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Lee SC, Tsai PH, Yu KH, Chan TM. Effects of Mind-Body Interventions on Immune and Neuroendocrine Functions: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Healthcare (Basel) 2025; 13:952. [PMID: 40281902 PMCID: PMC12027091 DOI: 10.3390/healthcare13080952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 04/15/2025] [Accepted: 04/18/2025] [Indexed: 04/29/2025] Open
Abstract
Objective: Chronic stress affects the immune system via the hypothalamic-pituitary-adrenal (HPA) axis and autonomic system. Chronic inflammation is a risk factor for cardiovascular diseases, cancer onset and progression, susceptibility to infection, and cognitive impairment. Mind-body interventions (MBIs) could affect the immune and neuroendocrine systems, and we aimed to assess the correlations among these systems through a meta-analysis. Methods: RCTs were identified by searching three databases: PubMed, Embase, and Scopus. Of the 1697 studies identified, 89 were included in this study. Risk of bias was examined using the Cochrane risk-of-bias assessment tool. Data were pooled using a random-effects model, and SMDs were calculated. I2 statistics and Egger's test were used to assess the significance of the asymmetry. Influence diagnostics were used to assess whether pooled effects were disproportionately dependent on any single study. The trim-and-fill method was applied to all identified asymmetric instances. Meta-regression was used to examine the moderating effect of MBI efficacy on biomarkers. Results: MBIs generally decreased the levels of inflammatory factors, such as the CRP, IL-6, TNF-α, IL-1, IL-8, IL-17, ESR, and cortisol, and increased IL-10, IFN-γ, IL-1ra, BDNF, and secretory IgA. In a subgroup analysis of the CNS and cancer, qigong and yoga showed increased BDNF and IL-6, respectively. Notably, IL-10 was increased in inflammatory diseases, and IFN-γ was increased in viral infections. Conclusions: This study revealed MBIs decrease inflammatory cytokine and increase anti-inflammatory, antiviral, and immune-activating factors. These results suggest the MBIs including gentle physical exercise may be beneficial for neuropsychiatric disorders or tumors. Prospero registration number: CRD42024507646.
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Affiliation(s)
- Shih-Ching Lee
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 106, Taiwan
- Division of Rheumatology, Allergy and Immunology, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan
| | - Ping-Han Tsai
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Division of Rheumatology, Allergy and Immunology, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan
| | - Kuang-Hui Yu
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Medical College, Chang Gung University, Taoyuan 333, Taiwan
| | - Tien-Ming Chan
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Medical College, Chang Gung University, Taoyuan 333, Taiwan
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Vallazhath A, Thimmappa PY, Joshi HB, Hebbar KR, Nayak A, Umakanth S, Saoji AA, Manjunath NK, Hadapad BS, Joshi MB. A comprehensive review on the implications of Yogic/Sattvic diet in reducing inflammation in type 2 diabetes. Nutr Diabetes 2025; 15:14. [PMID: 40216734 PMCID: PMC11992243 DOI: 10.1038/s41387-025-00371-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 03/25/2025] [Accepted: 03/28/2025] [Indexed: 04/14/2025] Open
Abstract
Chronic inflammation in type 2 diabetes (T2D), characterized by constitutively activated immune cells and elevated pro-inflammatory mediators along with hyperglycaemia and increased free fatty acids and branched chain amino acid levels, significantly alters the immuno-metabolic axis. Over the years, dietary intervention has been explored as an effective strategy for managing T2D. Evidence from experimental and clinical studies indicates that various diets, including Mediterranean, Nordic, Palaeolithic and ketogenic diets, increase insulin sensitivity, decrease gluconeogenesis, and adiposity, and exert anti-inflammatory effects, thus preserving immuno-metabolic homeostasis in individuals with T2D. Indian dietary sources are categorized as Sattvic, Rajasic, and Tamasic, depending on their impact on health and behaviour. The Yogic diet, commonly recommended during yoga practice, is predominantly Sattvic, emphasizing plant-based whole foods while limiting processed and high-glycaemic-index items. Yogic diet is also recommended for Mitahara, emphasizing mindful eating, which is attributed to calorie restriction. Adopting a Yogic diet, featuring low-fat vegetarian principles, strongly reduces inflammatory mediator levels. This diet not only ameliorates insulin resistance and maintains a healthy body weight but also regulates immunomodulation, enhances gut microbiome diversity and provides essential phytonutrients, collectively preventing inflammation. Although, preliminary studies show aforementioned beneficial role of Yogic diet in improving diabetes associated metabolic and inflammatory changes, precise cellular and molecular mechanisms are not yet understood. Hence, further studies are warranted to decipher the mechanisms. This review summarizes the multiple roles of Yogic diet and related dietary components in mitigating inflammation and enhancing glycaemic control in T2D.
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Affiliation(s)
- Anupama Vallazhath
- Department of Ageing Research, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Pooja Yedehalli Thimmappa
- Department of Ageing Research, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Harshit B Joshi
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Krishna Raghava Hebbar
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Anupama Nayak
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, India
| | | | - Apar Avinash Saoji
- Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, 560105, Karnataka, India
| | | | - Basavaraj S Hadapad
- Division of Ayurveda, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Manjunath B Joshi
- Department of Ageing Research, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India.
- Centre for Ayurveda Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India.
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Giridharan S. Beyond the Mat: Exploring the Potential Clinical Benefits of Yoga on Epigenetics and Gene Expression: A Narrative Review of the Current Scientific Evidence. Int J Yoga 2023; 16:64-71. [PMID: 38204768 PMCID: PMC10775846 DOI: 10.4103/ijoy.ijoy_141_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 01/12/2024] Open
Abstract
Yoga, an ancient practice rooted in Indian philosophy, has gained widespread popularity for its numerous physical and mental health benefits. In the recent years, there has been growing interest in understanding how yoga influences gene expression and epigenetic modifications. This narrative review investigates the molecular mechanisms, by which yoga influences gene expression, focusing on deoxyribonucleic acid (DNA) methylation, and histone modifications. Research literature was sourced from various databases to select randomized clinical trials and comparative cohort studies examining yoga's impact on gene expression and epigenetic changes. Our findings suggest that yoga could exert anti-inflammatory effects, as it downregulates pro-inflammatory cytokines, soluble interleukin IL-2 receptor gene expression, and transcription factors. Yoga also boosts the innate antiviral response and brain health by enhancing natural defense genes and microRNA-29c expression. Notably, it activates telomerase, linked with cellular longevity, and promotes nitric oxide synthetase and neuroprotective gene expression, implying benefits for ocular health. In addition, yoga fosters DNA repair and cellular integrity maintenance by increasing oxoguanine glycosylase one protein and p53 gene expression. However, the diversity of yoga interventions in these studies complicates direct comparisons and broader application. The current research primarily focuses on short-term outcomes, offering a limited understanding of yoga's long-term epigenetic impacts. Future research should address these gaps by studying the enduring effects of Yoga, personalizing interventions, and contrasting techniques.
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Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases 2022; 10:diseases10040107. [PMID: 36412601 PMCID: PMC9680480 DOI: 10.3390/diseases10040107] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Physical activity has been documented as a foundational approach for weight management and obesity, improving several cardiometabolic and mental health indices. However, it is not clear whether yoga practice can induce beneficial improvements in anthropometric and body composition parameters, performance, metabolic health, and well-being among overweight/obese people. The aim of this topical review was to catalog training studies examining the psychophysiological responses to yoga interventions in order to detect which outcomes have been investigated, the research methods applied, and the conclusions. The inclusion/exclusion criteria were met by 22 published articles involving 1178 (56% female) overweight/obese participants. This brief review on yoga-induced adaptations demonstrates that this widely used meditative movement activity can meaningfully improve the vast majority of the selected markers. These beneficial alterations are focused mostly on various anthropometric and body composition variables, cardiovascular disease risk factors, physical fitness parameters, quality of life, and stress in previously inactive overweight/obese individuals. Instead, yoga-based physical exercise interventions investigating anxiety, depression, mood state, exercise enjoyment, affect valence, and adherence were limited. Further research should focus on the yoga intervention configuration and potential mechanisms behind favorable changes in various psychophysiological indices through large-scale, rigorously designed randomized controlled trials implementing long-term interventions in overweight/obese individuals.
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