The impact of yoga on components of Energy Balance
Yoga may lower body weight in those who are overweight or obese, but it is unclear whether this is due to decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA).
Improving lifestyle modification measures for weight reduction is an essential public health goal due to the rising prevalence of overweight and obesity, the resulting incidence of comorbidities, and the enormous financial burden on health care systems across the world.
Current recommendations for the treatment of obesity propose lifestyle modification strategies that include lowering energy intake (EI), increasing physical activity (PA), and strengthening counseling for behavioral changes by qualified interventionists. This lifestyle change intervention strategy often results in a short-term weight loss of 5–10%, which has substantial health advantages. However, the long-term effectiveness of sustaining weight reduction is limited, with around fifty percent of lost weight being returned within one year. 8-11 The obesity treatment recommendations advocate continuing involvement in a long-term (1 year) comprehensive weight loss maintenance programme for long-term weight reduction maintenance. Therefore, it is essential to examine realistic and cost-effective long-term strategies for enhancing the efficacy of lifestyle change programmes, as stated in 7 and 12 above.
Yoga is a kind of alternative therapy that is rapidly gaining popularity, and it may be an effective way to increase the efficacy and durability of long-term weight reduction results via lifestyle modification therapies. A recent systematic review and meta-analysis of randomized controlled trials (RCTs) revealed that yoga treatments led to substantial decreases in body mass index (BMI) in the subset of five studies that included individuals with overweight, obesity, or metabolic syndrome. However, it has not been explored systematically whether a lower BMI resulted from a lower EI, a higher TDEE, or both. This is a significant information gap, as understanding the amount to which yoga therapies affect various energy balance indicators might influence the development of more effective lifestyle change programmes.
Yoga may possibly enhance energy balance through a number of different processes.
For instance, yoga may lower EI by enhancing mindfulness and the mind-body connection, enhancing mood affect, and decreasing stress.Regular yoga practice is connected with improved nutritional quality and emotional eating control among adults without obesity. In qualitative research, persons who lost weight through yoga revealed mental changes away from weight reduction and toward health, as well as enhanced awareness, attention, and self-esteem. Enhancements in self-esteem and stress reductions may be particularly important for moderating the detrimental impacts of weight stigma on weight loss, good eating, and physical activity. In addition, certain yoga poses may boost EE both directly and indirectly by eliminating some of the barriers to adopting and sustaining PA in general, since yoga can reduce back and joint pain and improve physical function, isometric strength, cardiorespiratory fitness, and balance. These unique psychological and physiological changes associated with yoga interventions may therefore provide a form of activity that is more reinforcing for some individuals than higher intensity resistance or aerobic activities, as well as support changes in EI and moderate/vigorous intensity PA, both of which are known to be essential for weight management. After the intervention, these factors may help the longer-term maintenance of dietary and physical activity modifications.
Although these findings are encouraging, the majority of the data supporting the good benefits of yoga on energy balance comes from cross-sectional or retrospective research conducted on groups that are not obese. Understanding how yoga affects various components of energy balance in individuals with overweight or obesity can lead to the development of innovative and perhaps more successful weight loss treatments. To far, however, there has been no systematic review of the literature investigating the extent to which yoga therapies result in decreased EI, increased EE, or a mix of both in individuals with excess body weight. In light of this, the purpose of this systematic review was to assess the available evidence on the effect of yoga therapies on EI and PA in people with overweight or obesity.
In addition, two randomised controlled trials included participants with metabolic syndrome, as opposed to those with an overweight or obese BMI. These were included in this review because a high waist circumference is one of the three necessary criteria for metabolic syndrome and is also an indicator of central obesity and the first-line treatment for metabolic syndrome consists of dietary and physical activity changes, similar to the treatment for obesity.
Yoga treatments differed considerably with respect to the types and particular body-, breath-, and mind-based activities included, as well as the quantity of detail offered to understand the style of yoga or practises included in the intervention. All research featured asanas, or body-based yoga poses, with three studies concentrating only on asanas. The level of the asana practises included in the treatments ranged from low intensity (described as restorative, therapeutic, or stretching in three interventions to high intensity (described as physically demanding) in six interventions. Two papers mentioned pranayama regulated breathing methods, but only the research. addressed them in detail. One research briefly discussed breathing as a component of the warm-up, whereas four studies emphasised breathing during postures or relaxation. Three studies specified using meditation practices in accordance with classical Patanjali teachings, while one merely stated meditation as a component of relaxation and another incorporated Bible-centered meditations during relaxation.
Energy intake results
Seven studies examined some aspect of food consumption both prior to and following a yoga intervention.
Five of these studies coupled yoga with food guidelines or advice, but two studies did not give dietary guidance and urged participants specifically not to modify their diet throughout the intervention. All studies investigated dietary intake or nutrition using self-reported measures, such as a modified nutrition-behavior questionnaire, the Eating Behavior Inventory, a food frequency questionnaire, a 24-hour recall, 30-day food records, and a food frequency questionnaire, No research employed more stringent assessments of free-living appetite or nutritional consumption (e.g., measures of hunger and satiety, doubly labelled water, etc.).
Theoretically, yoga may alter a number of important variables of health behaviour change that promote weight loss in obese individuals.
It is unknown whether yoga-induced weight reduction results from lower EI, increased PA, or both. Consequently, this comprehensive review investigated the effect of yoga on EI and PA in people with obesity. Our findings imply that the addition of yoga to a weight loss programme may aid in the reduction of EI and improvement of numerous food consumption factors. However, there is inadequate evidence that yoga therapies may independently change EI. There is some evidence that self-reported physical activity rises in response to a yoga intervention, but there is no consistent evidence that yoga is connected with increased non-yoga physical activity. Importantly, the yoga + diet intervention led to higher decreases in EI and increases in PA than the diet intervention alone in the only major RCT included in the systematic review in which participants were not told to maintain their usual diet and PA habits. Consequently, while the overall body of literature is insufficient to definitively describe the effects of yoga on EI and PA among individuals with overweight and obesity, there is promising preliminary evidence that yoga can lead to improvements in both diet and PA, especially when combined with a lifestyle intervention. There is a need for further large-scale, thoroughly planned, sufficiently powered research to look for between-group variations in dietary and physical activity changes.
In addition, there was much variation across the research included in this evaluation with regard to the diverse kinds and particular yoga practices that comprised the yoga therapies, making it difficult to compare data across studies. So far, there is no consensus over which types of yoga should be included in interventions, which hinders the scientific investigation of yoga and its potential health benefits. In the context of obesity or related chronic disease treatment, the intensity of yoga practices and the purpose of their inclusion (i.e., as a form of exercise versus reducing appetite, pain, stress, or mitigating weight stigma) should be considered, measured, and described in greater detail in future studies. Importantly, trials done in India and China placed a lot more emphasis on detailing the exact yoga practices included in each intervention, and employed practices that were more compatible with true yoga techniques outlined in old Sanskrit writings.These interpretations emphasize body-based poses as a type of exercise, reflecting how yoga has been adopted commercially in the West, largely as a form of exercise. However, other essential components of a genuine yoga practise, such as pranayama breathing and meditation practises, should be included in yoga intervention studies in Western cultures, as is the norm in the East. Reducing (or limiting) EI results in more weight reduction than exercise-only interventions, and is therefore essential for effective weight control. Cross-sectional evidence suggests that yoga promotes dietary intake practises and psychological changes that support weight management, such as increased consumption of fruits and vegetables, decreased consumption of sugar-sweetened beverages and snack foods, decreased consumption of fast food, increased motivation to make healthier food choices, mindful eating, and better management of emotional eating and stress. However, according to the findings of this comprehensive review, there is insufficient evidence to demonstrate that yoga therapies reduce EI in individuals who are overweight or obese. While there appears to be modest within-group changes or positive alterations immediately following a short-term intervention, these results are not supported by group by time interactions (suggesting yoga does not alter dietary intake more or less than control conditions) or are not apparent after making the necessary statistical adjustments. In one of the larger trials included in this analysis, however, food consumption was favorably modified to a greater amount than in the diet-only control group. Notably, all dietary information was derived from participant self-reports, which are frequently erroneous in adults with obesity, and may have masked real dietary changes. Therefore, the benefits of a yoga intervention on objective EI and its drivers in obese individuals are mainly unclear.
Several unique elements of yoga show that yoga positively affects components upstream, which may promote EI-related lasting behaviour changes and help weight reduction maintenance. Following 10 minutes of decreased respiration, subjective hunger ratings improve (6 bpm vs. 9 bpm). Consistent slower breathing techniques used as part of a typical yoga practice helped alleviate hunger, making it easier to sustain decreases in EI over time. Yoga may also improve self-efficacy in managing diet, and decrease the frequency of binge eating, hence promoting long-term weight loss. In a qualitative study of people who lost weight with yoga, all respondents who were overweight prior to weight reduction reported the process as involving a mental change toward healthier eating, as well as an improvement in mood and emotional stability. Many reported that yoga led to more attentive eating, changes in food choices, and less emotional and/or stress-related eating. In conclusion, early data shows that yoga may enhance critical psychological and physiological features that are crucial for dietary improvement. However, as noted by this comprehensive review, so far, no rigorous study has evaluated the direct effect of a yoga intervention on food consumption or particular elements of hunger in individuals with overweight or obesity.
PA is also essential for weight reduction, particularly weight loss maintenance, since individuals who successfully maintain their weight loss participate in high amounts of PA on a daily basis.
This is also reflected in the current PA guidelines for weight control, which prescribe 300 minutes per week of moderate intensity PA. All six trials that permitted participants to alter PA27, and one where participants were advised not to alter PA29 observed increases in self-reported PA or resting metabolic rate following the intervention. However, only three researchers reported p-values for these improvements, one intervention was a 5-day residential retreat, and the observed increase in PA was not maintained among participants who completed a 3-month follow-up. In addition, objectively assessed PA through accelerometers did not increase in one trial, but self-reported PA rose (p-values not included).
These findings provide tentative support for the hypothesis that PA may rise after a yoga intervention. It is crucial to highlight, however, that many kinds of yoga elicit minimal levels of EE; hence, it is vital to evaluate changes in non-yoga PA and resting metabolic rate, since they may have a greater influence on long-term changes in TDEE. In other words, it may not be the EE linked with yoga that considerably increases TDEE, but rather greater EE levels from other TDEE components. However, even a minor gain in non-yoga physical activity is encouraging, since it implies that individuals did not offset increases in yoga physical activity with decreases in other physical activity. With moderate and intense activity, compensation might occur and hamper weight reduction. 49-51 Yoga may be an exercise method that is not connected with compensation, however this is hypothetical. This may be due to yoga's significantly lower EE compared to other workout modalities with a higher intensity. 48 A recent study including non-obese older individuals revealed that a 6-month yoga intervention had no effect on total, resting, or PA EE. This review also contained a single research that found an increase in resting metabolic rate (100 kcal/day), but this was not analysed in combination with body composition to contextualize results and was tested with a portable indirect calorimeter, which may be inaccurate. Obese individuals require more study on objectively observed non-yoga PA, resting metabolic rate, and TDEE during a yoga intervention.
This review underlines the scarcity of research that has assessed the benefits of yoga treatments on PA in people who are overweight or obese. However, additional studies in groups that are not predominantly overweight or obese shows that yoga practise will boost PA levels via processes unrelated to the hypothesised rise in EE from yoga sessions. Yoga can increase PA involvement in obese individuals by reducing back and joint discomfort. During a 10-week yoga intervention to prevent weight gain in Puerto Rican college students, self-reported walking rose in the yoga arm, but dropped in the control arm, which was more sedentary. Yoga boosted positive affect, physical function, and self-esteem in a non-obese group after a 20-week behavioural weight loss intervention involving mind-body approaches (i.e., meditation, imagery). Lastly, in a nationally representative poll of yoga practitioners, over two-thirds said that yoga encouraged them to eat healthier (63%) and exercise more frequently (63%). Consequently, there is a strong motivation for future studies to evaluate the extent to which yoga leads to changes in total and non-yoga PA levels in individuals with obesity using objective measurements in order to fill in the remaining research gaps.
This review is the first to describe changes in EI and PA in response to yoga in obese individuals, and it identified some limitations that must be noted when evaluating the research. The prevalent reliance on self-reported measurements of food intake and physical activity is the most significant weakness of the available research. The inaccuracy of these measures in distinguishing true hinders the present understanding of how yoga practice may alter other health-related behaviors. Due to their inability to capture behavioral variability, short measures of nutritional intake and PA, such as 24-hour eating recalls and PA questionnaires, are particularly prone to error. In addition, the use of multiple self-report measures and different metrics from the same measure makes it impossible to compare the results of different research. Future study employing more stringent methodologies for assessing EI, hunger, PA, and total EE (e.g., doubly labeled water, accelerometers, meal studies, and food photography) is necessary and justified.
Current interpretation is additionally constrained by the health behavior advice participants got from many treatments. Instructions to prevent EI and PA alterations hide any independent changes and likely lessen the genuine effect of yoga on EI and PA. In addition, there was considerable variation in the type of yoga in each intervention, with some offering more information than others. Comparing research rigorously is hampered by the diversity of participant teaching and yoga intervention approaches. A disadvantage of this specific review is that a meta-analysis was not possible given the variances in research design and outcomes measurements.
In conclusion, relatively little data suggests that yoga improves EI and PA characteristics in individuals who are overweight or obese. However, this is at least partially attributable to the limited number of studies that have measured these outcomes in this population in response to a yoga intervention (most with small sample sizes), the wide variation in study designs, and the absence of rigorous, objective measurements of these variables. The compelling justification for exploring the effects of yoga on EI and PA during weight loss implies that yoga offers potential as a method to aid in the weight reduction and maintenance of weight loss in obese individuals. Unknown is whether yoga can alter energy balance as a stand-alone intervention or as part of a complete lifestyle modification programme. In order to lessen the burden of obesity, it is necessary to examine the effects of yoga on energy intake (EI) and physical activity (PA) using objective measures of energy balance in order to determine how yoga promotes weight reduction in this group.