Exploring The Physiological Effects of Yoga: A State of The Art Review
Exploring The Physiological Effects of Yoga: A State of The Art Review
Exploring The Physiological Effects of Yoga: A State of The Art Review
P-ISSN: 2394-1685
E-ISSN: 2394-1693
Impact Factor (ISRA): 4.69
Exploring the Physiological Effects of Yoga: A State of
IJPESH 2016; 3(2): 316-320
© 2016 IJPESH
the Art Review
www.kheljournal.com
Received: 19-01-2016
Accepted: 22-02-2016 Manjula Suri, Namita Saini, Shipra Gupta
Manjula Suri
Abstract
Department of Physiology and
Promotive Health,
The objective of this study is to review the results of selected articles regarding the physiological effects
Institute of Home Economics, of Yoga and Diet counseling. According to B.K.S. Iyengar, yoga is an ancient Indian science which
University of Delhi, includes all aspects of one’s being, from health to self-realization. Yoga is self-management of life,
Delhi, India. which includes changes in diet, mental attitude and the practice of specific techniques such as yoga
asanas (postures), breathing practices (pranayamas), meditation, to attain the highest level of
Namita Saini consciousness. There is an increase in scientific research on yoga, but we do find very few reviews
Department of Physical regarding yogic practices and diet counseling in health and disease. Keeping this in mind, review of
Education, Institute of Home relevant articles was done to evaluate the physiological effects of yogic practices and diet counseling.
Economics, University of Delhi, Review found that there were considerable health benefits, including improved sleep pattern, cognition,
Delhi, India. body mass index, reproductive health, respiration, blood pressure, joint disorders, diabetes and recovery
from and treatment of addiction. It reduced stress, anxiety, depression, chronic pain, cardiovascular and
Shipra Gupta cancer risk. Yoga also influenced overall well-being, quality of life, autonomic function and immunity.
Department of Food and
Therefore Yoga and Diet counseling is a novel emerging clinical discipline of mind-body medicine
Nutrition, Institute of Home
Economics, University of Delhi,
which is increasingly used worldwide under alternative medicine.
Delhi, India.
Keywords: asana, pranayama, meditation, cognition, body mass index, mind-body medicine
Introduction
Complementary and alternative medicine (CAM) is a rapidly evolving field of medicine that
consists of therapy used as an alternatives or adjuncts to conventional medicines/therapy. The
National Center for Complementary and Alternative Medicine (NCCAM) [1] defines CAM as
‘a group of diverse medical and health care systems, practices, and products that are not
presently considered to be part of conventional medicine. A vast array of CAM therapies are
have been broadly divided by the NCCAM into: biologically based therapies (e.g. herbs,
aromatherapy, dietary supplement use, oxygen therapy), mind-body interventions (e.g. yoga,
hypnotherapy, art therapy), energy therapies (e.g. Reiki, Tai Chi), manipulative and body
based methods (e.g. chiropractic, reflexology) and alternative medical systems (e.g.
homeopathy, Chinese herbal medicine, naturopathy). [1] The CAM therapies include major
therapeutic lifestyle changes (TLCs) which are accessible, effective and cost effective when
used alone or adjunctively [2, 3]. TLCs offer improvements in physical health, self-esteem, and
quality of life. [4] Some TLCs—for example, exercise, diet, yoga and meditation are enjoyable
and may therefore become healthy self-sustaining habits. [5] It may also be neuroprotective and
reduce the risk of subsequent age-related cognitive losses and corresponding neural shrinkage.
[6-8]
Healthy lifestyle behaviors that encompass regular exercise, weight control and healthy
nutrition, have the potential to greatly reduce cancer-treatment-associated morbidity and
mortality in cancer survivors and can enhance quality of life. [9] Yoga may improve health
through down regulation of the hypothalamo pituitary adrenal axis and the sympathetic
nervous system. Exercise and nutritional counseling may benefit the metabolic and
Correspondence reproductive abnormalities associated with PCOS (Polycystic Ovary Syndrome). [10] Broad
Shipra Gupta
dietary advice (i.e. low intake of sodium chloride, saturated fat and energy), implemented by a
Department of Food and
Nutrition Institute of Home nutritionist, may have a significant effect in uncomplicated, mild-to-moderate life style
Economics, University of Delhi, diseases. Dietary and possibly other lifestyle habits are strongly influenced by experiences and
Delhi, India. role models in childhood, suggesting that dietary interventions should probably always target
~ 316 ~
International Journal of Physical Education, Sports and Health
Whole families, e.g. in primary prevention of CHD (Coronary reduction in heart rate, skin conductance, oxygen
Heart Disease).[11] Therefore there is a need for non- consumption, and increase in breath volume, thus protecting
pharmacologic treatment e.g. yoga and diet counseling in against ischemic heart disease and myocardial infarction [27].
uncomplicated lifestyle diseases. Although documented Yoga improves selective attention, concentration, visual
scientific evidence strongly indicates that yoga has promotive, scanning abilities, a repetitive motor response [28], reversal
preventive as well as curative potential but further studies are ability, eye-hand co-ordination, speed and accuracy [29]. Yogic
needed to examine how far the results of the present researches meditation enhances cognitive processes underlying the
are valid for those having life style diseases. generation of P300 [30]. Left-sided unilateral forced nostril
breathing led to right-hemisphere dominance and improved
Physiological Basis of Yoga spatial skills while maneuver on opposite side showed left
a) Deeper relaxation during yoga may lead to hemisphere dominance with improved verbal skills [31].
neuroplasticity, changes in the hypo-pituitary–pancreatic Practicing Yogic asanas improved fine coordinated
axis and sympathetic nervous system [12]. movements [32]. And neural performance as well as higher
b) Pranayama, stretches the lung tissue producing inhibitory critical fusion frequency indicating reduced fatigue and stress
signals from cardio-respiratory region involving vagi, due level [33].
to the action of slowly adapting receptors and
hyperpolarizing currents. These inhibitory signals may Cardiac System: Yoga significantly decreased oxygen
lead to changes in the autonomic nervous system; and consumption, heart rate and diastolic blood pressure [34] It has
reduced metabolism and parasympathetic dominance [13]. been shown to be effective in the treatment of hypertension [35,
36]
Pranayama may modify various inflatory and deflatory due to decrease in the frequency and intensity of
lung reflexes and interact with central neural element to proprioceptive and enteroceptive impulse traffic reaching the
modify homeostasis [14]. hypothalamus. Yoga helped in regression of coronary lesions,
c) Regeneration of pancreatic cells during yoga may increase improving myocardial perfusion and symptomatic
utilization and metabolism of glucose in peripheral improvement in Angiographically proved coronary artery
tissues, liver, and adipose tissues [15, 16] Yoga can lead to disease patients [37]. Pranayama breathing increased
improvement in the sensitivity of the b-Cells of the parasympathetic activity, i.e. reduced basal heart rate,
pancreas to the glucose signal and also the improvement increased valsalva ratio and deep breathing difference in heart
in insulin sensitivity [17] Direct stimulation of the pancreas rate; and reduced sympathetic activity, i.e. reduction in fall of
by the postures can rejuvenate its capacity to produce systolic blood pressure on posture variation [38]. It improved
insulin [18] cardiovascular risk factors (namely maximal O2 consumption -
d) Muscular relaxation, development and improved blood VO2max and high density lipoprotein cholesterol [HDL-C]) in
supply to muscles might enhance insulin receptor middle-aged and older women [39]. Resting heart rate
expression on muscles causing increased glucose uptake variability (HRV) and related physical and psychological
by muscles and thus reducing blood sugar [19]. parameters [40].
e) Yoga can lead to improved lipid levels which could be
due to increased hepatic lipase and lipoprotein lipase at Respiratory System: In bronchial asthma patients, there was a
cellular level and increase uptake of triglycerides by steady and progressive improvement in pulmonary functions
adipose tissues [20, 21]. and significant reduction in exercise induced
f) Meditation seems to modify activity of ascending reticular bronchoconstriction as well as in Asthma Quality of Life
activating system and autonomic centers in the brainstem (AQOL) scores in the yoga group compared with control
thus affecting cardio-respiratory and metabolic parameters group [41]. It decreased exercise-induced bronchoconstriction in
[22]
. the yoga group, particularly in the exercise-sensitive subjects.
[41]
g) A study observed higher gray matter density in lower . Yoga improved the QOL and reduced rescue medication
brain stem regions of experienced meditators compared use in bronchial asthma, and achieved the reduction earlier
with age-matched non-meditators and experienced than conventional treatment alone [42]. Yoga training produced
meditators had structural differences in brainstem regions statistically significant (P < 0.05) increase in FEV, FEV1,
with cardio-respiratory control [23] peak expiratory flow rate (PEFR) also increased significantly
h) Practicing meditation enhanced the speed with which (P < 0.01) after the yoga training.
attention can be allocated and relocated thus, increased the
depth of information processing and reducing response Chronic obstructive pulmonary disease (COPD) patients
latency [24]. subjected to yoga showed statistically significant
i) The skin resistance increased markedly at the onset of improvements for the St. George Respiratory questionnaire,
meditation and decreased after meditation but maintained vital capacity, maximal inspiratory pressure, and maximal
higher than before meditation [22]. expiratory pressure, thereby improved QOL and lung function
j) Higher melatonin levels could be one mechanism through on a short-term basis [43]. The elderly had improved respiratory
which the claimed health promoting effects of meditation function and sympathovagal balance after yoga respiratory
occur [25]. exercises [44]. Yoga practice results in a significant increase in
maximum expiratory pressure, maximum inspiratory pressure,
Effects of Yoga on different systems of Human Body breath holding time after expiration, breath holding time after
Nervous System: Yoga showed a significant reduction in the inspiration, and hand grip strength [45]. It resulted in improved
markers of intrinsic neurohormonal activity such as urinary ventilatory functions in the form of lowered respiratory rate,
excretion of catecholamines, aldosterone, as well as serum and increases in the forced vital capacity, forced expiratory
testosterone and luteinizing hormone levels. It also showed an volume at the end of first second, maximum voluntary
increase in the urinary excretion of cortisol [26]. Relaxation ventilation, peak expiratory flow rate, and prolongation of
exercises in Yoga reduced sympathetic activity with a breath holding time [46, 47]. An increase in inspiratory and
~ 317 ~
International Journal of Physical Education, Sports and Health
expiratory pressures suggests that yoga training improves the avoiding the four species with high mercury levels (shark,
strength of expiratory and as well as inspiratory muscles. swordfish, king mackerel, and tilefish) [58].
3) Reduces excessive calories: For societies confronting the
Musculoskeletal System: Yoga improves dexterity, strength “globesity” epidemic, reducing excess calories offers both
and musculoskeletal coordination of the practitioners. It economic and public health benefits [59]. For individuals,
involves co-ordinated action of synergistic and antagonistic reducing excess calories offers medical and
muscles which brings increased steadiness, strength, stamina, neuroprotective benefits [60]. This neuroprotection is
flexibility, endurance, anaerobic power, better neuro-muscular especially important in light of recent findings suggesting
coordination and improved orthostatic tolerance. Load bearing that adult obesity may be associated with reduced
strengthens the bones and prevents age-related weakening, cognitive function, as well as reduced white and gray-
thus helping in prevention of osteoporosis. Yogic techniques matter brain volume [61, 62]. Fortunately, pescovegetarian
are known to improve one's overall performance and work diets are low in calories.
capacity [48]. Sharma et al [49] observed the effect of lifestyle
intervention based on yoga, on subjective well-being in normal Individual TLCs appear to counter many medical and
and diseased subjects. They reported significant improvement psychological complications of contemporary pathogenic
in the subjective well-being scores of 77 subjects within a lifestyles. This raises a hopeful possibility: May be multiple
period of 10 days as compared to controls. Therefore, even a TLCs will be even more effective and additive? There is
brief intervention can make an appreciable contribution to evidence for this possibility in both animal studies and clinical
primary prevention as well as management of lifestyle medicine. For example, physical activity increases
diseases. Oken et al [50] found that hatha yoga practices for by neuronogenesis in the rat hippocampus. However, the effect is
elderly resulted in significant improvement in quality of life maximal only when the animals are exposed to a rich social
and physical measures compared to walking exercise and wait- environment rather than living in isolation [63]. Similarly, in his
list control groups. Iyengar hatha yoga practice improved hip program to reverse coronary arteriosclerosis, Dean Ornish
extension, increase stride length, and decrease anterior pelvic employed four TLCs - exercise, vegetarian diet, relaxation and
tilt in elderly and that yoga programs tailored to elderly adults stress management, and social support. Each proved
may offer a cost-effective means of preventing or reducing beneficial, and the effects were additive [64]. This might also be
age-related changes in these indices of gait function [51] true for other lifestyle disorders? Quite possibly, but as yet we
have no clear answer. A report by the US Institute of Medicine
Reproductive System: Schmidt et al [52] reported a reduction [65]
summarised the numerous health issues of cancer survivors
in urinary excretion of adrenaline, noradrenaline, dopamine, and reviewed the potential benefits of lifestyle modifications.
and aldosterone, a decrease in serum testosterone and In this Review, US Institute of Medicine report (from 2004 to
luteinizing hormone levels and an increase in cortisol 2006), and address: the strength of evidence for
excretion, indicating optimal changes in hormones. recommendations in areas of diet and exercise, with an
Narendran et al [53] observed that yoga practiced by pregnant emphasis on weight management and osteoporosis prevention,
women resulted in an increase in birth weight, decrease in as well as diet and exercise-related complementary and
preterm labor, and decrease in IUGR either in isolation or alternative treatments about healthy lifestyle practices.
associated with PIH, with no increased complications. Women
in their third trimester showed greater reductions in perceived Conclusion
stress and trait anxiety, [54]. Therefore yoga can be used to Therapeutic life style changes that encompass yoga, healthy
prevent or reduce obstetric complications. nutrition etc. have the potential to reduce morbidity and
mortality and enhance quality of life. Since the effect of yoga
Endocrine System: Practice of yoga leads to modulation of and diet/nutritional counseling may be additive, therefore
neuro-endocrine axis. Chaya et al [55] reported significant studies need be conducted to observe the additive effect of
decrease in fasting plasma insulin in the yoga practitioners and yoga and diet counseling on physiological parameters. To
is associated with increased insulin sensitivity and attenuation summarize, Yoga and Diet counseling is a novel emerging
of the negative relationship between body weight or waist clinical discipline of mind-body medicine which is
circumference and insulin sensitivity. Yogic asanas led to increasingly used worldwide as non-pharmacological form of
increased sensitivity of B cells of pancreas to the glucose promotive, preventive and curative treatment for life style
signal [56]. Tooley et al [57] concluded that meditation can affect diseases.
plasma melatonin levels resulting in health promoting effects
of meditation. These observations suggest that yoga can be Acknowledgement
used to increase endogenous secretion of melatonin, which, in The authors would like to express their gratitude to the
turn, might be responsible for improved sense of well-being. University of Delhi for funding the publication of this review
under the scheme Innovation Projects 2015-16.
Physiological Effects of Diet and Nutritional Counselling
There is now considerable evidence of the importance of References
nutrition for health, and researchers suggests that dietary 1. National Center for Complementary and alternative
factors are so important that the health of nations may be medicine. What is complementary and alternative
linked to them. The key principles for Diet counseling and medicine (CAM)? Publication No. D156. 2002, URL:
TLCs are to emphasize a diet that http://nccam.nih.gov/health/whatiscam/
1) Consists predominantly of multicolored fruits and 2. Walsh R. Lifestyle and Mental Health. American
vegetables (a “rainbow diet”). Psychologist, 2011; 66(7):579-592.
2) Contains some fish (a “pescovegetarian diet”): Preference doi:10.1037/a0021769.American Psychological
should be given to cold deep-seawater fish (e.g., salmon), Association 0003-066X/11/
which are high in beneficial omega-3 fish oils, while 3. McMorris T, Tomporowski P, Audiffren M. Exercise and
~ 318 ~
International Journal of Physical Education, Sports and Health
cognitive function. Chichester, England: Wiley- meditation practice: A literature review. Neurosci
Blackwell, 2009. doi:10.1002/9780470740668 Biobehav Rev 1985; 9:557-61.
4. Deslandes A, Moraes H, Ferreira C, Veiga H, Silveria H, 21. Tulpule TH, Shah HM, Shah SJ, Haveliwala HK. Yogic
Mouta R et al. Exercise and mental health: Many reasons exercises in the management of ischaemic heart
to move. Neuropsychobiology, 2009; 59:191-198. disease. Indian Heart J. 1971; 23:259-64.
doi:10.1159/000223730 22. Wallace RK, Benson H, Wilson AF. A wakeful hypo-
5. Didonna F. (Ed.). Clinical handbook of mindfulness. New metabolic physiological state. Am J Physiol. 1971;
York, NY: Springer, 2009. doi:10.1007/978-0-387-09593- 221:795-9.
6 23. Vestergaard-Poulsen P, van-Beek M, Skewes J, Bjarkam
6. Hamer M, Chida Y. Physical activity and risk of CR, Subberup M, Bertelsen J et al. Long-term meditation
neurodegenerative disease: A systematic review of is associated with increased gray matter density in the
prospective evidence. Psychological Medicine 2009; 39:3- brain stem. Neuroreport 2009; 20:170-4.
11. doi:10.1017/S0033291708003681 24. Van Leeuwen S, Singer W, Melloni L. Meditation
7. Pagnoni G, Cekic M. Age effects on gray matter volume Increases the Depth of Information Processing and
and attentional performance in Zen meditation. Improves the Allocation of Attention in Space. Front Hum
Neurobiological Aging, 2007; 28:1623-1627. Neurosci 2012; 6:133.
doi:10.1016/j.neurobiolaging.2007.06.008 25. Tooley GA, Armstrong SM, Norman TR, Sali A. Acute
8. Raji CA, Ho AJ, Parikshak NN, Becker JT, Lopez OL, increase in night time plasma melatonin levels following a
Kuller LH et al. Brain structure and obesity. Human Brain period of meditation. Biol Psychol. 2000; 53:69-
Mapping, 2010; 31:353-364. doi:10.1002/hbm.20870 78. [PubMed]
9. Lee Jones W. Wendy Demark-Wahnefried. Diet, exercise, 26. Selvamurthy W, Sridharan K, Ray US, Tiwary RS, Hedge
and complementary therapies after primary treatment for KS, Radhakrishnan U et al. A new physiological approach
cancer Lancet Oncol 2006; 7:1017-26. to control essential hypertension. Indian J Physiol
10. Bruner B, Chad K, Chizen D. Effects of exercise and Pharmacol. 1998; 42:205-13.
nutritional counseling in women with polycystic ovary 27. Vempati RP, Telles S. Yoga based guided relaxation
syndrome. Appl Physiol Nutr Metab. 2006; 31(4):384-91. reduces sympathetic activity judged from baseline
11. Hanna Lagstriim, Ritva Seppanen, Eero Jokinen, Mari levels. Psychol Rep. 2000; 90:487-94.
Salrninen, Olli Sirnell. The impact of child-targeted 28. Sarang SP, Telles S. Immediate effect of two yoga-based
dietary counseling of parents on food (milk) preferences relaxation techniques on performance in a letter
of preschool-aged children in the STRIP project. cancellation task. Percept Mot Skills. 2007; 105:379-85.
Scandinavian Journal of Nutrition/Naringsforskning. 29. Telles S, Praghuraj P, Ghosh A, Nagendra HR. Effect of a
2001; 45:51-56. one-month yoga training program on performance in a
12. McCall T. The Scientific Basis of Yoga Therapy. athttp:// mirror-tracing task. Indian J Physiol Pharmacol. 2006;
www. yogajournal.com/ for_teachers/, 2016. 50:187-90.
13. Jerath RJ, Edry VA, Barnes VA, Jerath V. Physiology of 30. Sarang SP, Telles S. Changes in p300 following two
long pranayamic breathing: Neural respiratory elements yoga-based relaxation techniques. Int J Neurosci. 2006;
may provide a mechanism that explains how slow 116:1419-30.
breathing shifts the autonomic nervous system. Med 31. Jella SA, Shannahoff-Khalsa DS. The effects of unilateral
Hypotheses 2006; 67:566-71. forced nostril breathing on cognitive performance. Int J
14. Tandon OP. Yoga and its applications. In: Tandon OP, Neurosci. 1993; 73:61-8.
Tripathi Y, editors. Best and Taylor's Physiological Basis 32. Tells S, Hanumanthaiah BH, Nagarathna R, Nagendra
of Medical Practice. 13th ed. Gurgaon: Wolters Kluwer HR. Plasticity of motor control systems demonstrated by
health/Lippincott Williams and Wilkins publishers, 2012, yoga training. Indian J Physiol Pharmacol. 1994; 38:143-
1217-30. 4.
15. Dang KK, Sahay BK. Yoga and Meditation, Medicine 33. Telles S, Nagarathna R, Vani PR, Nagendra HR. A
update. In: Singh MM, editor. The Association of combination of focusing and defocusing through yoga
Physicians of India. New Delhi: APICON, The reduces optical illusion more than focusing alone. Indian J
Association of Physicians of India conference 1999; Physiol Pharmacol. 1997; 41:179-82.
9:502-512, 1:57-58. 34. Madanmohan, Rai UC, Balavittal V, Thombre DP, Swami
16. Sahay BK, Murthy KJR. Long term follow up studies on Gitananda. Cardiorespiratory changes during savitri
effect of yoga in diabetes. Diab Res Clin Pract 1988; pranayama and shavasan. The yoga review 1983; 3:25-34.
5(1):S655. 35. Datey KK, Deshmukh SN, DalviCP, Vinekar SL.
17. Manjunatha S, Vempati RP, Ghosh D, Bijlani RL. An “Shavasana”: A yogic exercise in the management of
investigation into the acute and long-term effects of hypertension’. Angiology 1969; 20:325-333.
selected yogic postures on fasting and postprandial 36. Patel C, North WRS. Randomised controlled trial of yoga
glycemia and insulinemia in healthy young subjects. and biofeedback in management of hypertension. Lancet
Indian J Physiol Pharmacol. 2005; 49:319-24. 1975; 19:93-95.
18. Ramaiah SA. Yoga Therapy for Diabetes: Washington, 37. Yogendra J, Yogendra HJ, Ambardekar S, Lele RD,
D.C. Study, International Conference on Traditional Shetty S, Dave M, et al. Beneficial effects of yoga
Medicine, Madras. Madras, India: Published by Siddha lifestyle on reversibility of ischaemic heart disease:
Medical Board, Govt. of Tamil Nadu, 1986. Caring heart project of International Board of Yoga. J
19. Chandratreya S. Diabetes & Yoga. [Accessed Jun 16, Assoc Physicians India. 2004; 52:283-9.
2012].athttp:// www.yogapoint. com/ therapy 38. Veerabhadrappa SG, Baljoshi VS, Khanapure S, Herur A,
/diabetes_yoga.htm. Patil S, Ankad RB et al. Effect of yogic bellows on
20. Delmonte MM. Biochemical indices associated with cardiovascular autonomic reactivity. J Cardiovasc Dis
~ 319 ~
International Journal of Physical Education, Sports and Health
The author has requested enhancement of the downloaded file. All in-text references underlined in blue are linked to publications on ResearchGate.