Abstract

BackgroundType 2 diabetes is a major health problem in many countries including India. Yoga may be an effective type 2 diabetes prevention strategy in India, particularly given its cultural familiarity.MethodsThis was a parallel, randomized controlled pilot study to collect feasibility and preliminary efficacy data on yoga for diabetes risk factors among people at high risk of diabetes. Primary outcomes included: changes in BMI, waist circumference, fasting blood glucose, postprandial blood glucose, insulin, insulin resistance, blood pressure, and cholesterol. We also looked at measures of psychological well-being including changes in depression, anxiety, positive and negative affect and perceived stress. Forty-one participants with elevated fasting blood glucose in Bangalore, India were randomized to either yoga (n = 21) or a walking control (n = 20). Participants were asked to either attend yoga classes or complete monitored walking 3–6 days per week for eight weeks. Randomization and allocation was performed using computer-generated random numbers and group assignments delivered in sealed, opaque envelopes generated by off-site study staff. Data were analyzed based on intention to treat.ResultsThis study was feasible in terms of recruitment, retention and adherence. In addition, yoga participants had significantly greater reductions in weight, waist circumference and BMI versus control (weight −0.8 ± 2.1 vs. 1.4 ± 3.6, p = 0.02; waist circumference −4.2 ± 4.8 vs. 0.7 ± 4.2, p < 0.01; BMI −0.2 ± 0.8 vs. 0.6 ± 1.6, p = 0.05). There were no between group differences in fasting blood glucose, postprandial blood glucose, insulin resistance or any other factors related to diabetes risk or psychological well-being. There were significant reductions in systolic and diastolic blood pressure, total cholesterol, anxiety, depression, negative affect and perceived stress in both the yoga intervention and walking control over the course of the study.ConclusionAmong Indians with elevated fasting blood glucose, we found that participation in an 8-week yoga intervention was feasible and resulted in greater weight loss and reduction in waist circumference when compared to a walking control. Yoga offers a promising lifestyle intervention for decreasing weight-related type 2 diabetes risk factors and potentially increasing psychological well-being.Trial registrationClinicalTrials.gov Identified NCT00090506.

Highlights

  • Type 2 diabetes is a major health problem in many countries including India

  • Lower cutpoints for waist circumference plus additional criteria for body mass index (BMI) and truncal subcutaneous fat have been recommended as criteria for metabolic syndrome in the Indian population based on their predisposition for Type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) [4,8]

  • Attendance each week for participants in the yoga group did not differ from attendance in the control group (4 ± 0.5 yoga classes per week vs. 3.8 ± 0.5 monitored walks per week, p = 0.13); participants in the yoga group had higher overall attendance compared to control (p = 0.02)

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Summary

Introduction

Type 2 diabetes is a major health problem in many countries including India. Yoga may be an effective type 2 diabetes prevention strategy in India, given its cultural familiarity. Type 2 diabetes mellitus (T2DM) is a major global health problem with a prevalence of 366 million in 2011 that is projected to increase by 51%, reaching 552 million by 2030 [1,2]. India follows this global trend with a prevalence of 60 million in 2011 that is projected to increase by. Metabolic syndrome is another characterization of high risk individuals with at least three of the following five risk factors: elevated FBG, elevated blood pressure, low high-density lipoproteins (HDL), elevated triglycerides and abdominal obesity [7]. Lower cutpoints for waist circumference plus additional criteria for body mass index (BMI) and truncal subcutaneous fat have been recommended as criteria for metabolic syndrome in the Indian population based on their predisposition for T2DM and cardiovascular disease (CVD) [4,8]

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