literature review of yoga

• Open access
• Published: 15 May 2023

Perceived benefit of yoga among adults who have practiced yoga for a long time: a qualitative study

• Şengül Akdeniz 1 &
• Özlem Kaştan 2  

BioPsychoSocial Medicine volume  17 , Article number:  19 ( 2023 ) Cite this article

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Previous quantitative studies have shown many of the perceived benefits of yoga practice on the mind and body. Although there are many quantitative studies in the international literature on yoga, the number of qualitative studies showing the experience of yoga practice is insufficient. An accurate demonstration of yoga participents experiences, opinions, and judgments on this subject requires a qualitative, rather than a quantitative approach.

This study was to explore the benefit perceived by adults who have practiced yoga for a long time.

Design and method

This qualitative study is based on a hermeneutic–phenomenological approach. The research sample consisted of 18 adults who volunteered to participate in the research and regularly joined yoga practice. The study data were collected through individual and focus group interviews with the participants who practise yoga and analyzed by content analysis method.

We created five themes. Themes coded by researchers: meaning of the concept of yoga (theme 1), physical, mental, and social state before starting yoga (theme 2), reasons for practising yoga (theme 3), the participants' experiences related to their physical and mental health and social relationships (theme 4), and difficulties of doing yoga (theme 5). In addition, individuals in the study reported their perceptions of the concept of "yoga" through the creation of metaphors that completed the following sentence “yoga is like ……”. These metaphors were used to give insight into the participants deep feelings about yoga.

Conclusions

Both in their individual and focus group interviews, almost all of the participants described that doing yoga has positive benefits on the mind and body. The positive experiences of the participants in the study included decrease in pain and flexibility, increase in sleep quality, development of positive personality traits, increase in self-esteem, and coping with anxiety and stress more effectively. Because the study was qualitative and long-term, it was able to evaluate the beliefs, attitudes and behaviors of individuals in a realistic, systematic, and detailed manner.

While low stress levels create a positive impact, higher ones adversely affect the functioning of all organs and systems in the organism and may lead to various diseases. It is therefore important to manage to control stress and cope with it [ 1 ]. Various techniques are used to control or reduce stress and change stress-coping strategies and behaviors. Yoga is a technique for relaxing the mental health and controlling stress via internal and external resources [ 2 ]. Studies on yoga suggest that yoga is an effective method of coping with stress, leading to growing self-awareness and a positive increase in quality of life [ 3 , 4 , 5 , 6 , 7 ]. Studies have found that yoga has positive effects on coping with stress, increasing sleep quality, growing self-confidence, relaxation, and strengthening memory and concentration [ 8 , 9 ]. A randomized controlled study on yoga puts forward that yoga is effective in coping with neuronal and endocrine changes and stress, and also decreases the prevalence of mental illnesses by reducing depression and anxiety [ 9 ]. The study conducted by Tulloch et al. (2018) shows that yoga has a significant role in improving balance, movement, and mental health [ 6 ].

Studies suggest that yoga has positive effects on physical health as well as on mental health. It is reported that the use of yoga-based exercises as an alternative complementary treatment has a positive effect on various chronic diseases, such as paralysis [ 10 ], arthritis [ 11 ], obesity [ 9 ], type 2 diabetes [ 12 ], cardiovascular disease [ 13 ], metabolic syndrome [ 14 ], and cancer [ 15 ]. There are many studies showing the positive physical, mental, and social effects of yoga. As yoga has spread all over the world and has been nourished by the cultures in the areas where it has spread, many types of yoga have emerged. The most important effects of all types of yoga are that they teach the power to reveal the positive qualities of human beings and to reduce their deficiencies [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].

Tulloch et al. suggest that yoga allows a person to focus, enter a peaceful state, and then incorporate the benefits of this relaxing experience into their lifestyle [ 6 ]. Yoga reveals the integrity of mind, body, muscle, bone, and spiritual in a holistic manner. When practicing yoga, people know which muscle is moving in each stretching movement, and a physical integrity is achieved by concentrating on it. Yoga is a great form of exercise focused on human anatomy for physical health. When it comes to yoga movements, many people may think of some acrobatic movements and difficult postures. Because each individual's anatomical structure, joints and bones are different, the limits of being able to do these postures are also different. As the movements are performed, the body opens and stretches. Yoga poses, which have hundreds of variations today, have been diversified over time by yoga experts according to their knowledge of anatomy and the areas they focus on. The perception of yoga as a part of physical culture has been attributed to its stress-reducing and relaxing properties based on anatomical and physiological assumptions [ 2 , 4 , 5 , 6 ]. Yoga is also used as an alternative treatment for some diseases. According to the literature, there are no studies showing negative physical, mental, or social effects of yoga. However, more studies are needed on exactly which health problems yoga has a positive effect on.

Although yoga is known to be especially effective in protective and improving the health of healthy adults, scientific studies in this field are both few in number and are usually short-term studies. Among the studies that have been conducted on yoga, qualitative studies in which the subjective experiences of individuals practising yoga are questioned are limited. In the literature review, there was no qualitative study on yoga conducted in Turkey that take into account long-term lifestyle and for which positive effects are revealed. Yoga is less well known and practiced in Turkey compared to other countries. One of the first reasons for this is that yoga is not well known in Turkey. In addition, the income and education level compared to other countries constitute other factors affecting the promotion and demand of yoga education and philosophy. Yoga as an academic research subject in Turkey started to intensify after 2015. The exact number of yoga practitioners in Turkey is not known. Compared to abroad, there are very few yoga instructors and yoga centers in Turkey compared to other countries. It is thought that this study will contribute to the recognition of yoga in Turkey.

This study was done for a long period, two years, to investigate how the emotions, thoughts, and experiences of adults related to the effect of yoga-based exercises on their physical, mental, emotional, belief, and social health states.

Study design and sampling

In order to explore the benefit perceived on the physical, spiritual, emotional and social situations by adults who have practiced yoga for a long time, we used a qualitative research method that investigates the event(s) related to a situation in depth within a person’s own boundaries (environment, time, etc.) to do a holistic analysis [ 16 ]. The study used a holistic, multiple design; a case study design in which more than one situation perceived as holistic is handled and compared. The population of the study consisted of the individuals practising yoga.

In a qualitative study, data collection is terminated when the data reaches a saturation point, when there is no new information, and/or data starts to repeat itself [ 16 ]. Therefore, our research participants consisted of 18 individuals who volunteered to participate in the research and regularly joined yoga practice. Individual interviews were done in January 2020, and focus group interviews were held in February 2020. The participants were given information about the place and time of the meeting, and a meeting room was made available and arranged in a way that was suitable fort he study.

Data collection

Data was collected through individual and focus group interviews with the participants and through participant observation. The participants practiced yoga two days a week. For this reason, focus group participants were divided into two groups of nine, with the groups meeting on different days, and the group participants were interviewed before and after doing yoga. The group discussions lasted approximately one hour. Focus group interviews allowed us to see social interactions before and after yoga.

The interviews were conducted via a semi-structured interview form. A Personal Information Form and a Semi-Structured Interview Form were used during the interviews. It took an average of 45–50 min. to conduct these interviews. The researcher acting as a participant observer went to a yoga studio selected for participant observation two days a week from April 5, 2018 to March 11, 2020. During this time, social communication was observed in different areas of the studio such as classrooms, changing rooms, and kitchen. Yoga classes are voluntarily offered at the yoga studio and there may be changes in the profile of the students who join these classes. The researcher attended yoga classes between 12.00–13.00 h, twice a week, for 2 years. During the first year, the participant observer researcher attended yoga classes almost without missing any of them, and recognized changes in his body and thinking about what yoga is and its effects. The researcher acting as a participant observer observed all participants individually from the beginning of his participation in the yoga classes. Participants did their physical activity of yoga on a mat that was suitable for the person's height, that was heat-insulated, and that was not too high and did not allow slipping. It was done under the guidance of a trainer in a yoga hall appropriate for yoga. The participants were observed to have experienced difficulties in performing some physical movements due to their age and flexibility characteristics, particularly in the initial phase. It was observed that as time passed and yoga activity became a habit among the participants, these difficulties decreased in parallel with the duration of yoga. Moreover, both the atmosphere of the yoga hall and the group interaction of all participants were observed.

Personal information form

The personal information form contains questions about seven items: gender, age, education, occupation, chronic disease, chronic pain, and duration of yoga practice.

Semi-structured interview guide

The semi-structured interview form contains six questions including the meaning of the concept of yoga, the physical, mental and social state before starting yoga, the reasons for practising yoga, the effects of yoga on the physical, mental and social state, the difficulties of doing yoga, and a metaphor to explain what yoga is like. In addition, the researcher asked probing questions in order to deepen and clarify the issue during the individual interview.

Data analysis

The data obtained as a result of individual interviews was analyzed through the descriptive analysis method. This analysis method addresses the statements and results of the participants regarding the research question. Data is summarized and interpreted according to the pre-determined themes in this type of analysis [ 16 ]. Data analysis was done with the Nvivo 10 package program. Firstly, the data collected as a result of individual interviews and participant observations was documented, and upon completion of all individual interviews, themes were created. Researchers initially worked independently while creating themes, and then the themes were compared and common themes were formed. In the data analysis, the researchers obtained mostly consistent results. When the researchers did not agree with each other, the interview text was read in detail in order to obtain a common impression by making an in-depth naive reading. For the reliability of the research, two experts who did not know about the study were asked to code according to the themes. Apart from descriptive data, numerical analyzes of data collected as a result of individual interviews were also presented and interpreted in the study. Moreover, in order to increase the validity and reliability of the study, direct quotations were made from participant statements.

Ethical aspect of research

Ethical approval from ……University Clinical Research Ethics Committee (approval number: 70904504/299, date of approval 05/07/2019) and permission from the yoga trainer who contributed to the research were obtained for carrying out the study. This study was conducted in accordance with the principles of the Helsinki Declaration. The yoga practitioners who participated in the study were informed that the research was a scientific study, that an individual interview would be held, and that their real names would not be used in data analysis, each participant was given a code number (P1–P18) and their informed voluntary consent was obtained.

Analysis of the Personal Information Form found that the age range of the 18 participants was between 23 and 68 years, 6 were between 40–50 years old and 16 were women. Considering the occupations, 4 were lecturers, 3 were civil servants, 6 were students, teachers, or retired teachers (2 each), and 1 each was a nurse, painter, administrative assistant, massage therapist, or housewife. With respect to the disease state of the participants, it was revealed that 15 of them had a history of chronic disease, 11 had chronic pain, and 3 had anxiety disorder. The duration of yoga practice varied from 2 to 5 years (Table 1 ).

We created five themes. Themes coded by the researchers: meaning of the concept of yoga (theme 1), physical, mental and social state before starting yoga (theme 2), reasons for practising yoga (theme 3), the participants' experiences related to their physical and mental health, and social relationships (theme 4), and difficulties of doing yoga (theme 5). In addition, individuals in the study reported their perceptions of the concept of "yoga" through the creation of metaphors that completed the following sentence “yoga is like ……”. These metaphors were used to give insight into the participants deep feelings about yoga.

Theme 1: Meaning of the concept of yoga

Of the participants, 11expressed the meaning of the concept of yoga with the theme “exercise”, while 5 replied “healthy life” and “calmness”, 3 ‘harmony’, and 2 "awareness" and “balance” (Table 2 ). Some of the participants' statements regarding the meaning of the concept of yoga are as follows:

For me, the concept of yoga means standing against the speed culture created by our current age, and the calmness that occurs as a result this stance (P3) (Theme-calmness) .

Yoga means ensuring harmony between the inner world and the outer world for me (P12) (Theme-harmony-balance).

It is a form of physical exercise that focuses on breathing and protects our physical and mental health through stretching movements (P4) (Theme-exercise-healthy life).

It's the best time I spare to myself. I become aware of my whole body (P13) (Theme-awareness).

It is the movements and rest that calm your mind and make you feel mentally fit while stretching and resting the body through relevant body movements (P9) (Theme-exercise).

Theme 2: Physical, mental, and social state before starting yoga

After the participants were asked about their physical, mental and social state before starting yoga, they gave the following responses: 6 were "doing sports other than yoga"; 4 were "fatigued" and had "coping difficulty"; 3 had " physical ailments', 'sedentary life' and felt 'negative emotions', and 1 had 'social isolation' (Table 2 ).

Some of the participants' statements about their physical, spiritual and social state before starting yoga are as follows:

I couldn't find time to rest, I often had neck pain, and I had lung disease in the winters (P10) (Theme—physical ailments).

I had fatigue, leg pain and oedema, as well as varicose pain that did not go away (P17) (Theme—physical ailments).

I had a monotonous life, I was a fairy godmother, I always said yes to everyone, and I did not have time to spare to myself and to be on my own (P18) (Theme-sedentary life).

I was interested in sports that required more speed. I didn't know the importance of slowing down and awareness of body (P11) (Theme-sports other than yoga).

I was in a stressful state with difficult-to-cope emotions (P1) (Theme-feeling negative emotions- coping difficulty).

Before starting yoga, I was less tolerant of events and feeling more lonely, and thanks to yoga, I believe that I have overcome these negative emotions, and my presence in the universe is so pleasant and I am grateful for being a part of the universe (P5) (Theme-feeling negative emotions).

Before I started doing Yoga, especially my mind was like a machine running full-time (P3) (Theme-fatigue).

I had a very intense pace of work. Since my husband worked out of the city, it was really exhausting and wearing to assume the responsibility of two children, to be both a mother and father, to run a large hospital and to attend classes at school (P15) (Theme-Coping difficulty).

I've been trying to do yoga with you for two years. During this period, I had angio ablation because of rhythm disturbance, but it was not successful and drug treatment was started. Meanwhile, I had anxiety and a fear that I didn't know about, I started yoga at this very moment, my fears decreased every day, I felt my soul healed, and after five months, I stopped taking antidepressants. I felt relief in my heart (P16) (Theme-anxiety).

Theme 3: Reasons for practising yoga

Participants stated that they practised yoga for a healthy life (8), to raise awareness (6), to reduce pain (9), to be calm (3), to cope with stress (1), and to increase positive thinking (1) (Table 2 ).

Some of the participants' statements regarding their reasons for practising yoga are as follows:

Yoga strengthens the immune system, allows you to have a healthy skeletal system, and even strong and flexible muscles, and it regulates the circulatory system, positively affects the digestive system, reduces stress, improves sleep quality, and improves communication skills and self-confidence (P6) (Theme—healthy life).

When I do yoga, I feel that I think in a healthier way and my body is healthier. I also feel mentally and spiritually purified (P9) (Theme—healthy life).

Severe cricks started in my back. I had crick in my back for five times in a year, I stayed in bed for months and had injections. The quality of my life decreased so much that I was afraid to even go for a walk. I went to a doctor and the doctor said I was having a heavy muscle spasm, and he recommended yoga. My brother had been practising yoga for about a year and he was so happy, I started it thanks to him. I was in a lot of pain on the first day when I started yoga. And when I got out of the yoga hall, a miracle happened. I felt so good, I can't describe it. I got healthy again (P8) (Theme—Reducing pains).

I started yoga because I thought it would relax my mind. I thought it would help me relax and get me out of the stressful situation. And it helped as I thought (P15) (Theme—coping with stress).

Being able to be on my own and integrating with myself mentally and physically, I feel my calm and peaceful mood in my daily life increased, and I feel my muscles relax and my body relax (P16) (Theme- raising awareness).

Events that used to worry me for days and make me nervous now make me laugh. I can focus better now. And most importantly, my energy has gone up. Now I can easily get rid of the usual negativities around me (P10) (Theme—increasing positive thinking).

Theme 4: Experiences of the participants' physical, mental and social state

Participants stated the effects of yoga on their physical, mental and social states as follows: increasing positive emotions (12), relieving (11), reducing pain (9), increasing positive personality traits and raising awareness (5), increasing sleep quality and self-esteem (4).

Some of the participants' statements about the effects of yoga on their physical, mental and social states are as follows:

I had back and neck pain due to working at a desk and stress. I had less pain for 2 years (P10) (Theme-reducing pain).

Physically, my muscle structure has been strengthened, and I can see it clearly. My spinal posture has improved. I feel it is good for my herniated disc. It relieved my back pain (P12) (Theme- reducing pain).

My back pain has decreased, I have become more flexible and I feel more peaceful. (P4) (Theme- reducing pain).

My back pain with which I had struggled before yoga is over… I have not taken a single muscle relaxant for 7 months, I have not had an injection… I had headaches like migraine and they decreased greatly (P8) (Theme- reducing pain).

Thanks to the breathing exercises, the quality of my sleeping pattern got better (P13) (Theme- increasing sleep quality).

My sleeping pattern has become regular by proper breathing since I started practicing yoga, (P17) (Theme- increasing sleep quality).

Psychologically, yoga has transformed me into a more balanced and calm person (P1) (Theme-increasing positive personality traits).

On the days when I practice yoga, my brain works harder, and I'm more humorous and tolerant, smiling and less forgetful (P2) (Theme-increasing positive personality traits).

Yoga allowed me to become stronger psychologically, and it increased my quality of life, and since it motivated me positively, based on the belief that I could do whatever I wanted, positive thoughts in my soul were reflected on my body and created an integrity (P10) (Theme- increasing self-esteem-increasing positive emotions).

Being aware of my body and emotions has been good for my physical and mental health (P11) (Theme—increasing awareness).

For me, yoga takes you on a journey into your inner world. It raises awareness of your body, your inner world, and your essence. It teaches to be unified with the body, to listen to it and to perceive the messages coming from it (P12) (Theme- raising awareness).

I feel much more energetic, I do not get sick, I do not feel pain in my body, I do not get tired, I do not get angry, I am calmer when communicating with people and I can understand them. Since I feel stronger, I have no difficulty in performing my work and I can work with pleasure (P6) (Theme- increasing positive emotions).

I feel energetic thanks to the deep breath I take in yoga. The feeling of fatigue is over (P16) (Theme—relieving).

I feel a relief in my joints, and I do not feel fatigue (P2) (Theme- relieving).

But I think yoga decreases the stress level and increases the happiness hormone, and ensures spiritual, mental and physical balance (P16) (Theme—coping with stress).

I can say that it allows me to control my anxiety because it calms my mind psychologically (P9) (Theme—coping with stress) (Table 2 ).

Theme 5: Difficulties of doing yoga

Participants described, their difficulties in practising yoga, with the themes of physical difficulty (10) and mental difficulty (1).

Some of the participants' statements about the difficulties of practicing yoga are as follows:

While practising yoga, you have to throw away the thoughts in our head for 1–1.5 h, and if you push yourself away for a moment, you will break from the group in yoga because the movements are coordinated with commands. This is of course difficult after a certain age (P2) (Theme- mental difficulty). This participant (P2) is the oldest participant of the study group.

Some of the movements we do physically are difficult for me, which is because I didn't do yoga or any sports when I was a child, so it can sometimes be difficult for me to manage my muscles (P10) (Theme—physical difficulty) (Table 2 ).

Metaphors about doing yoga

When participants were asked to compare their experience of doing yoga to something thirteen metaphors emerged (Fig.  1 ). The responses to the question about the metaphor for practicing yoga were generally collected within the framework of supporting and guiding (teacher, sports, lighthouse, energy source), relaxing and peaceful (worshipping, lightning rod, nature, sea, sun), flexibility and elegance (swan, flamingo, butterfly, child) themes.

Participants’ metaphors for practising yoga

Worshipping: I can compare yoga to worshipping because I think it is a spiritual and meditative action. I feel that I am getting closer to God. (P1) .

Sports: The human body is an excellent machine. Yoga is a sport that makes this machine work most perfectly for many years. All organs support each other physically and chemically. The brain governs it (P2).

Lightning rod: I would compare it to a lightning rod. Because I think that yoga grounds the tense energy accumulated on the body, just as the lightning rod provides grounding without damaging the building where the lightning strikes (P9).

Nature: The only thing which I can compare yoga to is nature's own cycle. Because while we are practising yoga as a part of nature, we begin to stretch at first, and move slowly with breathing exercises. Then we get caught up in the flow of yoga, just like the flow of nature. Finally, we finish the action of yoga as nothing in nature is infinite. However, since there is no end in nature, yoga is also completely unfinished, and we turn into another type, mood and energy frequency (P3).

Sun: I compare yoga to the sun because it warms me inside (P4).

Sea: I think of yoga practice as the peace/infinite happiness that the still/calm blue sea gives me (P5). I compare yoga to the deep blue sea with its visible bottom, creating waves towards the golden sand, containing cleanliness, clarity and peace in it (P10).

Lighthouse: Yoga prevents you from getting lost by allowing you to find your direction like a lighthouse (P6).

Energy source: I would say yoga is an energy source of life because I would change my whole life according to yoga. This has been my belief. (P8).

Flamingo: I compare practising yoga to a flamingo standing on one leg. Flamingos regulate their body temperature by being able to stand on one leg for a long time (P11).

Child: I compare yoga to a child. Because they can make every move with their flexible body (P13).

Butterfly: I would compare yoga to flying like a butterfly over the fragrant coloured flowers in a lush environment on the river bank. Because that's how I feel when I practise yoga (P15).

Teacher: I compare yoga to a teacher. It teaches us our spiritual and physical body. It teaches the spiritual depths of the body to turn back to the essence (P16).

Swan: I feel like a swan while practising yoga, the climax of emotions, elegant movements, movements as if you are evolving into nature (P18).

With this study, the experiences of individuals who have been practicing yoga for a long time were revealed. The benefit perceived by adults who practiced yoga for a long time was demonstrated in terms of physical, mental, and social aspects by qualitative analysis method. The findings obtained from the study showed that at the end of the yoga practice, which was applied two sessions per week for two years, the individuals had reductions in pain and flexibility, relaxation in the spiritual field, higher sleep quality, positive personality traits, self-esteem, and positive emotion, and they were effectively able to cope with anxiety and stress.

Because the study was qualitative the situations experienced by the individuals, their reactions to events and their beliefs, attitudes and behaviours were evaluated in a more realistic, systematic and detailed way. The original aspect of this study is that it is both a qualitative study and that the participants became aware of the positive effects of yoga in daily life and adopted the habit of regularly practicing yoga. One of the conclusions that can be obtained from this study is that starting yoga early and continuing it for a long time will relieve physical difficulties. Thus, individuals can be encouraged to participate in daily life and their quality of life can be improved by increasing their yoga physical fitness and physical activity levels.

For the participants participating in this study, yoga has different meanings, such as exercise, healthy life, worshipping, calmness, harmony, awareness, and balance. The origin of the word "yoga" in the literature is etymologically based on the Sanskrit words "joug" and "yuj (g)" which mean "connection" and "unity". As a thought, yoga means that all different aspects that make up the human being are combined with it in a balanced way. In this context, yoga is also expressed as a “life system’ that explains the basic principles of life and the “truth” in its entirety without breaking it down [ 17 ]. In a study on yoga, the meaning of yoga was expressed as body awareness, energy and physical, mental and emotional integrity caused by physical posture, breathing work and relaxation [ 18 ]. In another study, participants interpreted yoga as regeneration, moral force and, awareness of the body, a finding similar to our study [ 19 ].

A study by Kuru, Alici and colleagues [ 20 ], similarly stated that for participants, yoga meant personal transformation. It is known in the literature that yoga has positive contributions to both healthy people and those with health problems in the physical, social, and spiritual aspects. Similar to the results of the study, other studies have shown that yoga improves mood [ 21 ], reduces stress [ 22 ], increases well-being [ 23 ] and improves the quality of life [ 3 , 24 ].

In this study, metaphor terms related to practicing yoga were usually collected within the framework of the supporting, guiding, relaxing, peaceful, flexibility and elegance themes. The study showed that the metaphors for practising yoga were in harmony with the literature. It is generally accepted in the literature that yoga creates physical and psychological benefits, and it is generally reported that it can be used for strengthening muscles, reducing stress, and maintaining the physical and psychological well-being of the person, and relieving the ailments such as fatigue, pain, difficulty in concentration and loss of balance [ 25 ]. Yoga is also a lifestyle activity, and lifestyle contributes to the continuity of the ontological sense of security. We, as human beings, need ontological security due to our concern about the continuation of our existence. We manage this anxiety through daily routine, social interactions, and lifestyle choices [ 26 ]. Yoga practice aims to improve or maintain physical fitness and health [ 8 ]. The perception of yoga as a part of physical culture has been attributed to its stress-reducing and relaxing properties depending on anatomical and physiological assumptions [ 27 ]. Physical activity stimulates several brain chemicals that make you feel happier, much more relaxed, and less anxious. Scientific studies show that physical activity performed through yoga can decrease depression. The results of this study revealed positive improvements with yoga from the aspects of feeling good and positive emotions, more positive perception of one's body image, physical self-esteem, and self-pride. Moreover, as in similar studies, it was seen in this study that yoga decreased stress, improved stress-coping power, and positively affected the quality and duration of sleep among those having sleep disorders [ 9 , 10 , 11 , 27 , 28 ].

In this study, female participants were in the majority as in other studies [ 28 , 29 ]. In this study, only two of the eighteen participants were male. When yoga studies are examined, it is seen that yoga is a field where women are predominant. The reasons for this situation are the effects of certain gender roles and stereotypes about women and men. It is accepted that women are more open to innovation, spiritual practices, and accepting their shortcomings. These differences that are accepted as existing between men and women are based on gender roles. According to the results of the research, it was revealed that not practicing yoga is a result of prejudice in men and that they are worried that they will experience social prejudice. The data obtained from studies showing the socio-demographic characteristics of yoga practitioners in Turkey are similar to the results of this study [ 7 , 29 , 30 ].

Limitations of study

The results of this study were limited to people who practice yoga in a particular institution. In addition, due to the nature of the qualitative study, it only covers the answers of eighteen participants.

The study has enabled us to deeply understand what yoga is and how it affects people. It has been found that problems such as pain and anxiety that individuals face in their daily life can be more easily solved with regular yoga practice. Yoga is a slow and elegant activity suitable for all participants that can improve the life energy of the participants. Practicing yoga has brought about positive developments in the subjects, such as feeling good and positive, experiencing inner comfort and peace, feeling stronger in their world of belief, perceiving their own body images more positively, valuing themselves physically and being proud of themselves. It is recommended that the effects of yoga be revealed by qualitative research in different populations. It is recommended that yoga be started at an early age and done regularly as it provides easy resolution of significant problems such as pain, anxiety, sleeping, stress, that negative affect our daily life.

Availability of data and materials

The data and materials of the current study are available from the corresponding author on reasonable request.

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Akdeniz, Ş., Kaştan, Ö. Perceived benefit of yoga among adults who have practiced yoga for a long time: a qualitative study. BioPsychoSocial Med 17 , 19 (2023). https://doi.org/10.1186/s13030-023-00276-3

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At the request of Jasmine Chehrazi, Founder of  YogaActivist.org , a group of nine graduate students enrolled in the Master of Public Health (M.P.H.) program at The George Washington University conducted a literature review on the health benefits of yoga. The review provides  YogaActivist.org with information needed to further develop its network of studio-supported yoga outreach programs to diverse communities, both locally and nationally. Specifically, the review highlights the dynamic interplay between stress, weight, and other disease indicators—all of which can be addressed, if not mitigated, through routine participation in yoga.

The group of M.P.H. students searched for relevant articles in academic, peer-reviewed journals, including, but not limited to, the Journal of General Internal Medicine, Journal of Psychiatric Practice, Alternative Therapies in Health and Medicine, International Journal of Nursing Studies, Journal of Affective Disorders, Rehabilitation Oncology, and Topics in Clinical Nutrition. The search was by no means exhaustive, but the group found and summarized 19 different articles demonstrating the effectiveness of yoga in promoting physiological and mental health, as well as in controlling disease and disease indicators. While the 19 studies differ in study type, design, purpose, sample size, target population, yoga method(s) and technique(s), length of follow-up, and overall findings, they together demonstrate the widespread applicability of yoga to diverse populations, irrespective of gender, age, race/ethnicity, weight, or health status.

Through the literature review, the nine students found documentation of yoga’s effectiveness in treating musculoskeletal conditions, improving mental health, reducing stress and anxiety, increasing cortisol levels (associated with self-esteem and tenacity and lower levels of nervousness and depression), improving pulmonary function among asthmatic children, increasing exercise self-efficacy, reducing and/or controlling blood pressure, slowing weight gain, controlling diabetes mellitus, and improving overall mood. Such benefits extend to individuals across the life span. While yoga alone is insufficient to reverse disease or substantially improve health status, the literature suggests that yoga, when combined with other intervention measures, can reap significant physiological and mental health benefits for diverse populations. Yoga is a personal, non-competitive physical activity. When practiced correctly and routinely, yoga provides individuals of all ages with the motivation and self-efficacy needed to live and maintain healthier lifestyles.

Below is a summary of each of the 19 articles regarding the effectiveness of yoga interventions in promoting health. The summaries are categorized by the primary health or behavioral objective of each study.

Yoga and Mental Health

1) Lee SW, Mancuso CA, Charlson ME. Prospective study of new participants in a community-based mind-body training program. J Gen Intern Med. 2004;19(7):760-5.

FINDING: A 3-month yoga program improved mental health scores and other quality of life measures. Yoga Type: Dahn-hak. 1) stretching exercises for large muscle groups and shoulders, neck,hips, back, and knees, 2) postures are held for “energy accumulation 3) 5- to 10-minute meditation intended to facilitate “energy awareness”, 4) repetition of the large muscle group stretches. Yoga Frequency/Duration : 1-hour class offered 2-to-3 times per week for 3 months.

OBJECTIVE: To measure changes in health-related quality of life associated with 3 months of mind-body training as practiced in community-based settings.

METHODS: A prospective cohort study was done in eight centers for the practice of mind-body training in the metropolitan New York City area with 194 adults, and 171 completed the follow-up survey.  Participants typically attended a 1-hour class two to three times per week.  They were given a questionnaire before the classes began and 3 months later with questions about mental and physical health from validated survey instruments.

RESULTS: At baseline, new participants reported lower scores than U.S. norms for 7 of 8 domains of the Medical Outcomes Study SF-36 general health questionnaire.  After 3 months of training, within patient change scores improved in all domains (P< .0001), including a change of +15.5 in the mental health domain. In hierarchical regression analysis, younger age, baseline level of depressive symptoms and a history of hypertension were independent predictors of greater improvement in the SF-36 mental health score. Five participants (2.9%) reported a musculoskeletal injury.

2) Uebelacker LA, Epstein-Lubow G, Gaudiano, BA. Hatha. Yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract. 2010;16:22–33.

FINDING:  A review of eight clinical trials showed the yoga may help treat depression.  Note: Methodological concerns with most trials. Yoga Type : Some asana-focused, some meditation-focused Yoga Frequency/Duration : Varied in length from 3 days to 12 weeks and in intensity from daily to once per week.

OBJECTIVE: Review the literature of studies evaluating the efficacy of yoga for the treatment of depression and possible mechanisms .

METHODS: Studies were included in the review if they were clinical trials with one of the intervention arms involving a predominantly yoga intervention and a requirement for participants to have a diagnosed depressive disorder or elevated depression symptoms.

RESULTS: Eight trials were found. The number of participants ranged from 28 to 89.  Of the five studies that compared yoga to no/minimal treatment, four found some evidence that yoga was superior to the control group, and the final one did not directly compare the two groups. Studies varied in length of intervention from 3 days to 12 weeks and in intensity from daily to once per week, and different types of yoga were used (some asana-focused and some meditation-focused). Effect sizes of differences varied widely, and methodological differences and flaws threatening internal validity make it difficult to draw generalizable conclusions.

3) Birdee GS, Legedza, AT, Saper RB. Characteristics of yoga users: results of a national survey. J Gen Intern Med . 2008;23(10):1653-1658.

FINDING: A national survey of yoga users showed it to be helpful for overall health and well being, mental health, and musculoskeletal conditions. Yoga Type: N/A Yoga Frequency/Duration : Self-report that person had practiced yoga during past 12 months (and not tai chi or qi gong)

OBJECTIVE: To characterize yoga users, medical reasons for use, perceptions of helpfulness, and disclosure of use to medical professionals.

METHODS: A cross-sectional study was done using data from the National Health Interview Survey Alternative Medicine Supplement with 31,044 respondents. Survey participants were asked if they had practiced yoga during the past 12 months. If they had practiced yoga, but not tai chi or qi gong, they were asked whether they practiced yoga for medical conditions and if it helped their condition and also how important yoga was in maintaining their general health and well-being.

RESULTS: The prevalence of yoga use for health in the U.S. was 5.1percentwith a mean age of 39.5. Most yoga users (58%) felt that yoga was an important part of maintaining their health and well-being. A smaller percentage of yoga users reported using yoga to treat specific medical conditions (16%). Among medical conditions, 10.5percentand 3.3percentof yoga users reported using yoga to specifically treat musculoskeletal and mental health conditions, respectively. A majority of these yoga users reported yoga as helpful for their mental health (83%) and musculoskeletal condition (76%).

4) Woolery A, Myers H, Sternlieb B, Zeltzer L. A yoga intervention for young adults with elevated symptoms of depression. Alter Ther Health Med . 2004;10(2):60-63.

FINDING: A 5-week program of yoga showed reductions in depression and anxiety among young adults. Yoga Type : Iyengar Yoga Frequency/Duration : Two 1-hour classes per week for 5 weeks

OBJECTIVE: To determine the short-term effect of yoga on mood in mildly depressed young adults.

METHODS: Twenty-eight 18-29 year olds with mild depression were randomly assigned to an intervention group or a wait-list control group. The intervention group participated in a 5-week yoga program of two 1-hour classes per week. Measurements of depression and anxiety levels were made using the Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), and Profile of Mood States (POMS) survey instruments before classes began, midway through the program and at the program’s completion. Morning cortisol levels were also taken at the same time points.

RESULTS: The yoga group showed a significantly greater reduction in depression compared to the control group (p<.001). A similar pattern was seen for trait anxiety (p<.001) Significant pre- to post-class reductions were seen in depression-dejection, tension-anxiety, anger-hostility, fatigue-inertia, confusion-bewilderment, and total mood disturbance. Yoga participants also showed higher morning cortisol levels, which are associated with self-esteem, hardiness, and tenacity, and lower levels of nervousness and depression.

5) Chen KM, Chen MH, Chao HC, Hung HM Lin, HS, et al. Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial. Inter J Nurs Stud. 2008;4:154-163.

FINDING: A 6-month yoga program improved sleep quality, depression, and perceived health status among older adults who reside in the community. Yoga Type : Warm up, hatha yoga gentle stretching, relaxation, and guided-imagery meditation. Yoga Frequency/Duration : 70 minutes three times per week for six months.

OBJECTIVE: To test the effects of six months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially among the indicators of sleep quality, depression, and self-perception of health status.

METHODS: A cluster randomized trial was conducted in eight senior citizen activity centers in southern Taiwan. Participants were randomly assigned into either the experimental (n = 62) or the control (n = 66) group based on their attendance at selected senior activity centers. A 70-minute silver yoga exercise program was implemented three times per week for six months as the intervention for the participants in the experimental group.

RESULTS: The mental health indicators of the participants in the experimental group were significantly improved in comparison to the participants in the control group after the silver yoga interventions (all p < .05). Many of the indicators improved after three months of the intervention and were maintained throughout the six month study. These indicators included subjective sleep quality (as measured by the Pittsburgh Sleep Quality Index (PSQI) score), daytime dysfunction, physical and mental health perception, and depression state.Silver yoga exercise sessions were taught 3 times per week, for 70 minutes each session, over 6 months.  Each 70-minute session included a warm up, hatha yoga gentle stretching, relaxation, and guided-imagery meditation.  No additional details regarding postures or sequence are provided.  For consistency over the course of the intervention, yoga instructors followed a pre-recorded tape made by the principal investigator which verbally guided them through the sequence of postures for each session.

6 ) Gupta N, Khera S, Vempati RP, Sharma R, Bijlani RL. Effect of yoga based lifestyle intervention on state and trait anxiety. Indian J Physiol Pharmacol. 2006;50(1): 41-47.

FINDING: Short educational program for stress management and lifestyle modification based on yoga leads to reduction in anxiety. Yoga Type : Asanas and pranayama Yoga Frequency/Duration : 8-day outpatient course, 3-4 hours/day, over 10 days (with a 2-day weekend break)

OBJECTIVES: To study the short-term impact of a comprehensive, yet brief, lifestyle intervention based on yoga in diseased and normal individuals.

METHODS: The research subjects had a history of hypertension, coronary artery disease, diabetes mellitus, obesity, psychiatric disorders and thyroid disorders. The intervention consisted of asanas, pranayanama, relaxation techniques, group support, individualized advice, lectures and films on philosophy of yoga, and the place of yoga meditation in daily life, meditation, and stress management.

RESULTS: Outcome measures were anxiety scores taken on the first and last days of the course. Among diseased individuals, improvement was seen in anxiety levels.

7) Galantino ML, Cannon N, Hoelker T, Iannaco J, Quinn L. Potential benefits of walking and yoga on perceived levels of cognitive decline and persistent fatigue in women with breast cancer. Rehab Oncol. 2007;25(3):3-12.

FINDING: Exercise, specifically walking and yoga, have been proven effective in enhancing quality of life and decreasing fatigue in breast cancer populations. Yoga Type : variable Yoga Frequency/Duration : variable

OBJECTIVE: To investigate available evidence for the effect of walking and yoga on breast cancer survival following chemotherapy.

METHODS: Authors searched randomized clinical controlled trials, systematic reviews, cohort studies, and case series for information regarding the effect of walking and yoga on quality of life, persistent fatigue, and perceived levels of cognitive decline in breast cancer populations.

RESULTS: Yoga proved to be beneficial in breast cancer populations, leading to improvements in sleep quality, strength, flexibility, and quality of life. The three main components of yoga—asanas (yoga physical postures), pranayama (breathing exercises/patterns), and dhyana (meditation)—have been shown to decrease fatigue and improve perceptions of vitality.

8 ) Janakiramaiah N, Gangadhar BN, Naga Venkatesha Murthy PJ, Harish MG, Subbakrishna DK, et al. Antidepressant efficacy of Sudarshan Kriya yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine. J Affect Disord. 2000;57(1-3):255-259.

FINDING: Once daily practice of Sudarshan Kriya yoga (SKY) was found to be equally effective to medication and nearly as effective as electro-shock therapy in the remission of depression among patients. Yoga Type : Sudarshan Kriya yoga was used with some changes.  To make it widely acceptable to patients and the medical profession, some of the adventitious components (e.g., briefing about positive attitudes to life ‘living in the present’, etc.) were dropped as were the meditative aspects. The physiological technique consisting of only specified rhythms of breathing. This adaptation for clinical purposes was designated Sudarshan Kriya Yoga. There were three sequential components interspersed with normal breating while sitting with eyes closed. The procedure closed with 10-15 minutes of Yoga Nidra (tranquil state) in supine position. Yoga Frequency/Duration : Six 45-minute sessions during mornings per week.  For patients with marked diurnal retardation, afternoon sessions were also recommended.  Mean number of sessions was 20.

OBJECTIVE: To investigate the efficacy of yoga practice as it compares to traditional treatments of clinical depression.

METHODS: Randomized, control study of 45 patients hospitalized with severe depression (as defined by the Beck Depression Inventory and Hamilton Rating Scale for Depression). The patients were divided into three groups with the first receiving electroconvulsive therapy three times weekly for four weeks. The second group was administered imiprimine, an antidepressant medication, at typical dosing. The last group was trained in SKY and encourages to practice it daily. Pre/Post test surveys focused on depressive effects.

RESULTS: Patients practicing SKY were noted to have a 67percentremission rate of their symptoms showed it to be as effective as imiprimine and nearly as effective as electroconvulsive therapy. Though compelling, the findings are subject to possible selection bias due to inadequate group sizes for statistical validity. However, they are highly suggestive that further investigation into the clinical efficacy of yoga practice is warranted and could present itself as a low-risk/high-reward alternative to traditional depression treatments.

9) Vedamurthachar A, Janakiramaiah N, Hegde JM, Shetty TK, Subbakrishna DK, et al. Antidepressant efficacy and hormonal effects of Sudarshan Kriya Yoga (SKY) in alcohol dependent individuals. J Affect Disord. 2006;94:249-253.

FINDING: Practice of yoga was found to demonstrate antidepressant effects in a randomized control trial among consenting patients participating in alcohol detoxification programs. Measures of cortisol, ACTH and prolactin revealed a possible biological mechanism for yoga’s effects. Yoga Type : The SKY consisted of three distinctive breathing periods (Pranayama):1. Ujjayi pranayama: Consists of slowdeep breathing. Each cycle includes breathing in, holding, breathing out and holding.2. Bhastrika pranayama consists of forced inhalation and exhalation 20 times. Ujjayi and Bhastrika pranayama requires about 12–15 min.3. Cyclical breathing consists of slow, medium, and fast cycles of breathing practiced for a total duration of 30min.These three procedures are done in sitting posture (Sukhasana) with eyes closed. This was followed by Yoga Nidra (lying in a tranquil state) for about 20 min. Yoga Frequency/Duration : One 65-minute session once per day for two weeks.

OBJECTIVE: To determine the effectiveness of yoga practice in the treatment of depression among individuals participating in alcohol dependence detoxification.

METHODS: After a week of detoxification management, subjects were recruited to participate in a randomized-control study. There were a total of 60 subjects who participated in a two-week study. The control group was provided standard detoxification, while the intervention group practiced daily sessions of breathing exercises and yoga practice. Effects were measured with the use of the Beck Depression Inventory (BDI) pre/post each session and morning plasma cortisol, ACTH and prolactin measures were taken prior to and following the two-week intervention.

RESULTS: Both the control and intervention groups displayed a reduction in self-reported depression symptoms according to the BDI. Additionally, there was a noted correlation between depression symptom reduction and reduction of morning plasma cortisol levels among the intervention group participants. Physical measures of cortisol suggest a biological pathway for the observed results among program participants. The small group size is a possible confounder of these results. Also, it was noted by those administering the study that depression symptoms declined in all patients over that same period. However, the level of reduction and the effects on cortisol measures suggest a biological pathway of depression reduction in those practicing yoga.

Yoga and Stress in Children

10) Mendelson T, Greenberg, MT, Dariotis, JK, Gould, LF, Rhoades, BL, et al. Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth. J Abnorm Child Psychol. May 4, 2010; DOI:10.1007/s10802-010-9418-x.

FINDING: A 12-week intensive yoga program improved involuntary stress responses in 4 th and 5 th graders. Yoga Type : Yoga-inspired postures and movement series, including bending, stretching, and fluid movement. Poses were selected to enhance muscle tone and flexibility, and students were taught the health benefits of the poses. Students also practiced breathing, starting with beginner exercises and gradually moving to more advanced ones. These exercises trained the youths to use their breath to center and calm themselves. At the end of each class, youth lay on their backs with their eyes closed while the instructors guided them through a mindfulness practice, which involved attending to a specific focus for several minutes, such as paying attention to each breath or sending out positive energy to others. The brief period of discussion prior to the guided mindfulness practice in which instructors offered didactic information about topics such as identifying stressors, using mindfulness techniques to respond to stress, cultivating positive relationships with others, and keeping one’s mind and body healthy. This information was oftenwoven into the subsequent guided mindfulness practice (e.g., using the breath to create calm if something stressful has happened). Yoga Frequency/Duration : Four 45-minute session per week for 12 weeks.

OBJECTIVE: To assess the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention.

METHODS: Ninety-seven 4 th and 5 th graders in the inner city of Baltimore participated in a 4-day per week 12-week yoga and mindfulness program at school. Each yoga session lasted 45 minutes and occurred during a non-academic time period. Students were given a questionnaire to assess their stress response, depressive symptoms, and relations with peers and school, all of which used validated instruments.

RESULTS: Many students were eager to join the program, and a focus group showed that participants had a positive experience with the program.  The intervention group’s survey responses showed significant improvements in involuntary stress responses as compared to controls (p<.001). Significant different were also seen on three subscales, including rumination, intrusive thoughts, and emotional arousal (p<.01).

11) Stueck M, Gloeckner N. Yoga for children in the mirror of science: working spectrum and practice fields of the training of relaxation with elements of yoga for children. Early Child Dev Care. 2005;175:371-377.

FINDING: In a small study, a 15-week program of yoga and relaxation training improved stress responses in preteens. Yoga Type : 1) Relaxation. Used technique called ‘journey through the body’, which consists of different concentration tasks on single body parts. Other used first relaxation techniques are breathing techniques from yoga (ujjayi, nadhi shodana, alternating breathing). 2) Yoga exercises. a) 23 different yoga exercises (based on Shivananda-Yoga, Rishikesh/India) b) individual complex of yoga exercises c) participants can develop their own complex yoga and instruct others. 3) Series of activities such as massage techniques (partner massage, ball massage), meditation (candle meditation), sensory exercises (discovering of objects by touching and smelling), and interactive exercises (‘trust game’, ‘jumping lotus flower’) as well as six different imagery techniques. Yoga Frequency/Duration : One 1-hour session per week for 15 weeks.

OBJECTIVE: To determine whether yoga can assist in reducing stress responses in preteens.

METHODS: Forty-eight 11-12-year olds with abnormal exam anxiety participated in the study with 21 students assigned to the experimental group to participate in a 15-session program of relaxation, yoga, and other meditation and social interaction exercises. Each session lasted one hour. A questionnaire with stress-related items was given to students before the sessions began, immediately after the 15-week program, and three months after the program ended.

RESULTS: Students involved in the program showed improvement in several stress measures. Significant effects were seen in a comparison immediately after the training: decreased aggression, decreased helplessness in school, decreased physical complaints, improved stress coping abilities. In a comparison 3-months later, the following effects were seen: improvements in emotional balance, decreased anxiety, decreased shyness in social contacts, and decreased impulsiveness. In the first post-test measurement, parents also reported their students as being calmer and more balanced (71.4%), less impulsive, aggressive and hot-tempered (38.1%), more concentrated (38.1%), and having fewer complaints (38.1%).  Comparisons to the control group were not statistically measured.

Yoga and Attention Problems in Children

12) P eck HL, Kehle TJ, Bray MA, Theodore LA. Yoga as an intervention for children with attention problems. School Psych Rev. 2005;34z:415-424.FINDING: A small study showed an improvement in “time on task” for elementary school students with attention problems. Yoga Type : “Yoga Fitness for Kids” DVD by Gaiam (2003). Deep breathing, postures, and relaxation exercises.  Poses included frog, downward dog and bridge. Movement in a gamelike manner interspersed between poses. Ended with guided imagery while lying on their backs. Yoga Frequency/Duration : Two 30-minute sessions per week for 3 weeks.

OBJECTIVE: To investigate the effectiveness of yoga for improving time on task in children with attention problems.

METHODS: Ten students ages 6-10 with attention problems (but not diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)) participated in a 30-minute yoga videotape program twice per week for 3 weeks. Measurements were made of children’s “time on task”, defined as the percentage of intervals observed where the students had eye contact with the teacher or assigned task and performed the requested classroom assignments in 10-minute observations. Measurements occurred twice per week as follows: baseline for 3-7 weeks (varying by grade level), intervention for 3 weeks, and follow-up for 3 weeks.  Measurements occurred at the same time each day, and a child of the same gender (for each child in the program) in each classroom was chosen as a comparison.

RESULTS: An improvement in the mean “time on task” was seen both immediately following the intervention (effect size 1.5 to 2.7) and in the follow-up period (effect size 0.77 to 1.95). No change was seen in the comparison group.

Yoga and Asthma in Children

13) Jain SC, Rai L, Valecha A, Jha, UK,  Bhatnagar SO ,  Ram K . Effect of yoga training on exercise tolerance in adolescents with childhood asthma. J Asthma . 1991;28(6):437-442.

FINDING: Yoga training improved pulmonary function and exercise capacity in children and teens with asthma. Yoga Type : Yogic cleansing procedures, postures, and breathing. Yoga Frequency/Duration : Daily for 90 minutes in morning and 1 hour in evening for 40 days.

OBJECTIVE: To determine if yoga can improve pulmonary function and exercise capacity in children with asthma.

METHODS: A study of 46 children with a mean age of 15.8 years and a history of asthma was performed. Children participated in 40 days of yoga training, and measurements were made of forced expiratory volume, distance walked in a 12-minute time period and overall physical fitness as assessed by a modified Harvard Step Test. Twenty-six patients were followed for up to two years and asthma symptoms and medication requirements were measured.

RESULTS: Improvements were seen in expiratory volume, distance walked in a 12-minute time period and overall physical fitness.  Of patients followed for up to two years, children showed a continued reduction in asthma symptoms and less need for medication.  Fourteen of the children with mild asthma who continued yoga every day for 15-30 minutes remained asymptomatic.NOTE: This article was not available through GWU. The data were obtained from the abstract and from a review article: Galantino ML, Galbavy R, Quinn L. Therapeutic effects of yoga for children: a systematic review of the literature.  Pediatr Phys Ther . 2008;20(1):66-80.

Yoga and Obesity, Diabetes, and Cardiovascular Disease

14) Kristal AR, Littman AJ, Benitez D, White E. Yoga practice is associated with attenuated weight gain in healthy, middle-ages men and women. Altern Ther Health Med. 2005;11(4):28-33.

FINDING: Practicing yoga for four or more years slowed weight gain in middle-ages adults. Yoga Type : N/A Yoga Frequency/Duration : Self-report of number of days per week and minutes per day they practiced yoga and the number of years. Yoga practice was grouped into three categories of increasing intensity.

OBJECTIVE: To examine whether yoga practice is associated with a lower mean 10-year weight gain after age 45.

METHODS: 15,550 adults ages 53 to 57 were recruited into the Vitamin and Lifestyle cohort study between 2000 and 2002.  A validated physical activity questionnaire was given to the participants, which asked about a variety of activities including yoga.  Participants reported the number of years in the last 10 years that they did each activity and the number of days per week and minutes per day.  Yoga practice was grouped into three categories of increasing intensity. Self-reported weight and height were used to calculate participants’ current BMI, and the weight change was calculated from the difference between their current weight and their weight at age 45 (also by self-report).

RESULTS: Individuals with a BMI less than 25 who practiced yoga for four or more years had a 3.1 lb. lower weight gain than those who had not practiced yoga. Individuals who were overweight and practiced yoga for four or more years showed an 18.5 lb. lower weight gain. All models were adjusted for other physical activity, dietary factors, and other obesity-related variables.

15) Sahay BK. Role of yoga in diabetes. J Assoc of Physicians India . 2007; 55 :121-126.

FINDING: Yoga has a role in diabetes control and prevention. Yoga Type : Pranayama Yoga Frequency/Duration : N/A

OBJECTIVE: To assess the role of yoga on glycemic control, insulin kinetics, body composition, exercise tolerance, and co-morbidities including hypertension and dyslipidemia.

METHODS: Individuals with diabetes and without diabetes were randomized to different groups and performed yogic practices for 45 minutes each day, which was followed by relaxation practices.

RESULTS: The studies confirmed that yoga has a useful role in the control of diabetes mellitus. Fasting and postprandial blood glucose levels decreased significantly. There were significant changes in insulin kinetics and those of counter-regulatory hormones such as cortisol. There was a decrease in fatty acids. There was an increase in lean body mass and a decrease in body fat percentage. The number of insulin receptors was increased, and there was an improvement in insulin sensitivity and a decline in insulin resistance.

16) Yang K, Bernardo LM, Sereika SM, Conroy MB, Balk J, et al. Utilization of a 3-month yoga program for adults at high risk for type 2 diabetes: a pilot study. Evid Based Complement Alternat Med . Published on-line: August  18, 2009 doi:10.1093/ecam/nep117. 1-7.

FINDING: Yoga may help to lower adult risk for type 2 diabetes, reduce cardio-metabolic risk factors, and increase exercise self-efficacy. Yoga Type : Vinyasa Yoga Frequency/Duration : 1-hour sessions, 2 times per week, for 3 months. Each session began with a 5-7 min warm-up and ended with a 10 min relaxation period.

OBJECTIVE: To conduct a pilot study to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes.

METHODS: Twenty-three adults were randomly assigned to either a yoga intervention group, which participated in a 3-month yoga intervention with 1-hour Vinyasa style yoga sessions twice per week, or an educational group, which received general health educational materials every 2 weeks. Participants had to: (1) be between 45 and 65 years of age; (2) be non-exercisers (no more than 30 minutes twice per week) for the previous year; (3) have a family history of type 2 diabetes, and; (4) have at least one cardio-metabolic risk factor. All participants completed questionnaires and had blood tests at baseline and at the end of the 3-month program to measure blood pressure, blood glucose, insulin, lipid levels, and body weight, as well as to assess exercise self-efficacy.

RESULTS: Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides, and exercise self-efficacy. Findings suggest that a yoga program would possibly help to lower adults’ risk for type 2 diabetes, as well as reduce cardio-metabolic risk factors for adults at high risk for type 2 diabetes.

17) Guarracino JL, Savino S, Edelstein S. Yoga participation is beneficial to obesity prevention, hypertension control, and positive quality of life. Top Clin Nutr . 2006;21(2):108-113.

FINDING: Yoga may be beneficial in controlling weight, blood pressure, and mood. Yoga Type : Hatha and relaxation yoga. Yoga Frequency/Duration : The majority of study participants (55.7%) had practiced yoga for less than 1 year, followed next by those who had practiced yoga for more than 5 years (31.4%). The majority of participants (57.1%) practiced yoga for 1-2 hours per week, followed by those who spent less than 1 hour per week practicing yoga (24.3%).

OBJECTIVE: To evaluate the effects of hatha and relaxation yoga on obesity, blood pressure, and quality of life.

METHODS: Seventy healthy women and men ages 18 years or older were recruited from 3 fitness centers in Massachusetts after completing a 1-hour yoga class and were asked to complete a survey. The survey was used to measure how the participants felt after the yoga class, and questions included those related to yoga frequency and duration, other physical activity and duration, past and present medication use, food consumption behavior, demographic information, and data related to height, weight, blood pressure, tricep skinfold, and waist and mid-arm circumference.

RESULTS: According to survey results of the 70 participants, hatha and relaxation yoga had a statistically significant role in controlling weight, hypertension, and mood. Of the participants, those who had practiced yoga for less than 1 year had a significantly higher systolic blood pressure (mean 117.13) than those who had practiced yoga for 1-4 years (mean 107.56). However, the survey participants’ mean BMI (24.41) was significantly different from the BMI used as a cutoff for determining obesity (30.0), thus suggesting that individuals who practice hatha and relaxation yoga may not generally be obese.

18) Yang K. A review of yoga programs for four leading risk factors of chronic diseases. Evid Based Complement Alternat Med . 2007;4(4):487-491.

FINDING: Yoga programs may be effective in reducing body weight, blood pressure, blood glucose, and cholesterol. Yoga Type : Other than duration and frequency, most articles did not describe the yoga sessions in detail. Of the few articles that did identify the type of yoga studied, the most common was Hatha yoga. Yoga Frequency/Duration : The most common duration and frequency of yoga sessions in the studies were 30-60 min per session, with sessions meeting daily for 4-10 weeks. Many studies also used sessions meeting 2-3 times per week for 8-12 weeks.

OBJECTIVE: To review published studies of yoga programs and to determine the effect of yoga interventions on chronic disease risk factors, such as overweight, hypertension, high glucose level, and high cholesterol.

METHODS: A systemic search was conducted, yielding 32 articles from electronic databases published between 1980 and 2007. Of the 32 articles reviewed, 12 described experimental studies, 18 described quasi-experimental studies, and 2 described observational studies. Only 7 of the studies were conducted in the United States, and only 16 of the studies focused on subjects with diabetes, hypertension, or cardiovascular disease.

RESULTS: In analyzing the 32 articles, the authors found that yoga interventions are generally effective in reducing body weight, blood pressure, blood glucose level, and cholesterol level. However, only a few studies examined long-term effects.

Yoga and other Health Issues

19) Pullen PR, Thompson WR, Benardot D, Brandon LJ, Mehta PK, et al. The Benefits of yoga for African American heart failure patients. Med Sci Sports and Exerc. 2010:42(4): 651-657.

FINDING: Yoga improves cardiovascular endurance for African Americans who have suffered from heart failure. Yoga Type : Pranayama and Asanas. Yoga Frequency/Duration : 5 minute warm-up, including breathing exercises a 40 minute period of postures, ending with a 15 minute relaxation phase. Patients attended a total of 16 supervised sessions over an 8-10 week period.

OBJECTIVE: To see if yoga can improve physical and psychological parameters (cardiovascular endurance (VO2peak), flexibility, quality of life (QoL) and inflammatory markers) among patients with heart failure (HF), particularly among African Americans.

METHODS: Forty patients (38 AA, 1 Asian, 1 Caucasian) with systolic or diastolic HF were randomized to the yoga group (YG, N=21) or the control group (CG, N=19). All patients were asked to follow a home walking program. Pre- and post-measurements included a treadmill stress test to peak exertion, flexibility, interleukin-6 (IL-6), C- reactive protein (CRP), and extra cellular-super oxide dismutase (EC-SOD). QoL was assessed by the Minnesota Living with Heart Failure Questionnaire (MLwHFQ).

RESULTS: Yoga therapy offered additional benefits to the standard medical care of predominantly AA HF patients by improving cardiovascular endurance, QoL, inflammatory markers and flexibility.

Organizational Feature: Crossover Yoga Project

The Crossover Yoga Project (CYP) is a nonprofit organization that empowers teen female survivors of sexual trafficking, substance and physical abuse, in foster care, runaway shelters and within the juvenile detention system. CYP’s I Believe in Me curriculum provides tools to build resilience, gain self-confidence, provide pyschoeducation, character development and awareness of the impact that […]

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When she’s not working full-time as a Health Fitness Specialist at MedFit Corporate Services in Philadelphia, Dana takes time to share yoga with those truly in need. Not only does Dana offer  complementary yoga for individuals who could not afford it otherwise, but she volunteers as Program Director for Sprout Yoga, a national network developing […]

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Yoga in the schools: a systematic review of the literature

Affiliation.

• 1 University at Buffalo, State University of New York, NY, USA. [email protected]
• PMID: 23070680

Objective: The objective of this research was to examine the evidence for delivering yoga-based interventions in schools.

Methods: An electronic literature search was conducted to identify peer-reviewed, published studies in which yoga and a meditative component (breathing practices or meditation) were taught to youths in a school setting. Pilot studies, single cohort, quasi-experimental, and randomized clinical trials were considered.

Research: quality was evaluated and summarized.

Results: Twelve published studies were identified. Samples for which yoga was implemented as an intervention included youths with autism, intellectual disability, learning disability, and emotional disturbance, as well as typically developing youths.

Conclusion: Although effects of participating in school-based yoga programs appeared to be beneficial for the most part, methodological limitations, including lack of randomization, small samples, limited detail regarding the intervention, and statistical ambiguities curtailed the ability to provide definitive conclusions or recommendations. Findings speak to the need for greater methodological rigor and an increased understanding of the mechanisms of success for school-based yoga interventions.

Publication types

• Systematic Review
• Autistic Disorder / therapy
• Learning Disabilities / therapy