The Effects of Yoga Exercises in Overweight and Obese Women

Официальное название

The Effects of Yoga Exercises on Body Composition, Respiratory Parameters and Functional Levels in Overweight and Obese Women: A Randomized Controlled Trial

Обзор

Obesity has been defined by the World Health Organization (WHO) as an abnormal accumulation of fat in the body that negatively affects health and has been reported to be the most significant public health problem of the 21st century. In the late 1990s, WHO described obesity as a "global epidemic." This epidemic and its associated complications cause the death of 2.8 million adults annually. Additionally, obesity imposes a significant financial burden on countries' healthcare and social security systems. Therefore, obesity stands out as an issue that requires urgent preventive measures. Obesity is associated with various abnormalities in respiratory functions. Changes in respiratory system mechanics due to decreased lung volumes indicate a strong link between obesity and chronic respiratory diseases. Furthermore, obesity is a risk factor for conditions such as hypertension, cardiovascular diseases, and diabetes. Yoga is known to have numerous positive effects on health and can provide significant benefits, particularly in improving respiratory functions. Yoga is also an important tool for coping with stress, which can positively influence the respiratory system. It has been reported that yoga reduces the impact of stress on respiratory rate, promoting deep breathing and relaxation. Some studies on the effects of yoga on obesity have not reached significant conclusions. A study comparing the effects of Vinyasa and Hatha yoga on obesity management found that neither type had a significant effect on metabolism. These studies fail to fully explain the mechanism by which yoga affects obesity due to differences in yoga styles and their lack of standardization, variations in practice durations, and the differing characteristics of study populations. Furthermore, studies on obesity and yoga often have short intervention durations (an average of 8 weeks), with most involving 60-90 minute sessions conducted 1-2 times per week. Since longer-term studies are needed to better understand the relationship between obesity and yoga, this study aims to investigate the effects of yoga exercises on body composition, respiratory parameters, functional level, sleep quality, quality of life, and emotional state in overweight and obese women.

Подробное описание

Obesity is a preventable yet significant health burden classified as a lifestyle disease. It is defined as excessive fat accumulation in the body, reaching levels that can negatively impact health. Body mass index (BMI) is used to classify overweight and obesity. The World Health Organization (WHO) defines overweight in adults as a BMI of 25 kg/m² or higher and obesity as a BMI of 30 kg/m² or higher. The prevalence of obesity is increasing worldwide, especially in developing countries. The point prevalence rate in women (15%) is higher than in men (11%). Over the past fifty years, global obesity rates have tripled. A study determined that over 1.9 billion adults aged 18 and older were overweight, with 650 million of them classified as obese.

Obesity is a known risk factor for numerous chronic diseases, including hypertension, hyperlipidemia, type 2 diabetes, coronary heart disease, stroke, cancer, depression, and knee osteoarthritis. Since a sedentary lifestyle is one of the primary causes of obesity, regular physical activity is recommended as a treatment option for non-morbid obesity. Various studies have demonstrated a strong inverse relationship between physical activity and BMI. However, it is well known that obese individuals face challenges in increasing and maintaining physical activity levels. Therefore, there is a search for pragmatic interventions that are easy to implement and promote increased physical activity for sustainable weight loss in obese individuals.

According to the 2012 report of the National Health Statistics in the United States, the prevalence of using any complementary medicine method among adults over 18 years old was 33.2%, with yoga being one of the most frequently preferred methods. Compared to other exercises, yoga offers several advantages, such as being independent of weather conditions, requiring no financial cost, and being applicable in both indoor and outdoor settings, which has contributed to its increasing popularity and widespread adoption.

Yoga, derived from the Sanskrit word meaning "union," aims to harmonize the mind, body, and spirit. Traditional yoga consists of the eight limbs defined by Patanjali: Yamas and Niyamas (moral and ethical restraints), Asanas (postures), Pranayama (breath regulation), Pratyahara (withdrawal of senses), Dharana (concentration), Dhyana (meditation), and Samadhi (self-realization). Yoga is designed to enhance both physical and mental health, thus improving overall quality of life. Numerous studies have shown that yoga reduces stress levels and enhances general well-being. In addition to its physical health benefits, yoga positively impacts psychological health. Research suggests that yoga can improve body image and quality of life.

The current U.S. National Physical Activity Guidelines categorize yoga as a light-intensity (such as Hatha yoga) or moderate-intensity (such as Vinyasa or power yoga) physical activity, depending on the style. Additionally, yoga can function as both an aerobic and strength-based exercise, depending on the style and postures practiced. The guidelines recommend 150-300 minutes of moderate-intensity yoga per week for adults. The American College of Sports Medicine classifies yoga as a neuromotor exercise, suggesting its practice at least 2-3 times per week for 20-30 minutes per session without specifying intensity levels. Yoga has several benefits, including preventing weight gain, reducing body fat mass, and increasing lean body mass.

Mooventhan and Khode conducted a study involving 40 participants in the yoga group and 39 in the control group, where 10-minute morning yoga sessions, six days a week for two weeks, significantly reduced body weight. Similarly, Kanojia et al. found a statistically significant reduction in body weight among healthy women aged 18-20 who practiced yoga for 40 minutes, six times a week, over three menstrual cycles compared to the control group.

Yoga postures can serve as a moderate-intensity exercise for individuals with limited aerobic capacity or restricted exercise ability. While enhancing physical strength, flexibility, and endurance, yoga also improves sleep patterns. Research suggests that yoga practices can have beneficial effects on sleep disorders. Yoga promotes relaxation and reduces stress and anxiety, thereby improving sleep quality. Several scientific studies have demonstrated that yoga techniques such as Pranayama and meditation help enhance sleep quality and alleviate insomnia.

Вмешательства

• Поведенческое yoga exercises
  The yoga program, based on Hatha yoga content, will be conducted in groups of 10 participants, for 12 weeks, 3 days a week, at the same time each day (12:00-13:00), and will be administered by an experienced physiotherapist (Appendix 4). Before starting the training program, the exercise group will be given a one-week adaptation period, during which the exercises to be performed in three sessions per week will be taught. Participants in the exercise group who miss sessions for various reasons

Первичные конечные точки

• Forced Vital Capacity (FVC) [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Assessment of Dynamic Balance and Functional Level (Timed Up and Go Test) [Срок оценки: From enrollment to the end of treatment at twelve weeks"]
• Body Mass Index [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Waist Circumference [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Hip Circumference [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Forced Expiratory Volume at One Second (FEV1) [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Peak Expiratory Flow (PEF) [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Maximum Mid-expiratory Flow 25-75% (MMEF25-75) [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• FEV1/FVC [Срок оценки: From enrollment to the end of treatment at twelve weeks]
• Weight (kg) [Срок оценки: From enrollment to the end of treatment at twelve weeks]

Вторичные конечные точки (4)

• Assessment of Quality of Life (Short Form-36) [Срок оценки: From enrollment to the end of treatment at twelve weeks"]
• Assessment of Sleep Quality (Pittsburgh Sleep Quality Index - PSQI) [Срок оценки: From enrollment to the end of treatment at twelve weeks"]
• Assessment of Emotional Status (Beck Depression Inventory (BDI)) [Срок оценки: From enrollment to the end of treatment at twelve weeks"]
• Assessment of Emotional Status (Beck Anxiety Inventory (BAI)) [Срок оценки: From enrollment to the end of treatment at twelve weeks"]

Критерии участия

Критерии включения

• Age between 18-65 years
• Body Mass Index (BMI) ≥ 25
• Waist circumference > 88 cm
• Waist-to-hip ratio > 0.8
• Being literate, willing to participate, and signing the informed consent form
• No mental disorders
• No orthopedic or neurological conditions affecting balance
• No history of surgical operations in the last 6 months

Критерии исключения

• Pregnant and breastfeeding mothers
• Participants following any diet program for obesity
• Individuals with syndromic or endocrine-related obesity
• Participants who regularly exercise
• Individuals using psychiatric medication
• Participants with a medical history that would prevent them from practicing yoga
• Participants with cardiovascular diseases that prevent exercise
• Participants with a yoga history within the last 6 months
• Individuals with any complications of obesity requiring medication, such as Type 2 diabetes or Stage 2 hypertension
• Experiencing pain over 7 on the Visual Analog Scale (VAS)

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• Ulusoy, M., Sahin, N. H., & Erkmen, H. (1998). Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of cognitive psychotherapy, 12(2), 163.
• Telles S, Sharma SK, Singh A, Kala N, Upadhyay V, Arya J, Balkrishna A. Quality of Life in Yoga Experienced and Yoga Naive Asian Indian Adults with Obesity. J Obes. 2019 Apr 30;2019:9895074. doi: 10.1155/2019/9895074. eCollection 2019. PMID 31183215
• Shohani M, Badfar G, Nasirkandy MP, Kaikhavani S, Rahmati S, Modmeli Y, Soleymani A, Azami M. The Effect of Yoga on Stress, Anxiety, and Depression in Women. Int J Prev Med. 2018 Feb 21;9:21. doi: 10.4103/ijpvm.IJPVM_242_16. eCollection 2018. PMID 29541436
• Panwar, S. H. E. E. T. A. L., Chourishi, A. S. H. U. T. O. S. H., & Makwana, J. A. Y. A. N. T. (2012). Effect of pranayama (yoga) on pulmonary function test of young healthy students. Int J Pharma Bio Sci, 3(4), 12-6.
• Kargün, M., Togo, O. T., Biner, M., & Pala, A. (2016). Üniversite öğrencilerinin fiziksel aktivite düzeylerinin incelenmesi. Marmara Üniversitesi Spor Bilimleri Dergisi, 1(1), 61-72.
• Hisli, N. (1989). Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J. Psychol., 7, 3-13.
• Gündede, E. (2018). Serebral palsili çocukların fonksiyonelliği ile ebeveynlerinin bakım yükü, aktivite düzeyi, yaşam kalitesi ve psikolojik durumu arasındaki ilişki. Okan Üniversitesi, İstanbul.
• Cramer H, Thoms MS, Anheyer D, Lauche R, Dobos G. Yoga in Women With Abdominal Obesityߞa Randomized Controlled Trial. Dtsch Arztebl Int. 2016 Sep 30;113(39):645-652. doi: 10.3238/arztebl.2016.0645. PMID 27776622

Идентификаторы

NCT: NCT06979830 · OMU2025/87

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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