Research shows Iyengar Yoga's potential Therapeutic Effects on Major Diseases and Skin Aging through its ability to curtail Inflammation [Revised Version 2]

Prelude.

This is the year 2011. Regardless of whether you do yoga or not, I hope by now you'd know, at a bare minimum, that it benefits our health at some level. But, how many of us (including yoga aficionados like yours truly) can honestly say we understand the mechanisms of yoga's positive effects on our bodies? I chose this topic because I realized that, as an advocate for yoga, I've been intellectually lazy and hypocritical, to preach the health benefits of yoga, armed with only a vague understanding of the underlying biomechanisms. 

In this era, where education, abundant information and savvy consumerism rule, it's simply not enough to settle for vague ideas. I needed to see the hard science and tangible proof for what I believe. I trust that all of you, my smart friends, also aspire for the same clarity. Not only in matters relating to yoga, but to be diligent in all areas pertaining to your health.

Of course, even for the most educated amongst us, it's impossible to know everything. But what is more important than focusing on making the right decision every time, is to try and go in with your eyes wide open, instead of blindly following exercise trends that are being mass marketed by the fitness industry. It further aggravates me to see equally mindless trappings being popularized by some within the yoga circle. Indeed, it's important to recognize that not all yoga methods are created equal, and be able to discern among them. If you merely go along unthinkingly with popular herding instincts, you will likely end up with the same diseases and imbalances that are plaguing the common herd today. 

I'm not interested in promoting paranoia or intellectual pomposity. But somewhere between one extreme of obsessive research and excessive intellectualizing, and the other extreme of total apathy and disregard for hard facts, I'm sure we can strike the balance to make logical, reasonable and well-thought decisions when picking the best for our bodies. Remember : Health is wealth, so don't take it lightly!

Overview of Iyengar yoga's potential therapeutic effects on the human body.

In a study conducted at Ohio State University College of Medicine, entitled "Stress, Inflammation, and Yoga Practice" (1), regular and long term practice of Iyengar yoga was found to significantly reduce and control stress-induced inflammatory reactions in the human body. 

Chronic Inflammation has been intricately linked to many major illnesses such as cardiovascular diseases, type 2 diabetes, arthritis, osteoporosis, Alzheimer's disease, periodontal diseases, obesity, age related decline in bodily functions, as well as skin aging. Hence, the ability of Iyengar yoga in suppressing such inflammation may ultimately lead us to greatly improved health and youthful vitality.

What is chronic inflammation and its roles in diseases and skin aging?

Touted as the new poster child in health sciences today, chronic inflammation has been tightly connected with a multitude of diseases that are afflicting us in modern times. Essentially, inflammation is our bodies' response to infection, whereby defense cells move from our blood stream into invaded tissue to fight perceived threats to our bodies. Chronic inflammation is a low grade but persistent kind of inflammation.

As explained in a joint study “Interleukin-6 and Chronic Inflammation” between the University Hospital of Geneva and University of Geneva School of Medicine, this defense mechanism triggers the secretion of Cytokines, which are protein molecules involved in the communication between our cells, setting the stage for inflammation (2). Interleukin (IL)-6 is one such important cytokine being released in the process, and plays a protective role when secreted in short bursts and at limited levels during the acute phase of inflammation. However, As IL-6 production continues in a persistent and constant manner, acute inflammation soon transforms into chronic inflammation, turning IL-6 into highly detrimental proinflammatory factors (2).

Increased levels of IL-6 during chronic inflammation, has been consistently associated with cardiovascular diseases, osteoporosis, dementia, Alzheimer's, type 2 diabetes, Arthritis and cancer (2). In a separate study completed at Hallym University in Korea, it was also reported that elevated levels of ultraviolet-induced IL-6 caused inflammation in our skin cells and damaged the integrity of the skin matrix. Without a firm network, collagen and elastin fibers in our skin tissue begin to breakdown, eventually resulting in skin aging and the formation of wrinkles (3). 

Why specifically Iyengar yoga and not other forms of yoga? 

At this point, it is pertinent to emphasize that in this particular research study, the only form of yoga examined was the Iyengar method. Therefore, only the health benefits of Iyengar yoga, and not other forms of yoga, can be concluded from this study. In the report, Iyengar yoga was described as a form of Hatha yoga, which "combines body postures, or asanas, breath control or pranayama, and meditation." 

The report also states that Iyengar yoga was specifically chosen for the study because this practice "emphasizes the use of props to help students achieve precise postures safely and comfortably according to their body types and needs." Furthermore, inflammation in our bodies could result from even modest amounts of psychological stressors, anxiety and depression. Hence, Iyengar yoga was favored because "a restorative session was selected rather than a vigorous sequence in order to promote recovery from stressors."

What is Iyengar yoga?

Iyengar yoga is characterized by certain distinguishing features. First, there is strong focus on precise and correct anatomical alignment. Second, the prominent use of props in supported postures encourages relaxation in our muscle fibers, and hence lessen their tendency to resist stretching. Third, postures are sequenced in a certain manner to enhance cumulative therapeutic effects. Fourth, the concept of holding each posture longer creates deeper penetration of beneficial effects while at the same time, builds strength, endurance, and continuous refinement of the postures.

According to B.K.S. Iyengar (founder of Iyengar yoga), in Light on the Yoga Sutras of Patanjali (4), one of the many cornerstones of yoga is that the practitioner "knows his body and its orderly functions" and "possesses an excellent body with grace, strength, perfect complexion and lustre". It is therefore plain to see that good health and great skin were indeed one of the many original intents of yoga as envisioned by Mr. Iyengar.

Perhaps it should not be surprising to find immense health benefits from the practice of Iyengar yoga, although it is indeed gratifying and reassuring to learn the scientific explanation and see supportive evidence for it. 

Not only is this form of yoga grounded in technical precision and biomechanics, it also embodies philosophy and the beauty of human art form. Hence, it is an all-rounded practice requiring full engagement of the intellect as well as the physicality. To quote Mr. Iyengar : "When I practice, I am a philosopher; When I teach, I am a scientist; when I demonstrate, I am an artist."(5)


Who were the subjects?

Inflammatory changes in "experts" as well as "novices" of yoga were compared and contrasted. For the purposes of this study, long term practitioners, described as "experts" were those who practiced at least 1-2 times per week (each session lasting 75-90 mins), for a total of at least 2 years, and at least 2 times per week for the past year. "Novices" were defined as those who either attended yoga classes, or had a home practice with videos, for a total of 6-12 sessions.


The subjects were controlled for immunological or endocrinological health conditions and were taking medication; and also those with medical conditions impacting such systems e.g. cancer, recent surgeries, diabetes etc. Additionally, smokers, those taking statin, beta blockers, psychoactive drugs, excessive alcohol users, those with convulsive disorders, as well as those with BMI above or equal to 30, were also excluded from the study.

Brief report on the results of the study.

Levels of cytokine IL-6 production were first measured from blood samples taken from both novice and expert groups following the administration of designated stressors on the subjects, but before the subjects underwent the yoga sessions. Results showed major differences between the 2 groups.

In novices’ blood samples, average IL-6 levels were 41% higher than the experts’. In addition, the chances of detecting C-reactive proteins in a novice’s blood stream were 4.75 times higher than detecting similar from an expert’s. C-reactive proteins are influenced by rising IL-6 levels, and released by fat cells during the occurrence of an inflammation.

Across the board, 60% of novices in the group were found to produce high levels of IL-6 cytokines whereas only 24% of experts in the group were found to be high producers. On the other hand, 40% of the experts were classified as low producers of IL-6 compared with 0% of novices who were low producers of IL-6.

Post yoga sessions, both novices’ and experts’ blood IL-6 levels were again measured, and compared with their individual baseline measurement taken before the yoga session. This time, no substantial comparative differences appeared from their individual baseline IL-6 measurements. 

Although at first sight, these results seem contradictory but in fact, they hold one very important implication : that a single short term session of yoga will not suffice to affect the status quo of IL-6 production within our bodies. However, a regular and long term practice of yoga will indeed make significant headways in creating beneficial changes to the inflammatory production of IL-6 in our bodies.

Conclusion.

Yoga, when practiced correctly, can bring significantly positive changes to our minds and bodies. Unfortunately, it is a common misconception that yoga is simply stretching to the outer limits of our flexibility, working up buckets of sweat, or twisting ourselves into positions that are purely idealization by popular media. In fact, simply jamming our bodies and joints by brute force into positions for which we are ill prepared, is contraindicative and highly injurious to our bodies.

Iyengar yoga is a sophisticated system, designed with a strong emphasis on alignment and the use of props, to sequentially prepare and lead the practitioner safely up to advanced postures that are within the practitioner's capabilities and anatomical limitations. Iyengar yoga does not approve of contorting our bodies to fit prescribed shapes at all costs. On the contrary, it is only when postures have been modified to fit our unique selves, our evolving development and our ever changing needs, that they will bring us the greatest gains!

As such, Iyengar yoga promotes better structural alignment; evens out muscular imbalances; increases flexibility, strength, endurance, stability and grace. Additionally, it instils a sense of proprioception in the practitioner, i.e. improving body awareness and neurological control over our muscles, joints etc., all of which are important yet often overlooked factors in the maintenance of health, especially as we age. Going even further, Iyengar yoga's ability to limit inflammation makes it an excellent alternative and complementary accessory in the treatment and prevention of many modern afflictions and aging. 

I am not against the use of pharmaceuticals and cosmetics. They are definitely a permanent fixture in today's context that is useful to have; and in many cases, they are a requisite for basic sustenance of modern life. That said, I feel there is generally an over reliance and excessive use of such materials presently. On top of that, way too little emphasis have been placed on preventative measures upfront. It has become the norm to think we can solve all our health and aging problems simply by popping pills or slathering "miracle creams" on our faces. Unfortunately, these merely serve to treat some symptoms, but fail to address the causation in most cases.

Moreover, in doing so, we overlook the fact that the human body is a highly intelligent, albeit complex, system that has a huge capacity to fine tune itself if only we would give it a chance, by creating the right conditions for it to flaunt its inherent talent. Science has now shown us one way towards creating a favourable condition under which our bodies  can flourish. Obviously, practicing Iyengar yoga alone won't prevent or cure all diseases, but incorporating it into our lives might put us in prime positions to receive bountiful health and radiant skin in the long run!

Sources:

1. Kiecolt-Glaser, Janice K, Ph.D., Christian, Lisa, Ph.D., Preston, Heather, B.A., Houts, Carrie R., M.S., Malarkey, William B., M.D., Emery, Charles F., Ph.D., Glasser, Ronald, Ph.D. (2010). Stress, Inflammation, and Yoga Practice. The Ohio State University, Columbus, Ohio. Psychosom Med. 2010 February; 72(2): 113. doi: 10.1097/PSY.0b013e3181cb9377.
2. Gabay, Cem. (2008). Interleukin-6 and Chronic Inflammation. University Hospital of Geneva and University of Geneva School of Medicine, Switzerland. Biomed Central Ltd. Arthritis Research and Therapy 2006. 8(Supp 2): S3 (doi:10.1186/ar1917).
3. Bae, Ji-Young., Choi, Jung-Suk., Kang, Sang-Wook. (2009). Dietary compound ellagic acid alleviates skin wrinkle and inlfammation induced by UV-B irradiation. Hallym University, Chuncheon, Korea. 2010 John Wiley & Sons A/S. Experimental Dermatology. 19, Pp182-190.
4. B.K.S. Iyengar. (2002) Light on the Yoga Sutras of Patanjali. 2002 Edition. Thorsons. Harper Collins Publishers. London, U.K. Pp 37.
5. The Official Website, B.K.S. Iyengar. Ramamani Iyengar Memorial Yoga Institute. Pune, India. Retrieved 2011, 14 May from http://www.bksiyengar.com/default.asp

How Food, Sex & Drugs all share the same Neurochemical Pathways

What is your perception of a food addict? For most, it would conjure images of an ill disciplined glutton, perhaps even someone irresponsible and obese. What if the truth is that the individual does not have control over their decision to eat; that the compulsion to eat is driven by the biochemistry of their brain? Would that knowledge make us more empathetic in terms of eating disorders? Probably so. As someone who is passionate in learning about nutrition, I see it as my duty to understand the drivers of eating disorders, including compulsive eating and food addiction. Science has provided some answers to what I suspected - that compulsive eating is not simply a behavioral problem but in many cases, is indeed a behavior driven by problematic physiological mechanisms.

I chanced upon the article "Curb Compulsive Eating Naturally", published in a free magazine Life Extension (1), which expounds that the same neurochemical mechanism that pushes people to eat uncontrollably are the same ones which drive people to drug addiction. The article goes further to explore the power of saffron in combatting this problem. But for the sake of brevity, I shall focus on the mechanisms of the neurotransmitters dopamine and serotonin, pertaining specifically to compulsive eating and food addiction.

According to a study done in 2010 by Johnson PM and Kenny PJ (2), the similarity between drug and food addiction lies in the reaction of dopamine receptor D2. Dopamine is released by pleasurable experiences such as food, sex and drugs. Consumption of drugs blocks dopamine retrieval thereby flooding brain with the neurotransmitter, and overstimulating receptors. Over time, the brain adapts by decreasing activity. However, the need for constant stimulation will draw people to consume more drugs, creating a vicious cycle. In the same way, consumption of excessive or junk food drives food addicts into compulsive eating.

Although this is the first time parallels have been drawn between drug and food addiction, the relationship between food and release of dopamine is a well established one. In an earlier study in 2002 by scientists at Brookhaven National Laboratory (3), it has been determined that the mere sight and smell of food spikes levels of dopamine. Even more interesting is the fact that obese subjects had elevated levels of dopamine but decreased levels of dopamine receptors.

While researching for serotonin's role in regulating the psychiatric nature of compulsive eating, I came across a study by Kaye, Walter in 2008 (4) which showed how disruptions to 5 H-T functions upsets emotional and reward pathways which also mediates feeding, hence exposing individuals to the possibility of disturbed eating behaviors, known as emotional eating or worse, compulsive eating. Additionally, in 1992,  Blundell, J (5) had proven serotonin's central role in modulating feeding behavior lies in how nutritional information is being transcribed onto 5 H-T systems and also, in the distribution of 5 H-T neurons in the brain at locations known to be crucial for feeding. Based on these findings, the researchers showed how manipulation of serotonin could cause changes in feeding behavior.

This proves that our feeding behaviors can hardly be viewed in isolation from our psychiatric and physiological makeup. It is indeed heartening to learn that by targeting the neurochemistry of compulsive eating, which is the root of the problem, we might be in a better position to help food addicts, or at the very least, have more empathy for their predicament.

Sources:

1. Goepp, Julius. (2010). Curb Compulsive Eating Naturally. Life Ext. Sept-Oct 2010:29-35

2. Johnson PM, Kenny PJ. Scripps Research Institute (2010, March 29). Compulsive eating shares addictive biochemical mechanism with cocaine, heroin abuse, study shows. ScienceDaily. Retrieved September 23, 2010, from http://www.sciencedaily.com /releases/2010/03/100328170243.

3.  New Addiction Link Found. U.S. Dept of Energy Research News. (2002, June 3) Retrieved September 23, 2010 from http://www.eurekalert.org/features/doe/2002-06/dnl-nfl061302.php

4.  Kaye, W. (2008) Neurobiology of Anorexia and Bulimia Nervosa. Physiol Behav. 94(1): 121–135

5.  Blundell, J. (1992) Serotonin and the biology of feeding. The American Journal of Clinical Nutrition. 55 (1 Supp): 156S-157S

A study on food components which target the regulation of inflammatory disorders induced by obesity [Revised version of original posting on April 10, 2011]

In a recent study which was published in “Mediators of Inflammation” (1), scientists reported that obesity is associated with a silent yet constantly ongoing inflammation of the body. Generally, we perceive inflammation to be characterized by some form of physical expression such as swelling, itching, the production of heat, pain, redness, or some manifestation which can be seen or felt. But inflammation in our bodies is, in fact, any reactionary response to offensive triggering factor/s; & such inflammation may not even be detectable by our senses! This latter form of inflammation, which best describes the type which besieges an obese individual, is unapparent to us because it occurs at a cellular level (more on that later).

Technically defined as having a BMI of 30 or above, obesity is known to induce the silent inflammation described above & consequently, may have serious & adverse effects on our healths. Obesity-induced inflammation which occurs in fat tissue, has been proven to lead to a host of diseases that plague us today including insulin resistance, type 2 diabetes, heart diseases & immune disorders. Fortunately, some food components have been discovered to have combative abilities against such inflammation. Let's look at the process of inflammation in greater detail, & how food components act to control it.

What causes inflammation in fatty tissue?

Before we delve further, it is important that you understand that these inflammatory responses take place at individual cellular levels within our fatty tissue. To give you a clearer idea - if you think of the spare tire around your belly {BG's comment: oh you know THAT spare tire}, that ream of fatty tissue is made up of hundreds, thousands or even {BG's comment: heaven forbid!} millions of individual fat cells. 

The onset of inflammation at the site of an individual fat cell happens as a result of interaction between 2 major players : Macrophages & MCP-1. Macrophages are a type of immune cells within our blood stream & MCP-1 is a substance found to be residing in the individual fat cell. The interaction between these 2 players, & hence inflammation, is described below.

First of all, MCP-1 induces macrophage infiltration from our blood stream into the individual fat cells. Post macrophage infiltration into the fat cell, MCP-1 is also responsible for activating these macrophages to release inflammatory mediators (substances that create inflammation). When released, inflammatory mediators will affect insulin signaling & at the same time, act to increase the production of fatty acids (in particular, harmful saturated fatty acids) within the fat cell. Elevated levels of saturated fatty acids will, in turn, influence our genes to express pro-inflammatory factors that encourage even further inflammatory responses. In this manner, macrophages & MCP-1 interact at the sites of individual fat cells to create a vicious cycle of inflammation within our bodies.

Therefore, it is not surprising to learn that macrophage infiltration is found to be prominent in fat tissue and correlates positively with BMI, fat tissue size as well as total amount of overall body fat in an individual. The presence of MCP-1 is also known to be significantly higher in the obese individual. 

How do food components act to control inflammation?

Food components act by targeting various master regulators of inflammatory gene expression, thereby inhibiting the release of various inflammatory mediators. 

Master regulators of inflammatory gene expression include firstly, NF-kB & JNK, both of which are important transcription factors i.e. proteins involved in the flow of genetic information; and secondly, PPARy, which is a protein that acts as a receptor for other molecules to bind on to. Food components control mediators of inflammation either by acting to directly influence NF-kB & JNK (PPARy-independent) or indirectly via PPARy (PPARy-dependent).

Therefore, in a PPARy-independent situation, food components act on NF-kB & JNK to suppress mediators of inflammation by direct interference of the flow of genetic information, which in turn results in interruption of the genetic signaling pathways necessary for the inflammatory gene expression.

On the other hand, in a PPARy-dependent scenario, food components work hand in hand with PPARy to exert an anti inflammatory effect. PPARy acts as the lock in a "Lock and Key system" which certain food components can latch onto. This locking action then sets off a chain of molecular mechanisms in the cell, which interferes with the signaling pathways of inflammatory gene expression resulting in suppressed production of inflammatory mediators.

Phew! Now that the hard part is over, here is the good news! So which food components regulate inflammation? As explained, food components can work either dependent or independent of PPARy.

PPARy-dependent food components:

Compound	Origin	Actions
Abietic Acid	Pine - in rosin fraction of species such as grand fir, lodgepole pine.	Suppress proinflammatory mediators; increase adiponection (hormone which regulates fat metabolism); act with PPARy to mitigate inflammation.
Auraptene	Citrus Fruits - mainly in peel.	regulate flow of information in genes targeted by PPARy; increase adiponectin secretion; decrease proinflammatory mediators; promote glucose uptake.
Capsaicin	Hot Pepper	induce thermogenisis & fat oxidation; decreases secretion of inflammatory mediators, increases expression of adiponectin; suppresses macrophage migration and activation, improves insulin resistance.
Dehydroabietic Acid	Pine Rosin	PPARy agonist - binds to & acts like PPARy.
Isohumulone	Hummulus Lupulus	PPARy agonist.
Isoprenoid	Herbs	anti-tumor proliferation, anti-diabetes, controls cholesterol.
Resveratrol	Red Wine (dont u love this)	PPARy agonist.
6-Shogaol	Ginger	Acts with PPARy to increase production of adiponectin.

PPARy-independent food components:

Compound	Origin	Actions
Anthocyanin	Red/Purplish Fruit such as grapes, blueberries; apples; beans.	Anti-oxidant; inhibition of inflammatory mediators.
Diosgenin	Fenugreek; wild yam.	Suppress inflammatory mediators induced by interaction between fat cells & macrophages.
6-Gingerol	Ginger	increase adiponectin, a hormone which regulates fat metabolism.
Luteolin	Medicinal plants; some vegetables & fruits.	Anti-oxidant; anti-inflammatory; anti-allergy; inhibit JNK activity in macrophages.
Naringenin	Citrus fruits	Inhibit inflammation caused by interaction between fat cells & macrophages.
Naringenin Chalcone	Tomato peel	same effect as Naringenin, only more significant.
Polyunsaturated Fatty  Acids	Fish Oil	Anti-obesity; anti-inflammatory factors. However, requires cofactors such as folic acid, vitamins, minerals, L-arginine (a protein) for anti-inflammatory actions.

Conclusion:

By learning how compounds derived from food sources regulate inflammation in fat cells, we may have seeded various new & natural avenues to managing inflammatory related diseases caused by obesity, such as diabetes & cardiovascular diseases.

In the same vein, another recent study published in the Journal of Obesity, "Anti-Inflammatory Nutrition as a Pharmalogical Approach to treat Obesity" (2), the researchers have also concluded that a food based anti-inflammatory approach, which targets & suppresses inflammation in our bodies, could be used in conjunction with conventional drugs to enhance the treatment of obesity.

In view of the rising socio-economic costs of waging an uphill fight against epidemic obesity & related diseases, these studies bring renewed hopes for a more holistic, cheaper & hopefully, more effective solution for containing the spiraling situation

Sources: 

(1)Shizuka Hirai, Nobuyuki Takahashi, Tsuyoshi Goto, Shan Lin, Taku Uemura, Rina Yu, Teruo Kawada (March, 2010). Functional Food Targeting the Regulation of Obesity-Induced Inflammatory Responses and Pathologies. Mediators of Inflammation. Hidawi Publishing Corporation. Vol 2010; Article 367838.

(2) Barry Sears, Camillo Ricordi (May, 2010). Anti-Inflammatory Nutrition as a Pharmalogical Approach to Treat Obesity. Journal 0f Obesity. Hidawi Publishing Corporation. Vol 2011; Article 431985.