Yoga for the Treatment of Metabolic Syndrome

Restorative Yoga for Therapy of the Metabolic Syndrome: A Pilot Trial

We tested the following hypotheses:

1. That a standardized yoga therapy will improve insulin sensitivity (primary outcome), and other features of the metabolic syndrome such as hypertension and dyslipidemia (secondary outcomes), we will perform a 2-hour oral glucose tolerance test, fasting blood tests, and a physical examination before and after randomization of subjects to a 10-week yoga therapy intervention or wait-list control group.
2. That a yoga therapy is feasible in overweight and underactive individuals with the metabolic syndrome, that adherence to a yoga intervention is acceptable, and that yoga therapy is associated with improved quality of life, we will assess the adherence to twice-weekly yoga group sessions (for weeks1-5) and weekly yoga group sessions (for weeks 6-10), frequency of home yoga therapy practice, and self-reported quality of life before and after the intervention in both treatment groups.
3. To elucidate a potential mechanism for the effect of yoga on changes in insulin resistance by evaluating markers of inflammation from adipose tissue (adipocytokines). We hypothesize that these biochemical parameters will show modest improvement with yoga therapy and that changes in these parameters will be associated with improvements in insulin sensitivity.

Study Overview

• Status: Completed
• Conditions: Metabolic Syndrome
• Intervention / Treatment: Behavioral: Restorative yoga therapy

Detailed Description

Study Interventions: There will be a 12-week intervention period.

1. Yoga Therapy Group: Those randomized to yoga therapy will receive twice-weekly group yoga sessions at the Osher Center for the entire intervention period. The yoga postures and breathing techniques will be taught by a qualified and certified yoga instructor using a standardized protocol that was determined by a Yoga Expert Panel. Each group yoga session will take approximately 90 minutes. Participants will also be required to practice yoga at home at least 3 times per week, and be given yoga materials (mat, blocks, straps), an instruction manual, and a video for their use at home. They will be asked to keep a calendar log of the dates/times that they practiced yoga at home. This group will also receive a 20-30 minute session with a counselor to discuss Standard Health Education at the beginning of the 12-week intervention. This session will be similar to the control group intervention.
2. Standard Health Education Group: Participants assigned to the standard health education group will receive an individual 20-30 minute session with a trained research associate within a week of their baseline visit. In this session, participants will be informed of the importance of a healthy lifestyle, given written information of the Food Guide Pyramid12 and told to follow the equivalent of the National Cholesterol Education Program Step I diet13. They will be counseled to reduce weight and increase physical activity. This is similar to the intervention given to the "Standard Lifestyle Group" in the Diabetes Prevention Program4.

• Study Type: Interventional
• Enrollment (Actual): 26
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • California
    • San Francisco, California, United States, 94115
      • University of California, San Francisco

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 30 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. to be between the ages of 30 and 65 years,

2. fulfill at least three criteria for the metabolic syndrome per the NCEP guidelines:

   • waist circumference (>88 cm for women; >102 cm for men),
   • HDL-cholesterol (<50 mg/dl for women; <40 mg/dl for men),
   • triglycerides >=150 mg/dL
   • fasting glucose >=100 mg/dL, and/or
   • high blood pressure (>=130/>=85 or use of antihypertensive medication), and
3. report an underactive or sedentary lifestyle defined as accumulating less than 30 minutes of moderate intensity endurance exercise 5 days per week.

Exclusion Criteria:

1. Pregnancy or lactation
2. Coronary heart disease (defined as a myocardial infarction or cardiac intervention with percutaneous transluminal catheterization or coronary artery bypass graft surgery) event or hospitalization in the past 6 months
3. Chronic illnesses: cancer, kidney disease, cirrhosis, rheumatogic diseases, or chronic infections
4. Current use of these medications: oral diabetes medications, insulin, steroid hormones, oral contraceptives, hormone replacement therapy, niacin, fibrates.
5. Regular participation (>1/week) yoga for past 3 months or concurrent use of yoga
6. Current major psychiatric illness, cognitive impairment, or substance abuse
7. Plans to move out of the study region within 6 months
8. Life-expectancy of < 6 months
9. Concurrent enrollment in any other studies, experimental therapies, or blinded treatments

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: A; Restorative yoga therapy group: one orientation workshop for 3 hours, then twice-weekly group yoga therapy classes for first 5 weeks followed by once-weekly group yoga classes for another 5 weeks. The group will also be asked to practice their yoga postures at home for 30 minutes three times per week.	Behavioral: Restorative yoga therapy; 3-hour workshop at study initiation. Then twice-weekly group yoga classes for 5 weeks, then once-weekly group yoga classes for 5 weeks. Home yoga practice for 90 minutes/week throughout the 10 week trial.
No Intervention: B; The control group is a wait-list control group with no active intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Fasting plasma glucose level	10 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
Blood pressure	10 weeks
Feasability of yoga postures	10 weeks
Adherence to protocol	10 weeks
Insulin sensitivity	10 weeks
Weight	10 weeks
Waist circumference	10 weeks
Heart rate variability	10 weeks

Collaborators and Investigators

• Sponsor: University of California, San Francisco
• Collaborators: Cliff Lede Foundation
• Investigators: Principal Investigator: Alka M. Kanaya, MD, University of California, San Francisco

Study record dates

Study Major Dates

• Study Start: October 1, 2006
• Primary Completion (Actual): April 1, 2007
• Study Completion (Actual): June 1, 2007

Study Registration Dates

• First Submitted: January 16, 2008
• First Submitted That Met QC Criteria: January 30, 2008
• First Posted (Estimate): January 31, 2008

Study Record Updates

• Last Update Posted (Estimate): January 31, 2008
• Last Update Submitted That Met QC Criteria: January 30, 2008
• Last Verified: January 1, 2008

More Information

Terms related to this study

• Keywords: overweight; metabolic syndrome; sedentary
• Additional Relevant MeSH Terms: Pathologic Processes; Glucose Metabolism Disorders; Metabolic Diseases; Disease; Insulin Resistance; Hyperinsulinism; Syndrome; Metabolic Syndrome
• Other Study ID Numbers: H9377-29543-02; CHR#H9377-29543-02