1056
achieve high rates of virologic suppression despite adherence
rates less than 95%. J Acquir Immune Defic Syndr 2007;
45:4–8.
Chenglong Liu, Ph.D.
Department of Medicine, Georgetown University,
Washington, DC
Virginia Lerch M.P.H.
Department of Epidemiology and Biostatistics, The
George Washington University School of Public Health
and Health Services, Washington, DC
Kathleen Weber B.S.N.
Hektoen Institute of Medicine and The CORE Center at
John H. Stroger Hospital of Cook County, Chicago, IL
Michael F. Schneider, M.S.
Department of Epidemiology, Johns Hopkins Bloomberg
School of Public Health, Baltimore, MD
Gerald B. Sharp, Dr.P.H.
Epidemiology Branch, Basic Sciences Program, National
Institute of Allergy and Infectious Diseases, National
Institutes of Health, Bethesda, MD
Lakshmi Gorapaju, Ph.D.
Department of Medicine, Georgetown University,
Washington, DC
Anjali Sharma, M.D.
Division of Infectious Diseases, SUNY Downstate
Medical Center, Brooklyn, NY
Alexandra Levine, M.D.
City of Hope National Medical Center, Duarte, CA
Monica Gandhi, M.D.
Division of Infectious Disease, Department of Medicine,
University of California, San Francisco,
San Francisco, CA
Daniel Merenstein, M.D.
Department of Family Medicine, Georgetown University
Medical Center, Washington, DC
Address reprint requests to:
Chenglong Liu, Ph.D.
Department of Medicine
Georgetown University
2233 Wisconsin Avenue NW, Suite 214
Washington, DC 20007
E-mail: cl278@georgetown.edu
DOI: 10.1089/acm.2007.0679
POSITIVE IMPACT OF YOGA AND
PRANAYAM ON OBESITY, HYPERTENSION,
BLOOD SUGAR, AND CHOLESTEROL:
A PILOT ASSESSMENT
Dear Editor:
Yoga is an integral part of Ayurveda and refers to the
joining of the “lower human nature to the higher.”1 It is a
LETTERS TO THE EDITOR
mind–body practice that usually incorporates pranayam
(breathing exercises), asanas (postures), and meditation.
Yoga has been used as a therapeutic intervention in Indian
medicine for many centuries and is used to treat a wide range
of medical conditions2; however, its efficacy is being rec-
ognized in the West3,4 and could have a major impact on
the health profile of the nation.5
In 2006, Swami Ramdevji Maharaj, a proponent of this
practice, visited England to conduct yoga and pranayam
camps in four different locations: Ilford, Leicester, Bolton, and
Harrow (all in the United Kingdom). The camps between them
attracted nearly 8000 participants, many from South Asian mi-
nority ethnic groups. Before and after these visits (6–7 days
later), data were collected after informed consent on a cohort
of attendees at the workshops (asked at the workshops to vol-
unteer for the assessment) who had diabetes, hypertension,
obesity, and dyslipidemia. The volunteers attended the camps
for 7 days (3 hours daily) during which they practiced the var-
ious breathing practices of pranayam (bhastrika, kapalbhati,
bahya, and anulom vilom), meditation (udgith, OM recitation,
and pranav), and undertook yoga postures.
Initial assessments were done on 510 volunteers. Eighty-
two (82) did not return for follow-up, leaving 428 on whom
both before and after data were collected. Analyses were done
on these 428 (150 male; 278 female) volunteers with a mean
age of 58 years (range 20–80), in whom paired data are avail-
able. Sixty-five percent (65%; n  280) had diabetes melli-
tus, 81% (n  349) had hypertension, 65% (n  280) had hy-
perlipidemia, and 41% (n  177) were obese (body–mass
index [BMI] 25 kg/m2). The conditions were self-reported
to researchers by the patients themselves. Twenty-one per-
cent (21%) of the subjects had all 4 conditions. Each volun-
teer had the following measurements done: weight; height;
blood pressure; blood glucose; and cholesterol (finger prick
using the Accu-Chek system; Roche Diagnostics Ltd., Lon-
don, UK). Blood glucose and cholesterol were available in
only 258 subjects because of a malfunction of the meters, re-
sulting in no paired data. The results are shown in Table 1.
The effect on BMI appeared most pronounced among the
severely obese patients (BMI  40 kg/m2), in whom the
mean BMI dropped by 0.58 kg (p  0.004, n  18) and the
obese patients (BMI 30–39.9) in whom mean BMI dropped
by 0.62 kg (p  0.012, n  135). Overall, 56% of subjects
lost weight. In 38% of the hypertensive patients, normal
blood pressure was recorded after 6–7 days (mean 163/98
to 135/80). Sixty-six percent (66%) of patients had de-
creased cholesterol after the study period.
Although these results are promising in terms of the ef-
fect of yoga on disease markers, they are not conclusive. We
recognize that the study has several drawbacks and short-
comings and was not controlled. Measurements were all done
during the camps (at start and after 6–7 days) and whether
these effects are sustained is not known. It is also possible that
some of the effects, such as weight loss, may be related to di-
etary modifications, which were also advocated during the
camps. However, the study looked at a group of self-selected
LETTERS TO THE EDITOR 1057

TABLE 1. IMPACT OF YOGA AND PRANAYAM ON OBESITY, HYPERTENSION, BLOOD GLUCOSE, AND CHOLESTEROL

Before (mean  SD) After (mean  SD) p value

Weight (kg) 72.8  15.4 72  15.2 0.001

BMI (kg/m2) 28.92  5.4 28.56  5.5 0.001
Blood pressure
Systolic (mm Hg) 158  24 150  22 0.001
Diastolic (mm Hg) 92  12 87  12 0.001
Blood glucose 7.0  2.6 6.7  2.5 0.001
(mmol/L)
Blood cholesterol 5.08  0.94 4.77  0.91 0.001
(mmol/L)

Note: N  428 for each parameter except glucose and cholesterol groups where n  258.
SD, standard deviation; BMI, body–mass index.

people for a relatively short duration, over which time the mean 5. Garrow D, Egede L. Association between complementary and
values for the 4 parameters seemed to change favorably with alternative medicine use, preventative care practices, and use of
yoga. A much larger randomized controlled trial over a much conventional medical services among adults with diabetes. Di-
longer period is needed to confirm the positive effects found abetes Care 2006;29:15–19.
here, and this is planned. Raman Gokal, M.D., F.R.C.P., F.A.S.N.
Manchester Royal Infirmary
Didsbury
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