From the archives (2016): Its time for a little bit of Yoga in our lives – India Today

Ommm. Come June 21 and the collective cosmic hum will resonate through the nation once again. Like it did last year, when 200 million Indians twisted, turned and upended themselves into incredible postures, setting two Guinness World Records on the first International Day of Yoga. Leading 37,000 enthusiasts under the arching shadow of India Gate on Rajpath in Delhi was Prime Minister Narendra Modi, dressed in pristine white with a tricolour scarf. "Yoga is not for contorting your body. Then, circus people would be called yogis," his words floated in the warm June air. "Yoga is a part of everyday life."

Is it? Yoga has been with India for at least 5,000 years: Mohenjodaro stone seals depict figures in yoga poses, Krishna uses the word yoga over a hundred times in the Bhagvad Gita, Buddha asks his monks to control hunger, thirst and desire by pressing the tongue against the palate, the Svetasvatara Upanishad talks about the death-defying 'fire of yoga', Patanjali weaves together meditation, practical asanas and spirituality in his Yoga Sutra, while medieval traditions of yogi Gorakhnath focus on bodily disciplines of hatha yoga. But in the 21st century, India seems unsure about the scope of its enormous ancient legacy. Yoga has become a cherished icon of Indian civilisation and cultural glory, but what is its purpose in modern life: sublime transcendence, magical power or plain good health? Statistics tell the story: just about 14.3 million Indians do yoga, a puny 10 per cent of the population, records a 2015 Assocham report.

What has changed in the 123 years since Swami Vivekananda introduced yoga at the Parliament of Religions in Chicago in 1893 is the dramatic popularity of yoga in the West. The newly released 2016 'Yoga in America' study by the Yoga Journal and Yoga Alliance shows that the number of yoga practitioners in the US has zoomed by almost 50 per cent from 20.4 million in 2012 to over 36 million. The annual spend on yoga classes, clothing, equipment and accessories has gone up from $10 billion to $16 billion in the past four years.

Beyond yoga's global popularity is a new landscape of health. Wellness revolution is the new metaphor for life in balance. Scratch beneath the surface and you have an unsettling world of long work-hours, strict deadlines, sleep debt, a precipitous drop in physical activity, an unholy reliance on fat-laden convenience foods, vicious stress loop at home and work-all spiralling down into an abyss of chronic lifestyle disorders. No wonder global corporate biggies are getting into wellness reward systems: if IBM does so for healthy eating, exercise and curbing smoking, PepsiCo does the same for losing flab. In the midst of this gloomy picture, yoga has emerged as the new prescription: stretches, twists and bends moored to a philosophy of life that can prevent disease and promote well-being.

The changing form and significance of yoga echo the fascinating story of modern science. As Princeton University medical anthropology scholar Joseph S. Alter argues in his 2004 book Yoga in Modern India, "Yoga's transformation into a popular activity idolised for its health value is based on modern ideas about science and medicine." The current interpretations of yoga and practitioners of yogic medicine and fitness, he points out, combine the ideas of biology, physiology and anatomy with those of metaphysics. As Dr Andrew Weil, physician, bestselling author and a messiah of wellness in America told India Today, "I've become known as one of the few physicians who teaches doctors to use breathing as a primary therapy. But I learnt none of this in medical school. I learnt about this from several sources, the first being yoga, where one division, pranayam, is about breathing."

Ask Dr Dean Ornish, pioneer of the wellness revolution whose journey began when as a medical student in the '70s, he trained with yogi Swami Satchidananda. Ornish was the first to prove through evidence-based study that a plant-based diet, combined with mind-body stimulations like yoga, can stop or even reverse the progression of heart disease, Type 2 diabetes and even early stages of some cancers. "From the data of thousands of patients, we have found it improves blood flow, reduces inflammation, turns on about 500 genes that protect against diseases in just three months and lengthens the life-enhancing telomerase in chromosomes," he told INDIA TODAY.

Modern western medicine tends to reject alternative ways of healing as 'pseudo-science', with 'no valid scientific evidence'. Yet, with diabetes, heart disease and cancer rates rising across the world, researchers are turning to other systems of medicine. And an explosion of scientific studies points towards yoga as a possible way to quality life in the future. From back pain to asthma, heart attacks to blood pressure, depression to anti-ageing, sexual dysfunction to hypertension-yoga seems to hold a key that may open up a new scientific paradigm. But without a lot more evidence, randomised controlled clinical trials, it will remain, at best, an exercise in navel-gazing.

Here is our selection of ideas, practices and new rules of yoga to help you navigate your way through an ancient bequest that we need to take seriously.

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Doc, I have switched to yoga to shed weight and boost my blood sugar profile. And, yes, I've stopped that 45-minute aerobic activity I was doing every day. It's ok, no?" Sorry, that's a mistake. It's relinquishing a scientifically proven physical activity regime and replacing it with a yet unproven entity-though the latter has an 'Indian' tag to it and hence is emotionally close and culturally appropriate for all of us.

The problem with our ancient practices and therapies-be it yoga or ayurvedic medicines-is that we take what is written in our ancient treatises as gospel truth. Once, while conversing with an Ayurveda specialist, I was shocked to hear his view that modern and 'gold standard' methods of clinical trials should not be applied to ayurvedic drugs/ancient yogic practices, since they are already "proven" beyond doubt-in our ancient treatises.

According to Panini, yoga meant "yujsamadhau" or to concentrate-spiritually, physically, or for attaining a particular goal. It ultimately translates to a 'disciplined and purer' way of life-by way of balanced diet, meditation and stretching and static exercises. Isn't that what is required to prevent and manage obesity and diabetes? Maybe we could add aerobic exercise to it, which many 'modern' yoga techniques, say, 'power yoga', incorporate. Current practices (popular in the 21st century) of physical activity in yoga, which might have influence on body weight, are derived from Hatha ('force') yoga, believed to be founded by Lord Shiva himself.

The increasing popularity of yoga worldwide has raised scientific curiosity. Despite that, scientific studies on the links between yoga and obesity remain dismal. Putting key words like "yoga and obesity" in the Pubmed search engine (National Library of Medicine, USA) yields only 14 references. A meta-analysis of 25 trials carried out on patients with diabetes showed some benefits on body weight and waist circumference with yoga, comparable to moderate intensity physical activity regime in a few trials, while other trials did not show any benefit. One suitable place for yoga could be with elderly individuals who have a handicap that prevents them from doing aerobic physical activity. Careful asanas could maintain or improve stability of lower limbs and improve dwindling muscle tone.

By Dr Anoop Misra, executive chairman, Fortis C-DOC Hospital for Diabetes and Allied Sciences, New Delhi

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The practice of yoga has been known in the Indian subcontinent for several millennia now. The declaration of International Yoga Day on June 21, after an impassioned call for it at the United Nations General Assembly by Prime Minister Narendra Modi, has given it second wind in many ways.

The role of yoga in promoting well-being and disease prevention has long been considered intuitively obvious. This is especially true since modern-age 'lifestyle' diseases are an epidemic the world over. In a developing country like ours, we face the wrath of these diseases at a much younger age due to our susceptibility to cardiovascular diseases.

However, for the modern scientific medical world to accept yoga as a preventive and therapeutic tool for cardiovascular diseases requires robust physiological mechanistic studies and clinical trials to prove its benefits. An amalgam of 10 studies suggested yoga led to better exercise capacity and quality of life in patients with chronic disease. Another review of asana-based yoga, published in the European Journal of Preventive Cardiology, found yoga better than no exercise at all and similar in benefit to traditional exercises like cycling and brisk walking.

Asanas led to significant reductions in BMI, blood pressure, LDL (bad) cholesterol and improvement in HDL (good) cholesterol. The benefits were hypothesised to be due to improved neuro-endocrine, metabolic and cardio-vagal functioning. The advantage of yoga over other forms of exercise is its greater acceptability and accessibility. Yogic asanas need no expensive equipment and can be done by even those with limited mobility or with no outdoor activity.

However, credible studies are limited, as is evident from the fact that the cited review was based on 37 small studies of just 2,768 subjects. The scientific community would demand larger multi-centric, randomised clinical trials. The ongoing Yoga-CaRe trial, through Indo-UK collaboration, is looking at both the physiological effects and the clinical outcomes of yoga as a cardiac rehabilitation tool.

As we move on, we need many such clinical trials in several diseases, where yoga intuitively seems to be of potential benefit, such as in high BP, heart failure or heart rhythm abnormalities for us to be on firmer ground in promoting it to the scientific world. This research obviously would best come from India and government agencies need to proactively promote and fund such research. This would also enable India to take a lead through 'Made in India' research and increase India's soft power on the world stage!

By Dr Ambuj Roy, additional professor of cardiology at the All India Institute of Medical Sciences, New Delhi

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India is on track to become the world's most populous nation in less than a decade, according to the UN. Yet, the elephant in the bedroom is that infertility cuts across all sections of our society. The issues might be different in different geographical areas, but for about 10-12 per cent Indians, childlessness and infertility are no longer private sorrows, they are a blatant and obvious anomaly and rising dramatically in the cities.

A variety of healing approaches and therapies from around the world-that have historically not been included in conventional western medicine-are being used in infertility treatment now, largely under the rubric of complementary and alternative medical therapies (CAM). They may not provide an answer to everything, but they can play a role in enhancing the success of infertility treatments. And yoga is one such.

Many women undergoing infertility treatment feel a sense of control while doing yoga. It is believed to control negative thought, which might arise out of hormonal imbalance. Yoga practitioners feel that certain asanas help with infertility by opening up the pelvis and hip joints, increasing blood flow to the pelvis, and rebalancing hormones.

Urban India suffers from what I call voluntary infertility. Both partners work these days, come back exhausted, perhaps eat takeaway food and sleep right after dinner. Educated women also defer marriage or childbearing till they can afford a maid, a car, a driver and a three-bedroom apartment. By which time the biological clock slows down.

The Shirshasana or head stand, Sarvangasana or shoulder stand, Chakrasana or the wheel pose and Titliasana or the butterfly pose-are the recommended asanas for fertility enhancement. The Kapalbhati and Anulom-Vilom breathing techniques improve the immune system.

I practise yoga myself and have recommended it to several patients. We looked at eight women who performed immunity strengthening asanas, such as Shirshasana, Sarvangasana, Bhujangasana and Dhanurasana for 8-9 months and took no other immunity modifying medication. We observed a small decrease in the antibody levels of three women. But it's too small a sample, large multi-centric trials are needed to authenticate yoga's benefits on fertility management.

By Dr Firuza R. Parikh is director, Department of Assisted Reproduction, Jaslok Hospital, Mumbai

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MENTAL AGILITY: Boosts brain function.

CARDIAC FITNESS: Significantly lowers risk of heart disease.

BLOOD FLOW: Improves circulation, blood sugar, blood pressure.

FLEXIBILITY: Strengthens bones, muscles, improves flexibility, balance, spine elasticity, and prevents back pain.

WEIGHT: Helps reduce and maintain healthy weight.

HAPPINESS: Helps battle depression by raising serotonin hormone levels that regulates sleep, appetite and mood.

BREATHING: Brings down respiratory rate, lungs work better, keeps asthma, bronchitis at bay.

ANTI-AGEING: Head, hand and shoulder stands help retain youthfulness.

STRESS RELIEF: Alters gene expression, protects against stress, hypertension and stress-related cancers.

SEXUALITY: Improves sexual function.

FITNESS: Reduces side-effects of menopause.

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Five cure-all asanas that help combat a whole gamut of ailments

1. Balasana (CHILD POSE)Eases headaches and lower back pain.

2. Uttamasana (STANDING FORWARD BEND)Helps relieve stress, depression, indigestion and sleeplessness.

3. Bhujangasana (COBRA POSE)Useful for lower back pain, weight loss, boosting sex life

4. Trikonasana (TRIANGLE POSE)Helps burn fat, battles back pain, stress, boosts sex life

5. Virbhadrasana (WARRIOR POSE)Builds stamina, balance, relieves backache, sciatica and indigestion

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Good for brain gain: Yoga and meditation are more effective than crosswords and memory games for combating the mental decline that often precedes Alzheimers, reports the April 2016 issue of Journal of Alzheimers Disease.

Not just a stretch: The latest Harvard Heart Letter reports a study in which people who did yoga regularly lost about five pounds in weight, five points off blood pressure and harmful LDL cholesterol by 12 points.

Fight MS fatigue: Swiss scientists from the University of Basel report that yoga has a positive impact on those suffering from the auto-immune disorder multiple sclerosis (MS): less fatigue, depression, pins and needles, itchiness and numbness.

For cancer patients: Yoga works the best at improving quality of life for breast cancer patients suffering from sleep disorders arising out of drug side-effects or anxiety, report researchers from the University of Rochester in New York.

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From the archives (2016): Its time for a little bit of Yoga in our lives - India Today