS: Significant changes (P < 0.05) were seen in social competence, empathy, and altruism in batches 2 and 3, whereas changes in batch 1 showed nonsignificant improvements. Analyses of the parental data indicated a significant improvement in parent relationship (P = 0.035) and also nonsignificant improvement in all other outcomes. CONCLUSION: Results suggested that yoga intervention might help in improving psychosocial fitness in adolescents. It also helped to demonstrate that administering yoga was acceptable and feasible in a residential setting.

Lifestyle - A Common Denominator for the Onset and Management of Migraine Headache: Complementing Traditional Approaches with Scientific Evidence.

BACKGROUND: Ayurveda and Yoga have gained popularity in the management of various chronic health problems associated with pain including migraine headache. It is evident from both scientific as well as traditional literature that stress, diet, sleep, and exposure to extreme climatic conditions act as triggering factors for the onset of migraine. Hence, it is essential to focus on lifestyle including diet as important factors for prevention and as adjuvant factors in the management of migraine headache. AIM: The aim was to propose a new perspective to the understanding of migraine headache keeping in view the role of lifestyle including diet. METHODS: Classical Ayurveda texts and traditional Yoga scriptures were used to compile information on the role of lifestyle including diet in the onset and management of migraine headache. This was complemented by PubMed-based review of scientific literature. OUTCOME: Ayurveda texts provide an extensive information about the basic understanding, causes, precipitating factors, and management of migraine headache, while Yoga texts refer to the concept of mental stress (adhi) leading to physical health problems (vyadhi). It is evident from the literature that diet, sleep, exposure to extreme climatic conditions, and mental stress play an important role in the onset and management of migraine headache. CONCLUSION: Lifestyle appears to be the common factor for both onset and management of migraine headache.

Evolution from four mental states to the highest state of consciousness: A neurophysiological basis of meditation as defined in yoga texts.

This chapter provides a theoretical introduction to states of consciousness and reviews neuroscientific investigations of meditation. The different states of consciousness consist of four mental states, i.e., cancalata (random thinking), ekagrata (non-meditative focusing), dharna (focused meditation), and dhyana (meditation) as defined in yoga texts. Meditation is a self-regulated mental process associated with deep relaxation and increased internalized attention. Scientific investigations on meditation reported changes in electrophysiological signals and neuroimaging measures. But most outcomes of meditation studies showed inconsistent results, this may be due to heterogeneity in meditation methods and techniques evolved in the last 200 years. Traditionally, the features of meditation include the capacity to sustain a heightened awareness of thoughts, behaviors, emotions, and perceptions. Generally, meditation involves non-reactive effortless monitoring of the content of experience from moment to moment. Focused meditation practice involves awareness on a single object and open monitoring meditation is a non-directive meditation involved attention in breathing, mantra, or sound. Therefore, results of few empirical studies of advanced meditators or beginners remain tentative. This is an attempt to compile the meditation-related changes in electrophysiological and neuroimaging processes among experienced and novice practitioners.

Association between Cyclic Meditation and Creative Cognition: Optimizing Connectivity between the Frontal and Parietal Lobes.

BACKGROUND: Important stages of creativity include preparation, incubation, illumination, and verification. Earlier studies have reported that some techniques of meditation promote creativity but have not specified which stage is enhanced. Here, we report the influence of cyclic meditation (CM) on creative cognition measured by a divergent thinking task. Our aim was to determine the degree of association between the two. METHODS: Twenty-four university students were randomly assigned to an experimental group (CM) and controls (Supine Rest), 35 min/day for 7 days. Creativity performance was assessed pre and post using Abbreviated Torrance Test for Adults (ATTA), while 64-channel electroencephalography (EEG) was used to measure brain activity during both CM/SH and the creativity test. RESULTS: Results indicated that CM training improved creativity performance, producing a shift to predominant gamma activity during creativity compared controls who showed delta activity. Furthermore, the experimental group showed more activation of frontal and parietal regions (EEG leads F3, F4 and P3, P4) than controls, i.e., the regions of the executive network responsible for creative cognition, our particular regions of interest where specialized knowledge is being stored. CONCLUSION: Improvement on creativity test performance indicates that CM increases association and strengthens the connectivity between frontal and parietal lobes, the major nodes of default mode network and executive attention network, enhancing the important stages of creativity such as preparation, incubation, and illumination.

Traditional practices and recent advances in Nadi Pariksha: A comprehensive review.

The significance of Nadi Pariksha is well understood and effectively used by Ayurveda practioners for assessing Tridoshas and various physiological and psychological states of the patient. The traditional texts Sarangadhara Samhita, YogaRatnakara, Basavarajeeyam and Bhavaprakasha have discussed the details of Nadi Pariksha in succinct set of slokas. Ayurveda has thousands of years of rich experience in Nadi Pariksha with strong literature support but is subjective in nature and the need for studying nadi with a scientific approach is well understood. Recently, pulse wave velocity has gained significant research interest as it is considered to be a strong indicator of cardiovascular disease; however, the relevance of pulse wave analysis to Nadi Pariksha has not been studied. In this review, traditional methods of Nadi Pariksha as defined in Ayurveda classics and the recent advances in pulse wave analysis are discussed. As per classical texts, qualities or properties of pulse such as pulse movement (gati), speed of the pulse (vega), stability of the pulse (sthiratva) and hardness of the artery (kathinya) play major role in Nadi Pariksha and in the current review these properties were analyzed and compared with the modern pulse parameters namely pulse wave velocity, pulse rate variability and arterial stiffness. The significance of pulse wave velocity in cardiovascular studies is discussed and the need for extending these studies to Ayurveda is highlighted.