title: The Effects of a Gentle Yoga Program on Sleep, Mood, and Blood Pressure in Older Women with Restless Legs Syndrome (RLS): A Preliminary Randomized Controlled Trial Increased dopamine tone during meditation-induced change of consciousness. Globalization of Diabetes Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity. Depression and Increased Mortality in Diabetes: Unexpected Causes of Death Reductions in Regimen Distress Are Associated With Improved Management and Glycemic Control Over Time Stress management improves long-term glycemic control in type 2 diabetes. Incidence of diabetes in middle-aged men is related to sleep disturbances. Effect of Yoga asanas on nerve conduction in type 2 diabetes. Community based yoga classes for type 2 diabetes: an exploratory randomised controlled trial Yoga on Our Minds: A Systematic Review of Yoga for Neuropsychiatric Disorders Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: the Fremantle Diabetes Study. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial. Benefits of Yoga for Psychosocial Well-Being in a US High School Curriculum: A Preliminary Randomized Controlled Trial A Randomized Controlled Trial of Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in Patients With Uncontrolled Type 2 Diabetes Prospective association between lung function and the incidence of diabetes: findings from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators The effectiveness of yoga for the improvement of well-being and resilience to stress in the workplace. Efficacy of an eight-week yoga intervention on symptoms of restless legs syndrome (RLS): a pilot study. The role of depression and anxiety in onset of diabetes in a large population-based study. Heart rate variability as a predictor of negative mood symptoms induced by exercise withdrawal. Brain-heart connection and the risk of heart attack. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure Pilot study: Mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Effects of Yoga on Sleep Quality and Depression in Elders in Assisted Living Facilities Comprehensive yogic breathing program improves quality of life in patients with diabetes The Effects of Yoga on Hypertensive Persons in Thailand A resilience intervention in African-American adults with type 2 diabetes. Effects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia. Effect of yoga-nidra on blood glucose level in diabetic patients. Effects of yoga on psychological health in older adults. Cardiac autonomic function in patients with diabetes improves with practice of comprehensive yogic breathing program Completion report: Effect of Comprehensive Yogic Breathing program on type 2 diabetes: A randomized control trial Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews
abstract: Objective . To examine the effects of yoga versus an educational film program on sleep , mood , perceived stress , and sympathetic activation in older women with RLS . Methods . Participants were drawn from a larger trial regarding the effects of yoga on cardiovascular disease risk profiles in overweight , sedentary postmenopausal women . Seventy-five women were r and omized to receive either an 8-week yoga ( n = 38 ) or educational film ( n = 37 ) program . All 75 participants completed an RLS screening question naire . The 20 women who met all four diagnostic criteria for RLS ( n = 10 yoga , 10 film group ) comprised the population for this nested study . Main outcomes assessed pre- and post-treatment included : sleep ( Pittsburgh Sleep Quality Index ) , stress ( Perceived Stress Scale ) , mood ( Profile of Mood States , State-Trait Anxiety Inventory ) , blood pressure , and heart rate . Results . The yoga group demonstrated significantly greater improvements than controls in multiple domains of sleep quality and mood , and significantly greater reductions in insomnia prevalence , anxiety , perceived stress , and blood pressure ( all P's≤0.05 ) . Adjusted intergroup effect sizes for psychosocial variables were large , ranging from 1.9 for state anxiety to 2.6 for sleep quality . Conclusions . These preliminary findings suggest yoga may offer an effective intervention for improving sleep , mood , perceived stress , and blood pressure in older women with RLS This is the first in vivo demonstration of an association between endogenous neurotransmitter release and conscious experience . Using 11C-raclopride PET we demonstrated increased endogenous dopamine release in the ventral striatum during Yoga Nidra meditation . Yoga Nidra is characterized by a depressed level of desire for action , associated with decreased blood flow in prefrontal , cerebellar and subcortical regions , structures thought to be organized in open loops subserving executive control . In the striatum , dopamine modulates excitatory glutamatergic synapses of the projections from the frontal cortex to striatal neurons , which in turn project back to the frontal cortex via the pallidum and ventral thalamus . The present study was design ed to investigate whether endogenous dopamine release increases during loss of executive control in meditation . Participants underwent  two 11C-raclopride PET scans : one while attending to speech with eyes closed , and one during active meditation .  The tracer competes with endogenous dopamine for access to dopamine D2 receptors predominantly found in the basal ganglia . During meditation , 11C-raclopride binding in ventral striatum decreased by 7.9 % . This corresponds to a 65 % increase in endogenous dopamine release . The reduced raclopride binding correlated significantly with a concomitant increase in EEG theta activity , a characteristic feature of meditation . All participants reported a decreased desire for action during meditation , along with heightened sensory imagery . The level of gratification and the depth of relaxation did not differ between the attention and meditation conditions . Here we show increased striatal dopamine release during meditation associated with the experience of reduced readiness for action . It is suggested that being in the conscious state of meditation causes a suppression of cortico-striatal glutamatergic transmission . To our knowledge this is the first time in vivo evidence has been provided for regulation of conscious states at a synaptic level Type 2 diabetes is a global public health crisis that threatens the economies of all nations , particularly developing countries . Fueled by rapid urbanization , nutrition transition , and increasingly sedentary lifestyles , the epidemic has grown in parallel with the worldwide rise in obesity . Asia 's large population and rapid economic development have made it an epicenter of the epidemic . Asian population s tend to develop diabetes at younger ages and lower BMI levels than Caucasians . Several factors contribute to accelerated diabetes epidemic in Asians , including the “ normal-weight metabolically obese ” phenotype ; high prevalence of smoking and heavy alcohol use ; high intake of refined carbohydrates ( e.g. , white rice ) ; and dramatically decreased physical activity levels . Poor nutrition in utero and in early life combined with overnutrition in later life may also play a role in Asia 's diabetes epidemic . Recent advances in genome-wide association studies have contributed substantially to our underst and ing of diabetes pathophysiology , but currently identified genetic loci are insufficient to explain ethnic differences in diabetes risk . Nonetheless , interactions between Westernized diet and lifestyle and genetic background may accelerate the growth of diabetes in the context of rapid nutrition transition . Epidemiologic studies and r and omized clinical trials show that type 2 diabetes is largely preventable through diet and lifestyle modifications . Translating these findings into practice , however , requires fundamental changes in public policies , the food and built environments , and health systems . To curb the escalating diabetes epidemic , primary prevention through promotion of a healthy diet and lifestyle should be a global public policy priority OBJECTIVES Yoga and exercise have beneficial effects on  mood and anxiety .  γ-Aminobutyric acid (GABA)-ergic activity is reduced in mood and anxiety disorders . The practice of yoga postures is associated with increased brain GABA levels . This study addresses the question of whether changes in mood , anxiety , and GABA levels are specific to yoga or related to physical activity . METHODS Healthy subjects with no significant medical/psychiatric disorders were r and omized to yoga or a metabolically matched walking intervention for 60 minutes 3 times a week for 12 weeks . Mood and anxiety scales were taken at weeks 0 , 4 , 8 , 12 , and before each magnetic resonance spectroscopy scan . Scan 1 was at baseline . Scan 2 , obtained after the 12-week intervention , was followed by a 60-minute yoga or walking intervention , which was immediately followed by Scan 3 . RESULTS The  yoga subjects ( n = 19 ) reported greater improvement in mood and greater decreases in anxiety than the walking group ( n = 15 ) . There were positive correlations between improved mood and decreased anxiety and thalamic GABA levels . The yoga group had positive correlations between changes in mood scales and changes in GABA levels . CONCLUSIONS The 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise . This is the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety . It is also the first time that a behavioral intervention ( i.e. , yoga postures ) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales . Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety , the reported correlations are in the expected direction . The possible role of GABA in mediating the beneficial effects of yoga  on mood and anxiety warrants further study BACKGROUND This study examined the effects of brief daily yogic meditation on mental health , cognitive functioning , and immune cell telomerase activity in family dementia caregivers with mild depressive symptoms . METHODS Thirty-nine family dementia caregivers ( mean age 60.3 years old ( SD = 10.2 ) ) were r and omized to practicing Kirtan Kriya or listening to relaxation music for 12 min per day for 8 weeks . The severity of depressive symptoms , mental and cognitive functioning were assessed at baseline and follow-up . Telomerase activity in peripheral blood mononuclear cells ( PMBC ) was examined in peripheral P BMC pre-intervention and post-intervention . RESULTS The meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning compared with the relaxation group . In the meditation group , 65.2 % showed 50 % improvement on the Hamilton Depression Rating scale and 52 % of the participants showed 50 % improvement on the Mental Health Composite Summary score of the Short Form-36 scale compared with 31.2 % and 19 % , respectively , in the relaxation group ( p < 0.05 ) . The meditation group showed 43 % improvement in telomerase activity compared with 3.7 % in the relaxation group ( p = 0.05 ) . CONCLUSION This pilot study found that brief daily meditation practice s by family dementia caregivers can lead to improved mental and cognitive functioning and lower levels of depressive symptoms . This improvement is accompanied by an increase in telomerase activity suggesting improvement in stress-induced cellular aging . These results need to be confirmed in a larger sample PURPOSE Recent evidence suggests that depression is linked to increased mortality among patients with diabetes . This study examines the association of depression with all-cause and cause-specific mortality in diabetes . METHODS We conducted a prospect i ve cohort study of primary care patients with type 2 diabetes at Group Health Cooperative in Washington state . We used the Patient Health Question naire ( PHQ-9 ) to assess depression at baseline and review ed medical records supplemented by the Washington state mortality registry to ascertain the causes of death . RESULTS Among a cohort of 4,184 patients , 581 patients died during the follow-up period .  Deaths occurred among 428 ( 12.9 % ) patients with no depression , among 88 ( 17.8 % ) patients with major depression , and among 65 ( 18.2 % ) patients with minor depression . Causes of death were grouped as cardiovascular disease , 42.7 % ; cancer , 26.9 % ; and deaths that were not due to cardiovascular disease or cancer , 30.5 % . Infections , dementia , renal failure , and chronic obstructive pulmonary disease were the most frequent causes in the latter group . Adjusting for demographic characteristics , baseline major depression ( relative to no depression ) was significantly associated with all-cause mortality ( hazard ratio [HR]=2.26 , 95 % confidence interval [ CI ] , 1.79–2.85 ) , with cardiovascular mortality ( HR = 2.00 ; 95 % CI , 1.37–2.94 ) , and with noncardiovascular , noncancer mortality ( HR = 3.35 ; 95 % CI , 2.30–4.89 ) . After additional adjustment for baseline clinical characteristics and health habits , major depression was significantly associated only with all-cause mortality ( HR = 1.52 ; 95 % CI , 1.19–1.95 ) and with death not caused by cancer or atherosclerotic cardiovascular disease ( HR = 2.15 ; 95 % CI , 1.43–3.24 ) . Minor depression showed similar but nonsignificant associations . CONCLUSIONS Patients with diabetes and coexisting depression face substantially elevated mortality risks beyond cardiovascular deaths OBJECTIVE Cross-sectional and longitudinal associations among regimen  distress  ( RD ) , self-management , and glycemic control were undertaken to explore mechanisms of operation among these variables . RESEARCH DESIGN AND METHODS In a behavioral r and omized control trial ( RCT ) to reduce RD , 392 adults with type 2 diabetes were assessed for  RD , diet , exercise , medication adherence , and HbA1c at baseline and at 4 and 12 months . Associations among RD , self-management , and HbA1c were examined in cross-sectional analyses at baseline , in prospect i ve analyses using baseline values to predict change over time , and in time-varying analyses . RESULTS At baseline , greater RD and poorer medication adherence were independently associated with higher HbA1c ( P = 0.05 and P < 0.001 , respectively ) , and greater RD was associated with poorer medication adherence ( P = 0.03 ) . No consistent pattern of significant prospect i ve associations was found . Significant time-varying findings showed that decreases in RD were associated with improvements in medication adherence ( P < 0.01 ) , physical activity ( P < 0.001 ) , and HbA1c ( P = 0.02 ) over time following intervention . Changes in self-management were not associated with changes in HbA1c over time . CONCLUSIONS In the context of an RCT to reduce distress , RD , self-management , and HbA1c were interrelated in cross-sectional and time-varying analyses . Decreases in RD were associated with improvements in both self-management and HbA1c over 12 months . Findings point to the complex and likely multifaceted pathways of association among these key constructs , with results indicating significant linkages between RD and both self-management and glycemic control over time OBJECTIVE There is conflicting evidence regarding the utility of stress management training in the treatment of diabetes . The few studies that have shown a therapeutic effect of stress management have used time-intensive individual therapy . Unfortunately , widespread use of such interventions is not practical . The aim of the present investigation is to determine whether a cost-effective , group-based stress management training program can improve glucose metabolism in patients with type 2 diabetes and to determine whether a particular subset of patients is more likely to get positive results . RESEARCH DESIGN AND METHODS Patients with type 2 diabetes were r and omized to undergo a five-session group diabetes education program with or without stress management training .  Participants ( n = 108 ) were followed for 1 year , during which HbA(1c ) tests and question naires assessing perceived stress , anxiety , and psychological health were administered at regular intervals to evaluate treatment effects . RESULTS Stress management training was associated with a small ( 0.5 % ) but significant reduction in HbA(1c ) . Compliance with the treatment regimen decreased over time but was similar to that seen in patients receiving stress management for other reasons in the clinic . Trait anxiety ( a measure of stable individual differences in anxiety proneness ) did not predict response to treatment , showing that highly anxious patients did not derive more benefit from training . CONCLUSIONS The current results indicate that a cost-effective , group stress management program in a " real-world " setting can result in clinical ly significant benefits for patients with type 2 diabetes OBJECTIVE Sleep deprivation  in healthy men has been experimentally found to result in disturbances in glucose metabolism and in sympathovagal imbalance . The aim of the present study was to investigate whether sleep disturbances and elevated resting heart rate are associated with increased risk of developing diabetes . RESEARCH DESIGN AND METHODS A group of 6,599 initially healthy , nondiabetic men aged 44.5 + /- 4.0 years took part in a prospect i ve , population -based study in Malmö , Sweden . The incidence of diabetes during a mean follow-up of 14.8 + /- 2.4 years was examined in relation to self-reported difficulties in falling asleep and resting heart rate at baseline . Diabetes was assessed at follow-up in all subjects by question naire and in a subgroup of 1,551 men by blood glucose measurement . RESULTS A total of 615 ( 9.3 % ) subjects reported either difficulties in falling asleep or regular use of hypnotics ( seen as markers of sleep disturbances ) , and 158 ( 2.4 % ) subjects reported both of these . Altogether , 281 ( 4.3 % ) of the men developed diabetes during the follow-up period . Logistic regression models showed difficulties in falling asleep or regular use of hypnotics ( odds ratio [ OR ] 1.52 [ 95 % CI 1.05 - 2.20 ] ) and resting heart rate ( OR per 10 bpm 1.13 [ 0.99 - 1.30 ] ) to be associated with development of diabetes when full adjustments were made for baseline age , biological risk factors , lifestyle , family history of diabetes , and social class . CONCLUSIONS The results suggest that sleep disturbances and , possibly , elevated resting heart rate , in middle-aged men , are associated with an increased risk of diabetes Twenty Type 2 diabetic subjects between the age group of 30 - 60 years were studied to see the effect of 40 days of Yoga asanas on the nerve conduction velocity . The duration of diabetes ranged from 0 - 10 years . Subject suffering from cardiac , renal and proliferative retinal complications were excluded from the study  Yoga asanas included Suryanamskar . Tadasan , Konasan , Padmasan Pranayam , Paschimottansan Ardhmatsyendrasan , Shavasan , Pavanmukthasan , Sarpasan and Shavasan . Subjects were called to the cardio-respiratory laboratory in the morning time and were given training by the Yoga expert . The Yoga exercises were performed for 30 - 40 minutes every day for 40 days in the above sequence . The subjects were prescribed certain medicines and diet . The basal blood glucose , nerve conduction velocity of the median nerve was measured and repeated after 40 days of Yogic regime .  Another group of 20 Type 2 diabetes subjects of comparable age and severity , called the control group , were kept on prescribed medication and light physical exercises like walking . Their basal & post 40 days parameters were recorded for comparison . Right h and and left h and median nerve conduction velocity increased from 52.81 + /- 1.1 m/sec to 53.87 + /- 1.1 m/sec and 52.46 + /- 1.0 to 54.75 + /- 1/1 m/sec respectively . Control group nerve function parameters deteriorated over the period of study , indicating that diabetes is a slowly progressive disease involving the nerves . Yoga asanas have a beneficial effect on glycaemic control and improve nerve function in mild to moderate Type 2 diabetes with sub- clinical neuropathy Background Yoga is a popular therapy for diabetes but its efficacy is contested . The aim of this study was to explore the feasibility of research ing community based yoga classes in Type 2 diabetes with a view to informing the design of a definitive , multi-centre trial Methods The study design was an exploratory r and omised controlled trial with in-depth process evaluation . The setting was two multi-ethnic boroughs in London , UK ; one with average and one with low mean socio-economic deprivation score . Classes were held at a sports centre or GP surgery . Participants were 59 people with Type 2 diabetes not taking insulin , recruited from general practice lists or opportunistically by general practice staff . The intervention group were offered 12 weeks of a twice-weekly 90-minute yoga class ; the control group was a waiting list for the yoga classes . Both groups received advice and leaflets on healthy lifestyle and were encouraged to exercise . Primary outcome measure was HbA1c . Secondary outcome measures included attendance , weight , waist circumference , lipid levels , blood pressure , UKPDS cardiovascular risk score , diabetes-related quality of life ( ADDQoL ) , and self-efficacy . Process measures were attendance at yoga sessions , self-reported frequency of practice between taught sessions , and qualitative data ( interviews with patients and therapists , ethnographic observation of the yoga classes , and analysis of documents including minutes of meetings , correspondence , and exercise plans ) . Results Despite broad inclusion criteria , around two-thirds of the patients on GP diabetic registers proved ineligible , and 90 % of the remainder declined to participate . Mean age of participants was 60 + /- 10 years .  Attendance at yoga classes was around 50 % . Nobody did the exercises regularly at home . Yoga teachers felt that most participants were unsuitable for ' st and ard ' yoga exercises because of limited flexibility , lack of basic fitness , co-morbidity , and lack of confidence . There was a small fall in HbA1c in the yoga group which was not statistically significant and which was not sustained six months later , and no significant change in other outcome measures . Conclusion The benefits of yoga in type 2 diabetes suggested in some previous studies were not confirmed . Possible explanations ( apart from lack of efficacy ) include recruitment challenges ; practical and motivational barriers to class attendance ; physical and motivational barriers to engaging in the exercises ; inadequate intensity and /or duration of yoga intervention ; and insufficient personalisation of exercises to individual needs . All these factors should be considered when design ing future trials . Trial registration National Research Register ( 1410 ) and Current Controlled Trials ( IS RCT N63637211 ) Background : The dem and for clinical ly efficacious , safe , patient acceptable , and cost-effective forms of treatment for mental illness is growing . Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being . Objective : To systematic ally examine the evidence for efficacy of yoga in the treatment of selected major psychiatric disorders . Methods : Electronic search es of The Cochrane Central Register of Controlled Trials and the st and ard bibliographic data bases , MEDLINE , EMBASE , and PsycINFO , were performed through April 2011 and an up date d in June 2011 using the keywords yoga AND psychiatry OR depression OR anxiety OR schizophrenia OR cognition OR memory OR attention AND r and omized controlled trial ( RCT ) . Studies with yoga as the independent variable and one of the above mentioned terms as the dependent variable were included and exclusion criteria were applied . Results : The search yielded a total of 124 trials , of which 16 met rigorous criteria for the final review . Grade B evidence supporting a potential acute benefit for yoga exists in depression ( four RCTs ) , as an adjunct to pharmacotherapy in schizophrenia ( three RCTs ) , in children with ADHD ( two RCTs ) , and Grade C evidence in sleep complaints ( three RCTs ) . RCTs in cognitive disorders and eating disorders yielded conflicting results . No studies looked at primary prevention , relapse prevention , or comparative effectiveness versus pharmacotherapy . Conclusion : There is emerging evidence from r and omized trials to support popular beliefs about yoga for depression , sleep disorders , and as an augmentation therapy . Limitations of literature include inability to do double-blind studies , multiplicity of comparisons within small studies , and lack of replication . Biomarker and neuroimaging studies , those comparing yoga with st and ard pharmaco- and psychotherapies , and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health BACKGROUND Although yoga and meditation have been used for stress reduction with reported improvement in inflammation , little is known about the biological mechanisms mediating such effects . The present study examined if a yogic meditation might alter the activity of inflammatory and antiviral transcription control pathways that shape immune cell gene expression . METHODS Forty-five family dementia caregivers were r and omized to either Kirtan Kriya Meditation ( KKM ) or Relaxing Music ( RM ) listening for 12 min daily for 8 weeks and 39 caregivers completed the study .  Genome-wide transcriptional profiles were collected from peripheral blood leukocytes sample d at baseline and 8-week follow-up . Promoter-based bioinformatics analyses tested the hypothesis that observed transcriptional alterations were structured by reduced activity of the pro-inflammatory nuclear factor (NF)-κB family of transcription factors and increased activity of Interferon Response Factors ( IRFs ; i.e. , reversal of patterns previously linked to stress ) . RESULTS In response to KKM treatment , 68 genes were found to be differentially expressed ( 19 up-regulated , 49 down-regulated ) after adjusting for potentially confounded differences in sex , illness burden , and BMI . Up-regulated genes included immunoglobulin-related transcripts . Down-regulated transcripts included pro-inflammatory cytokines and activation-related immediate-early genes . Transcript origin analyses identified plasmacytoid dendritic cells and B lymphocytes as the primary cellular context of these transcriptional alterations ( both p<.001 ) . Promoter-based bioinformatic analysis implicated reduced NF-κB signaling and increased activity of IRF1 in structuring those effects ( both p<.05 ) . CONCLUSION A brief daily yogic meditation intervention may reverse the pattern of increased NF-κB-related transcription of pro-inflammatory cytokines and decreased IRF1-related transcription of innate antiviral response genes previously observed in healthy individuals confronting a significant life stressor OBJECTIVE To examine prospect ively the relationship between diabetes , glycemic control , and spirometric measures . RESEARCH DESIGN AND METHODS From a community-based cohort , 495 Europid ( i.e. , of European descent ) patients with type 2 diabetes who had no history of pulmonary disease underwent baseline spirometry between 1993 and 1994 . A subset of 125 patients was restudied a mean of 7.0 years later . The main outcome measures included forced vital capacity ( FVC ) , forced expiratory volume in 1 s ( FEV1 ) , vital capacity ( VC ) , and peak expiratory flow ( PEF ) corrected for body temperature , air pressure , and water saturation and were expressed either in absolute terms or as percentage-predicted value for age , sex , and height . RESULTS Mean percentage-predicted values of each spirometric measure were decreased > 10 % in the whole cohort at baseline and absolute measures continued to decline at an annual rate of 68 , 71 , and 84 ml/year and 17 l/min for FVC , FEV1 , VC , and PEF , respectively , in the 125 prospect ively studied patients . Declining lung function measures were consistently predicted by poor glycemic control in the form of a higher up date d mean HbA1c , follow-up HbA1c , or follow-up fasting plasma glucose . In a Cox proportional hazards model , decreased FEV1 percentage-predicted value was an independent predictor of all-cause mortality . CONCLUSIONS Reduced lung volumes and airflow limitation are likely to be chronic complications of type 2 diabetes , the severity of which relates to glycemic exposure . Airflow limitation is a predictor of death in type 2 diabetes after adjusting for other recognized risk factors Background Yoga has been shown to be a simple and economical therapeutic modality that may be considered as a beneficial adjuvant for type 2 diabetes mellitus . This study investigated the impact of Hatha yoga and conventional physical training ( PT ) exercise regimens on biochemical , oxidative stress indicators and oxidant status in patients with type 2 diabetes . Methods This prospect i ve r and omized study consisted of 77 type 2 diabetic patients in the Hatha yoga exercise group that were matched with a similar number of type 2 diabetic patients in the conventional PT exercise and control groups . Biochemical parameters such as fasting blood glucose ( FBG ) , serum total cholesterol ( TC ) , triglycerides , low-density lipoprotein ( LDL ) , very low-density lipoproteins ( VLDL ) and high-density lipoprotein ( HDL ) were determined at baseline and at two consecutive three monthly intervals . The oxidative stress indicators ( malondialdehyde – MDA , protein oxidation – POX , phospholipase A2 – PLA2 activity ) and oxidative status [ superoxide dismutase ( SOD ) and catalase activities ] were measured . Results The concentrations of FBG in the Hatha yoga and conventional PT exercise groups after six months decreased by 29.48 % and 27.43 % respectively ( P < 0.0001 ) and there was a significant reduction in serum TC in both groups ( P < 0.0001 ) . The concentrations of VLDL in the managed groups after six months differed significantly from baseline values ( P = 0.036 ) . Lipid peroxidation as indicated by MDA significantly decreased by 19.9 % and 18.1 % in the Hatha yoga and conventional PT exercise groups respectively ( P < 0.0001 ) ; whilst the activity of SOD significantly increased by 24.08 % and 20.18 % respectively ( P = 0.031 ) . There was no significant difference in the baseline and 6 months activities of PLA2 and catalase after six months although the latter increased by 13.68 % and 13.19 % in the Hatha yoga and conventional PT exercise groups respectively ( P = 0.144 ) . Conclusion The study demonstrate the efficacy of Hatha yoga exercise on fasting blood glucose , lipid profile , oxidative stress markers and antioxidant status in patients with type 2 diabetes and suggest that Hatha yoga exercise and conventional PT exercise may have therapeutic preventative and protective effects on diabetes mellitus by decreasing oxidative stress and improving antioxidant status . Trial Registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) : BACKGROUND Sleep disturbances , depression , and low perception of health status are commonly seen in elderly population ; however , clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging . Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults . OBJECTIVE To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers , especially their sleep quality , depression , and self-perception of health status . DESIGN Cluster r and omized trial . SETTING S Eight senior activity centers , southern Taiwan . PARTICIPANTS A sample of 139 participants was recruited , and 128 of them completed the study . INCLUSION CRITERIA ( 1 ) community-dwelling older adults ages 60 and over , ( 2 ) no previous training in yoga , ( 3 ) able to walk without assistance , ( 4 ) cognitively alert based on the Short Portable Mental Status Question naire ( SPMSQ ) score of eight or higher , and ( 5 ) independent or mildly dependent in self-care based on a Barthel Index ( BI ) score of 91 or higher . The mean age of the participants was 69.20 + /- 6.23 years , and the average number of chronic illness was 0.83 + /- 0.90 . The average BI score of the participants was 99.92 + /- 0.62 , and the mean SPMSQ score  was 9.90 + /- 0.30 . METHODS Participants were r and omly assigned into either the experimental ( n=62 ) or the control ( n=66 ) group based on attendance at selected senior activity centers . A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group . RESULTS Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions , and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study . The mental health indicators of the participants in the experimental group were all better than the participants in the control group ( all p<.05 ) . CONCLUSIONS After 6 months of silver yoga exercises , the sleep quality , depression , and health status of older adults were all improved Objective : To test feasibility of yoga within a high school curriculum and evaluate preventive efficacy for psychosocial well-being . Methods : Grade 11 or 12 students ( N = 51 ) who registered for physical education ( PE ) were cluster-r and omized by class 2:1 yoga : PE-as-usual . A Kripalu-based yoga program of physical postures , breathing exercises , relaxation , and meditation was taught 2 to 3 times a week for 10 weeks . Self-report question naires were administered to students 1 week before and after . Primary outcome measures of psychosocial well-being were Profile of Mood States — Short Form and Positive and Negative Affect Schedule for Children . Additional measures of psychosocial well-being included Perceived Stress Scale and Inventory of Positive Psychological Attitudes . Secondary measures of self-regulatory skills included Resilience Scale , State Trait Anger Expression Inventory-2 ™ , and Child Acceptance Mindfulness Measure . To assess feasibility , yoga students completed a program evaluation . Analyses of covariance were conducted between groups with baseline as the covariate . Results : Although PE-as-usual students showed decreases in primary outcomes , yoga students maintained or improved . Total mood disturbance improved in yoga students and worsened in controls ( p = .015 ) , as did Profile of Mood States-Short Form ( POMS-SF ) Tension-Anxiety subscale ( p = .002 ) . Although positive affect remained unchanged in both , negative affect significantly worsened in controls while improving in yoga students ( p = .006 ) . Secondary outcomes were not significant . Students  rated yoga fairly high , despite moderate attendance . Conclusions : Implementation was feasible and students generally found it beneficial . Although not causal due to small , uneven sample size , this preliminary study suggests preventive benefits in psychosocial well-being from Kripalu yoga during high school PE . These results are consistent with previously published studies of yoga in school setting OBJECTIVE To test cognitive behavioral therapy for  adherence and depression ( CBT-AD ) in type 2 diabetes . We hypothesized that CBT-AD would improve adherence ; depression ; and , secondarily , hemoglobin A1c ( A1C ) . RESEARCH DESIGN AND METHODS Eighty-seven adults with unipolar depression and uncontrolled type 2 diabetes received enhanced treatment as usual ( ETAU ) , including medication adherence , self-monitoring of blood glucose ( SMBG ) , and lifestyle counseling ; a provider letter documented psychiatric diagnoses . Those r and omized to the intervention arm also received 9–11 sessions of CBT-AD . RESULTS Immediately after acute treatment ( 4 months ) , adjusting for baseline , CBT-AD had 20.7 percentage points greater oral medication adherence on electronic pill cap ( 95 % CI −31.14 to −10.22 , P = 0.000 ) ; 30.2 percentage points greater SMBG adherence through glucometer downloads ( 95 % CI −42.95 to −17.37 , P = 0.000 ) ; 6.44 points lower depression scores on the Montgomery-Asberg Depression Rating Scale ( 95 % CI 2.33–10.56 , P = 0.002 ) ; 0.74 points lower on the Clinical Global Impression ( 95 % CI 0.16–1.32 , P = 0.01 ) ; and 0.72 units lower A1C ( 95 % CI 0.29–1.15 , P = 0.001 ) relative to ETAU . Analyses of 4- , 8- , and 12-month follow-up time points indicated that CBT-AD maintained 16.3 percentage points higher medication adherence ( 95 % CI −26.1 to −6.5 , P = 0.001 ) ; 22.3 percentage points greater SMBG adherence ( 95 % CI −36.1 to −8.6 , P = 0.002 ) ; and 0.63 units lower A1C ( 95 % CI 0.06–1.2 , P = 0.03 ) after acute treatment ended . For depression , there was some evidence of continued improvement posttreatment , but no between-group differences . CONCLUSIONS CBT-AD is an effective intervention for adherence , depression , and glycemic control , with enduring and clinical ly meaningful benefits for diabetes self-management and glycemic control in adults with type 2 diabetes and depression OBJECTIVE To determine whether impaired pulmonary function is a significant predictor of the incidence of diabetes . RESEARCH DESIGN AND METHODS Using data from the National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study , a cohort study of a representative sample of U.S. adults , we examined the prospect i ve associations between pulmonary function and incidence of diabetes . Our analyses included 4,830 U.S. men and women aged 25 - 74 years who had a baseline interview and examination ( including spirometry ) from 1971 through 1975 and were followed through 1992 - 1993 .  Incident diabetes ( n=443 ) was based on self- or proxy reports , hospitalization , or death certificates . RESULTS After multiple adjustment , forced expiratory volume in 1 s ( FEV1 ) , forced vital capacity ( FVC ) , percentage of predicted FEV1 , and percentage of predicted FVC were significantly and inversely associated with the incidence of diabetes , but the ratio of FEV1 to FVC was not . Obstructive lung disease ( defined by the Global Initiative for Chronic Obstructive Lung Disease classification ) was not significantly associated with the incidence of diabetes , but restrictive lung disease was ( hazard ratio=1.45 , 95 % CI 1.04 - 2.03 ) . The association did not differ significantly by smoking status . CONCLUSIONS Although several prospect i ve studies have found that impaired pulmonary function may increase the risk for developing diabetes , additional research is needed to better underst and these relationships and their possible implication BACKGROUND A growing body of research shows that mindfulness meditation can alter neural , behavioral and biochemical processes . However , the mechanisms responsible for such clinical ly relevant effects remain elusive . METHODS Here we explored the impact of a day of intensive practice of  mindfulness meditation in experienced subjects ( n=19 ) on the expression of circadian , chromatin modulatory and inflammatory genes in peripheral blood mononuclear cells ( P BMC ) . In parallel , we analyzed a control group of subjects with no meditation experience who engaged in leisure activities in the same environment ( n=21 ) . P BMC from all participants were obtained before ( t1 ) and after ( t2 ) the intervention ( t2-t1=8h ) and gene expression was analyzed using custom pathway focused quantitative-real time PCR assays . Both groups were also presented with the Trier Social Stress Test ( TSST ) . RESULTS Core clock gene expression at baseline ( t1 ) was similar between groups and their rhythmicity was not influenced in meditators by the intensive day of practice . Similarly , we found that all the epigenetic regulatory enzymes and inflammatory genes analyzed exhibited similar basal expression levels in the two groups . In contrast , after the brief intervention we detected reduced expression of histone deacetylase genes ( HDAC 2 , 3 and 9 ) , alterations in global modification of histones ( H4ac ; H3K4me3 ) and decreased expression of pro-inflammatory genes ( RIPK2 and COX2 ) in meditators compared with controls . We found that the expression of RIPK2 and HDAC2 genes was associated with a faster cortisol recovery to the TSST in both groups . CONCLUSIONS The regulation of HDACs and inflammatory pathways may represent some of the mechanisms underlying the therapeutic potential of mindfulness-based interventions . Our findings set the foundation for future studies to further assess meditation strategies for the treatment of chronic inflammatory conditions OBJECTIVES Recent research has indicated concern for the degree of stress and emotional well-being among university staff . This study examined the effectiveness of yoga in enhancing emotional well-being and resilience to stress among university employees . METHODS In a r and omized controlled trial at a British university , we recruited 48 employees and r and omized them into either a yoga or a wait-list control group . The yoga group was offered six weeks of Dru Yoga , comprising one 60-minute class per week . These classes were offered by a certified Dru Yoga instructor at lunchtime from January-March 2008 . The wait-list control group received no intervention during this six-week study . Baseline and end-program measurements of self-reported mood and well-being were self-assessed with the Profile of Mood States - Bipolar ( POMS-Bi ) and the Inventory of Positive Psychological Attitudes ( IPPA ) . RESULTS This six-week yoga intervention result ed in significantly improved POMS-Bi and IPPA scores for the yoga compared to the wait-list control group for seven of eight measures of mood and well-being . In comparison to the wait-list control group at baseline and the end of the program , the yoga group reported marked improvements in feelings of clear-mindedness , composure , elation , energy , and confidence . In addition , the yoga group reported increased life purpose and satisfaction , and feelings of greater self-confidence during stressful situations . CONCLUSION These results show that even a short program of yoga is effective for enhancing emotional well-being and resilience to stress in the workplace . We suggest that employers should consider offering yoga classes to their employees BACKGROUND Restless legs syndrome ( RLS ) is a common and highly burdensome sleep disorder . While relaxation therapies , including yoga , are often recommended for RLS management , rigorous supporting research is sparse . The goal of this preliminary study was to assess the effects of yoga on RLS symptoms and related outcomes in women with RLS . METHODS Participants were 13 nonsmoking women with moderate to severe RLS , who did not have diabetes , sleep apnea , or other serious concomitant chronic conditions , and who were not pregnant . The intervention was a gentle , 8-week Iyengar yoga program . Core outcomes assessed pre- and post-treatment were RLS symptoms and symptom severity ( International RLS Scale [ IRLS ] and RLS ordinal scale ) , sleep quality ( Medical Outcomes Study Sleep Scale ) , mood ( Profile of Mood States ) , and perceived stress ( Perceived Stress Scale ) . Participants also completed yoga logs and a brief exit question naire regarding their experience with the study . RESULTS Ten ( 10 ) women , aged 32 - 66 years , completed the study . Participants attended an average 13.4±0.5 ( of 16 possible ) classes , and completed a mean of 4.1±0.3 ( of 5 possible ) homework sessions/week . At follow-up , participants demonstrated striking reductions in RLS symptoms and symptom severity , with symptoms decreasing to minimal/mild in all but 1 woman and no participant scoring in the severe range by week 8 . Effect sizes ( Cohen 's d ) were large : 1.6 for IRLS total , and 2.2 for RLS ordinal scale . IRLS scores declined significantly with increasing minutes of homework practice per session ( r=0.70 , p=0.025 ) and total homework minutes ( r=0.64 , p<0.05 ) , suggesting a possible dose-response relation . Participants also showed significant improvements in sleep , perceived stress , and mood ( all p's≤0.02 ) , with effect sizes ranging from 1.0 to 1.6 . CONCLUSIONS These preliminary findings suggest that yoga may be effective in attenuating RLS symptoms and symptom severity , reducing perceived stress , and improving sleep and mood in women with RLS OBJECTIVE Recent research has shown that depression may predict incident  diabetes . The aims of the study are to investigate if symptoms of  depression  and anxiety precede the onset of diabetes or vice versa and to examine if mediating factors may explain such associations . METHODS A prospect i ve population -based study ( N=37,291 ) investigating the associations between  symptoms of  depression/anxiety  and diabetes was conducted . RESULTS Individuals reporting symptoms of depression and anxiety at baseline had increased risk of onset of type 2 diabetes at 10-year follow-up . No gender differences were found . The analyses did not reveal underlying factors that mediated the association . Baseline diagnosis of diabetes was not associated with subsequent symptoms of anxiety or depression among males or females . CONCLUSION Diabetes did not predict symptoms of depression or anxiety . Symptoms of depression and anxiety emerged as significant risk factors for onset of type 2 diabetes independent of established risk factors for diabetes , such as socioeconomic factors , lifestyle factors , and markers of the metabolic syndrome . The comorbidity between depression and anxiety may be the most important factor INTRODUCTION / PURPOSE Negative mood symptoms occur frequently in sedentary population s , but individual vulnerability factors for developing these complaints have not been systematic ally evaluated . This investigation examined whether the autonomic nervous system ( ANS ) serves a role in the development of negative mood after controlled exercise withdrawal . METHODS Forty participants ( mean age of 31.3 + /- 7.5 yr , 55 % women ) who exercised regularly ( > or= 30 min of continuous aerobic exercise at least three times a week during the past 6 months ) were r and omized either to withdrawal from regular aerobic exercise ( N=20 ) or to continue regular aerobic exercise ( N=20 ) for 2 wk . Measurements were taken before exercise withdrawal and at 2-wk follow-up . Various dimensions of negative mood were measured with the multidimensional fatigue inventory , profile of mood states , and Beck depression inventory-II . ANS activity was assessed by heart rate variability ( HRV ) analyses , examining low-frequency ( 0.04 - 0.15 Hz : lf ) and high-frequency ( hf ) domains ( 0.15 - 0.40 Hz ) . The lf/hf ratio was used as index of sympathovagal balance . Protocol adherence was documented by ambulatory activity monitoring . RESULTS Exercise withdrawal result ed in significantly higher negative mood scores at follow-up compared with control ( P<0.05 ) . Baseline lf/hf ratios correlated with the increases in symptoms ( r>0.4 ; P<0.05 ) in the  exercise-withdrawal  group independently of gender , age , weight , baseline fitness level , and baseline symptom status . The  exercise-withdrawal and control groups displayed no significant change in hf HRV , lf HRV , or lf/hf HRV during the 2 wk . CONCLUSION Reduced parasympathetic ANS activity as measured by HRV is predictive of the development of negative mood after deprivation of usual exercise activities . No significant changes in HRV were observed during the 2-wk exercise deprivation period . These findings are relevant to the underst and ing of mood changes in response to short-term exercise withdrawal , such as sports injuries and recovery from medical procedures Autonomic functions , such as increased sympathetic and parasympathetic activity and the brain 's suprachiasmatic nucleus , higher nervous centres , depression , hostility and aggression appear to be important determinants of heart rate variability ( HRV ) , which is , itself , an important risk factor of myocardial infa rct ion , arrhythmias , sudden death , heart failure and atherosclerosis . The circadian rhythm of these complications with an increased occurrence in the second quarter of the day may be due to autonomic dysfunction as well as to the presence of excitatory brain and heart tissues . While increased sympathetic activity is associated with increased levels of cortisol , catecholamines , serotonin , renin , aldosterone , angiotensin and free radicals ; increased parasympathetic activity may be associated with greater levels of acetylecholine , dopamine , nitric oxide , endorphins , coenzyme Q10 , antioxidants and other protective factors . Recent studies indicate that hyperglycemia , diabetes , hyperlipidemia , ambient pollution , insulin resistance and mental stress can increase the risk of low HRV . These risk factors , which are known to favour cardiovascular disease , seem to act by decreasing HRV . There is evidence that regular fasting may modulate HRV and other risk factors of heart attack . While exercise is known to decrease HRV , exercise training may not have any adverse effect on HRV . In a recent study among 202 patients with acute myocardial infa rct ion ( AMI ) , the incidence of onset of chest pain was highest in the second quarter of the day ( 41.0 % ) , mainly between 4.0 - 8.0 AM , followed by the fourth quarter , usually after large meals ( 28.2 % ) . Emotion was the second most common trigger ( 43.5 % ) . Cold weather was a predisposing factor in 29.2 % and hot temperature ( > 40 degrees celsius ) was common in 24.7 % of the patients . Dietary n-3 fatty acids and coenzyme Q10 have been found to prevent the increased circadian occurrence of cardiac events in our r and omized controlled trials , possibly by increasing HRV . We have also found that n-3 fatty acids plus CoQ can decrease TNF-alpha and IL-6 in AMI which are pro-inflammatory agents . There is evidence that dietary n-3 fatty acids canenhance hippocampal acetylecholine levels , which may be protective . Similarly , the stimulation of the vagus nerve may inhibit TNF synthesis in the liver and acetylecholine , the principal vagal neurotransmitter , significantly attenuates the release of pro-inflammatory cytokines TNF-alpha , interleukin 1,6 and 18 , but not the anti-inflammatory cytokine IL-10 in experiments . Therefore , any agent which can enhance brain acetylecholine levels , may be used as a therapeutic agent in protecting the suprachiasmatic nucleus , higher nervous centres , vagal activity and sympathetic nerve activity which are known to regulate the body clock and HRV and the risk of SCD and heart attack BACKGROUND In chronic heart failure ( CHF ) , impaired pulmonary function can independently contribute to oxygen desaturation and reduced physical activity . We investigated the effect of breathing rate on oxygen saturation and other respiratory indices . METHODS  Arterial oxygen saturation ( SaO2 ) and respiratory indices  were recorded during spontaneous breathing ( baseline ) and during controlled breathing at 15 , six , and three breaths per min in 50 patients with CHF and in 11 healthy volunteers ( controls ) . 15 patients with CHF were r and omly allocated 1 month of respiratory training to decrease their respiratory rate to six breaths per min . Respiratory indices  were recorded before training , at the end of training , and 1 month after training . FINDINGS During spontaneous breathing , mean SaO2 was lower in CHF patients than in controls ( 91 - 4 % [ SD 0.4 ] vs 95.4 % [ 0.2 ] , p<0.001 ) . Controlled breathing increased SaO2 at all breathing rates in patients with CHF . Compared with baseline , minute ventilation increased at 15 breaths per min ( + 45.9 % [ 9.8 ] , p<0.01 ) , did not change at six breaths per min , and decreased at three breaths per min ( -40.3 % [ 4.8 ] , p<0.001 ) . In the nine CHF patients who had 1 month of respiratory training , resting SaO2 increased from 92.5 % ( 0.3 ) at baseline to 93.2 % ( 0.4 ) ( p<0.05 ) , their breathing rate per min decreased from 13.4 ( 1.5 ) to 7.6 ( 1.9 ) ( p<0.001 ) , peak oxygen consumption increased from 1157 ( 83 ) to 1368 ( 110 ) L/min ( p<0.05 ) , exercise time increased from 583 ( 29 ) to 615 ( 23 ) min/s ( p<0.05 ) , and perception of dyspnoea reduced from a score of 19.0 ( 0.4 ) to 17.3 ( 0.9 ) on the Borg scale ( p<0.05 ) . There were no changes in the respiratory indices in the patients who did not have respiratory training . INTERPRETATION Slowing respiratory rate reduces dyspnoea and improves both resting pulmonary gas exchange and exercise performance in patients with CHF OBJECTIVES The purpose of this study was to pilot a brief ( 6-week ) group curriculum for providing mindfulness training to obese individuals , called Mindful Eating and Living ( MEAL ) . SETTING AND DESIGN Participants were recruited through a local Young Men 's Christian Association ( YMCA ) in spring 2006 . Data was collected at three time points : baseline , completion of intervention ( 6 weeks ) , and 3-month follow-up ( 12 weeks ) . INTERVENTION Six weekly two-hour group classes ( with two monthly follow-up classes ) . Content included training in mindfulness meditation , mindful eating , and group discussion , with emphasis on awareness of body sensations , emotions , and triggers to overeat . MAIN OUTCOME MEASURES Key variables assessed included changes in weight , body-mass index ( BMI ) , eating behavior , and psychological distress . In addition , physiological markers of cardiovascular risk were evaluated including C-reactive protein ( hsCRP ) , adiponectin , low-density lipoprotein ( LDL ) , and plasminogen activator inhibitor-1 ( PAI-1 ) . RESULTS Ten obese patients enrolled with a mean BMI of 36.9 kg/m² [ SD±6.2 ] . The mean weight was 101 kg/m² and the mean age was 44 years ( SD=8.7 ; range=31 - 62 ) . Compared to baseline data , participants showed statistically significant increases in measures of mindfulness and cognitive restraint around eating , and statistically significant decreases in weight , eating disinhibition , binge eating , depression , perceived stress , physical symptoms , negative affect , and C-reactive protein . CONCLUSIONS This study provides preliminary evidence that a eating focused mindfulness-based intervention can result in significant changes in weight , eating behavior , and psychological distress in obese individuals Background : Being relocated to an assisted living facility can result in  sleep disturbances and depression in elders . This may be attributed to or worsened by lack of regular physical activity . Appropriate exercise programs may be an important component of quality of life in this group of transitional frail elders . Purpose : This study aim ed to test the effects of a 6-month yoga exercise program in improving sleep quality and decreasing depression in transitional frail elders living in assisted living facilities . Methods : A quasi-experimental pretest- and -posttest design was used . A convenience sample of 69 elderly residents of assisted living facilities was divided r and omly into a yoga exercise ( n = 38 ) and control group ( n = 31 ) based on residence location . A total of 55 participants completed the study . The intervention was implemented in three small groups , and each practice group was led by two pretrained certified yoga instructors three times per week at 70 min per practice session for 24 weeks . The outcome measures of sleep quality ( Pittsburgh Sleep Quality Index ) and depression state ( Taiwanese Depression Question naire ) were examined at baseline , at the 12th week , and at the 24th week of the study . Results : After 6 months of performing yoga exercises , participants ' overall sleep quality had significantly improved , whereas depression , sleep disturbances , and daytime dysfunction had decreased significantly ( p < .05 ) . In addition , participants in the intervention group had better results on all outcome indicators than those of participants in the control group ( p < .05 ) . Conclusions and Implication s for Practice : It is recommended that yoga exercise be incorporated as an activity program in assisted living facilities or in other long-term care facilities to improve sleep quality and decrease  depression  in institutionalized elders Objective : To assess the effect of a comprehensive yogic breathing program on glycemic control and quality of life ( QOL ) in patients with diabetes . Material s and Methods : This is a prospect i ve r and omized controlled intervention trial . Patients having HbA1c between 6 and 9 % for at least 3 months with lifestyle modification and oral antidiabetic medication were included . They were followed-up and r and omized at 6 months into two groups : one group receiving st and ard treatment of diabetes and the other group receiving st and ard treatment of diabetes and taught and told to regularly practice the comprehensive yogic breathing program ( Sudarshan Kriya Yoga and Pranayam ) . Change in fasting and post-pr and ial blood sugars , glycated hemoglobin and QOL as assessed by the World Health Organization QOL WHOQOL BREF question naire were assessed . Results : There was a trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group following st and ard treatment alone , although this was not significant . There was significant improvement in physical , psychological and social domains and total QOL post-intervention in the group practicing the comprehensive yogic breathing program as compared with the group following st and ard treatment alone . Conclusion : There was significant improvement in the QOL and a non-significant trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group that was following st and ard treatment alone To determine the effectiveness of a yoga program on blood pressure and stress , a group of hypertensive patients in Thail and were studied , with the experimental group showing significantly decreased mean stress scores and blood pressure , heart rate , and body mass index levels compared with the control group . Further studies are suggested to determine the effects of yoga on hypertension in Thail and OBJECTIVES To explore the feasibility and outcomes of a resilience-based diabetes self-management education ( RB-DSME ) program to improve psychological and physiological health in African-American adults with type 2 diabetes . METHODS An experimental group ( N = 32 ) received RB-DSME and a comparison group ( N = 33 ) received st and ard DSME .  Psychological and physiological measures were taken at baseline and 6 months . ANCOVAs assessed whether the experimental group improved its overall outcome relative to the comparison group , while controlling for baseline scores . RESULTS The experimental group 's outcomes were significantly improved vis-à-vis the comparison group for diabetes knowledge , positive meaning , HDL cholesterol , and fasting blood glucose . CONCLUSIONS The RB-DSME shows feasibility and promise for enhancing health ; a full-scale r and omized trial is warranted OBJECTIVE The present study was conducted to assess the effectiveness of yoga in the management of dyslipidemia in patients of type 2 diabetes mellitus . METHODS This r and omized parallel study was carried out in Medical College Triv and rum , Kerala , India . Hundred type 2 diabetics with dyslipidemia were r and omized into control and yoga groups . The control group was prescribed oral hypoglycemic drugs . The yoga group practice d yoga daily for 1 h duration along with oral hypoglycemic drugs for 3 months . The lipid profiles of both the groups were compared at the start and at the end of 3 months . RESULTS After intervention with yoga for a period of 3 months the study group showed a decrease in total cholesterol , triglycerides and LDL , with an improvement in HDL . CONCLUSION Yoga , being a lifestyle incorporating exercise and stress management training , targets the elevated lipid levels in patients with diabetes through integrated approaches Diabetes is a metabolic disorder , which has become a major health challenge worldwide . South East Asian countries have a highest burden of diabetes . In India the prevalence of diabetes is rising rapidly especially in the urban population because of increasing obesity and reduced physical activity . An objective of this study is to evaluate the effect of Yoga-Nidra on blood glucose level in diabetic patients . This study was conducted on 41 , middle aged , type-2 diabetic patients , who were on oral hypoglycaemic .  These patients were divided in to two groups : ( a ) 20 patients on oral hypoglycaemic with yoga-nidra , and ( b ) 21 were on oral hypoglycaemic alone . Yoga-nidra practice d for 30 minutes daily up to 90 days , parameters were recorded every . 30th day . Results of this study showed that most of the symptoms were subsided ( P < 0.004 , significant ) , and fall of mean blood glucose level was significant after 3-month of Yoga-nidra . This fall was 21.3 mg/dl , P < 0.0007 , ( from 159 + /- 12.27 to 137.7 + /- 23.15 , ) in fasting and 17.95 mg/dl , P = 0.02 , ( from 255.45 + /- 16.85 to 237.5 + /- 30.54 ) in post pr and ial glucose level . Results of this study suggest that subjects on Yoga-nidra with drug regimen had better control in their fluctuating blood glucose and symptoms associated with diabetes , compared to those were on oral hypoglycaemics alone BACKGROUND The objective of this study was to assess the effect of a yoga intervention on psychological health  in older adults . METHOD A r and omized controlled trial study , conducted at 2 North Florida facilities for older adults . Subjects were 98 older adults , ages 65 to 92 . Participants were r and omly assigned to chair yoga , chair exercise , and control groups and assessed preintervention , postintervention , and 1-month follow-up on the State Anger Expression Inventory , State Anxiety Inventory , Geriatric Depression Scale , Lawton 's PGC Morale Scale , General Self-Efficacy Scale , Chronic Disease Self-Efficacy Scales , and Self- Control Schedule . RESULTS Yoga participants improved more than both exercise and control participants in anger ( Cohen 's d = 0.89 for yoga versus exercise , and 0.90 for yoga versus control , pretest to posttest ; and d = 0.90 and 0.72 , pretest to follow-up ) , anxiety ( d = 0.27 , 0.39 and 0.62 , 0.63 ) , depression ( d = 0.47 , 0.49 and 0.53 , 0.51 ) , well-being ( d = 0.14 , 0.49 and 0.25 , 0.61 ) , general self-efficacy ( d = 0.63 , 1.10 and 0.30 , 0.85 ) , and self-efficacy for daily living ( d = 0.52 , 0.81 and 0.27 , 0.42 ) . Changes in self-control moderated changes in psychological health . CONCLUSIONS Over a 6-week period , our findings indicate yoga 's potential for improving psychological health in older adults Background : The aim of this study was to observe the effect comprehensive yogic breathing ( Sudarshan Kriya Yoga [ SKY ] and Pranayam ) had on cardiac autonomic functions in patients with diabetes . Material s and Methods : This is a prospect i ve r and omized controlled intervention trial . Cardiac autonomic functions were assessed in 64 diabetics . Patients were r and omized into two groups , one group receiving st and ard therapy for diabetes and the other group receiving st and ard therapy for diabetes and comprehensive yogic breathing program . St and ard therapy included dietary advice , brisk walking for 45 min daily , and administration of oral antidiabetic drugs . Comprehensive yogic breathing program was introduced to the participants through a course of 12 h spread over 3 days . It was an interactive session in which SKY , a rhythmic cyclical breathing , preceded by Pranayam is taught under the guidance of a certified teacher . Cardiac autonomic function tests were done before and after 6 months of intervention . Results : In the intervention group , after practicing the breathing techniques for 6 months , the improvement in sympathetic functions was statistically significant ( P 0.04 ) . The change in sympathetic functions in the st and ard therapy group was not significant ( P 0.75 ) . Parasympathetic functions did not show any significant change in either group . When both parasympathetic and sympathetic cardiac autonomic functions were considered , there was a trend toward improvement in patients following comprehensive yogic breathing program ( P 0.06 ) . In the st and ard therapy group , no change in cardiac autonomic functions was noted ( P 0.99 ) . Conclusion : Cardiac autonomic functions improved in patients with diabetes on st and ard treatment who followed the comprehensive yogic breathing program compared to patients who were on st and ard therapy alone Background : Yoga has been shown to be beneficial in diabetes in many studies , though r and omized control trials are few . The aim of this r and omized control trial was to see the effect of Sudarshan Kriya and related practice s ( comprehensive yogic breathing program ) on quality of life , glycemic control , and cardiac autonomic functions in diabetes . Diabetes mellitus is a risk factor for sudden cardiac death . Cardiac autonomic neuropathy has been implicated in the causation of sudden cardiac death . Therefore , a maneuver to prevent progression of cardiac autonomic neuropathy holds significance . Material s and Methods : A total of 120 patients of diabetes on oral medication and diet and exercise advice were r and omized into two groups : ( 1 ) Continued to receive st and ard treatment for diabetes . ( 2 ) Patients administered comprehensive yogic breathing program and monitored to regularly practice yoga in addition to st and ard treatment of diabetes . At 6 months , quality of life and postpr and ial plasma glucose significantly improved in the group practicing yoga compared to baseline , but there was no significant improvement in the fasting plasma glucose and glycated hemoglobin . Results : On per protocol analysis , sympathetic cardiac autonomic functions significantly improved from baseline in the group practicing comprehensive yogic breathing . Conclusion : This r and omized control trial points towards the beneficial effect of yogic breathing program in preventing progression of cardiac neuropathy . This has important implication s as cardiac autonomic neuropathy has been considered as one of the factors for sudden cardiac deaths This report summarizes the current evidence on the effects of  yoga interventions on various components of mental and physical health , by focussing on the evidence described in review articles . Collectively , these review s suggest a number of areas where yoga may well be beneficial , but more research is required for virtually all of them to firmly establish such benefits . The heterogeneity among interventions and conditions studied has hampered the use of meta- analysis as an appropriate tool for summarizing the current literature . Nevertheless , there are some meta-analyses which indicate beneficial effects of yoga interventions , and there are several r and omized clinical trials ( RCT 's ) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health .  Yoga may well be effective as a supportive adjunct to mitigate some medical conditions , but not yet a proven st and -alone , curative treatment . Larger-scale and more rigorous research with higher method ological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective , may be practice d at least in part as a self-care behavioral treatment , provides a life-long behavioural skill , enhances self-efficacy and self-confidence and is often associated with additional positive side effects
target: Collectively , findings suggest that yogic practice s may promote significant improvements in several indices of importance in DM2 management , including glycemic control , lipid levels , and body composition .
  More limited data suggest that yoga may also lower oxidative stress and blood pressure ; enhance pulmonary and autonomic function , mood , sleep , and quality of life ; and reduce medication use in adults with DM2 .
background: A growing body of evidence suggests yogic practice s may benefit adults with type 2 diabetes ( DM2 ) .
  In this systematic review , we evaluate available evidence from prospect i ve controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management .