Edited by: Deanne Helena Hryciw, Griffith University, Australia
Reviewed by: Olivia Holland, Griffith University, Australia; Lannie O'Keefe, Victoria University, Australia
This article was submitted to Obesity, a section of the journal Frontiers in Endocrinology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Trial registration: (CTRI/2018/05/014077).
The Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study is an ongoing cross sectional national study of the prevalence of obesity, diabetes, and hypertension across the Indian sub-continent (
Lifestyle changes which include increased physical activity, a healthy diet and a positive attitude have been recommended for the management of obesity (
A single study demonstrated a decrease in central obesity in 60 female participants after 12 weeks of yoga (
The aim of this study was to determine if in adult females with central obesity a 12 week program of yoga or of nutritional advice could (i) alter anthropometric measurements associated with a risk of developing diseases associated with central obesity and (ii) positively influence the lipid profile and quality of life.
Fifty two healthy Asian Indian adult females with central obesity with ages between 30 and 59 years (group average age ± SD; 43.98 ± 6.89 years) were recruited for the trial. The trial profile is provided in Figure
Trial profile of the study.
The baseline characteristics of the participants.
Number of participants (n) | 26 | 26 |
Number of participants in 30–45 (years) age group | 12 | 16 |
Number of participants in 46–59 (years) age group | 14 | 10 |
Age in years (mean ± SD) | 45.9 ± 7.4 | 42.5 ± 8.3 |
Weight in kg (mean ± SD) | 74.62 ± 12.03 | 78.92 ± 12.03 |
BMI in kg/m2 (mean ± SD) | 31.75 ± 4.17 | 33.31 ± 4.71 |
Waist circumference in cm (mean ± SD) | 100.77 ± 10.79 | 101.06 ± 8.56 |
Type of diet | Vegetarian | Vegetarian |
Health | Normal | Normal |
Taking any medication | No | No |
Consumption of alcohol or nicotine in any form | No | No |
The present single blind comparative controlled trial was carried out between April and August 2016 where assessors were blinded to the group to which the participants belonged. The yoga group practiced yoga for 75 min/day, for 3 consecutive days in a week, over a 12 week period. Along with this they were given a diet plan for 1,900–2,000 Kcal/day developed based on the guidelines from the National Institute of Nutrition, India (
At the start of the trial an attempt was made to convince participants to be randomly allocated to yoga or nutritional advice groups. However participants had time and practical constraints. Hence based on their convenience they were assigned to either intervention. However several participants of the nutritional advice group mentioned that they were interested to learn yoga later on.
The following assessments were carried out by individuals who were blinded to the group to which the participants belonged.
Participants were lightly clothed and asked to stand upright with their feet 25–30 cm apart and weight evenly distributed on both feet. The tape measure which was used for assessments (Gülick Anthropometric tape Model J00305, Lafayette Instrument, U.S.A.) was fitted around the abdomen without compressing soft tissue. The waist circumference was measured to the nearest 0.1 cm in a horizontal plane midway between the inferior costal margin and the iliac crest.
The participant was asked to lie supine on their back. The caliper used to measure the supine sagittal abdominal diameter has two arms attached to a vertical scale [Holtain-Kahn Abdominal Caliper 50 cm (98.609XL), U.K.]. The standard method was followed by which the lower arm of the caliper was placed under the participant (
The hip circumference was measured around the pelvis at the point of maximal protrusion of the buttocks. The ratio of the waist circumference to the hip circumference was derived and is a ratio of the fat stored centrally inside the abdomen (waist circumference) and fat stored peripherally (hip circumference).
Seven anthropometric indices were derived from direct measurements using standardized formulae (
The body mass index (BMI) was calculated as the body weight (in kg), in light clothing and without footwear, divided by the height (in meters squared). The accuracy of the weighing machine (Model DS 215 N, Essae-Teraoka Pvt. Ltd, Bengaluru, India) was up to 0.05 kg. The height was measured to the nearest 0.1 cm.
BMI = Weight (kg)/ Height 2(m).
WHR = WC (cm)/HC (cm).
ABSI = WC (m)/[BMI 2/3 (kg/m2) Height ½ (m)]
where WC and height are expressed in m and BMI in kg/m2.
CI = 0.109 −1 WC (m) [Weight (kg) / Height (m)] −1/2
where WC is measured in cm, weight in kg and height in m.
AVI = [2WC2 (cm) + 0.7 (WC - HC) 2 (cm)]/1000
where WC and HC (hip circumference) are expressed in cm.
VAI female = {WC (cm)/[36.58 +1.89BMI (kg/m2)]} [TG (mmol/L)/0.81] [1.52/HDL (mmol/L)]
where WC is expressed in cm, BMI in kg/m2, Triglycerides in mmol/L, and HDL in mmol/L.
BRI = 364.2 – 365.5 [1 –π −2 WC 2 (m) Height −2 (m)] 1/2
where WC and height are expressed in m.
Antecubital venous blood samples were collected under sterile conditions. Total cholesterol, triglycerides, high density, and low density lipoprotein cholesterol were estimated using appropriate enzymes followed by spectrophotometry.
A structured interview was carried out to recall the food and fluids which the participants had consumed in the 24 h prior to the study. The method was as follows: participants were asked (i) to recall and list the foods they had consumed during the 24 h preceding the assessment, (ii) the method of preparation (e.g., raw, cooked, boiled, or baked), (iii) the size of utensils used, the interviewer had four types of utensils (i.e., a bowl, cup, glass, and spoon), each of which had four sizes. Participants were asked to indicate the size used by them. The volume of each of the utensils of different sizes had already been determined (
Physical activity was assessed using the International Physical Activity Questionnaire Short Form (IPAQ) (
The Moorehead-Ardelt Quality of Life Questionnaire was used to assess six aspects of the quality of life (QoL) (
Participants received a 45 min presentation on nutrition (1 presentation/week) for 12 weeks. The person who gave the presentation had a minimum of 12 years of education including 2 years of training in science. The presenter used slides made by the research institute conducting the trial. The 12 topics of the presentations were: (i) five basic food groups, (ii) vegetarian diet, (iii) proteins, (iv) fats, (v) carbohydrates, (vi) dietary fiber, (vii) vitamins, (viii) minerals, (ix) probiotics, (x) iron deficiency, (xi) calcium, and (xii) antioxidants.
The yoga intervention consisted of (i) a universal prayer (3 min)1, (ii) yoga posture
Details of the yoga intervention.
1 | Universal prayer | 3 min | |
2 | 1. |
3 min | |
2. |
6 min | ||
3. |
3 min | ||
4. |
6 min | ||
5. |
3 min | ||
6. |
3 min | ||
3 | 1. |
3 min | |
2. |
3 min | ||
3. |
3 min | ||
4. |
1 min | ||
4 | 1. |
3 min | |
2. |
3 min | ||
3. |
1 min | ||
5 | 1. |
3 min | |
2. |
6 min | ||
3. |
3 min | ||
4. |
6 min | ||
6 | 6 min | ||
2. |
1 min | ||
7 | Guided relaxation | 6 min | |
75 min |
Participants of both groups were given a diet plan for a balanced diet of 1900–2000 Kcal/day. The diet plan included fruits, vegetables, lentils, complex carbohydrates, and dairy products. Hence it was a lacto-vegetarian diet. The ratio of carbohydrates, protein and fats in the diet was based on the guidelines for a balanced diet for an Indian population published by the National Institute of Nutrition, India (
1May all be prosperous and happy
May all be free from illness
May all see what is uplifting
May no one suffer
Peace, peace, peace
The data obtained at the beginning and end of the 12 week period for the two groups were compared with a repeated measures analysis of variance (ANOVA) followed by multiple
Both nutritional advice and yoga groups were subdivided based on age as (i) participants between 30 and 45 years and (ii) those who were 46 years and above.
For (i) and (ii) there were separate between group comparisons of values at baseline and after 12 weeks using
None of the participants reported any adverse events during the trial. At baseline the visceral adiposity index (VAI), levels of triglycerides and of VLDL differed significantly between the nutritional advice and yoga groups. The group mean values ± SD for the (i) anthropometric measures and anthropometric indices, (ii) lipid profile, (iii) energy intake/day and energy expenditure/day, and (iv) quality of life are given in Tables
Anthropometric variables.
Waist circumference (cm) | 100.8 ± 10.8 | 97.9 ± 8.6 |
0.30 | 0.72 | 5.00 | 101.1 ± 8.6 | 94.8 ± 7.1 |
0.81 | 4.14 | 8.41 |
SAD (cm) | 23.5 ± 2.8 | 23.3 ± 2.3 | 0.08 | −0.35 | 0.73 | 24.1 ± 2.6 | 23.1 ± 2.6 |
0.39 | 0.45 | 1.52 |
Hip circumference (cm) | 111.7 ± 7.4 | 109.2 ± 6.8 |
0.36 | 0.79 | 4.16 | 112.3 ± 10.4 | 107.8 ± 9.3 |
0.46 | 2.79 | 6.16 |
BMI (kg/m2) | 31.8 ± 4.2 | 31.3 ± 4.1 | 0.12 | −0.10 | 1.06 | 33.3 ± 4.7 | 32.2 ± 5.4 |
0.22 | 0.52 | 1.68 |
Waist/hip ratio | 0.9 ± 0.1 | 0.9 ± 0.1 | 0.17 | −0.01 | 0.03 | 0.9 ± 0.1 | 0.9 ± 0.1 |
0.31 | 0.00 | 0.04 |
A body shape index | 0.081 ± 0.01 | 0.079 ± 0.01 |
0.22 | −0.02 | 0.29 | 0.079 ± 0.01 | 0.06 ± 0.01 |
0.21 | 0.04 | 0.35 |
Conicity index | 1.3 ± 0.1 | 1.3 ± 0.1 | 0.21 | −0.00 | 0.05 | 1.3 ± 0.2 | 1.3 ± 0.1 |
0.28 | 0.01 | 0.06 |
Abdominal volume index | 20.7 ± 4.3 | 19.4 ± 3.4 |
0.33 | 0.44 | 2.02 | 21.2 ± 6.1 | 19.3 ± 5.6 |
0.33 | 1.08 | 2.65 |
Visceral adiposity index | 2.9 ± 1.4 |
3.0 ± 2.1 | 0.02 | −0.51 | 0.44 | 2.2 ± 1.1 | 2.3 ± 0.9 | 0.07 | −0.51 | 0.37 |
Body roundness index | 6.9 ± 2.0 | 6.4 ± 1.5 |
0.30 | 0.18 | 0.84 | 7.0 ± 2.4 | 6.3 ± 2.2 |
0.33 | 0.40 | 1.06 |
Lipid profile.
Total cholesterol (mmol/L) | 4.6 ± 0.8 | 5.0 ± 0.8 |
0.54 | −0.7 | −0.15 | 4.6 ± 0.8 | 4.6 ± 1.0 | 0.02 | −0.3 | 0.23 |
Triglycerides (mmol/L) | 1.72 ± 0.7 |
1.7 ± 0.7 |
0.01 | −0.21 | 0.19 | 1.35 ± 0.5 | 1.30 ± 0.42 | 0.18 | −0.11 | 0.27 |
LDL cholesterol (mmol/L) | 2.8 ± 0.6 | 3.0 ± 0.6 |
0.41 | −0.44 | −0.02 | 3.1 ± 0.6 | 3.0 ± 0.7 | 0.15 | −0.08 | 0.27 |
HDL cholesterol(mmol/L) | 1.2 ± 0.3 | 1.3 ± 0.3 | 0.13 | −0.14 | 0.06 | 1.23 ± 0.24 | 1.1 ± 0.3 |
0.50 | 0.03 | 0.22 |
VLDL (mmol/L) | 0.77 ± 0.3 |
0.78 ± 0.29 |
0.04 | −0.10 | 0.08 | 0.58 ± 0.24 | 0.56 ± 0.15 | 0.12 | −0.06 | 0.11 |
Estimated energy intake/day based on 24 h diet recall questionnaire.
Protein (gm)/day | 53.8 ± 17.4 | 55.7 ± 10.3 | 0.13 | −9.15 | 5.44 | 59.0 ± 14.0 | 50.7 ± 10.4 | 0.68 | 1.24 | 15.23 |
Fat (gm)/day | 47.5 ± 19.6 | 46.9 ± 18.5 | 0.03 | −8.87 | 10.03 | 39.2 ± 14.1 | 41.4 ± 16.7 | 0.15 | −11.88 | 7.39 |
Carbohydrates (gm)/day | 193.6 ± 76.9 | 222.0 ± 77.5 | 0.38 | −79.07 | 22.12 | 216.5 ± 55.4 | 248.7 ± 114.2 | 0.37 | −82.78 | 18.42 |
Energy intake (Kcal)/day | 1625.9 ± 395.4 | 1716.3 ± 384.6 | 0.24 | −320.57 | 139.89 | 1753.5 ± 423.5 | 1590.6 ± 366.0 | 0.42 | −67.33 | 393.13 |
Estimated energy expenditure/day based on (i) International Physical Activity Questionnaire—Short Form and (ii) Harris-Benedict equation to determine the basal metabolic rate.
Total energy (Kcal) spent/day | 2022.6 ± 238.7 | 1995.6 ± 205.7 | 0.12 | −87.79 | 141.78 | 2158.8 ± 322.6 | 2019.5 ± 219.8 | 0.52 | 24.10 | 253.67 |
Quality of life.
General self-esteem | 0.22 ± 0.27 | 0.3 ± 0.16 | 0.37 | −0.185 | 0.015 | 0.22 ± 0.25 | 0.30 ± 0.16 | 0.39 | −0.188 | 0.012 |
Physical activity | 0.25 ± 0.23 | 0.32 ± 0.15 | 0.37 | −0.165 | 0.026 | 0.24 ± 0.23 | 0.25 ± 0.22 | 0.05 | −0.130 | 0.61 |
Social contacts | 0.22 ± 0.29 | 0.30 ± 0.15 | 0.35 | −0.104 | 0.081 | 0.24 ± 0.23 | 0.30 ± 0.17 | 0.30 | −0.130 | 0.168 |
Satisfaction concerning work | 0.32 ± 0.14 | 0.35 ± 0.12 | 0.24 | −0.108 | 0.046 | 0.29 ± 0.25 | 0.29 ± 0.22 | 0.00 | −0.085 | 0.069 |
Pleasure related to sexuality | 0.04 ± 0.31 | 0.14 ± 0.31 | 0.33 | −0.196 | 0.034 | 0.07 ± 0.31 | 0.14 ± 0.25 | 0.25 | −0.184 | 0.046 |
Focus on eating behavior | 0.29 ± 0.22 | 0.27 ± 0.21 | 0.09 | −0.072 | 0.110 | 0.2 ± 0.3 | 0.29 ± 1.9 |
0.07 | −0.183 | −0.001 |
Total quality of life | 1.34 ± 0.93 | 1.67 ± 0.78 | 0.39 | −0.675 | 0.014 | 1.23 ± 1.06 | 1.58 ± 0.87 |
0.37 | −0.690 | −0.002 |
The ANOVA values for the Within-Subjects factor (States), Between-Subjects factor (Groups) and interaction between the two are given below. The details of the ANOVA are available in the
There were significant differences between post and pre states for waist circumference (
There were significant differences between the groups in a body shape index (
Interaction between States and Groups was significant for waist circumference (
There were two
At baseline (pre) the visceral adiposity index (VAI,
The nutritional advice group showed a significant decrease in the waist circumference (
The yoga group had a significant decrease in waist circumference (
The participants of both groups were divided as two groups based on age, viz., 30–45 years and 46–59 years. For each age group, comparisons were made between nutritional advice and yoga groups using
Anthropometric variables and derived indices for two age range i.e., 30-45 and 46-59 year.
Number of participants (n) | 12 | 16 | ||||||
Waist circumference (cm) | 97.3 ± 12.3 | 98.0 ± 10.6 | 0.52 | 0.07 | 101.6 ± 9.3 | 95.3 ± 8.4 |
5.77 | 0.71 |
SAD (cm) | 22.0 ± 2.7 | 22.6 ± 2.5 | 1.25 | 0.25 | 24.0 ± 2.6 | 23.1 ± 2.8 |
3.34 | 0.34 |
Hip circumference (cm) | 110.8 ± 9.5 | 109.7 ± 9.0 | 0.70 | 0.12 | 113.2 ± 11.8 | 108.9 ± 9.8 |
4.25 | 0.40 |
BMI (kg/m2) | 30.5 ± 4.8 | 30.6 ± 4.5 | 0.20 | 0.02 | 33.1 ± 4.9 | 32.0 ± 4.7 |
4.08 | 0.24 |
Waist/hip ratio | 0.9 ± 0.1 | 0.9 ± 0.1 | 0.88 | 0.17 | 0.9 ± 0.1 | 0.9 ± 0.1 | 1.98 | 0.25 |
A body shape index | 0.1 ± 0.0 | 0.1 ± 0.0 | 0.368 | 0.00 | 0.08 ± 0.0 | 0.08 ± 0.0 |
4.0 | 0.31 |
Conicity index | 1.3 ± 0.1 | 1.3 ± 0.1 | 0.75 | 0.10 | 1.3 ± 0.2 | 1.3 ± 0.2 |
2.68 | 0.18 |
Abdominal volume index | 19.4 ± 4.9 | 19.5 ± 4.2 | 0.31 | 0.04 | 22.3 ± 7.3 | 20.5 ± 6.7 |
4.48 | 0.27 |
Visceral adiposity index | 2.9 ± 1.4 | 2.6 ± 1.3 | 0.92 | 0.26 | 2.1 ± 1.0 | 2.3 ± 0.8 | 1.65 | 0.28 |
Body roundness index | 6.2 ± 2.1 | 6.3 ± 1.8 | 0.35 | 0.04 | 7.4 ± 2.9 | 6.7 ± 2.6 |
4.01 | 0.26 |
Number of participants (n) | 14 | 10 | ||||||
Waist circumference (cm) | 103.8 ± 8.7 |
97.9 ± 6.8 |
3.26 | 0.79 | 100.2 ± 7.7 | 93.9 ± 4.8 |
3.33 | 1.03 |
SAD (cm) | 24.8 ± 2.3 | 23.9 ± 2.0 |
4.64 | 0.42 | 24.2 ± 2.7 | 23.1 ± 2.3 |
2.99 | 0.46 |
Hip circumference (cm) | 112.5 ± 5.2 | 108.8 ± 4.4 |
3.30 | 0.80 | 110.8 ± 8.1 | 106.2 ± 8.7 |
4.59 | 0.59 |
BMI (kg/m2) | 32.9 ± 3.4 | 31.9 ± 3.7 | 2.15 | 0.28 | 33.6 ± 4.6 | 32.6 ± 4.1 |
2.36 | 0.24 |
Waist/hip ratio | 0.9 ± 0.1 | 0.9 ± 0.1 |
2.19 | 0.32 | 0.9 ± 0.0 | 0.9 ± 0.0 | 1.07 | 0.30 |
A body shape index | 0.08 ± 0.0 | 0.08 ± 0.0 |
3.43 | 0.10 | 0.08 ± 0.0 | 0.1 ± 0.0 |
2.94 | 0.42 |
Conicity index | 1.4 ± 0.1 | 1.3 ± 0.1 |
4.18 | 0.77 | 1.3 ± 0.1 | 1.2 ± 0.1 | 2.01 | 0.55 |
Abdominal volume index | 21.8 ± 3.5 | 19.4 ± 2.6 |
4.61 | 0.82 | 19.4 ± 2.7 | 17.4 ± 2.2 |
3.30 | 0.82 |
Visceral adiposity index | 2.9 ± 1.4 | 3.3 ± 2.6 | 0.79 | 0.20 | 2.4 ± 1.2 | 2.2 ± 1.0 | 1.11 | 0.19 |
Lipid profile for two age range i.e., 30–45 and 46–59 year.
Number of participants (n) | 12 | 16 | ||||||
Total cholesterol (mmol/L) | 4.58 ± 0.78 | 5.43 ± 0.62 | 3.71 | 1.26 | 4.34 ± 0.77 | 4.20 ± 0.74 | 1.59 | 0.19 |
Triglycerides (mmol/L) | 1.75 ± 0.80 |
1.64 ± 0.52 | 0.55 | 0.17 | 1.22 ± 0.36 | 1.24 ± 0.34 | 0.39 | 0.07 |
LDL cholesterol (mmol/L) | 2.95 ± 0.49 | 3.41 ± 0.48 | 3.37 | 0.98 | 2.89 ± 0.59 | 2.76 ± 0.62 | 1.72 | 0.22 |
HDL cholesterol (mmol/L) | 1.17 ± 0.19 | 1.33 ± 0.24 | 1.60 | 0.74 | 1.22 ± 0.22 | 1.08 ± 0.20 | 3.33 | 0.68 |
VLDL (mmol/L) | 0.75 ± 0.32 | 0.72 ± 0.20 | 0.39 | 0.13 | 0.54 ± 0.17 | 0.54 ± 0.13 | 0.20 | 0.05 |
Number of participants (n) | 14 | 10 | ||||||
Total cholesterol (mmol/L) | 4.55 ± 0.84 | 4.54 ± 0.78 | 0.04 | 0.01 | 5.08 ± 0.55 | 5.35 ± 0.86 | 1.14 | 0.39 |
Triglycerides (mmol/L) | 1.70 ± 0.56 | 1.82 ± 0.79 | 0.78 | 0.19 | 1.56 ± 0.62 | 1.32 ± 0.42 | 1.59 | 0.48 |
LDL cholesterol (mmol/L) | 2.65 ± 0.60 | 2.62 ± 0.43 | 0.19 | 0.05 | 3.36 ± 0.42 | 3.31 ± 0.83 | 0.25 | 0.07 |
HDL cholesterol (mmol/L) | 1.28 ± 0.40 | 1.20 ± 0.32 | 1.09 | 0.23 | 1.28 ± 0.28 | 1.18 ± 0.35 | 1.78 | 0.33 |
VLDL (mmol/L) | 0.78 ± 0.26 | 0.84 ± 0.38 | 0.78 | 0.19 | 0.66 ± 0.31 | 0.60 ± 0.19 | 0.88 | 0.25 |
Estimated energy intake/day based on 24 h diet recall questionnaire for two different age range i.e., 30–45 and 46–59 year.
Number of participants (n) | 12 | 16 | ||||||
Protein (gm)/day | 51.9 ± 19.3 | 55.9 ± 12.0 | 0.54 | 0.26 | 64.5 ± 13.5 | 53.6 ± 8.9 | 2.79 | 0.98 |
Fat (gm)/day | 52.3 ± 22.1 | 54.9 ± 17.5 | 0.34 | 0.17 | 37.8 ± 13.2 | 42.7 ± 17.8 | 0.77 | 0.32 |
Carbohydrates (gm)/day | 198.0 ± 76.9 | 216.8 ± 60.8 | 0.68 | 0.28 | 238.2 ± 45.5 | 251.1 ± 97.6 | 0.43 | 0.18 |
Energy intake (Kcal)/day | 1601.4 ± 447.1 | 1738.8 ± 292.3 | 0.83 | 0.38 | 1744.6 ± 299.8 | 1679.9 ± 425.1 | 0.49 | 0.18 |
Number of participants (n) | 14 | 10 | ||||||
Protein (gm)/day | 55.9 ± 15.7 | 55.5 ± 8.6 | 0.09 | 0.03 | 50.7 ± 9.9 | 46.4 ± 11.5 | 1.03 | 0.42 |
Fat (gm)/day | 43.4 ± 16.9 | 40.1 ± 16.9 | 0.53 | 0.20 | 41.7 ± 16.0 | 39.2 ± 15.3 | 0.37 | 0.17 |
Carbohydrates (gm)/day | 189.8 ± 79.5 | 226.5 ± 91.5 | 1.09 | 0.45 | 181.8 ± 53.8 | 244.7 ± 142.6 | 1.12 | 0.62 |
Energy intake (Kcal)/day | 1646.9 ± 361.3 | 1696.9 ± 459.6 | 0.29 | 0.13 | 1767.8 ± 589.9 | 1447.7 ± 184.8 | 1.58 | 0.77 |
Estimated energy expenditure/day based on (i) International Physical Activity Questionnaire—Short Form and (ii) Harris-Benedict equation to determine the basal metabolic rate for two different age range i.e., 30-45 and 46-59 years.
Number of participants (n) | 12 | 16 | ||||||
Total energy (Kcal) spent/day | 2027.8 ± 275.2 | 2035.0 ± 233.8 | 0.07 | 0.03 | 2173.0 ± 299.5 | 2007.1 ± 226.9 | 2.40 | 0.65 |
Number of participants (n) | 14 | 10 | ||||||
Total energy (Kcal) spent/day | 2018.2 ± 213.2 | 1961.9 ± 180.0 | 0.75 | 0.30 | 2136.2 ± 372.5 | 2040.6 ± 218.3 | 1.00 | 0.33 |
Quality of life for two different age range i.e., 30–45 and 46–59 years.
Number of participants (n) | 12 | 16 | ||||||
General self-esteem | 0.3 ± 0.2 | 0.29 ± 0.19 | 0.15 | 0.06 | 0.2 ± 0.3 | 0.3 ± 0.2 | 0.99 | 0.28 |
Physical activity | 0.3 ± 0.2 | 0.3 ± 0.2 | 0.24 | 0.06 | 0.3 ± 0.2 | 0.3 ± 0.2 | 0.11 | 0.00 |
Social contacts | 0.2 ± 0.3 | 0.3 ± 0.2 | 1.27 | 0.60 | 0.2 ± 0.3 | 0.3 ± 0.2 | 0.63 | 0.23 |
Satisfaction concerning work | 0.3 ± 0.2 | 0.3 ± 0.1 | 0.0 | 0.00 | 0.4 ± 0.2 | 0.3 ± 0.2 | 0.48 | 0.17 |
Pleasure related to sexuality | 0.1 ± 0.3 | 0.1 ± 0.3 | 0.14 | 0.04 | 0.2 ± 0.2 | 0.2 ± 0.2 | 0.89 | 0.30 |
Focus on eating behavior | 0.3 ± 0.2 |
0.2 ± 0.2 | 0.89 | 0.33 | 0.2 ± 0.3 | 0.3 ± 0.2 | 1.23 | 0.44 |
Total quality of life | 1.4 ± 0.7 | 1.5 ± 0.9 | 0.36 | 0.09 | 1.5 ± 0.9 | 1.8 ± 0.8 | 1.15 | 0.32 |
Number of participants (n) | 14 | 10 | ||||||
General self-esteem | 0.2 ± 0.4 | 0.3 ± 0.1 | 1.93 | 0.58 | 0.2 ± 0.3 | 0.3 ± 0.1 | 1.59 | 0.65 |
Physical activity | 0.2 ± 0.3 | 0.4 ± 0.1 | 1.97 | 0.74 | 0.1 ± 0.3 | 0.2 ± 0.2 | 1.27 | 0.34 |
Social contacts | 0.3 ± 0.3 | 0.3 ± 0.2 | 0.60 | 0.17 | 0.3 ± 0.2 | 0.2 ± 0.2 | 0.16 | 0.05 |
Satisfaction concerning work | 0.3 ± 0.1 |
0.4 ± 0.1 |
1.37 | 0.72 | 0.2 ± 0.3 | 0.2 ± 0.3 | 1.21 | 0.25 |
Pleasure related to sexuality | −0.0 ± 0.3 | 0.1 ± 0.3 | 1.58 | 0.44 | −0.1 ± 0.4 | 0.0 ± 0.3 | 0.85 | 0.29 |
Focus on eating behavior | 0.3 ± 0.3 | 0.3 ± 0.2 | 0.38 | 0.10 | 0.2 ± 0.3 | 0.3 ± 0.1 | 1.72 | 0.63 |
Total quality of life | 1.3 ± 1.1 | 1.8 ± 0.7 | 1.87 | 0.62 | 0.8 ± 1.2 | 1.3 ± 1.0 |
2.57 | 0.47 |
At baseline the triglyceride levels and the focus on eating behavior (an aspect of the quality of life) were lower in the yoga group (
There were no significant changes in the nutritional advice group. In the yoga group there was a decrease in waist circumference, sagittal abdominal diameter, hip circumference, BMI, a body shape index, conicity index, abdominal volume index, and body roundness index (
At baseline the waist circumference and satisfaction concerning work (of the quality of life scale) were higher in the nutritional advice group compared to the yoga group (
The nutritional advice group showed a decrease in waist circumference, sagittal abdominal diameter, hip circumference, waist-hip ratio, a body shape index, conicity index, abdominal volume index, and body roundness index (
Following 12 weeks of nutritional advice there was a significant decrease in waist circumference, hip circumference, abdominal volume index, and increase in total cholesterol and LDL cholesterol. The yoga group at the end of 12 weeks showed a decrease in waist circumference, sagittal abdominal diameter, hip circumference, BMI, waist-hip ratio, a body shape index, conicity index, abdominal volume index, body roundness index, HDL cholesterol, and better total quality of life. When both groups were considered as two age ranges (i.e., 30–45 and 46–59 years), the results were different. For the 30–45 years age group the nutritional advice group showed no change after 12 weeks whereas the yoga group showed most of the changes mentioned above for the group as a whole. In contrast to this for the 46–59 year age group, the nutritional advice and yoga groups showed comparable benefits with reduction in most-anthropometric measures and indices at 12 weeks. Hence yoga may be especially useful for adult females between 30 and 45 years of age.
The waist circumference, hip circumference, abdominal volume index, and body roundness decreased in both groups irrespective of age. The waist circumference correlates with increased risk of cardiovascular disease (
The serum lipid profile was assessed using quantitative methods. The yoga group showed a significant decrease in HDL cholesterol. This reduction in HDL cholesterol has been seen in two other studies, in which obese participants received yoga for 6 days and 15 days (
In the nutritional advice group there was a significant increase in total cholesterol, and LDL levels. The explanation for this increase is not clear as the nutritional advice group was given the same dietary instructions as the yoga group. Mental stress levels have a positive correlation with total cholesterol, triglycerides and LDL cholesterol levels (
The yoga group showed significantly higher scores in focus on eating behavior (an aspect of quality of life) and total quality of life after 12 weeks. Previously the Moorehead-Ardelt Quality of Life Questionnaire has been used to compare the quality of life in obese persons who were experienced in yoga compared to those without any yoga experience and demonstrated a better quality of life in the group with prior yoga experience (
The centrally obese participants of the present trial showed no differences in their energy intake or energy expenditure after 12 weeks irrespective of the group to which they belonged. Energy intake was derived from the 24 h diet recall questionnaire which does not give an accurate idea of the diet during the 12 week period. Hence though the present results suggest that the energy intake in a day did not differ significantly with the energy expenditure in a day, between groups after 12 weeks it must be emphasized that both energy intake/day and energy expenditure/day were assessed by qualitative methods which lack the accuracy and objectivity of quantitative assessments.
The main limitations of the present findings are the study design and small sample size. Both the yoga and nutritional advice groups were given their intervention based on convenience, though the nutritional advice group did express an interest to learn yoga at some stage after the trial. The ideal design would have been a randomized controlled trial but after recruitment it was clear that though the participants were motivated to learn yoga, for personal reasons such as time constraints they were unable to state that they could complete 12 weeks of yoga practice successfully. This point demonstrates the practical difficulties a person may have in learning and practicing any intervention. Apart from this, though the supine sagittal abdominal diameter through anthropometry is an acceptable method to measure visceral adipose tissue, magnetic resonance imaging (MRI), dual-energy x-ray absorptiometry (DEXA), and computed tomography (CT) scans would be more accurate (
Yoga and nutritional advice with a diet plan can reduce anthropometric measures associated with diseases related to central obesity, with more changes in the yoga group. This difference was greater for the 30–45 years age range, where the nutritional advice group showed no change; while changes were comparable for the two groups in the 46–59 year age range. Hence yoga may be especially useful for adult females with central obesity between 30 and 45 years of age.
ST, SS, and AB designed the study. NK and SP performed data collection and analyses. ST and SS wrote the manuscript. NK, SP, and RG prepared the manuscript. ST, SS, NK, SP, RG, and AB proofread the manuscript.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer OH and handling Editor declared their shared affiliation.
The authors gratefully acknowledge the help of Dr. Jaideep Arya, Chief Central Coordinator of Patanjali Yog Samiti, Haridwar, Uttarakhand, India. The meticulous work of slide preparation for the nutritional advice group and the arrangement of data by Deepshikha Tyagi, Babita Vishwakarma, Kumar Gandharva, Savita Agnihotri, Alok Singh, Sadhna Verma, Deepak Pal, and Ankit Gupta was an important and indispensable contribution.
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