1 1690 254 OXIDATIVE STRESS INDUCED DAMAGE TO PATERNAL GENOME AND IMPACT OF MEDITATION AND YOGA - CAN IT REDUCE INCIDENCE OF CHILDHOOD CANCER? BACKGROUND: SPERM DNA DAMAGE IS UNDERLYING AETIOLOGY OF POOR IMPLANTATION AND PREGNANCY RATES BUT ALSO AFFECTS HEALTH OF OFFSPRING AND MAY ALSO RESULT IN DENOVO MUTATIONS IN GERM LINE AND POST FERTILIZATION. THIS MAY RESULT IN COMPLEX DISEASES, POLYGENIC DISORDERS AND CHILDHOOD CANCERS. CHILDHOOD CANCER LIKE RETINOBLASTOMA (RB) IS MORE PREVALENT IN DEVELOPING COUNTRIES AND THE INCIDENCE OF RB HAS INCREASED MORE THAN THREE FOLD IN INDIA IN THE LAST DECADE. RECENT STUDIES HAVE DOCUMENTED INCREASED INCIDENCE OF CANCERS IN CHILDREN BORN TO FATHERS WHO CONSUME ALCOHOL IN EXCESS AND TOBACCO OR WHO WERE CONCEIVED BY ASSISTED CONCEPTION. THE AETIOLOGY OF CHILDHOOD CANCER AND INCREASED DISEASE BURDEN IN THESE CHILDREN IS LIN KED TO OXIDATIVE STRESS (OS) AND OXIDATIVE DNA DAMAGE( ODD) IN SPERM OF THEIR FATHERS. THOUGH SEVERAL ANTIOXIDANTS ARE IN USE TO COMBAT OXIDATIVE STRESS, THE EFFECT OF MAJORITY OF THESE FORMULATIONS ON DNA IS NOT KNOWN. YOGA AND MEDITATION CAUSE SIGNIFICANT DECLINE IN OS AND ODD AND AID IN REGULATING OS LEVELS SUCH THAT REACTIVE OXYGEN SPEUES MEDITATED SIGNAL TRANSDUCTION, GENE EXPRESSION AND SEVERAL OTHER PHYSIOLOGICAL FUNCTIONS ARE NOT DISRUPTED. THUS, THIS STUDY AIMED TO ANALYZE SPERM ODD AS A POSSIBLE ETIOLOGICAL FACTOR IN CHILDHOOD CANCER AND ROLE OF SIMPLE LIFE STYLE INTERVENTIONS LIKE YOGA AND MEDITATION IN SIGNIFICANTLY DECREASING SEMINAL OXIDATIVE STRESS AND OXIDATIVE DNA DAMAGE AND THEREBY DECREASING INCIDENCE OF CHILDHOOD CANCERS. MATERIALS AND METHODS: A TOTAL OF 131 FATHERS OF CHILDREN WITH RB (NON-FAMILIAL SPORADIC HERITABLE) AND 50 CONTROLS (FATHERS OF HEALTHY CHILDREN) WERE RECRUITED AT A TERTIARY CENTER IN INDIA. SPERM PARAMETERS AS PER WHO 2010 GUIDELINES AND REACTIVE OXYGEN SPECIES (ROS), DNA FRAGMENTATION INDEX (DFI), 8-HYDROXY-2'-DEOXY GUANOSINE (8-OHDG) AND TELOMERE LENGTH WERE ESTIMATED AT DAY 0, AND AFTER 3 AND 6 MONTHS OF INTERVENTION. WE ALSO EXAMINED THE COMPLIANCE WITH YOGA AND MEDITATION PRACTICE AND SMOKING STATUS AT EACH FOLLOW-UP. RESULTS: THE SEMINAL MEAN ROS LEVELS (P<0.05), SPERM DFI (P<0.001), 8-OHDG (P<0.01) LEVELS WERE SIGNIFICANTLY HIGHER IN FATHERS OF CHILDREN WITH RB, AS COMPARED TO CONTROLS AND THE RELATIVE MEAN TELOMERE LENGTH IN THE SPERM WAS SHORTER. LEVELS OF ROS WERE SIGNIFICANTLY REDUCED IN TOBACCO USERS (P<0.05) AS WELL AS IN ALCOHOLICS (P<0.05) AFTER INTERVENTION. DFI REDUCED SIGNIFICANTLY (P<0.05) AFTER 6 MONTHS OF YOGA AND MEDITATION PRACTICE IN ALL GROUPS. THE LEVELS OF OXIDATIVE DNA DAMAGE MARKER 8-OHDG WERE REDUCED SIGNIFICANTLY AFTER 3 MONTHS (P<0.05) AND 6 MONTHS (P<0.05) OF PRACTICE. CONCLUSIONS: OUR RESULTS SUGGEST THAT OS AND ODD DNA MAY CONTRIBUTE TO THE DEVELOPMENT OF CHILDHOOD CANCER. THIS MAY BE DUE TO ACCUMULATION OF OXIDIZED MUTAGENIC BASE 8OHDG , AND ELEVATED MDA LEVELS WHICH RESULTS IN MDA DIMERS WHICH ARE ALSO MUTAGENIC, ABERRANT METHYLATION PATTERN, ALTERED GENE EXPRESSION WHICH AFFECT CELL PROLIFERATION AND SURVIVAL THROUGH ACTIVATION OF TRANSCRIPTION FACTORS. INCREASED MT DNA MUTATIONS AND ABERRANT REPAIR OF MT AND NUCLEAR DNA DUE TO HIGHLY TRUNCATRED DNA REPAIR MECHANISMS ALL CONTRIBUTE TO SPERM GENOME HYPERMUTABILITY AND PERSISTANT OXIDATIVE DNA DAMAGE. OXIDATIVE STRESS IS ALSO ASSOCIATED WITH GENOME WIDE HYPOMETHYLATION, TELOMERE SHORTENING AND MITOCHONDRIAL DYSFUNCTION LEADING TO GENOME HYPERMUTABILITY AND INSTABILITY. TO THE BEST OF OUR KNOWLEDGE, THIS IS THE FIRST STUDY TO REPORT DECLINE IN OS AND ODD AND IMPROVEMENT IN SPERM DNA INTEGRITY FOLLOWING ADOPTION OF MEDITATION AND YOGA BASED LIFE STYLE MODIFICATION.THIS MAY REDUCE DISEASE BURDEN IN NEXT GENERATION AND REDUCE INCIDENCE OF CHILDHOOD CANCERS. 2016 2 1589 60 MEDITATION & YOGA: IMPACT ON OXIDATIVE DNA DAMAGE & DYSREGULATED SPERM TRANSCRIPTS IN MALE PARTNERS OF COUPLES WITH RECURRENT PREGNANCY LOSS. BACKGROUND & OBJECTIVES: RECURRENT PREGNANCY LOSS (RPL) IS ONE OF THE DEVASTATING COMPLICATIONS OF PREGNANCY AND CURRENT FOCUS LIES IN ADDRESSING THE MANAGEMENT OF PATERNAL FACTORS. DYSREGULATION IN SELECTIVE TRANSCRIPTS DELIVERED TO OOCYTE AT FERTILIZATION CAN RESULT IN PREGNANCY LOSSES AND ADVERSELY AFFECT EMBRYOGENESIS. THE OBJECTIVE OF THIS STUDY WAS TO ASSESS THE EFFECT OF YOGA-BASED LIFESTYLE INTERVENTION (YBLI) ON SEMINAL OXIDATIVE STRESS (OS), DNA DAMAGE AND SPERMATOZOAL TRANSCRIPT LEVELS. METHODS: THE PRESENT STUDY WAS A PART OF A PROSPECTIVE ONGOING EXPLORATORY STUDY AND 30 MALE PARTNERS OF COUPLES WITH RPL WERE INCLUDED FROM AUGUST 2016 TO JUNE 2017. SEMEN SAMPLES WERE OBTAINED AT BASELINE AND AT THE END OF YBLI (21 DAYS). GENE EXPRESSION ANALYSIS WAS PERFORMED BY QUANTITATIVE POLYMERASE CHAIN REACTION ON SPERMATOZOAL FOXG1, SOX3, OGG1, PARP1, RPS6, RBM9, RPS17 AND RPL29. THE LEVELS OF SEMINAL OS AND SPERM DNA DAMAGE WAS ASSESSED BY MEASURING LEVELS OF REACTIVE OXYGEN SPECIES (ROS) BY CHEMILUMINESCENCE AND DNA FRAGMENTATION INDEX (DFI) BY SPERM CHROMATIN STRUCTURE ASSAY. RESULTS: SOX3, OGG1 AND PARP1 WERE OBSERVED TO BE UPREGULATED, WHILE FOXG1, RPS6, RBM9, RPS17 AND RPL29 SHOWED DOWNREGULATION. A SIGNIFICANT REDUCTION IN ROS LEVELS, AN INCREASE IN SPERM MOTILITY, SPERM COUNT (DONE TWICE) AND A DECREASE IN DFI WAS SEEN AFTER YBLI. INTERPRETATION & CONCLUSIONS: ADOPTING YBLI MAY HELP IN A SIGNIFICANT DECLINE IN OXIDATIVE DNA DAMAGE AND NORMALIZATION OF SPERM TRANSCRIPT LEVELS. THIS MAY NOT ONLY IMPROVE PREGNANCY OUTCOMES BUT ALSO IMPROVE THE HEALTH TRAJECTORY OF THE OFFSPRING. 2018 3 2652 52 YOGA IMPROVES MITOCHONDRIAL HEALTH AND REDUCES SEVERITY OF AUTOIMMUNE INFLAMMATORY ARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OXIDATIVE STRESS (OS) AND MITOCHONDRIAL ALTERATIONS HAVE BEEN IMPLICATED IN THE PATHOGENESIS OF RHEUMATOID ARTHRITIS (RA). VARIOUS ENVIRONMENTAL TRIGGERS LIKE AIR POLLUTANTS, SMOKING, UNHEALTHY SOCIAL HABITS AND SEDENTARY LIFESTYLE INDUCE OS, WHICH MAY COMPROMISE MITOCHONDRIAL INTEGRITY. THIS TRIAL WAS DESIGNED TO EXPLORE THE EFFECT OF 8-WEEKS YOGA PRACTICE ON MITOCHONDRIAL HEALTH AND DISEASE SEVERITY IN AN ACTIVE RA GROUP COMPARED WITH A USUAL-CARE CONTROL GROUP. METHODS: A TOTAL OF 70 SUBJECTS WERE RANDOMIZED INTO TWO GROUPS: YOGA GROUP AND NON-YOGA GROUP. MITOCHONDRIAL HEALTH WAS ASSESSED BY CALCULATION OF MITOCHONDRIAL DNA COPY NUMBER (MTDNA-CN), OS MARKERS, MITOCHONDRIAL ACTIVITY, MITOCHONDRIAL MEMBRANE POTENTIAL (DELTAPSIM), CIRCADIAN RHYTHM MARKERS AND TRANSCRIPTS ASSOCIATED WITH MITOCHONDRIAL INTEGRITY: AMPK, TIMP-1, KLOTHO, SIRT-1, AND TFAM. PARAMETERS OF DISEASE ACTIVITY AND DISABILITY QUOTIENT WERE ALSO ASSESSED BY DISEASE ACTIVITY SCORE - ERYTHROCYTE SEDIMENTATION RATE (DAS28-ESR) AND HEALTH ASSESSMENT QUESTIONNAIRE-DISABILITY INDEX (HAQ-DI), RESPECTIVELY. RESULTS: IN YOGA GROUP, THERE WAS A SIGNIFICANT UPREGULATION OF MTDNA-CN, MITOCHONDRIAL ACTIVITY MARKERS, DELTAPSIM, AND TRANSCRIPTS THAT MAINTAIN MITOCHONDRIAL INTEGRITY AFTER 8-WEEKS OF YOGA. THERE WAS OPTIMIZATION OF OS MARKERS, AND CIRCADIAN RHYTHM MARKERS POST 8-WEEKS PRACTICE OF YOGA. YOGA GROUP PARTICIPANTS SHOWED SIGNIFICANT IMPROVEMENTS IN DAS28-ESR (P < 0.05) AND HAQ-DI (P < 0.05) OVER THE NON-YOGA GROUP. CONCLUSION: ADOPTION OF YOGA BY RA PATIENTS HOLDS THE KEY TO ENHANCE MITOCHONDRIAL HEALTH, IMPROVE CIRCADIAN RHYTHM MARKERS, OS MARKER REGULATION, UPREGULATION OF TRANSCRIPTS THAT MAINTAIN MITOCHONDRIAL INTEGRITY, REDUCE DISEASE ACTIVITY AND ITS ASSOCIATED CONSEQUENCES ON HEALTH OUTCOME AND HENCE CAN BE BENEFICIAL AS AN ADJUNCT THERAPY. 2021 4 1392 45 IMPACT OF YOGA AND MEDITATION ON CELLULAR AGING IN APPARENTLY HEALTHY INDIVIDUALS: A PROSPECTIVE, OPEN-LABEL SINGLE-ARM EXPLORATORY STUDY. THIS STUDY WAS DESIGNED TO EXPLORE THE IMPACT OF YOGA AND MEDITATION BASED LIFESTYLE INTERVENTION (YMLI) ON CELLULAR AGING IN APPARENTLY HEALTHY INDIVIDUALS. DURING THIS 12-WEEK PROSPECTIVE, OPEN-LABEL, SINGLE ARM EXPLORATORY STUDY, 96 APPARENTLY HEALTHY INDIVIDUALS WERE ENROLLED TO RECEIVE YMLI. THE PRIMARY ENDPOINTS WERE ASSESSMENT OF THE CHANGE IN LEVELS OF CARDINAL BIOMARKERS OF CELLULAR AGING IN BLOOD FROM BASELINE TO WEEK 12, WHICH INCLUDED DNA DAMAGE MARKER 8-HYDROXY-2'-DEOXYGUANOSINE (8-OH2DG), OXIDATIVE STRESS MARKERS REACTIVE OXYGEN SPECIES (ROS), AND TOTAL ANTIOXIDANT CAPACITY (TAC), AND TELOMERE ATTRITION MARKERS TELOMERE LENGTH AND TELOMERASE ACTIVITY. THE SECONDARY ENDPOINTS WERE ASSESSMENT OF METABOTROPHIC BLOOD BIOMARKERS ASSOCIATED WITH CELLULAR AGING, WHICH INCLUDED CORTISOL, BETA-ENDORPHIN, IL-6, BDNF, AND SIRTUIN-1. AFTER 12 WEEKS OF YMLI, THERE WERE SIGNIFICANT IMPROVEMENTS IN BOTH THE CARDINAL BIOMARKERS OF CELLULAR AGING AND THE METABOTROPHIC BIOMARKERS INFLUENCING CELLULAR AGING COMPARED TO BASELINE VALUES. THE MEAN LEVELS OF 8-OH2DG, ROS, CORTISOL, AND IL-6 WERE SIGNIFICANTLY LOWER AND MEAN LEVELS OF TAC, TELOMERASE ACTIVITY, BETA-ENDORPHIN, BDNF, AND SIRTUIN-1 WERE SIGNIFICANTLY INCREASED (ALL VALUES P < 0.05) POST-YMLI. THE MEAN LEVEL OF TELOMERE LENGTH WAS INCREASED BUT THE FINDING WAS NOT SIGNIFICANT (P = 0.069). YMLI SIGNIFICANTLY REDUCED THE RATE OF CELLULAR AGING IN APPARENTLY HEALTHY POPULATION. 2017 5 508 32 COMPARATIVE EFFICACY OF A 12 WEEK YOGA-BASED LIFESTYLE INTERVENTION AND DIETARY INTERVENTION ON ADIPOKINES, INFLAMMATION, AND OXIDATIVE STRESS IN ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED CONTROLLED TRIAL. THE PRESENT RANDOMIZED CONTROLLED TRIAL (RCT) EVALUATED THE COMPARATIVE EFFICACY OF 12 WEEK YOGA-BASED LIFESTYLE INTERVENTION (YBLI) AND DIETARY INTERVENTION (DI) ALONE ON ADIPOKINES, INFLAMMATION, AND OXIDATIVE STRESS IN INDIAN ADULTS WITH METABOLIC SYNDROME (MET S). A PARALLEL, TWO ARM, RCT WAS CONDUCTED IN INTEGRAL HEALTH CLINIC (IHC), ALL INDIA INSTITUTE OF MEDICAL SCIENCES, INDIA FROM 2012 TO 2014. IHC IS AN OUTPATIENT FACILITY CONDUCTING YBLI PROGRAMS FOR PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. TWO HUNDRED SIXTY MEN AND WOMEN (20-45 YEARS) VISITING THE OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL WERE DIAGNOSED WITH MET S AND RANDOMIZED 1:1 TO RECEIVE 12 WEEK YBLI (N = 130) OR DI (N = 130). PRIMARY OUTCOMES WERE CHANGE IN PLASMA LEVELS OF ADIPOKINES (LEPTIN, ADIPONECTIN, AND LEPTIN:ADIPONECTIN RATIO), MARKERS OF INFLAMMATION (TUMOR NECROSIS FACTOR [TNF]-ALPHA, INTERLEUKIN [IL]-6), MARKERS OF OXIDATIVE STRESS (THIOBARBITURIC ACID REACTIVE SUBSTANCES [TBARS], 8-HYDROXY-2'-DEOXYGUANOSINE [8-OHDG], AND SUPEROXIDE DISMUTASE [SOD]) MEASURED AT BASELINE, 2 WEEKS, AND 12 WEEKS. YBLI GROUP SHOWED A SIGNIFICANT DECREASE IN LEPTIN, LEPTIN:ADIPONECTIN RATIO, IL-6, 8-OHDG, AND TBARS LEVELS, WHEREAS THERE WAS A SIGNIFICANT INCREASE IN ADIPONECTIN AND SOD LEVELS. NO SIGNIFICANT CHANGES WERE NOTICED IN DI ALONE GROUP. YBLI SHOWED SIGNIFICANTLY GREATER REDUCTION IN TBARS LEVELS THAN IN DI GROUP, SUGGESTIVE OF REDUCED OXIDATIVE STRESS IN ADULTS WITH MET S. A 12 WEEK YBLI HAD A POSITIVE IMPACT ON OXIDATIVE STRESS VERSUS DI ALONE IN ADULTS WITH MET S. 2019 6 1989 47 SPERM METHYLOME ALTERATIONS FOLLOWING YOGA-BASED LIFESTYLE INTERVENTION IN PATIENTS OF PRIMARY MALE INFERTILITY: A PILOT STUDY. A MAJORITY OF THE CASES OF PRIMARY MALE INFERTILITY ARE IDIOPATHIC WITH THE UNDERLYING MOLECULAR MECHANISMS CONTRIBUTING TO THE PATHOPHYSIOLOGY AS YET UNKNOWN. EFFECTS OF THE ENVIRONMENT CAN ALTER THE SPERM EPIGENOME THEREBY IMPACTING MALE REPRODUCTIVE HEALTH. EPIGENETIC MECHANISMS ARE CRUCIAL TO UNDERSTANDING HEALTH AND DISEASE, AND METHYLOME ALTERATIONS ARE NOW KNOWN TO HAVE FAR-REACHING CLINICAL IMPLICATIONS. HERE, WE REPORT THE RESULTS FROM OUR PILOT STUDY, A FIRST OF ITS KIND ANALYSIS OF THE EFFECT OF THE TRADITIONAL PRACTICE OF YOGA ON HUMAN SPERM QUALITY. WE FIND MARKED IMPROVEMENT IN SPERM CHARACTERISTICS IN PATIENTS OF IDIOPATHIC MALE INFERTILITY FOLLOWING A SUPERVISED 21-DAY YOGA REGIMEN. FURTHERMORE, NEXT-GENERATION SEQUENCING-BASED METHYLOME ANALYSIS REVEALS ALTERATIONS IN THE SPERM EPIGENOME OF THESE PATIENTS. WE FIND THAT THE PRACTICE OF YOGA IS ASSOCIATED WITH DNA METHYLATION CHANGES AT NEARLY 400 GENES, 147 OF WHICH WERE HYPERMETHYLATED WHILE 229 WERE HYPOMETHYLATED. THESE INCLUDED PROMOTERS OF SEVERAL GENES LINKED TO MAINTENANCE OF FERTILITY AND GENOMIC INTEGRITY. THIS NOVEL PIECE OF WORK DRAWS A DIRECT LINK BETWEEN POSITIVE LIFESTYLE PRACTICES AND MALE REPRODUCTIVE HEALTH. 2020 7 1394 45 IMPACT OF YOGA BASED LIFESTYLE INTERVENTION ON PSYCHOLOGICAL STRESS AND QUALITY OF LIFE IN THE PARENTS OF CHILDREN WITH RETINOBLASTOMA. BACKGROUND: CHILDHOOD CANCERS ARE ASSOCIATED WITH A PSYCHOLOGICAL BURDEN TO THE PARENTS AND HENCE, DECLINE THEIR MENTAL AND PHYSICAL HEALTH AND OVERALL QUALITY OF LIFE. PURPOSE: THE PURPOSE OF THE PRESENT STUDY IS TO INVESTIGATE THE IMPACT OF 12-WEEKS YOGA BASED LIFESTYLE INTERVENTION ON PSYCHOLOGICAL STRESS AND QUALITY OF LIFE IN THE PARENTS OF CHILDREN AFFECTED WITH RETINOBLASTOMA. METHOD: SINGLE ARM PROSPECTIVE CLINICAL TRIAL CONDUCTED FROM OCTOBER 2015 TO OCTOBER 2017 AT THE LABORATORY FOR MOLECULAR REPRODUCTION AND GENETICS, DEPARTMENT OF ANATOMY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. A PRE-TESTED 12-WEEKS YOGA BASED LIFESTYLE INTERVENTION INCLUDED ASANAS (PHYSICAL POSTURES), PRANAYAMA (BREATHING EXERCISES), DHYANA (MEDITATION), RELAXATION TECHNIQUES, LECTURES AND FILMS ON YOGA, INTERACTIVE SESSIONS AND INDIVIDUALIZED ADVICE WAS ADMINISTERED TO THE PARTICIPANTS. RESULTS: 12-WEEKS OF YOGA BASED LIFESTYLE INTERVENTION PROGRAMME LEADS TO A SIGNIFICANT IMPROVEMENT IN PSYCHOLOGICAL STRESS AND OVERALL QUALITY OF LIFE IN THE PARENTS OF RETINOBLASTOMA PATIENTS. THERE WAS A SIGNIFICANT IMPROVEMENT IN ALL THE DOMAINS (PHYSICAL HEALTH, PSYCHOLOGICAL HEALTH, SOCIAL RELATIONSHIPS, AND ENVIRONMENT) OF WHOQOL-BREF FROM BASELINE (DAY 0) TO 12-WEEKS OF YOGA BASED LIFESTYLE INTERVENTION. YOGA BASED LIFESTYLE INTERVENTION ALSO LED TO A SIGNIFICANT INCREASE IN THE LEVELS OF BRAIN DERIVED NEUROTROPHIC FACTOR, DEHYDROEPIANDROSTERONE SULPHATE, SIRTUIN 1 AND DECREASED THE CORTISOL AND IL-6 LEVELS. CONCLUSION: YOGA BASED LIFESTYLE INTERVENTION REDUCED THE SEVERITY OF PSYCHOLOGICAL STRESS AND RESULTED IN IMPROVEMENT IN OVERALL QUALITY OF LIFE AND UPREGULATION IN LEVELS OF SYSTEMIC BIOMARKERS OF NEUROPLASTICITY. YBLI MAY SERVE AS A BENEFICIAL THERAPY AND MAY ALSO ACT AS AN EFFECTIVE MEDIUM FOR BETTER STRESS MANAGEMENT TO DEVELOP BETTER COPING STRATEGIES IN THE PARENTS OF RETINOBLASTOMA PATIENTS. 2019 8 1789 38 PRELIMINARY INDICATIONS OF THE EFFECT OF A BRIEF YOGA INTERVENTION ON MARKERS OF INFLAMMATION AND DNA METHYLATION IN CHRONICALLY STRESSED WOMEN. YOGA IS ASSOCIATED WITH REDUCED STRESS AND INCREASED WELL-BEING, ALTHOUGH THE MOLECULAR BASIS FOR THESE BENEFITS IS NOT CLEAR. MOUNTING EVIDENCE IMPLICATES THE IMMUNE RESPONSE, WITH CURRENT STUDIES FOCUSED ON PROTEIN IMMUNE MARKERS (SUCH AS CYTOKINES) IN CLINICAL POPULATIONS. TO EXPLORE THE MOLECULAR IMPACT, THIS PILOT STUDY USES A SUBSAMPLE (N=28) FROM A RANDOMISED WAITLIST CONTROL TRIAL INVESTIGATING THE IMPACT OF AN 8-WEEK YOGA INTERVENTION IN A COMMUNITY POPULATION OF WOMEN REPORTING PSYCHOLOGICAL DISTRESS (N=116). WE MEASURED INTERLEUKIN-6 (IL-6), TUMOUR NECROSIS FACTOR (TNF) AND C-REACTIVE PROTEIN (CRP) PROTEIN LEVELS, AND THE DNA METHYLATION OF THESE GENES AND THE GLOBAL INDICATOR, LINE-1. CORRELATIONS BETWEEN THESE AND PSYCHOLOGICAL VARIABLES WERE EXPLORED, IDENTIFYING MODERATE CORRELATIONS WITH CRP PROTEIN LEVELS, AND METHYLATION OF IL-6, CRP AND LINE-1. MANY CYTOKINE SAMPLES WERE BELOW DETECTION, HOWEVER A MANN-WHITNEY U DEMONSTRATED A TREND OF MODERATE BETWEEN-GROUP EFFECT FOR ELEVATED IL-6 IN THE YOGA GROUP. METHYLATION ANALYSES APPLIED CROSS-SECTIONAL AND NON-CONTROLLED LONGITUDINAL ANALYSES. WAIST-TO-HEIGHT RATIO AND AGE WERE COVARIED. WE DEMONSTRATED REDUCED METHYLATION OF THE TNF REGION IN THE YOGA GROUP RELATIVE TO THE WAITLIST CONTROL GROUP. NO OTHER GENES DEMONSTRATED A SIGNIFICANT DIFFERENCE. LONGITUDINAL ANALYSIS FURTHER SUPPORTED THESE RESULTS. THIS STUDY IS ONE OF THE FIRST TO EXPLORE YOGA AND IMMUNOLOGICAL MARKERS IN A NON-CLINICAL POPULATION, AND IS THE FIRST STUDY TO EXPLORE DNA METHYLATION. THESE FINDINGS INDICATE THAT FURTHER RESEARCH INTO MOLECULAR IMPACT OF YOGA ON MARKERS OF IMMUNE FUNCTION IS WARRANTED, WITH LARGER STUDIES REQUIRED. 2016 9 2038 58 TELOMERASE ACTIVITY AND CELLULAR AGING MIGHT BE POSITIVELY MODIFIED BY A YOGA-BASED LIFESTYLE INTERVENTION. OBJECTIVES: RECENT STUDIES SHOWED THAT A BRIEF YOGA-BASED LIFESTYLE INTERVENTION WAS EFFICACIOUS IN REDUCING LEVELS OF OXIDATIVE STRESS AND CELLULAR AGING IN OBESE MEN. THE OBJECTIVE OF THIS CASE REPORT WAS TO ASSESS THE EFFICACY OF THIS INTERVENTION IN REDUCING THE LEVELS OF BIOCHEMICAL MARKERS OF CELLULAR AGEING, OXIDATIVE STRESS, AND INFLAMMATION AT BASELINE (DAY 0), AT THE END OF ACTIVE INTERVENTION (DAY 10), AND FOLLOW-UP AT DAY 90. DESIGN: SINGLE CASE REPORT FROM A PROSPECTIVE ONGOING STUDY WITH PRE-POST DESIGN ASSESSING THE LEVEL OF VARIOUS MARKERS OF CELLULAR AGING. SETTING: INTEGRAL HEALTH CLINIC, AN OUTPATIENT FACILITY CONDUCTING MEDITATION AND YOGA-BASED LIFESTYLE INTERVENTION PROGRAMS FOR MANAGEMENT OF CHRONIC DISEASES. PATIENT: A 31-YEAR-OLD MAN WITH CLASS I OBESITY (BODY-MASS INDEX, 29.5 KG/M(2)) WHO PRESENTED TO THE MEDICINE OUTPATIENT DEPARTMENT AT ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA, WITH A HISTORY OF FATIGUE, DIFFICULTY LOSING WEIGHT, AND LACK OF MOTIVATION. HE NOTED A MARKED DECREASE IN HIS ENERGY LEVEL, PARTICULARLY IN THE AFTERNOON. INTERVENTION: A PRETESTED INTERVENTION PROGRAM INCLUDED ASANAS (POSTURES), PRANAYAMA (BREATHING EXERCISES), STRESS MANAGEMENT, GROUP DISCUSSIONS, LECTURES, AND INDIVIDUALIZED ADVICE. RESULTS: FROM BASELINE (DAY 0) TO DAY 90, THE ACTIVITY OF TELOMERASE AND LEVELS OF BETA-ENDORPHINS, PLASMA CORTISOL, AND INTERLEUKIN-6 INCREASED, AND A SUSTAINED REDUCTION IN OXIDATIVE STRESS MARKERS, SUCH AS REACTIVE OXYGEN SPECIES AND 8-HYDROXY-2-DEOXY-GUANOSINE LEVELS. CONCLUSIONS: ADOPTING YOGA/MEDITATION-BASED LIFESTYLE MODIFICATION CAUSES REVERSAL OF MARKERS OF AGING, MAINLY OXIDATIVE STRESS, TELOMERASE ACTIVITY, AND OXIDATIVE DNA DAMAGE. THIS MAY NOT ONLY DELAY AGING AND PROLONG A YOUTHFUL HEALTHY LIFE BUT ALSO DELAY OR PREVENT ONSET OF SEVERAL LIFESTYLE-RELATED DISEASES, OF WHICH OXIDATIVE STRESS AND INFLAMMATION ARE THE CHIEF CAUSE. THIS REPORT SUGGESTS THIS SIMPLE LIFESTYLE INTERVENTION MAY BE THERAPEUTIC FOR OXIDATIVE DNA DAMAGE AND OXIDATIVE STRESS. 2015 10 683 54 EFFECT OF AN 8-WEEK YOGA-BASED LIFESTYLE INTERVENTION ON PSYCHO-NEURO-IMMUNE AXIS, DISEASE ACTIVITY, AND PERCEIVED QUALITY OF LIFE IN RHEUMATOID ARTHRITIS PATIENTS: A RANDOMIZED CONTROLLED TRIAL. VARIOUS EXTERNAL STRESSORS AND ENVIRONMENTAL CHALLENGES LEAD TO THE PROVOCATION OF THE IMMUNE SYSTEM IN AUTOIMMUNE DISEASES LIKE RHEUMATOID ARTHRITIS (RA). THE INAPPROPRIATE IMMUNE RESPONSE FURTHER TRIGGERS THE CASCADE OF INFLAMMATORY CHANGES RESULTING IN PRECIPITATION OF SYMPTOMS AND HAMPERS QUALITY OF LIFE (QOL). THE UNDERLYING PSYCHO-SOMATIC COMPONENT OF THE DISEASE REQUIRES A HOLISTIC APPROACH TO ITS TREATMENT DIMENSION RATHER THAN THE USE OF PHARMACOTHERAPY. THE APPLICABILITY OF MIND-BODY INTERVENTIONS HAS BECOME ESSENTIAL IN TODAY'S FAST-PACED LIFE. YOGA, A MIND-BODY TECHNIQUE, ALTERS THE MIND'S CAPACITY TO FACILITATE SYSTEMIC FUNCTIONING AT MULTIPLE ORGAN SYSTEM LEVELS. HENCE, WE CONDUCTED THIS STUDY TO EVALUATE THE IMPACT OF 8 WEEKS OF A YOGA-BASED LIFESTYLE INTERVENTION (YBLI) ON PSYCHO-NEURO-IMMUNE MARKERS, GENE EXPRESSION PATTERNS, AND QOL IN RA PATIENTS ON ROUTINE MEDICAL THERAPY. A TOTAL OF 66 PATIENTS WERE RANDOMIZED INTO TWO GROUPS: YOGA GROUP OR NON-YOGA GROUP AND WERE ASSESSED FOR A PANEL OF INFLAMMATORY CYTOKINES (IL-6, IL-17A, TNF-ALPHA, AND TGF-BETA), MIND-BODY COMMUNICATIVE MARKERS (BDNF, DHEAS, BETA-ENDORPHIN, AND SIRTUIN) AND TRANSCRIPT LEVELS OF VARIOUS GENES (IL-6, TNF-ALPHA, NFKB1, TGF-BETA, AND CTLA4). WE ASSESSED DISEASE ACTIVITY AND QOL USING THE DAS28-ESR AND WHOQOL-BREF QUESTIONNAIRE, RESPECTIVELY. YOGA GROUP OBSERVED SIGNIFICANT IMPROVEMENTS IN THE LEVELS OF MARKERS, WHICH INFLUENCED THE PSYCHO-NEURO-IMMUNE AXIS (P < 0.001) WITH AN ESTIMATED EFFECT SIZE FROM SMALL TO MEDIUM RANGE. IN THE YOGA GROUP, THERE WAS A SIGNIFICANT REDUCTION IN DAS28-ESR (P < 0.001) AND IMPROVEMENT SEEN IN THE PHYSICAL HEALTH, PSYCHOLOGICAL, SOCIAL RELATIONSHIPS DOMAINS (P < 0.001) OF QOL, EXCEPT ENVIRONMENTAL (P > 0.05). THE YOGA GROUP SHOWED DOWNREGULATION OF IL-6, TNF-ALPHA, AND CTLA4 AND UPREGULATION OF TGF-BETA. THESE RESULTS SUGGEST THAT A DECREASE IN DISEASE ACTIVITY AFTER YOGA PRACTICE IS ASSOCIATED WITH A SIGNIFICANT REDUCTION IN INFLAMMATORY CYTOKINES, THE ELEVATION OF MIND-BODY COMMUNICATIVE MARKERS, AND NORMALIZATION OF VARIOUS TRANSCRIPT LEVELS, WHICH IMPROVED QOL. THUS THE ADOPTION OF YBLI IMPROVES CLINICAL OUTCOME IN RA, AND DECREASES SYSTEMIC INFLAMMATION BY ITS BENEFICIAL EFFECTS ON PSYCHO-NEURO-IMMUNE AXIS AND NORMALIZATION OF DYSREGULATED TRANSCRIPTS. THUS YBLI MAY BE USED FOR RA PATIENTS AS AN ADJUNCTIVE THERAPY. 2020 11 812 34 EFFECT OF YOGA ON CARDIAC AUTONOMIC DYSFUNCTION AND INSULIN RESISTANCE IN NON-DIABETIC OFFSPRING OF TYPE-2-DIABETES PARENTS: A RANDOMIZED CONTROLLED STUDY. OBJECTIVE: THE PRESENT STUDY WAS AIMED TO DETERMINE THE EFFECT OF YOGA PROGRAM ON CARDIAC AUTONOMIC DYSFUNCTION AND INSULIN RESISTANCE IN NON-DIABETIC OFFSPRING OF DIABETES PARENTS. METHODS: A RANDOMIZED PASSIVE-CONTROLLED STUDY WAS CONDUCTED ON 64 NON-DIABETIC OFFSPRING OF TYPE-2-DIABETES PARENTS (MEAN-AGE:25.17YEARS). YOGA GROUP PARTICIPANTS RECEIVED YOGA TRAINING FOR 8 WEEKS. HEART-RATE VARIABILITY (HRV) INDICES: LOW FREQUENCY (LF), HIGH FREQUENCY (HF) AND LF/HF RATIO; FASTING BLOOD GLUCOSE (FBG), ORAL GLUCOSE TOLERANCE TEST (OGTT) AND INSULIN RESISTANCE (IR) WERE ESTIMATED AT BASELINE AND AFTER 8-WEEKS OF INTERVENTION. RESULTS: WE FOUND A SIGNIFICANT DECREASE IN LF (P=0.005), LF/HF RATIO (P=0.004), IR (P<0.001), OGTT (P=0.003) AND INCREASE IN HF (P=0.022) IN YOGA GROUP PARTICIPANTS. CONTROL GROUP PARTICIPANTS DID NOT SHOW ANY SIGNIFICANT CHANGE IN ANY VARIABLES. CONCLUSIONS: IMPROVEMENT IN CARDIAC AUTONOMIC FUNCTION AND INSULIN RESISTANCE BY YOGA TRAINING IMPLIES THAT YOGA CAN REDUCE THE RISK OF DEVELOPMENT OF DIABETES IN OFFSPRING OF DIABETES PARENTS. 2019 12 2629 52 YOGA FOR THE PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE. BACKGROUND: A SEDENTARY LIFESTYLE AND STRESS ARE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD). SINCE YOGA INVOLVES EXERCISE AND IS THOUGHT TO HELP IN STRESS REDUCTION IT MAY BE AN EFFECTIVE STRATEGY IN THE PRIMARY PREVENTION OF CVD. OBJECTIVES: TO DETERMINE THE EFFECT OF ANY TYPE OF YOGA ON THE PRIMARY PREVENTION OF CVD. SEARCH METHODS: WE SEARCHED THE FOLLOWING ELECTRONIC DATABASES: THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) (2013, ISSUE 11) IN THE COCHRANE LIBRARY; MEDLINE (OVID) (1946 TO NOVEMBER WEEK 3 2013); EMBASE CLASSIC + EMBASE (OVID) (1947 TO 2013 WEEK 48); WEB OF SCIENCE (THOMSON REUTERS) (1970 TO 4 DECEMBER 2013); DATABASE OF ABSTRACTS OF REVIEWS OF EFFECTS (DARE), HEALTH TECHNOLOGY ASSESSMENT DATABASE AND HEALTH ECONOMICS EVALUATIONS DATABASE (ISSUE 4 OF 4, 2013) IN THE COCHRANE LIBRARY. WE ALSO SEARCHED A NUMBER OF ASIAN DATABASES AND THE ALLIED AND COMPLEMENTARY MEDICINE DATABASE (AMED) (INCEPTION TO DECEMBER 2012). WE SEARCHED TRIAL REGISTERS AND REFERENCE LISTS OF REVIEWS AND ARTICLES, AND APPROACHED EXPERTS IN THE FIELD. WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS LASTING AT LEAST THREE MONTHS INVOLVING HEALTHY ADULTS OR THOSE AT HIGH RISK OF CVD. TRIALS EXAMINED ANY TYPE OF YOGA AND THE COMPARISON GROUP WAS NO INTERVENTION OR MINIMAL INTERVENTION. OUTCOMES OF INTEREST WERE CLINICAL CVD EVENTS AND MAJOR CVD RISK FACTORS. WE DID NOT INCLUDE ANY TRIALS THAT INVOLVED MULTIFACTORIAL LIFESTYLE INTERVENTIONS OR WEIGHT LOSS. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED TRIALS FOR INCLUSION, EXTRACTED DATA AND ASSESSED THE RISK OF BIAS. MAIN RESULTS: WE IDENTIFIED 11 TRIALS (800 PARTICIPANTS) AND TWO ONGOING STUDIES. STYLE AND DURATION OF YOGA DIFFERED BETWEEN TRIALS. HALF OF THE PARTICIPANTS RECRUITED TO THE STUDIES WERE AT HIGH RISK OF CVD. MOST OF STUDIES WERE AT RISK OF PERFORMANCE BIAS, WITH INADEQUATE DETAILS REPORTED IN MANY OF THEM TO JUDGE THE RISK OF SELECTION BIAS.NO STUDY REPORTED CARDIOVASCULAR MORTALITY, ALL-CAUSE MORTALITY OR NON-FATAL EVENTS, AND MOST STUDIES WERE SMALL AND SHORT-TERM. THERE WAS SUBSTANTIAL HETEROGENEITY BETWEEN STUDIES MAKING IT IMPOSSIBLE TO COMBINE STUDIES STATISTICALLY FOR SYSTOLIC BLOOD PRESSURE AND TOTAL CHOLESTEROL. YOGA WAS FOUND TO PRODUCE REDUCTIONS IN DIASTOLIC BLOOD PRESSURE (MEAN DIFFERENCE (MD) -2.90 MMHG, 95% CONFIDENCE INTERVAL (CI) -4.52 TO -1.28), WHICH WAS STABLE ON SENSITIVITY ANALYSIS, TRIGLYCERIDES (MD -0.27 MMOL/L, 95% CI -0.44 TO -0.11) AND HIGH-DENSITY LIPOPROTEIN (HDL) CHOLESTEROL (MD 0.08 MMOL/L, 95% CI 0.02 TO 0.14). HOWEVER, THE CONTRIBUTING STUDIES WERE SMALL, SHORT-TERM AND AT UNCLEAR OR HIGH RISK OF BIAS. THERE WAS NO CLEAR EVIDENCE OF A DIFFERENCE BETWEEN GROUPS FOR LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL (MD -0.09 MMOL/L, 95% CI -0.48 TO 0.30), ALTHOUGH THERE WAS MODERATE STATISTICAL HETEROGENEITY. ADVERSE EVENTS, OCCURRENCE OF TYPE 2 DIABETES AND COSTS WERE NOT REPORTED IN ANY OF THE INCLUDED STUDIES. QUALITY OF LIFE WAS MEASURED IN THREE TRIALS BUT THE RESULTS WERE INCONCLUSIVE. AUTHORS' CONCLUSIONS: THE LIMITED EVIDENCE COMES FROM SMALL, SHORT-TERM, LOW-QUALITY STUDIES. THERE IS SOME EVIDENCE THAT YOGA HAS FAVOURABLE EFFECTS ON DIASTOLIC BLOOD PRESSURE, HDL CHOLESTEROL AND TRIGLYCERIDES, AND UNCERTAIN EFFECTS ON LDL CHOLESTEROL. THESE RESULTS SHOULD BE CONSIDERED AS EXPLORATORY AND INTERPRETED WITH CAUTION. 2014 13 2854 49 YOGA- AND MEDITATION-BASED LIFESTYLE INTERVENTION INCREASES NEUROPLASTICITY AND REDUCES SEVERITY OF MAJOR DEPRESSIVE DISORDER: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CURRENT INTERVENTIONS FOR MAJOR DEPRESSIVE DISORDER (MDD) ARE SUBOPTIMAL, AND ONLY ONE THIRD RESPOND TO THEM ON INITIAL TREATMENT. NEUROPLASTICITY THEORIES ARE THE BASIS FOR SEVERAL EMERGING TREATMENTS. EVIDENCE ON THE IMPACT OF YOGA, A WELL-KNOWN MIND-BODY INTERVENTION, ON NEUROPLASTICITY IN MDD IS LIMITED. OBJECTIVES: TO DETERMINE THE EFFECTS OF 12-WEEK YOGA- AND MEDITATION-BASED LIFESTYLE INTERVENTION (YMLI) ON DEPRESSION SEVERITY AND SYSTEMIC BIOMARKERS OF NEUROPLASTICITY IN ADULT MDD PATIENTS ON ROUTINE DRUG TREATMENT. METHODS: A TOTAL OF 58 MDD PATIENTS WERE RANDOMIZED INTO YOGA OR CONTROL GROUP. THE SEVERITY OF DEPRESSION WAS ASSESSED WITH BECK DEPRESSION INVENTORY-II SCALE (BDI-II). BLOOD SAMPLES WERE COLLECTED BEFORE AND AFTER INTERVENTION FOR THE MEASUREMENT OF THE BIOMARKERS THAT CHARACTERIZE NEUROPLASTICITY, INCLUDING MIND-BODY COMMUNICATIVE AND CELLULAR HEALTH BIOMARKERS. RESULTS: THERE WAS A SIGNIFICANT DECREASE [DIFFERENCE BETWEEN MEANS, (95% CI)] IN BDI-II SCORE [-5.83 (-7.27, -4.39), P < 0.001] AND SIGNIFICANT INCREASE IN BDNF (NG/ML) [5.48 (3.50, 7.46), P < 0.001] AFTER YMLI COMPARED TO CONTROL GROUP. YMLI SIGNIFICANTLY INCREASED DHEAS, SIRTUIN 1, AND TELOMERASE ACTIVITY LEVELS, AND DECREASED CORTISOL, AND IL-6 LEVELS, IN ADDITION TO DECREASING DNA DAMAGE AND BALANCING OXIDATIVE STRESS. MULTIPLE REGRESSION ANALYSES WERE USED TO ASSOCIATE NEUROPLASTICITY BIOMARKERS WITH DEPRESSION SEVERITY. A 'POST-INTERVENTION CHANGE IN BDNF' X 'GROUP' INTERACTION INDICATED THAT YOGA GROUP HAD MORE BDNF IN ASSOCIATION WITH LESS BDI-II SCORES RELATIVE TO CONTROLS. INCREASED SIRTUIN 1 AND TELOMERASE ACTIVITY AND DECREASED CORTISOL SIGNIFICANTLY PREDICTED THIS ASSOCIATION (ALL P < 0.05). CONCLUSION: THESE RESULTS SUGGEST THAT DECREASE IN DEPRESSION SEVERITY AFTER YMLI IN MDD IS ASSOCIATED WITH IMPROVED SYSTEMIC BIOMARKERS OF NEUROPLASTICITY. THUS YMLI CAN BE CONSIDERED AS A THERAPEUTIC INTERVENTION IN MDD MANAGEMENT. 2018 14 35 46 A 12-WEEK YOGA-BASED LIFESTYLE INTERVENTION MIGHT POSITIVELY MODIFY CELLULAR AGING IN INDIAN OBESE INDIVIDUALS: A RANDOMIZED-CONTROLLED TRIAL. BACKGROUND: TELOMERES AND TELOMERASE ARE CONSIDERED CARDINAL BIOMARKERS OF CELLULAR AGING. SHORTER TELOMERES AND LOW TELOMERASE ACTIVITY HAVE BEEN ASSOCIATED WITH OBESITY AND ACCELERATED AGING. OBJECTIVE: TO COMPARE THE EFFECTS OF A YOGA-BASED LIFESTYLE INTERVENTION (YBLI) WITH THE STANDARD OF CARE (SOC) ON CELLULAR AGING BY ESTIMATING TELOMERE LENGTH (TL) AND TELOMERASE ACTIVITY IN OBESITY. DESIGN AND SETTING: A PARALLEL, TWO-ARM, RANDOMIZED-CONTROLLED TRIAL WAS CONDUCTED AT THE INTEGRAL HEALTH CLINIC, DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, FROM MARCH 2017 TO OCTOBER 2019. PARTICIPANTS: OBESE (N = 72), BODY MASS INDEX (BMI), 25-35 KG/M(2), AGED 20-45 YEARS, MALE (21), AND FEMALE (51). INTERVENTION: SEVENTY-TWO OBESE PARTICIPANTS WERE RANDOMIZED TO RECEIVE EITHER A 12-WEEK SOC (N = 36) OR YBLI (N = 36). SOC INCLUDED MANAGEMENT OF OBESITY AS PER INDIAN GUIDELINES INCLUDING A HYPOCALORIC INDIVIDUALIZED DIET AND PHYSICAL ACTIVITY. THE PRETESTED YBLI INCLUDED ASANA (PHYSICAL POSTURES), PRANAYAMA (BREATHING EXERCISES), AND MEDITATION. METHODS: BLOOD SAMPLES WERE COLLECTED FROM BOTH THE GROUPS AT BASELINE, 2, 4, AND 12 WEEKS. DNA WAS EXTRACTED FROM PERIPHERAL BLOOD MONONUCLEAR CELLS. TL WAS MEASURED BY QUANTITATIVE PCR, AND SERUM TELOMERASE LEVELS BY IMMUNOASSAY. OUTCOME MEASURES: PRIMARY OUTCOME MEASURES WERE THE CHANGES IN THE TL AND TELOMERASE LEVELS BETWEEN THE TWO GROUPS AT WEEK 12. SECONDARY OUTCOME MEASURES WERE THE CHANGES IN TL AND TELOMERASE, AND ANTHROPOMETRIC PARAMETERS (BODY WEIGHT, BMI, WAIST-TO-HIP RATIO) AT 2, 4, AND 12 WEEKS OF INTERVENTION IN BOTH SOC AND YBLI GROUPS. RESULTS: THERE WERE NO SIGNIFICANT CHANGES IN TL AND TELOMERASE LEVELS BETWEEN THE GROUPS AT WEEK 12. THE TL WAS SIGNIFICANTLY GREATER IN THE YBLI GROUP VERSUS THE SOC GROUP (P < 0.0001) AT 2 WEEKS. THE ANTHROPOMETRIC AND PHYSIOLOGICAL PARAMETERS WERE INFLUENCED POSITIVELY BY BOTH SOC AND YBLI. CONCLUSION: THE STUDY DID NOT MEET THE PRIMARY OBJECTIVE, ALTHOUGH THE RESULTS ARE SUGGESTIVE OF A POSITIVE IMPACT OF YBLI ON AGING IN OBESITY AS NOTED WITHIN THE YBLI GROUP. HOWEVER, THE RESULTS SHOULD BE INTERPRETED CAREFULLY, AND IN THE LIGHT OF OTHER PUBLISHED DATA. LARGER STUDIES TO BETTER UNDERSTAND THE POSSIBLE POSITIVE BENEFITS OF YBLI ON CELLULAR AGING ARE RECOMMENDED. CLINICAL TRAIL REGISTRATION NO. CTRI/2016/08/007136. 2022 15 1917 49 ROLE OF YOGA AND ITS PLAUSIBLE MECHANISM IN THE MITIGATION OF DNA DAMAGE IN TYPE-2 DIABETES: A RANDOMIZED CLINICAL TRIAL. BACKGROUND: ALTHOUGH YOGA IS FOUND TO BE BENEFICIAL IN THE MANAGEMENT OF TYPE 2 DIABETES (T2D), ITS MECHANISM OF ACTION IS POORLY UNDERSTOOD. T2D IS ALSO KNOWN TO BE ASSOCIATED WITH INCREASED OXIDATIVE STRESS (OS) AND DNA DAMAGE. PURPOSE: THIS STUDY EXAMINES HOW YOGA MODULATES OS-INDUCED DNA DAMAGE AND THE EFFICIENCY OF DNA REPAIR IN T2D CONDITIONS. METHODS: IN THIS ASSESSOR-MASKED RANDOMIZED CLINICAL TRIAL, T2D SUBJECTS (N = 61), AGED (MEAN +/- SD, 50.3 +/- 4.2) WERE RANDOMLY ALLOCATED INTO YOGA GROUP (31) THAT RECEIVED 10 WEEKS OF YOGA INTERVENTION AND CONTROL (30) WITH ROUTINE EXERCISES. MOLECULAR AND BIOCHEMICAL ASSESSMENTS WERE DONE BEFORE AND AFTER THE INTERVENTION PERIOD. STRUCTURAL EQUATION MODELING USING "R" WAS USED FOR MEDIATION ANALYSIS. RESULTS: AT THE END OF THE 10TH WEEK, YOGA GROUP SHOWED SIGNIFICANT REDUCTION IN DNA DAMAGE INDICATORS LIKE TAIL MOMENT (-5.88[95%CI: -10.47 TO -1.30]; P = .013) AND OLIVE TAIL MOMENT (-2.93[95%CI: -4.87 TO -1.00]; P < .01), OXIDATIVE DNA DAMAGE MARKER 8-OHDG (-60.39[95%CI: -92.55 TO -28.23]; P < .001) AND FASTING BLOOD SUGAR (-22.58[95%CI: -44.33 TO -0.83]; P = .042) COMPARED TO CONTROL. OGG1 PROTEIN EXPRESSION INDICATING DNA REPAIR, IMPROVED SIGNIFICANTLY (17.55[95%CI:1.37 TO 33.73]; P = .034) WHEREAS TOTAL ANTIOXIDANT CAPACITY DID NOT (5.80[95%CI: -0.86 TO 12.47]; P = 0.086). MEDIATION ANALYSIS INDICATED THAT IMPROVEMENTS IN OXIDATIVE DNA DAMAGE AND DNA REPAIR TOGETHER PLAYED A MAJOR MEDIATORY ROLE (97.4%) IN CARRYING THE EFFECT OF YOGA. CONCLUSION: THE BENEFICIAL EFFECT OF YOGA ON DNA DAMAGE IN T2D SUBJECTS WAS FOUND TO BE MEDIATED BY MITIGATION OF OXIDATIVE DNA DAMAGE AND ENHANCEMENT OF DNA REPAIR. CLINICAL TRIAL INFORMATION: (WWW.CTRI.NIC.IN) CTRI/2018/07/014825. 2022 16 2636 60 YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. BACKGROUND: URINARY INCONTINENCE IN WOMEN IS ASSOCIATED WITH POOR QUALITY OF LIFE AND DIFFICULTIES IN SOCIAL, PSYCHOLOGICAL AND SEXUAL FUNCTIONING. THE CONDITION MAY AFFECT UP TO 15% OF MIDDLE-AGED OR OLDER WOMEN IN THE GENERAL POPULATION. CONSERVATIVE TREATMENTS SUCH AS LIFESTYLE INTERVENTIONS, BLADDER TRAINING AND PELVIC FLOOR MUSCLE TRAINING (USED EITHER ALONE OR IN COMBINATION WITH OTHER INTERVENTIONS) ARE THE INITIAL APPROACHES TO THE MANAGEMENT OF URINARY INCONTINENCE. MANY WOMEN ARE INTERESTED IN ADDITIONAL TREATMENTS SUCH AS YOGA, A SYSTEM OF PHILOSOPHY, LIFESTYLE AND PHYSICAL PRACTICE THAT ORIGINATED IN ANCIENT INDIA. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. SEARCH METHODS: WE SEARCHED THE COCHRANE INCONTINENCE AND COCHRANE COMPLEMENTARY MEDICINE SPECIALISED REGISTERS. WE SEARCHED THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (WHO ICTRP) AND CLINICALTRIALS.GOV TO IDENTIFY ANY ONGOING OR UNPUBLISHED STUDIES. WE HANDSEARCHED PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH AND THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE. WE SEARCHED THE NHS ECONOMIC EVALUATION DATABASE FOR ECONOMIC STUDIES, AND SUPPLEMENTED THIS SEARCH WITH SEARCHES FOR ECONOMICS STUDIES IN MEDLINE AND EMBASE FROM 2015 ONWARDS. DATABASE SEARCHES ARE UP-TO-DATE AS OF 21 JUNE 2018. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS IN WOMEN DIAGNOSED WITH URINARY INCONTINENCE IN WHICH ONE GROUP WAS ALLOCATED TO TREATMENT WITH YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY SCREENED TITLES AND ABSTRACTS OF ALL RETRIEVED ARTICLES, SELECTED STUDIES FOR INCLUSION, EXTRACTED DATA, ASSESSED RISK OF BIAS AND EVALUATED THE CERTAINTY OF THE EVIDENCE FOR EACH REPORTED OUTCOME. ANY DISAGREEMENTS WERE RESOLVED BY CONSENSUS. WE PLANNED TO COMBINE CLINICALLY COMPARABLE STUDIES IN REVIEW MANAGER 5 USING RANDOM-EFFECTS META-ANALYSIS AND TO CARRY OUT SENSITIVITY AND SUBGROUP ANALYSES. WE PLANNED TO CREATE A TABLE LISTING ECONOMIC STUDIES ON YOGA FOR INCONTINENCE BUT NOT CARRY OUT ANY ANALYSES ON THESE STUDIES. MAIN RESULTS: WE INCLUDED TWO STUDIES (INVOLVING A TOTAL OF 49 WOMEN). EACH STUDY COMPARED YOGA TO A DIFFERENT COMPARATOR, THEREFORE WE WERE UNABLE TO COMBINE THE DATA IN A META-ANALYSIS. A THIRD STUDY THAT HAS BEEN COMPLETED BUT NOT YET FULLY REPORTED IS AWAITING ASSESSMENT.ONE INCLUDED STUDY WAS A SIX-WEEK STUDY COMPARING YOGA TO A WAITING LIST IN 19 WOMEN WITH EITHER URGENCY URINARY INCONTINENCE OR STRESS URINARY INCONTINENCE. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, DETECTION BIAS, AND IMPRECISION. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER YOGA RESULTS IN SATISFACTION WITH CURE OR IMPROVEMENT OF INCONTINENCE (RISK RATIO (RR) 6.33, 95% CONFIDENCE INTERVAL (CI) 1.44 TO 27.88; AN INCREASE OF 592 FROM 111 PER 1000, 95% CI 160 TO 1000). WE ARE UNCERTAIN WHETHER THERE IS A DIFFERENCE BETWEEN YOGA AND WAITING LIST IN CONDITION-SPECIFIC QUALITY OF LIFE AS MEASURED ON THE INCONTINENCE IMPACT QUESTIONNAIRE SHORT FORM (MEAN DIFFERENCE (MD) 1.74, 95% CI -33.02 TO 36.50); THE NUMBER OF MICTURITIONS (MD -0.77, 95% CI -2.13 TO 0.59); THE NUMBER OF INCONTINENCE EPISODES (MD -1.57, 95% CI -2.83 TO -0.31); OR THE BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE UROGENITAL DISTRESS INVENTORY 6 (MD -0.90, 95% CI -1.46 TO -0.34). THERE WAS NO EVIDENCE OF A DIFFERENCE IN THE NUMBER OF WOMEN WHO EXPERIENCED AT LEAST ONE ADVERSE EVENT (RISK DIFFERENCE 0%, 95% CI -38% TO 38%; NO DIFFERENCE FROM 222 PER 1000, 95% CI 380 FEWER TO 380 MORE).THE SECOND INCLUDED STUDY WAS AN EIGHT-WEEK STUDY IN 30 WOMEN WITH URGENCY URINARY INCONTINENCE THAT COMPARED MINDFULNESS-BASED STRESS REDUCTION (MBSR) TO AN ACTIVE CONTROL INTERVENTION OF YOGA CLASSES. THE STUDY WAS UNBLINDED, AND THERE WAS HIGH ATTRITION FROM BOTH STUDY ARMS FOR ALL OUTCOME ASSESSMENTS. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, ATTRITION BIAS, IMPRECISION AND INDIRECTNESS. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER WOMEN IN THE YOGA GROUP WERE LESS LIKELY TO REPORT IMPROVEMENT IN INCONTINENCE AT EIGHT WEEKS COMPARED TO WOMEN IN THE MBSR GROUP (RR 0.09, 95% CI 0.01 TO 1.43; A DECREASE OF 419 FROM 461 PER 1000, 95% CI 5 TO 660). WE ARE UNCERTAIN ABOUT THE EFFECT OF MBSR COMPARED TO YOGA ON REPORTS OF CURE OR IMPROVEMENT IN INCONTINENCE, IMPROVEMENT IN CONDITION-SPECIFIC QUALITY OF LIFE MEASURED ON THE OVERACTIVE BLADDER HEALTH-RELATED QUALITY OF LIFE SCALE, REDUCTION IN INCONTINENCE EPISODES OR REDUCTION IN BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AT EIGHT WEEKS. THE STUDY DID NOT REPORT ON ADVERSE EFFECTS. AUTHORS' CONCLUSIONS: WE IDENTIFIED FEW TRIALS ON YOGA FOR INCONTINENCE, AND THE EXISTING TRIALS WERE SMALL AND AT HIGH RISK OF BIAS. IN ADDITION, WE DID NOT FIND ANY STUDIES OF ECONOMIC OUTCOMES RELATED TO YOGA FOR URINARY INCONTINENCE. DUE TO THE LACK OF EVIDENCE TO ANSWER THE REVIEW QUESTION, WE ARE UNCERTAIN WHETHER YOGA IS USEFUL FOR WOMEN WITH URINARY INCONTINENCE. ADDITIONAL, WELL-CONDUCTED TRIALS WITH LARGER SAMPLE SIZES ARE NEEDED. 2019 17 834 42 EFFECT OF YOGA ON OXIDATIVE STRESS IN TYPE 2 DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: DIABETES MELLITUS HAS A SIGNIFICANT IMPACT ON PUBLIC HEALTH. OXIDATIVE STRESS PLAYS A MAJOR ROLE IN THE PATHOPHYSIOLOGY OF TYPE 2 DIABETES MELLITUS (T2DM), LEADING TO VARIOUS COMPLICATIONS OF T2DM. YOGA IS BEING WIDELY USED IN THE MANAGEMENT OF T2DM. THE PRIMARY OBJECTIVE OF THIS SYSTEMATIC REVIEW AND META-ANALYSIS IS TO UNDERSTAND THE EFFECTS OF YOGA ON OXIDATIVE STRESS PARAMETERS AMONG ADULT PATIENTS DIAGNOSED WITH T2DM. MATERIALS AND METHODS: ELECTRONIC DATABASES SUCH AS PUBMED, SCOPUS, COCHRANE LIBRARY AND SCIENCE DIRECT FROM START OF THE STUDY TILL MARCH 2020 WERE SEARCHED TO OBTAIN ELIGIBLE STUDIES. STUDY DESIGNS OF ALL NATURE WERE INCLUDED (EXCEPT CASE STUDIES AND REVIEWS). THE PRIMARY OUTCOME WAS MALONDIALDEHYDE (MDA) AND SECONDARY OUTCOMES INCLUDED FASTING PLASMA GLUCOSE, HBA1C AND SUPEROXIDE DISMUTASE (SOD) LEVELS. RESULTS: A TOTAL OF FOUR TRIALS WITH A TOTAL OF 440 PATIENTS MET THE INCLUSION CRITERIA. THE RESULTS OF META-ANALYSIS INDICATED THAT YOGA SIGNIFICANTLY REDUCED MDA (SMD: -1.4; 95% CI -2.66 TO -0.13; P = 0.03; I2 = 97%), FASTING PLASMA GLUCOSE LEVELS (SMD: -1.87: 95% CI -3.83 TO -0.09; P = 0.06; I2= 99%), AND HBA1C (SMD: -1.92; 95% CI - 3.03 TO -0.81; P = 0.0007; I2 = 92%) IN PATIENTS WITH T2DM. NO SUCH EFFECT WAS FOUND FOR SOD (SMD: -1.01; 95% CI -4.41 TO 2.38; P = 0.56; I2= 99%). CONCLUSION: THE AVAILABLE EVIDENCE SUGGESTS THAT YOGA REDUCES MDA, FASTING PLASMA GLUCOSE AND HBA1C, AND THUS WOULD BE BENEFICIAL IN THE MANAGEMENT OF T2DM AS A COMPLEMENTARY THERAPY. HOWEVER, CONSIDERING THE LIMITED NUMBER OF STUDIES AND ITS HETEROGENEITY, FURTHER ROBUST STUDIES ARE NECESSARY TO STRENGTHEN OUR FINDINGS AND INVESTIGATE THE LONG-TERM BENEFITS OF YOGA. 2022 18 688 45 EFFECT OF ANTENATAL EXERCISES, INCLUDING YOGA, ON THE COURSE OF LABOR, DELIVERY AND PREGNANCY: A RETROSPECTIVE STUDY. BACKGROUND: DELIVERING A CHILD IS A VERY STRESSFUL EXPERIENCE FOR WOMEN. PREGNANCY AND LABOR ENTAIL COMPLEX EVENTS THAT ARE UNIQUE TO EACH INDIVIDUAL FEMALE. THE MANAGEMENT OF LABOR PAIN IS OFTEN DONE USING ANALGESICS AND ANESTHESIA, WHICH HAVE BEEN SHOWN TO HAVE SOME SIDE EFFECTS. MORE COMPREHENSIVE DATA ARE NEEDED TO PROVIDE CLINICALLY SIGNIFICANT EVIDENCE FOR CLINICIANS TO CONFIDENTLY PRESCRIBE EXERCISES TO PATIENTS. THIS STUDY WAS DONE TO EVALUATE THE EFFECT OF ANTENATAL EXERCISES, INCLUDING YOGA, ON THE COURSE OF LABOR, DELIVERY, AND PREGNANCY OUTCOMES. METHODS: A RETROSPECTIVE STUDY WAS CONDUCTED AMONG 200 PRIMIPAROUS SUBJECTS (AGED 20-40). A QUESTIONNAIRE WAS PROVIDED TO THE SUBJECTS TO OBTAIN THEIR DEMOGRAPHIC AND OBSTETRICAL INFORMATION 6 WEEKS AFTER DELIVERY, AND THEIR HOSPITAL RECORDS WERE ALSO ASSESSED FOR FURTHER DETAILS. BASED ON THE NATURE AND DETAILS OBTAINED FOR THE ANTENATAL EXERCISES, SUBJECTS WERE DIVIDED INTO TWO GROUPS: CONTROL AND EXERCISE. OUTCOME MEASURES INCLUDED THE NEED FOR LABOR INDUCTION, SELF-PERCEIVED PAIN AND PERCEIVED EXERTION DURING LABOR, DURATION AND NATURE OF THE DELIVERY, NEWBORN INFANT WEIGHT, MATERNAL WEIGHT GAIN, HISTORY OF BACK PAIN, AND POST-PARTUM RECOVERY. THE TOTAL MATERNAL WEIGHT GAIN (IN KILOGRAMS) WAS CALCULATED FROM WEIGHT AT 6 WEEKS AFTER DELIVERY MINUS THE WEIGHT AT 12-14 WEEKS OF GESTATION. BACK PAIN DURING PREGNANCY AND SELF-PERCEIVED LABOR PAIN WERE MEASURED USING A VISUAL ANALOG SCALE (VAS). THE OVERALL PERCEIVED EXERTION DURING LABOR WAS MEASURED USING AN ADAPTED BORG SCALE FOR PERCEIVED EFFORT. RESULTS: THE SUBJECTS WHO FOLLOWED REGULAR ANTENATAL EXERCISES, INCLUDING YOGA, HAD SIGNIFICANTLY LOWER RATES OF CESAREAN SECTION, LOWER WEIGHT GAIN, HIGHER NEWBORN INFANT WEIGHT, LOWER PAIN AND OVERALL DISCOMFORT DURING LABOR, LOWER BACK PAIN THROUGHOUT PREGNANCY, AND EARLIER POST-PARTUM RECOVERY COMPARED TO THOSE WHO DID NO SPECIFIC EXERCISES OR ONLY WALKED DURING PREGNANCY. CONCLUSIONS: THIS RETROSPECTIVE STUDY SHOWED THAT REGULAR ANTENATAL EXERCISES, INCLUDING YOGA, RESULT IN BETTER OUTCOMES RELATED TO THE COURSE OF LABOR, DELIVERY, AND PREGNANCY. THESE RESULTS NOTABLY INDICATED THAT PREGNANT WOMEN SHOULD BE ACTIVE THROUGHOUT PREGNANCY AND FOLLOW A SUPERVISED EXERCISE PROGRAM THAT INCLUDES YOGA UNLESS CONTRAINDICATED. WE REQUIRE FURTHER LARGE-SCALE PROSPECTIVE STUDIES AND QUASI-EXPERIMENTAL TRIALS TO CONFIRM THE OBSERVED FINDINGS. 2020 19 833 47 EFFECT OF YOGA ON OXIDATIVE STRESS IN ELDERLY WITH GRADE-I HYPERTENSION: A RANDOMIZED CONTROLLED STUDY. BACKGROUND AND OBJECTIVES: HYPERTENSION, ESPECIALLY IN ELDERLY IS A STRONG RISK FACTOR FOR CARDIOVASCULAR MORTALITY AND MORBIDITY. OXIDATIVE STRESS HAS BEEN IMPLICATED AS ONE OF THE UNDERLYING CAUSE OF HYPERTENSION. YOGA HAS BEEN FOUND TO CONTROL HYPERTENSION IN THE ELDERLY, BUT THE UNDERLYING BENEFITS OF MECHANISM IN RELATION TO OXIDATIVE STRESS REGULATION REMAINS UNCLEAR. THE PURPOSE OF THE STUDY WAS TO INVESTIGATE THE EFFECT OF YOGA ON OXIDATIVE STRESS IN ELDERLY WITH GRADE-I HYPERTENSION. METHODS: AN OPEN PARALLEL-ARM RANDOMISED CONTROLLED STUDY WAS CONDUCTED AT BLDE UNIVERSITY'S SHRI B.M.PATIL MEDICAL COLLEGE, HOSPITAL AND RESEARCH CENTRE, INDIA ON ELDERLY MALE INDIVIDUALS WITH GRADE-I HYPERTENSION (N=57, AGE 60-80 YEARS). STUDY (YOGA) GROUP WAS ASSIGNED FOR YOGA INTERVENTION AND CONTROL GROUP FOR WALKING FOR ONE HOUR IN THE MORNING FOR SIX DAYS IN A WEEK FOR THREE MONTHS UNDER THE SUPERVISION OF YOGA INSTRUCTOR AND PHYSICAL TRAINING INSTRUCTOR RESPECTIVELY. SERUM MALONDIALDEHYDE (MDA) AS AN INDICATOR OF OXIDATIVE STRESS AND ANTIOXIDANTS SUCH AS SERUM SUPEROXIDE DISMUTASE (SOD), REDUCED GLUTATHIONE (GSH) AND VITAMIN C LEVELS WERE ESTIMATED. RESULTS: YOGA PRACTICE FOR THREE MONTHS HAS SIGNIFICANTLY REDUCED SERUM MDA LEVEL (P<0.001), AND ENHANCED ANTIOXIDANTS LEVEL SUCH AS SOD ACTIVITY (P=0.007), SERUM GSH (P=0.002) AND VITAMIN C (P=0.002). IN THE CONTROL GROUP, WE OBSERVED A SIGNIFICANT INCREASE IN SERUM MDA LEVEL (P=0.04) AND REDUCTION IN SERUM VITAMIN C LEVEL (P=0.015) WITH NO SIGNIFICANT DIFFERENCE IN THE SOD ACTIVITY AND GSH LEVEL. CONCLUSION: THESE FINDINGS SUGGEST THAT YOGA IS AN EFFECTIVE MEANS TO REDUCE OXIDATIVE STRESS AND TO IMPROVE ANTIOXIDANT DEFENSE IN ELDERLY HYPERTENSIVE INDIVIDUALS. 2014 20 2821 60 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017