International Yoga Day Special- Evolution of Yoga and Emerging Evidence

Yoga – Persevering History of 5000 Years

Yoga is a Sanskrit term meaning “union” or “connection”; originated in ancient India with earliest descriptions dating back to the Indus valley civilization. Until the last few decades, yoga remained confined by his modest presence to the realm of well-being; yet found loyal patrons in Swami Vivekananda and Eugenie Peterson (also known as Indira Devi) from Russia, who got inspired from vigorous learnings of yoga in India and later went onto start a yoga studio in Hollywood in late 1940’s.

Global Resurgence of Yoga

Over the last decade, the concept of yoga has gained increasing attention in the medical scientific community due to a greater recognition and understanding of psychosomatic concept of illness and its pervasiveness in certain chronic diseases.

The idea of celebrating International Day of Yoga, was a brainchild of Mr Narendra Modi, the current prime minister of India, which he had proposed for the first time during his speech at United Nations General Assembly (UNGA) – a wing of the United Nations, which later was accepted unanimously in the subsequent year.

Reported Effects of Yoga

Autonomic System

• Decreased sympathetic activation


• Increased parasympathetic activation

Neuro-Endocrine System

• Decreased S. Cortisols and S. Aldosterone


• Decreased S. Adrenaline


• Increased Endorphins

Potential Mechanism of Action of Yoga – Restoring Autonomic Nervous Control

An extensive body of literature indicates that performing yoga regularly and methodically may have neurohumoral effects such as decreased serum cortisol, catecholamine, and aldosterone levels. Chronic activation of these pathways have been implicated in a majority of cardiovascular disease states including hypertension, heart failure etc.

In addition, yoga and meditation have been found to increase melatonin, γ -amino butyric acid, and a myriad of other neurotransmitters. Scientific data also suggested a decreasein stress markers, such as 8-hydroxydeoxyguanosine, and an increase in endorphin levels with yoga; strongly bringing out its potential role in mitigating the effects of stress in humans.

We briefly highlight 3 interesting latest studies (two of which are published in 2019) indicating the integrative scope of yoga as valuable adjuvant across selected disease conditions

Yoga benefits Cancer related Fatigue

Results of multi-centric trial on the effect of yoga on cancer related fatigue (CRF) in 410 cancer survivors, indicated that yoga demonstrated significantly greater improvements in CRF compared with participants in standard survivorship care and resulted in greater improvements in overall sleep quality. The study suggested that up to37% of the improvements in CRF from yoga therapy resulted from improvements in sleep

Yoga - The Lifestyle Intervention with Highest CV Risk Reduction

This study, published in an eminent American journal compared the effectiveness of various lifestyle interventions in reducing 10-year cardiovascular disease risk. Various risk factors like stopping smoking, Mediterranean diet, aerobic exercise (walking) and yoga were identified and computational analysis was performed using data from corresponding published literature.

Base-case analysis revealed that yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals) followed by walking, Mediterranean diet and abstinence to smoking. Probabilistic and 1-way sensitivity analysis confirmed a similar trend.

Yoga Regulates Glucose Homoeostasis – In Hyperglycaemia and Hypoglycaemia

A study was conducted to observe the effects of 10 day yoga intervention program in 654 Type 2 Diabetes patients. Fasting plasma glucose (FPG) levels were measured at baseline and at the end of 10 days. No hypoglycaemic episodes were reported.

An interesting pattern was observed - the reduction in blood glucose levels was directly proportional to the baseline FPG levels. More interestingly, in patients with normal (70–100 mg/dL) and below normal baseline FPG levels, there was an “increase” rather than further decrease in the plasma glucose levels. Such data, apparently reported for the first time, suggested bidirectional (or rather physiological) effect of yoga on glucose homeostasis, implicating that yoga does not necessarily reduce blood glucose levels at all times and might help increase glucose levels in hypoglycaemia through autonomic activation.

Yoga – Unidimensional Public Perceptions - An #Instagram Study

A very unique study was conducted aiming at analysing 35000 content pieces on Instagram associated with #yoga over 9 days on understand the public perception of yoga.

The text analysis revealed #fitness was the most cited word (n = 5491), suggesting an emphasis on the physical aspect of yoga. The content analysis brought out that majority of words were categorized as good feelings (51%) and appearance (42%), while only a small amount was categorized as traditional teachings (3%). Images revealed mostly women (89%), who were underweight (68%), in minimal clothing (70%), demonstrating a basic pose (51%), in an indoor environment (57%). The results of this hinted that #yoga on Instagram seems to emphasize the physical nature of yoga.

Yoga – A Union of Eight Disciplines

The concept of yoga has eight components -ethics, self-discipline, physical posture, breath control, sensory transcendence, mental focus, meditation, and state of ecstasy. However, research data indicates a perception that people are more attracted towards the easier fragment of exercise, hinting a need for more awareness in this direction.

Final Thoughts

It will be interesting to trace in the coming times whether we are able to build, substantiate, define and integrate the scope of yoga in selected diseases, in an attempt to bridge and support current therapeutic gaps.

In an era of Continuous Blood Glucose Monitoring (CGMS), Ambulatory Blood Pressure Monitoring (ABPM) and Polysomnography studies, dynamic monitoring of manifestations of autonomic effects of yoga does not seem far-fetched. Observing and collating data on effects of yoga in larger-sized studies could open opportunities to establish place of yoga in practice and also potentially guide us to identify future bio-molecular targets for drug development.

Yoga is far beyond just a physical act of methodically performing locomotor manoeuvres which balance the autonomic nervous control. It is not just a part of life, but it’s a way of living. Happy International Day of Yoga!!

References

Adapted from

1. Gupta BM, Ahmed KKM, Dhawan SM, Gupta R. Yoga Research a Scientometric Assessment of Global Publications Output during 2007-16. Pharmacog J. 2018;10(3):394-402.


2. Raviteja R. Guddeti et al, Role of Yoga in Cardiac Disease and Rehabilitation, Journal of Cardiopulmonary Rehabilitation and Prevention 2018;:1-7


3. Po-Ju Lin et al, Influence of Yoga on Cancer-Related Fatigue and on Mediational Relationships Between Changes in Sleep and Cancer- Related Fatigue: A Nationwide, Multicenter Randomized Controlled Trial of Yoga in Cancer Survivors, Integrative Cancer Therapies 2019; 18: 1–11


4. Paula Chu, Comparative Effectiveness of Personalized Lifestyle Management Strategies for Cardiovascular Disease Risk Reduction, J Am Heart Assoc. 2016;5:e002737 doi: 10.1161/JAHA.115.002737


5. Venugopal Vijayakumar, Yoga as a Safer Form of Physical Activity in Type 2 Diabetes Mellitus: The Bidirectional Property of Yoga in Establishing Glucose Homeostasis, Int J Yoga. 2019 May-Aug; 12(2): 174–175.


6. Lacasse J et al, #Yoga on Instagram: Understanding the Nature of Yoga in the Online Conversation and Community, Int J Yoga. 2019 May-Aug;12(2):153-157


7. Govindasamy Agoramoorthy Interdisciplinary Science and Yoga: The Challenges Ahead, Int J Yoga. 2019 May-Aug; 12(2): 89–90.