Patterns of Yoga Practice and Physical Activity Following a Yoga Intervention for Adults With or at Risk for Type 2 Diabetes

Autor: Ann Gill Taylor, Viktor E. Bovbjerg, Cheryl Bourguignon, Kim E. Innes, Pamela A. Kulbok, Gina K. Alexander
Rok vydání: 2012
Předmět:
Zdroj: Journal of Physical Activity and Health. 9:53-61
ISSN: 1543-5474
1543-3080
DOI: 10.1123/jpah.9.1.53
Popis: Global increases in the incidence and prevalence of type 2 diabetes mellitus confirm the growing concern that diabetes has reached epidemic proportions and is an urgent priority for health care professionals in the United States and around the world.1,2 Rates of obesity continue to climb, likely because of contemporary realities: longer work hours in sedentary job positions, fast-food conveniences, labor-saving devices, and inactive forms of recreation.3 Recent reports estimate that 65% of adults living in the United States are either overweight or obese.4 Research findings have consistently pointed to the link between obesity and type 2 diabetes.5–7 The rationale for public health intervention is compelling; what remains uncertain, however, is the strategy that will be most effective for any given segment of the population. In spite of programs that have proliferated in various forms, the epidemic does not appear to be abating. In 2007, 1.6 million new cases of diabetes were diagnosed among adults aged 20 years and older.8 Findings from a recent integrative literature review9 indicate that the practice of yoga is a promising adjuvant approach for diabetes management. The proposed physiologic mechanisms of yoga practice are reduction of sympathetic nervous system reactivity, with associated decreases in accumulated stress, and activation of the parasympathetic response through vagal nerve stimulation, with associated elevation of mood states and inhibition of negative neuroendocrine responses.10 Diabetes-related physiologic effects of yoga include significant improvements in fasting and postprandial blood glucose, hemoglobin A1c, total cholesterol and low-density lipoprotein, triglycerides, coronary stenosis, oxidative stress, blood pressure, body weight, waist/hip ratio, heart rate, catecholamine levels, and need for medication relative to baseline.10–14 Yoga practice likewise influences psychosocial markers, because of its emphasis on relaxation, enhanced self-awareness, and mindfulness. Specific mental health benefits include improvements in quality of life, depression, stress, anxiety, quality of sleep, self-esteem, and overall psychological well-being.15–20 The long-term effects of yoga on individuals with diabetes remain unclear, which is a reflection of the lack of longitudinal research beyond 1 year postintervention. However, it is plausible that those who practice yoga over a longer period of time experience the cumulative effects of improved health status and health-related quality of life.20 Yoga is reputed to affect all areas of life, whether practiced on a regular basis for health promotion or embraced as a way of life.21,22 Yoga practice has demonstrated a positive effect on flexibility, musculoskeletal stability, range of motion, and pain associated with musculoskeletal disorders.21–24 A recent study among older adults living in Taiwan indicated that a yoga-based program had a positive effect on physical fitness.25 Although documentation of the long-term effects of yoga practice is scarce, reports of the long-term effects of physical activity on those with diabetes are available. Societal benefits, including reduced health care costs and mortality rates, augment the multiple personal benefits.26–28 Diabetes-related benefits of physical activity include improvements in physiologic and clinical markers such as insulin resistance, glycemic control, hypertension, atherogenic dyslipidemia, fibrinolytic and endothelial function, oxidative stress, regulation of body weight, body fat percentage, and waist/hip ratio.29–35 Psychosocial benefits of physical activity among individuals with or at risk for type 2 diabetes include improvements in mental health outcomes such as anxiety, stress, self-esteem, self-efficacy, and quality of life.36–38 While the benefits of yoga for health promotion are promising, findings from a recent investigation indicate that typical beginner-level yoga practice is not of sufficient intensity to meet current physical activity recommendations for health and cardiovascular fitness.39 Nonetheless, given the musculoskeletal benefits afforded by regular yoga practice, it is plausible that yoga may increase the capacity for physical activity, although no studies to date have tested this hypothesis. The National Center for Complementary and Alternative Medicine recently published a report highlighting the need for research that both examines the health behaviors of individuals who practice complementary and alternative therapies and explores avenues by which to foster health promotion in this distinct population.40 Despite the proliferation of yoga-based studies in recent years, few have tracked participants over time. Whether study participants continue to practice yoga or reap any long-term benefits for diabetes management is largely unknown. The aim of this longitudinal study was to describe patterns of yoga practice and to examine differences in physical activity over time between individuals with or at risk for type 2 diabetes mellitus who completed an 8-week yoga-based intervention, compared with controls. Specific time points ranged from baseline to 15 months postintervention.
Databáze: OpenAIRE
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