The Health Benefits of Yoga

I often describe yoga as being a bit ‘magical’. As a genetics-researcher-turned-yoga-teacher, it is no surprise to me how the benefits of the ancient practice of yoga are now being backed up by modern scientific research. The fields of movement science and neuroscience are fast accelerating, and it is fascinating to witness the emergence of yoga (and other mindfulness practices) as potential medical interventions.

Yoga practitioners frequently report a large cohort of benefits beyond increased strength and flexibility, and I here aim to summarise the evidence-based support for this. A quick search through peer-reviewed literature provides strong evidence that a consistent yoga practice can correlate with a vast array of health benefits. At a time where chronic health conditions are increasing at unprecedented levels and healthcare systems are struggling to cope, medical organisations are looking towards inexpensive interventions such as yoga to ease the burden. Yoga is an accessible and attractive option for many people, and shows enormous potential in improving health and wellbeing. National healthcare bodies, such as the NHS in the UK 1 and NIH in the US 2, are now recommending yoga for certain conditions, and there is a wealth of science-backed evidence to support this advice.

Yoga is an ancient Indian spiritual system which was thought to have originated over 5000 years ago. It is becoming a widely popularised practice, with yoga practitioner numbers in the US alone increasing from 20.4 million to 36 million between 2012 and 2016 3.

A common misconception, particularly in Westernised cultures, is that yoga is a purely physical movement system. However, the benefits of yoga are not limited to improved fitness, and the yogic tradition incorporates many more practices than asana (physical poses). In fact, there are only three asana aphorisms in the entirety of Yoga Sutras of Patanjali, one of the most pivotal yogic texts. The Yoga Sutras focus on other yogic practices, such as meditation, pranayama (breathwork) and sensory withdrawal, as well as following moral and ethical observances. In Western society most people practice hatha yoga, which combines asana, pranayama and meditation.

These tools of movement, breath and meditation come together to form a strong mindfulness practice. The breath is regulated and used as a focal point for the practitioner to bring his/her attention to which, when linked with movement, can have a strong physical ‘grounding’ effect. The practice of yoga has long been anecdotally linked with positive mental health and stress reduction for this reason. Research into yoga and other mind-body therapies (including Tai Chi, Qigong and meditation) and wellbeing, particularly psychological health, has proliferated in recent years. Yoga, mindfulness, meditation and breath awareness practices have also been incorporated into various healthcare programs, such as Mindfulness-Based Stress Reduction (MBSR) programs and Relaxation Response Resiliency Program (3RP).

Mind-body therapies have the potential to reduce healthcare utilisation, at a lower cost than a visit to the emergency room, hospitalisation or even other complementary and alternative medicine (CAM) therapies 4. 3RP, a mind-body medicine program designed by the Benson Henry Institute 5, was shown to decrease total healthcare utilization by 43% at one year of participation 6. This offers a ray of hope in the current epidemic of chronic disease.

Over 70% of all deaths worldwide are caused by chronic, or noncommunicable, disease 7. This huge cause of mortality is thought to be caused by four main behavioural risk factors; tobacco use, physical inactivity, alcohol intake and unhealthy diet. Although there has yet to be any large-scale studies on the potential of yoga in alcohol use disorder recovery, yoga at least offers promise as a complementary treatment in smoking cessation 8, and can also help promote healthy eating 9, as well as being a physical movement practice, particularly in the West.

The biochemical and neurological mechanisms underlying the correlation between yoga and improvements of various health conditions are now starting to be better understood. Emerging research into the impact of yoga on anxiety and unipolar depression shows promise, with putative biological and cognitive mechanisms implicated in this. Autonomic nervous system dysfunction has been shown to be linked with depression10 and anxiety11. There is evidence to suggest yoga can increase parasympathetic nervous system (PNS) activity and increase GABA levels in the thalamus, and these increases are correlated with improved mood 12.

The benefits of yoga are not limited to neurological and psychiatric improvements. Increased levels of inflammation are thought to be involved in many conditions such as fatigue, pain and depression 13. These symptoms are all highly responsive to mind-body therapies, which have been shown to reduce genomic markers for inflammatory signalling pathways.

Research exploring loneliness in older adults demonstrated a potential link between perception of loneliness and upregulated expression of pro-inflammatory genes in circulating leukocytes. The study also showed that participation in MBSR programs could reduce feelings of loneliness. Reduced gene expression of inflammation-related genes as a result of MBSR participation occurred in parallel with a decreased perception of loneliness. The NF-kB transcription factor, well known for its role in the expression of pro-inflammatory genes, in particular was down-regulated in MBSR practitioners 14. NF-kB also was shown to have consistently reduced activity amongst breast cancer survivors who practiced yoga 15.

Yoga clearly shows promise as a low-cost healthcare intervention, with the full number of reported benefits not limited to those described in this article. By making yoga and other mind-body therapies more accessible to a diverse range of populations, we may be able to reduce the burden on healthcare services and improve the quality of life of individuals suffering from a myriad of medical conditions. With this exponential rise in yoga-related research, I am eagerly awaiting an even deeper insight into the ‘magic’ that I continue to witness.

If you would like to comment on any of the issues raised by this article, particularly from your own experience or insight, Healthcare-Arena would welcome your views.

References

1. https://www.nhs.uk/live-well/exercise/guide-to-yoga/
2. https://nccih.nih.gov/health/yoga
3. https://www.yogaalliance.org/2016yogainamericastudy
4. Nahin RL, Barnes PM, Stussman BJ, Bloom B (2009) Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report: 1–14.
5. Park ER, Traeger L, Vranceanu AM, Scult M, Lerner JA, Benson H, et al. (2013) The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP). Psychosomatics 54: 165–174.
6. Stahl JE, Dossett ML, LaJoie AS, Denninger JW, Mehta DH, et al. (2017) Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. PLOS ONE 12(2)
7. https://www.who.int/en/news-room/fact-sheets/detail/noncommunicable-diseases
8. Beth C. Bock, Joseph L. Fava, Ronnesia Gaskins, Kathleen M. Morrow, David M. Williams, Ernestine Jennings, Bruce M. Becker, Geoffrey Tremont, Bess H. Marcus (2012) Yoga as a Complementary Treatment for Smoking Cessation in Women. J Womens Health (Larchmt) 21(2): 240–248
9. Watts A.W., Rydell S.A., Eisenberg M.E., Laska M.N., Neumark-Sztainer D. Yoga’s potential for promoting healthy eating and physical activity behaviors among young adults: A mixed-methods study. Int. J. Behav. Nutr. Phys. Act. 2018;15:42
10. Kop WJ, Stein PK, Tracy RP, Barzilay JI, Schulz R, Gottdiener JS. Autonomic nervous system dysfunction and inflammation con- tribute to the increased cardiovascular mortality risk associated with depression. Psychosom Med. Sep 2010;72(7):626-635.
11. Dieleman GC, Huizink AC, Tulen JH, et al. Alterations in HPA-axis and autonomic nervous system functioning in child- hood anxiety disorders point to a chronic stress hypothesis. Psy- choneuroendocrinology. Jan 2015;51:135-150.
12. Streeter CC, Whitfield TH, Owen L, et al. Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a random- ized controlled MRS study. J Altern Complement Med. Nov 2010;16(11):1145-1152.
13. Irwin MR, Cole SW. Reciprocal regulation of the neural and innate immune systems. Nat Rev Immunol. 2011;11(9):625–632
14. Creswell JD, Irwin MR, Burklund LJ, Lieberman MD, Arevalo JM, Ma J, et al. Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behav Immun. 2012;26(7):1095–1101.
15. Bower JE, Greendale G, Crosswell AD, Garet D, Sternlieb B, Ganz PA, et al. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: A randomized controlled trial. Psychoneuroendocrinology. 2014;43:20–2