8-Day Yoga Intervention

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8-Day Yoga Intervention
Iris Poole and Len Kravitz, Ph.D.

Study Reviewed:
Bijlani, R.L., Vempati, R.P. Yadav, R.K., Ray, R.B., Gupta, V., Sharma, R., Mehta, N., and Mahapatra, S.C. (2005). A Brief but Comprehensive Lifestyle Education Program Based on Yoga Reduces Risk Factors for Cardiovascular Disease and Diabetes Mellitus. The Journal of Alternative and Complementary Medicine, 11(2), 267-274.

Introduction
Many people strive to attain a lifestyle that includes a balanced diet, daily physical activity, mental tranquility, manageable stress levels, and regular sleep patterns. Too often, stressors of life, such as keeping up with information technology and/or the complexities of dealing with personal, local, national and world events, interfere with our achieving a healthy existence. Cardiovascular disease, diabetes mellitus and other disease-causing disorders may result. A seldom-researched question is whether any type of short-term intervention can meaningfully reduce these negative health consequences. Bijlani and colleagues (2005) present some intriguing and noteworthy data of an integrated yoga and lifestyle 8-day health risk reduction program that answers this investigative question.

Methods: Subjects
This study included 98 participants (males=67; females = 31), ages 20 – 74 years of age. Each participant attended this intervention program between May 2001 and November 2002. The subjects were a diversified group of people with health disorders commonly seen in societies throughout the world (see Table 1).

Methods: Program
The theory and applied program lasted 3-4 hours a day, for the 8-day intervention, which did not include the two weekend days. Participants were placed into small groups of 6-8 persons. The program consisted of asanas (physical postures) and pranayama (breathing exercises) for one hour, followed by a breakfast, and then the viewing of an educational video or a lecture (see Table 2 for complete 8-day intervention program). Essential and fundamental facts about nutrition were taught to the subjects, yet meals were not provided. The program providers encouraged participants to eat a low-fat vegetarian style diet, with moderate amounts of dairy products. However, it was entirely up to the subjects to implement any dietary information or recommendations into their lives. Thus, an interesting aspect of this study was the self-responsibility placed upon subjects.

An introduction to the principles of yoga and various techniques were provided. One whole session was dedicated to meditation principles and practices with two specific sessions on stress management. Group discussion and questions and answers were encouraged. Each day ended with a shavasana (a relaxation technique) or meditation. Self-healing was taught through imagery and/or autosuggestion.

Pamphlets from the lectures were distributed to participants to highlight important lessons and discussions. Each study participant also received one personalized meeting with a medical doctor during the 8-day intervention. The physician discussed and recommended lifestyle changes on diet, physical activity, smoking, drinking, and relaxation, and offered advise to specific problems and questions brought forward by the subject.

Methods: Study Design
Fasting blood samples were taken on day 1 for baseline values and on day 10 to compare the effects of change in glucose, cholesterol and triglycerides. However, analyses could only be conducted on 77 participants due to insufficient blood samples or because some patients drank tea before their blood draw.

Results
Fasting glucose, total cholesterol, LDL cholesterol (lousy type), VLDL cholesterol, total cholesterol/HDL ratio, and triglycerides were significantly lower, while HDL cholesterol (healthy type) was significantly higher on day 10 as compared to day 1. The researchers further divided the subjects into two subsets; one subset (55 subjects) consisted of those classified by the researchers as a high cholesterol (total cholesterol &Mac179; 200 mg/l) subgroup versus a second ‘normal cholesterol’ subset (43 subjects) whose cholesterol values were lower than these cut-off points. Analysis of the data clearly shows that the group with the higher cholesterol values, and thus at greater health risk, showed the most meaningful improvement. The researchers also separated the subjects into a hyperglycemic (blood glucose &Mac179; 104 mg/dl) group (48 subjects) versus a non-hyperglycemic group (29 subjects). Similarly, those at greater health risk, in the hyperglycemic group, showed the most consequential positive changes from the 8-day intervention.

Practice Findings and Discussion
This study clearly shows that an 8-day integrated program of yoga, stress management, diet, meditation and positive lifestyle modifications can improve important biochemical indices associated with heart disease, stroke, hypertension and diabetes mellitus. However, one study limitation clearly discussed by the authors is the lack of a control group in this investigation. Although a lengthy debate on control groups is not warranted at this time for this article, suffice it to say that a follow-up control-group design study by this research team, or another group of interested investigators, would be welcome. Practically, however, this study impressively supports the direction of the fitness industry as it moves into a much more integrated approach to health and fitness by combing exercise, mind-body interventions, stress management and healthy nutrition into programs, versus treating each area as a separate entity. For those fitness professionals currently incorporating inclusive wellness programs for some of their clients and students, this evidence is wonderfully enlightening to know how positive dramatic changes really may be attained early onset in the program.

Table 1. Health Diseases and Disorders of 98 Subjects in Study
Disease or Health Disorder Number
Backache 13
Bronchial asthma 5
Cervical spondylosis 6
Constipation 1
Coronary heart disease 25
Diabetes mellitus 20
Hypertension 26
Obesity 8
Osteoarthritis 8
Peptic ulcer/acid dyspepsia 6
Psychological problems (including anxiety, stress, depression, insomnia) 8
Tension headache 6
Various other health disorders 16
NOTE: Some subjects had more than one condition
Adapted from: Bijlani, et al. (2005). A Brief but Comprehensive Lifestyle Education Program Based on Yoga Reduces Risk Factors for Cardiovascular Disease and Diabetes Mellitus. The Journal of Alternative and Complementary Medicine, 11(2), 267-274.

Table 2. 8-Day Program Design
Day:
Day of Week Intervention: Break: Testing
1st Day: Wednesday Fasting blood samples taken
Participant grouping and introductions
Lecture: Introduction to yoga
Practice: Shavasana (relaxation technique)
2nd Day:
Thursday Practice: Asanas (physical postures) and Pranayama (Breathing)
Break
Lecture: Meditation
Practice: Meditation
Individualized advice with a doctor (2 subjects in a group)
3rd Day:
Friday Practice: Asanas and Pranayama
Break
Lecture: Fundamentals of nutrition
Practice: Meditation
Individualized advice with a doctor (2 subjects in a group)
4th Day
Saturday Off
5th Day
Sunday Off
6th Day
Monday Practice: Asanas and Pranayama
Break
Film: Samattvam (Equanimity or calmness)
Practice: Meditation/Shavasana
7th Day
Tuesday Practice: Asanas and Pranayama
Break
Film: Stress management
Practice: Meditation/Shavasana
8th Day
Wednesday Practice: Asanas and Pranayama
Break
Lecture: About your illness
Practice: Meditation/Shavasana
Individualized advice with a doctor (2 subjects in a group)
9th Day
Thursday Practice: Asanas and Pranayama
Break
Lecture: Yogic attitude in daily life
Practice: Meditation/Shavasana
Individualized advice with a doctor (2 subjects in a group)
10thDay
Friday Fasting blood sample
Practice: Asanas and Pranayama
Break
Lecture: Stress management
Practice: Meditation/Shavasana
Closing session
Adapted from: Bijlani, et al. (2005). A Brief but Comprehensive Lifestyle Education Program Based on Yoga Reduces Risk Factors for Cardiovascular Disease and Diabetes Mellitus. The Journal of Alternative and Complementary Medicine, 11(2), 267-274.

Biographies:
Iris Poole is completing her bachelor's degree in Exercise Science at the University of New Mexico (Albuquerque). She will begin graduate school this Summer 2006 at the University of Nevada, Las Vegas to earn a doctorate degree in Physical Therapy.

Len Kravitz, PhD, is the program coordinator of exercise science and a researcher at UNMA, where he won the 2004 Outstanding Teacher of the Year Award. He was also honored with the 1999 Canadian Fitness Professionals International Presenter of the Year Award, and was the first recipient of the IDEA Fitness Instructor of the Year Award.

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