Five Health Benefits of Standing Desks

 

Spending more of your day standing could reduce the risk of obesity, diabetes, cardiovascular disease and cancer

There was a time when standing desks were a curiosity—used by eccentrics like Hemingway, Dickens and Kierkegaard, but seldom seen inside a regular office setting.

That's changed, in large part due to research showing that the cumulative impact of sitting all day for years is associated with a range of health problems, from obesity to diabetes to cancer. Because the average office worker spends 5 hours and 41 minutes sitting each day at his or her desk, some describe the problem with a pithy new phrase that's undeniably catchy, if somewhat exaggerated: "Sitting is the new smoking."

Much of this research has been spurred by James Levine, an endocrinologist at the Mayo Clinic. "The way we live now is to sit all day, occasionally punctuated by a walk from the parking lot to the office," he recently said during a phone interview, speaking as he strolled around his living room. "The default has become to sit. We need the default to be standing."

All this might sound suspiciously like the latest health fad, and nothing more. But a growing body of research—conducted both by Levine and other scientists—confirms that a sedentary lifestyle appears to be detrimental in the long-term.

The solution, they say, isn't to sit for six hours at work and then head to the gym afterward, because evidence suggests that the negative effects of extended sitting can't be countered by brief bouts of strenous exercise. The answer is incorporating standing, pacing and other forms of activity into your normal day—and standing at your desk for part of it is the easiest way of doing so. Here's a list of some of the benefits scientists have found so far.

Reduced Risk of Obesity
Levine's research began as an investigation into an age-old health question: why some people gain weight and others don't. He and colleagues recruited a group of office workers who engaged in little routine exercise, put them all on an identical diet that contained about 1000 more calories than they'd been consuming previously and forbid them from changing their exercise habits. But despite the standardized diet and exercise regimens, some participants gained weight, while others stayed slim.

Eventually, using underwear stitched with sensors that measure every subtle movement, the researchers discovered the secret: the participants who weren't gaining weight were up and walking around, on average, 2.25 more hours per day, even though all of them worked at (sitting) desks, and no one was going to the gym. "During all of our days, there are opportunities to move around substantially more," Levine says, mentioning things as mundane as walking to a colleague's office rather than emailing them, or taking the stairs instead of the elevator.

Failing to take advantage of these constant movement opportunities, it turns out, is closely associated with obesity. And research suggests that our conventional exercise strategy—sitting all day at work, then hitting the gym or going for a run—"makes scarcely more sense than the notion that you could counter a pack-a-day smoking habit by jogging," as James Vlashos puts it in the New York Times. The key to reducing the risk of obesity is consistent, moderate levels of movement throughout the day.

Scientists are still investigating why this might be the case. The reduced amount of calories burned while sitting (a 2013 study found that standers burn, on average, 50 more calories per hour) is clearly involved, but there may also be metabolic changes at play, such as the body's cells becoming less responsive to insulin, or sedentary muscles releasing lower levels of the enzyme lipoprotein lipase.

Of course, all this specifically points to danger of sitting too much, not exactly the same as the benefit of standing. But Levine believes the two are closely intertwined.

"Step one is get up. Step two is learn to get up more often. Step three is, once you're up, move," he says. "And what we've discovered is that once you're up, you do tend to move." Steps one and two, then, are the most important parts—and a desk that encourages you to stand at least some of the time is one of the most convenient means of doing so.

Reduced Risk of Type 2 Diabetes and Other Metabolic Problems
The detrimental health impacts of sitting—and the benefits of standing—appear to go beyond simple obesity. Some of the same studies by Levine and others have found that sitting for extended periods of time is correlated with reduced effectiveness in regulating levels of glucose in the bloodstream, part of a condition known as metabolic syndrome that dramatically increases the chance of type 2 diabetes.

A 2008 study, for instance, found that people who sat for longer periods during their day had significantly higher levels of fasting blood glucose, indicating their their cells became less responsive to insulin, with the hormone failing to trigger the absorption of glucose from the blood. A 2013 study [PDF] came to similar findings, and arrived at the conclusion that for people already at risk of developing type 2 diabetes, the amount of time spent sitting could be a more important risk factor than the amount of time spent vigorously exercising.

Reduced Risk of Cardiovascular Disease
Scientific evidence that sitting is bad for the cardiovascular system goes all the way back to the 1950s, when British researchers compared rates of heart disease in London bus drivers (who sit) and bus conductors (who stand) and found that the former group experienced far more heart attacks and other problems than the latter.

Since, scientists have found that adults who spend two more hours per day sitting have a 125 percent increased risk of health problems related to cardiovascular disease, including chest pain and heart attacks. Other work has found that men who spend more than five hours per day sitting outside of work and get limited exercise were at twice the risk of heart failure as those who exercise often and sit fewer than two hours daily outside of the office. Even when the researchers controlled for the amount of exercise, excessive sitters were still 34 percent more likely to develop heart failure than those who were standing or moving.

Reduced Risk of Cancer

A handful of studies have suggested that extended periods of sitting can be linked with a higher risk of many forms of cancer. Breast and colon cancer appear to be most influenced by physical activity (or lack thereof): a 2011 study found that prolonged sitting could be responsible for as much as 49,000 cases of breast cancer and 43,000 cases of colon cancer annually in the U.S. But the same research found that significant amounts of lung cancer (37,200 cases), prostate cancer (30,600 cases), endometrial cancer (12,000 cases) and ovarian cancer (1,800 cases) could also be related to excessive sitting.

The underlying mechanism by which sitting increases cancer risk is still unclear, but scientists have found a number of biomarkers, such as C-reactive protein, that are present in higher levels in people who sit for long periods of time. These may be tied to the development of cancer.

Lower Long-Term Mortality Risk
Because of the reduced chance of obesity, diabetes, cardiovascular disease and cancer, a number of studies have found strong correlations between the amount of time a person spends sitting and his or her chance of dying within a given period of time.

A 2010 Australian study, for instance, found that for each extra hour participants spent sitting daily, their overall risk of dying during the study period (seven years) increased by 11 percent. A 2012 study found that if the average American reduced his or her sitting time to three hours per day, life expectancy would climb by two years.

These projects control for other factors such as diet and exercise—indicating that sitting, in isolation, can lead to a variety of health problems and increase the overall risk of death, even if you try to get exercise while you're not sitting and eat a healthy diet. And though there are many situations besides the office in which we sit for extended periods (driving and watching TV, for instance, are at the top of the list), spending some of your time at work at a standing desk is one of the most direct solutions.

If you're going to start doing so, most experts recommend splitting your time between standing and sitting, because standing all day can lead to back, knee or foot problems. The easiest ways of accomplishing this are either using a desk that can be raised upward or a tall chair that you can pull up to your desk when you do need to sit. It's also important to ease into it, they say, by standing for just a few hours a day at first while your body becomes used to the strain, and move around a bit, by shifting your position, pacing, or even dancing as you work.

4 Serious Health Issues From Sitting Too Long & How To Avoid Them

When you work at any job that requires long hours sitting at a computer – programming, accounting, writing – it is very easy to stay in that one position for eight to nine working hours every day.

 

Sure, you might get up for  a drink of water, a bathroom break, or for lunch, but I’m sure you can remember days when, before you knew it, you’d been sitting in that chair for two to four hours at a time. Deep down you know that sitting for such long period of time can’t be good, but really, how bad can it be?

I really started the long stretches at the computer starting at a very young age. I played video games as early as grade school, and did so for long hours into the night when I was in high school. Sitting for four or five hours straight during the weekend while playing an RPG was not unheard of. Time flies when you dive into those virtual worlds – it’s surreal sometimes.

I never really stopped to think what sort of damage I was doing to my body as a teenager. And once I graduated college and went to work as an engineer, I didn’t even consider what would happen to my body once I started sitting at a desk for almost eight hours every day – usually a couple of hours at one stretch before doing any walking.

Sure, the increasing waistline and tightening shirts after a year of full-time professional work gave me some clue what might be happening, but I figured once I started hitting the gym every day for an hour after work I could quickly handle that little problem.

Little did I know until many years later that not only was I making it biologically more difficult to lose weight later, but by allowing myself those long stretches at the desk, I was shortening my life by nearly seven years.

Killing Yourself by Sitting

You’re probably rolling your eyes and thinking to yourself, “Oh great, another article telling me how unhealthy it is to be sitting here reading this article.”

Look, I’m not about to start preaching turning off the computer and going for a long walk this very moment. I love computers. I don’t think I’ll ever quit sitting in front of a computer – but when you really start looking at the facts, it isn’t so much the fact that we’re all sitting in front of a computer, it’s the fact that we’re doing it for such long stretches of time without any break.

It’s important to understand just how seriously this behavior can affect you, because the threat is very real and it’s significant. There are four categories of health that studies show sitting too long can impact – cancer, diabetes, heart disease and obesity.

Overall – You’ll Die a Lot Earlier

Countless studies show time and time again that being physically inactive leads to a whole list of health problems that will kill you. Taking everything into account, the World Health Organization reports that being physically inactive comes in fourth as a leading risk factor for death. That’s Death with a capital D.

Just how much of a difference can it make? Well, a study published in the March 26th issue of the Archives of Internal Medicine found that after taking a sample of 200,000 people into account, there was a clear “association” between the act of sitting and “all-cause mortality”. Bottom line – sitting over eleven hours a day results in a 40 percent higher chance of dying from any cause at all. That’s crazy.

The WHO report mentioned above solidifies this finding. Inactivity was found to be the main cause of about a quarter of breast and colon cancers, 27 percent of diabetes cases, and 30 percent of heart disease cases.

The study in the Archives of Internal Medicine came from researchers at the University of Sydney, who reported that going to the gym or taking a walk is important, but prolonged sitting may actually be counteracting the health effects of that workout entirely.

Sit Too Long Can Increase Your Risk of Cancer

It seems like everything causes Cancer these days. Cellphones. Microwaves. Cat scans and X-Rays. But sitting?

Yup. Sitting increases your risk of getting cancer in a very big way.  The American Institute for Cancer Research held its annual conference early in 2012 and highlighted at that conference were specific research findings showing that 49,000 cases of breast cancer and 43,000 cases of colon cancer in the U.S. could be linked to inactivity.

It seems like such a cop-out doesn’t it? Like, researchers can’t find a specific correlation so they point at the fact that most of the people that got cancer sat around a whole lot. Well, good guess Sherlock, right? Well, not quite. Researchers, such as Dr. Christine Friedenreich, PhD, the leading epidemiologist at Alberta Health Services-Cancer Care who presented at the AICR conference, reported research results that physical activity may actually reduce inflammation linked to increased cancer risk.

The good news is that experts give you a very clear path to wipe out the risk starting right now. Take a break. The AICR responded directly to the research by urging readers to take a break from sitting every single hour – taking a couple of minutes to walk around, stretch, get a drink – whatever – can literally save your life.

There is a solid, proven benefit to taking those breaks. The National Health and Nutrition Examination Survey (NHANES) published its research findings in the European Heart Journal showing that for 4,757 participants in the study, short periods of light activity – even just a minute at a time – could reduce waistline, increase levels of good cholesterol, and even increase insulin resistance.  This is really serious stuff.

That Chair May Give You Diabetes and Heart Disease

Okay, so you know if you don’t give yourself at least a minute break every hour or so, you could be in for some trouble down the road with the C word, but is cancer the only concern (as though that’s not bad enough on its own)?

Well, unfortunately, Diabetes is the other risk factor when it comes to sitting around for hours at a time.

One study by researchers at the Harvard School of Public Health, took into account published scientific studies dating from 1970 all the way to 2011 and found that collectively, the data from those studies reveal a clear correlation between more than two hours of TV viewing time and risk factors for type 2 diabetes, as well as cardiovascular disease. The risk of heart disease increased by 15 percent. For diabetes, the risk increased by 20 percent for people that watched TV more than two hours a day. 20 percent!

Yet another published in the Journal of Applied Physiology in August of 2011 revealed that when people lower their activity from over 10,000 steps a day to less than 5,000 steps a day, physical changes in the body directly increase that person’s risk of type 2 diabetes.

Obviously, the opposite must hold true. If you get up from from that desk every 40 minutes and take a good 10 minute walk, and then take a nice 60 minute walk after work, the odds are pretty good that you could achieve a daily goal over 10,000 and significantly reduce your risk for type 2 diabetes.

There are many other studies, like the one out of the University of Mass at Amherst that showed that “1 day of sitting elicits large reductions in insulin action”, and another study from the University of South Carolina that found a direct correlation between time spent sitting and riding in a car, and cardiovascular disease death.

Sitting Too Long and Obesity

It should come as no surprise to anyone that if you sit too long during the day, you’ll get fat. So I’m not going to bore you with research that proves that, it’s pretty obvious. However, there was one particular study related to obesity and sitting too long that really threw me for a loop.

Clearly, the inactivity of sitting burns fewer calories and most people likely are not cutting down on calories just because they’re sitting so long (in fact, they’re probably snacking more), so that positive calorie balance will go directly to your bottom – or for some people, their spare tires.

But did you know that the mechanical pressure on your backside itself literally forces the cells in your fanny to transform into larger fat cells? Crazy right? It’s true.

Researchers at Tel Aviv University found that the preadipocyte cells, which are the cells in your body that turn into fat cells, will actually transform into fat cells faster when they are put under long periods of “mechanical stretching loads”.

This means – my dieting friends – that you can try and cut calories, but if you plan to continue sitting behind that desk for three or four hour stretches at a time without a single break, the odds are pretty good that you’re going to have some major junk in the trunk.

Unfortunately, the list doesn’t stop there. During my escapades through literary journals and University research websites, I discovered studies showing links between sitting too long and everything from increased risk of kidney disease, to a high risk for blood clots in the legs.  In fact, the blood clot issue related to excessive computer use is becoming known in medical circles as “e-thrombosis”.

So, now that you know sitting on that chair for several hours at a stretch is nearly as bad for your health as smoking, what are you going to do? I’ll tell you what I’m going to do. I’m going to install an Android timer on my tablet, set it to go off at work every 40 minutes, and take a 5 minute walk. It may not sound like much, but those breaks could literally save your life.

Do you have any ideas how to take some pressure off your backside during the day? What do you plan to do – if anything – to make a change? Share your ideas with everyone in the comments section below.

Eyes are a very delicate yet much needed part of the body. It is very easy to destroy or compromise your eyesight by simply being careless about eye strain and good healthy eye habits. This article will teach you some methods you can use to preserve and improve your eyesight.

How to Improve Your Eyesight

One Methods:Nutrition

Eyes are a very delicate yet much needed part of the body. It is very easy to destroy or compromise your eyesight by simply being careless about eye strain and good healthy eye habits. This article will teach you some methods you can use to preserve and improve your eyesight.

Steps

1. 
   1
   Learn about how vision works. This way, you can understand what you are doing when you are retraining your vision. Improving your vision is a matter of changing the habitual way you see and use your eyes.
   
   
2. 
   2
   Get an eye chart. Place it on the wall so you can measure your progress. You can usually find one online.
3. 
   3
   Do relaxation exercises. Place your hands together palm to palm and rub them together briskly creating heat. Place them over your eyes and let your eyes relax. Imagine a relaxing place. Do not let light in. Do this whenever you have time during the day, especially when you're sitting at the computer.
   • Use alternating hot and cold compresses on your eyes daily to help relax them.
4. 
   4
   Maintain moisture. Maintaining the natural balance of moisture within your eyes is one of the most important things you can do to keep them healthy. Dry eyes can be itchy, red and even painful. Try to blink frequently, even when you are focused on watching TV or working on your computer.
5. 
   5
   Exercise your eyes. If you think about the way your muscles work, then you probably understand that the less exercise they get, the worse off you are. The same thing goes for your eyes. There are specific exercises you can do, that may be able to help you see better.
   • Use the 20/20/20 exercise. Every twenty minutes, focus on an object that's at least twenty feet away, for twenty seconds. You'll be surprised at how much better your eyes feel.
   • Put your thumb five inches away from your face and focus on it, after five seconds focus on something behind it. Do this for about ten times and whenever you have time.
6. 
   6
   Increase eye flexibility. If you have ever undertaken an exercise program or played a sport, then you know that flexibility is important. If you don't stretch, or if you use the same muscles over and over again without moving opposite muscle groups, you lose flexibility. If you have a job that requires you to spend long hours looking at a screen, be sure you focus on different objects periodically; try not to keep your eyes in the same position for too long.
7. 
   7
   Lower the brightness level of your computer screen. Lowering the brightness level of your computer's monitor can help your eyes to relax. Don't lower it so much that you have trouble seeing, and avoid positioning your monitor so there are reflections.
8. 
   8
   Take regular breaks. If your eyes must focus on a task for long periods of time, take regular breaks. Taking a ten minute break every hour can help prevent eye strain and give your eyes a chance to heal themselves.
9. 
   9
   Reduce stress. Every one of the body's systems reacts to stress differently. The eyes are put under constant strain and stress - the more TV you watch, the more you stare at a computer screen, and the more you play games on your smartphone, the more stress you put on your eyes. Make an effort to use natural light, and take time away from your gadgets. You might be surprised to find that you see and feel better as a result.
10. 
    10
    Get some sleep. You might have noticed that when you go for long periods of time without adequate sleep, you feel tired and head-achy. You also may have noticed that your vision seems blurry and that it almost hurts to keep your eyes open. Sleep is important for all your bodily functions, and getting adequate rest can assist in eyesight improvement since sleep allows overworked eye muscles to relax completely.
11. 
    11
    Protect your eyes from UV rays. Wear good quality sunglasses that provide UV protection, and your eyes will thank you. Amazingly enough, you can gain eyesight improvement, and look great - all at the same time!

Nutrition

1. 
   1
   'Feed' your eyes. Just like the rest of the body, the eyes need good nutrition to function well. Carrots, kale, blueberries, apricots, and other foods rich in beta carotene are all good for your eyes. Stay away from junk food.^[1]
2. 
   2
   Stay hydrated. The average human body is made up of about 60% water, sometimes more. If your eyes are often dry, tired and blurry, try increasing your water intake. In addition, drinking plenty of water is important for your whole body.
3. 
   3
   Try taking Vitamins For Vital Vision. Help your eyes by getting plenty of vitamins A and C, as well as Lutein & Zeaxanthin.
   • Don't forget Omega 3's. Omega 3 fatty acids are essential nutrients that can help maximize your health. Most people know that they're good for your heart - what many don't realize is that Omega 3's can help keep your retinas healthy and stop age-related eyesight deterioration.
4. 
   4
   Take amino acids. Amino acids, especially Taurine, are essential for eye health. Amino acids protect your eyes from the free radicals that can cause damage over time - they keep eye tissue healthy and prevent eye deterioration.

Vigorous exercise tied to reduced flu risk

 

A report on a UK survey suggests that vigorous exercise may help reduce the risk of catching the flu. The survey finds no such link with moderate exercise. However, the report authors stress the results are preliminary and should be treated with caution.

The findings come from the UK Flusurvey, in which more than 4,800 people have so far taken part this year. The online survey, which is now in its fifth year, is run by the London School of Hygiene & Tropical Medicine.

The release is geared to coincide with National Science & Engineering Week, an annual event run by the British Science Association that aims to encourage more young people to engage in science.

Dr. Alma Adler, Research Fellow at the London School of Hygiene & Tropical Medicine, who is also an ambassador for National Science & Engineering Week, says:

"We're really interested in the preliminary findings around fitness activity and flu-like illness, as exercise is something that everyone can do to reduce your chance of having flu."

She emphasizes the need to treat the preliminary findings cautiously but also notes they are consistent with findings for other illnesses, adding to evidence about the health benefits of exercise.

Vigorous versus moderate exercise

The survey results suggest doing vigorous exercise for at least 2.5 hours a week can reduce the chance of experiencing a flu-like illness by around 10%.

A news release from the London School of Hygiene & Tropical Medicine notes that based on the data they have analyzed from more than 4,800 people who have completed the survey so far, the findings:

"... suggest that 100 cases of flu per 1,000 people could be prevented just by engaging in vigorous exercise. No differences were found in rates of flu-like illness based on the amount of moderate exercise reported..."

Health experts define vigorous intensity aerobic exercise as exercise that raises your pulse rate, makes you sweat and also makes you breathe hard and fast, to the point where you cannot say more than a few words without pausing for breath. Fast running or cycling is a good example.

Moderate intensity aerobic exercise raises your pulse rate and makes you sweat, but you are not working so hard that you cannot talk or sing the words to a song at the same time. Gentle jogging and walking fast enough to break into a sweat are good examples.

The Flusurvey

The Flusurvey is an online system for tracking flu trends in the UK. 

Launched in 2009, in the middle of the swine flu epidemic, the survey is now in its fifth year. Unlike traditional surveillance systems that collect data via doctor surgeries and hospitals, it collects data directly from the public who register online. The idea is to include people who do not visit the doctor - and who, as a result, do not feature in traditional flu tracking systems.

Every year, more questions are added to try and track as much information as possible about who does and who does not fall ill with the flu.

Once they register, participants are asked to fill in a profile survey asking general questions about themselves and flu risk factors (including age, vaccination status and household size). One of the questions also covers how much and what type of exercise they do, such as running, cycling and other sports.

Then, each week, participants report any flu-like symptoms since the last time they visited the site.

Lowest report of flu-like illness in recent times

This year's Flusurvey also shows some of the lowest reports of flu-like illness in recent times.

Over the winter flu season, only 4.7% of reports were positive for flu-like symptoms, compared with 6.0% last year, say the researchers who analyzed the results.

Another change they noticed is that children appear to have lower levels of flu-like symptoms compared with last year. This year, just 5.0% reported symptoms, compared with 7.9% in the year before.

The researchers suggest this could be a reason why flu has not been so rampant this year, as children are among the biggest spreaders of the disease.

In 2010, Medical News Today reported advice published by experts with the American College of Sports Medicine, who said while regular moderate exercise can help lower risk for respiratory infections, they do not recommend working out while sick, and in some cases, prolonged intense exercise can do more harm than good and weaken the immune system.

Stronger kids have lower risks for diabetes and heart disease

It is well known that having good physical fitness lowers risks for a number of health problems. But now, the first study to make the link between strength capacity in adolescents and reduced risk for diabetes, heart disease or stroke has been published in the journal Pediatrics.

 

Staying physically fit is an important value to instill in young people, not only because it creates healthy habits that can extend into adulthood, but also because it positively affects both short- and long-term health. 

For example, a recent study suggested exercising when young helps bones to grow big and strong for life, even conferring benefits during aging. 

The researchers of this latest study, led by Mark D. Peterson, research assistant professor at the University of Michigan Medical School, note that previous studies have found low muscular strength in teen boys is linked to several major causes of death in young adulthood, including suicide and cardiovascular diseases. 

To delve further, the investigators examined the impact of muscle strength in sixth grade boys and girls. 

In total, they assessed health data for more than 1,400 children between the ages of 10 and 12 years old, which included body fat percentage, glucose level, blood pressure, cholesterol levels and triglycerides - a type of fat that may increase risk of heart disease.

'Muscle strength equally important in children's cardiometabolic health'

Risks for diabetes and heart disease are significantly lower in strong kids, the research shows.

 

The data come from the Cardiovascular Health Intervention Program, which is a study of sixth graders from 17 Michigan schools between 2005 and 2008. 

Using a standardized handgrip strength assessment - recently recommended by the Institute of Medicine - the researchers tested the adolescents for strength capacity. 

Additionally, the participants' cardiorespiratory fitness was measured. This is how well the body is able to transport oxygen to muscles during extended exercise and how well the muscles are able to absorb and use it. 

Results showed that the adolescents with greater strength-to-body-mass ratios had "significantly" lower risks of diabetes and heart disease.

 

Commenting on their findings, Peterson says:

"It's a widely held belief that BMI [body mass index], sedentary behaviors and low cardiovascular fitness levels are linked to diabetes, heart disease and stroke, but our findings suggest muscle strength possibly may play an equally important role in cardiometabolic health in children."

Peterson's colleague, Prof. Paul M. Gordon, from Baylor University in Texas, suggests that strengthening activities are equally as important as participation in physical activity. 

The team notes that stronger kids also tended to have a lower BMI, lower body fat percentage, smaller waist circumferences and higher fitness levels. They believe theirs is the first study to show a strong link between strength and lower risks of diabetes, heart disease or stroke in adolescents - even after controlling for BMI, physical activity and cardiorespiratory fitness. 

"The stronger you are relative to your body mass, the healthier you are," Peterson says. 

"Exercise, sports and even recreational activity that supports early muscular strength acquisition, should complement traditional weight loss interventions among children and teens in order to reduce risks of serious diseases throughout adolescence," he adds.

aseball players frequently suffer from preventable arm pain

The most in-depth survey of its kind found that arm pain is common among supposedly healthy young baseball players and nearly half have been encouraged to keep playing despite arm pain. The findings suggest that more detailed and individualized screening is needed to prevent overuse injury in young ballplayers. The study, led by Columbia University Medical Center (CUMC) researchers, was published in the online edition of the American Journal of Sports Medicine.

 

"Both nationally and internationally, we're witnessing a troubling increase of elbow and shoulder injuries in young baseball players," said study leader Christopher S. Ahmad, MD, chief of sports medicine and professor of orthopedic surgery at NewYork-Presbyterian/Columbia and head team physician for the New York Yankees. "The likely explanation is that they're throwing too much, too early, putting increasing demands on their bodies that their bodies are not ready for. Despite current guidelines and precautions - for example, limiting pitch counts and emphasizing off-season rest - many players are still sustaining overuse injury to their throwing arm. Thus, it's vital that we develop better ways for coaches, parents, and clinicians to identify players at risk so we can prevent irreversible injury and season-ending surgery." 

As a first step toward this goal, Dr. Ahmad and his colleagues designed a questionnaire to learn more about the frequency, severity, and psychosocial effects of arm pain among active adolescent baseball payers. The questionnaire was completed by 203 players from New York and New Jersey between the ages of 8 and 18. All of the surveys were completed without input from parents or coaches. 

Among the survey's findings was that 74 percent of players reported having arm pain while throwing (answering that they "always," "often," "sometimes," or "rarely" experienced arm pain). Just 26 percent said they "never" had arm pain while throwing.

The study also found that:

• 80 percent reported having arm pain the day after throwing.
• 82 percent reported arm fatigue during a game or practice.
• 54 percent reported that arm pain limited the number of innings they could play.
• 75 percent reported that arm pain limited how hard they could throw.

Pitchers, compared with infielders and outfielders, were especially likely to have played with pain. One-quarter of pitchers reported that they "often" or "always" had pain the day after throwing. "These pitchers likely represent one of the higher-risk groups for incurring a future overuse injury and thus warrant particularly high monitoring," said Dr. Ahmad. 

Almost half (47 percent) of players reported that they had been encouraged to continue playing in a practice or game even though they were having pain. One in eight players aged 17 to 18 reported that they "always" felt encouraged to continue playing despite having arm pain. A majority of players reported that arm pain caused them to experience less enjoyment while playing and that it was responsible for holding them back from being a better player. 

"It's alarming that so many young baseball players are encouraged to play with pain," said Dr. Ahmad. "Years ago, prior to concussion protocols, we observed something similar in football, where players who suffered a concussion were routinely sent back into the game after 'recovering' for a few minutes. The initial concussion lowered the threshold for another concussion, and the repeated concussions put the player at risk for permanent damage. I think we're seeing a similar problem in baseball, where playing with arm pain is setting the stage for more serious injury." 

Dr. Ahmad suspects that this phenomenon has contributed to the recent rise in "Tommy John" surgeries among college and professional baseball players. ("Tommy John" surgery is the colloquial name for reconstruction of the elbow's ulnar collateral ligament. The procedure was named after the former Los Angeles Dodgers pitcher, who was the first to undergo this repair in 1974.) 

According to Dr. Ahmad, current precautions and guidelines are inadequate for preventing injury. "It's not enough to set pitch counts based on a player's age," he said. "While some 14 year olds are already quite mature, in terms of their skeletal structure, others haven't even started their growth spurt yet. We need to come up with more individualized throwing programs and better ways to detect which players are at risk for injury." Dr. Ahmad is currently investigating the use of ultrasound for correlating arm pain with tissue damage.

Running for exercise 'slows the aging process'

A new study from researchers at the University of Colorado Boulder and Humboldt State University, published in the journal PLOS ONE, finds that senior citizens who run several times a week expend the same amount of energy as a typical 20-year-old when walking. 

 

Seniors who run regularly have "a lower metabolic cost of walking" than older, sedentary adults and seniors who regularly walk for exercise.

 

"It's been known for a long time that as people age their maximum aerobic capacity, or 'horsepower,' declines, and that is true for runners as well," says study leader Prof. Justus Ortega, from Humboldt State University in Arcata, CA. 

"What's new here is we found that old runners maintain their fuel economy," he adds. 

The researchers recruited 15 men and 15 women with an average age of 69 who regularly ran or walked for exercise. For this study, "regularly" meant walking or running at least three times a week for a minimum of 30 minutes per workout, for at least 6 months. 

After undergoing preliminary health screenings at the University of Colorado Boulder (CU-Boulder) Clinical and Translational Research Center, the subjects were required to walk on a force-measuring treadmill. 

The participants' oxygen consumption and carbon dioxide production were measured while they used the treadmill across three speeds - 1.6 mph, 2.8 mph and 3.9 mph. Additional data for the study came from Prof. Ortega's dissertation on energy expended during treadmill tests by sedentary adults of a variety of ages.

Seniors who run for exercise are better at walking than those who walk for exercise

The team found that older adults who regularly participate in highly aerobic activities such as running have "a lower metabolic cost of walking" than older, sedentary adults and seniors who regularly walk for exercise.

The researchers explain that it was surprising to find that older adults who regularly run for exercise are better walkers than older adults who regularly walk for exercise. 

The take-home message of the study, the authors say, is that constantly running for exercise "slows down the aging process," allowing older people to move more easily and improving their quality of life. 

 

Co-author Prof. Rodger Kram, of CU-Boulder's Department of Integrative Physiology, explains:

"Walking for exercise has many positive health effects, like fending off heart disease, diabetes, weight gain and depression - it's just that walking efficiency does not seem to be one of them.
Because we found no external biomechanical differences between the older walkers and runners, we suspect the higher efficiency of senior runners is coming from their muscle cells."

Next, the team will investigate a hypothesis that the "powerhouses" inside individual cells - mitochondria - are implicated in this enhanced walking ability. People who work out regularly tend to have more mitochondria in their cells, in order to provide the energy necessary for powering larger muscles. 

Back in July, Medical News Today reported on a study published in the Journal of the American College of Cardiology, which found that running at a slow speed for just 5-10 minutes a day can significantly increase life expectancy. 

Leader of that study Duck-Chul Lee, from Iowa State University, said that while running is good for health, "more may not be better. You don't have to think it's a big challenge. We found that even 10 minutes per day is good enough. You don't need to do a lot to get the benefits from running."

Sleep apnea linked to impaired exercise capacity

A new study shows that compared to people who do not have the disorder, those who suffer from sleep apnea may not be capable of burning sufficiently high levels of oxygen during strenuous aerobic exercise.

Researchers found that people who suffer from obstructive sleep apnea - a condition where breathing stops and starts during sleep - are also likely to have a lower peak oxygen uptake during aerobic activity.

 

This was the conclusion of a study led by the University of California San Diego (UCSD) and published in the Journal of Clinical Sleep Medicine.

Obstructive sleep apnea - or more commonly just sleep apnea - is a condition where breathing starts and stops during sleep. A common feature is gasping or snorting noises during sleep - these are the moments when sleep is interrupted.

People who suffer from sleep apnea may also feel sleepy during the day because due to frequent interruption, night-time sleep is not sufficiently restorative.

Sleep apnea is linked to increased risk of a number of cardiovascular diseases, including high blood pressure, stroke, heart disease and irregular heart beat.

Researchers believe that an early marker of higher risk for stroke and heart attack is a measure of exercise capacity known as VO2 max or peak VO2 - the maximum oxygen a person burns during strenuous exercise.

VO2 max is commonly measured during cardiopulmonary exercise testing (CPET) where a patient's heart and lung function is assessed during aerobic activity such as riding a bicycle.

The authors note that there is increasing interest in using CPET as a way to categorize sleep apnea patients in terms of heart risk.

However, lead author Jeremy Beitler, assistant clinical professor in pulmonary and critical care medicine at UCSD, and colleagues suspect that using CPET and VO2 max in this way with sleep apnea patients may not be as straightforward as it might seem.

The relationship between sleep apnea and exercise capacity is not clear, they note in their study background. So they set out to test the idea that sleep apnea itself might be linked to impaired exercise capacity.

Obesity is not a reason apnea is linked to impaired exercise capacity

And what they found confirmed their suspicions; people with moderate to severe obstructive sleep apnea appear to have a lower peak oxygen uptake during aerobic activity compared to people who do not suffer from the sleep disorder.

One explanation might be that apnea sufferers are also more likely to be obese, and would be expected to be less fit anyway. But the team found patients with sleep apnea had reduced aerobic fitness even when compared with people of similar body mass index.

Prof. Beitler says that encouraging patients with sleep apnea to exercise more might be part of the answer, but it is not the whole answer:

"We believe the sleep apnea itself causes structural changes in muscle that contributes to their difficulty exercising."

In their investigation, the team evaluated men and women with a range of apnea symptoms. They assessed the severity of each patient's condition and also screened them for other sleep disorders that might interfere with the study findings.

Eventually, 15 men and women with moderate to severe apnea and 19 with mild or no apnea (the controls) took part in the CPET aerobic fitness assessment. After undergoing resting state assessments, the participants were asked to pedal an exercise bike, gradually increasing resistance until reaching the point of exhaustion.

Moderate to severe sleep apnea linked to 14% lower VO2 max

After adjusting for baseline differences, the results showed that the participants with moderate to severe apnea had on average 14% lower VO2 max than the controls.

Using the data from the sleep evaluation together with the CPET results, the researchers also found a link between the severity of apnea - as measured by the number of times breathing stops for 10 seconds or more per hour of sleep - and reduced peak VO2.

The team also found that this measure of apnea severity - known as Apnea Hypopnea Index - could predict 16% of the variability seen in the group's peak VO2, a result that Prof. Beitler sees as "a big discrepancy."

The researchers conclude that sleep apnea is linked to impaired exercise capacity and say further research is needed to evaluate whether CPET can contribute usefully to the prognosis of patients with sleep apnea.

In September 2014, Medical News Today reported a study that showed the reason sleep apnea causes brain damage is because of weaker blood flow in the brain.

Exercise effective for bone cancer patients

Findings being presented at the Clinical Oncology Society of Australia's (COSA's) Annual Scientific Meeting shows that traditional recommendations for cancer patients with bone metastases to avoid physical activity may not be the most effective. Instead, resistance training and aerobic exercise programs designed to avoid loading potentially fragile sites of bone metastases, are both safe and effective for patients. 

The study, conducted by the Health and Wellness Institute at Edith Cowan University examined the effects of a highly tailored exercise program on breast and prostate cancer patients with bone metastases. The programs avoided the more fragile skeletal sites while maintaining training stimulus to other areas of the body.

One of the investigators, Professor of Exercise Science at Edith Cowan University, Robert Newton said current practice saw patients with bone metastases avoid high intensity aerobic, resistance training or impacts, citing bone fragility, possibility of exacerbating the disease, or inability of patients with advanced cancer to benefit. However, extensive research into various patient populations had established that a rest strategy hastened decline and reduced survival. 

Professor Newton said patients who completed the exercise intervention showed significant improvements in neuromuscular strength (11%), aerobic fitness (5%), walking speed (12%), physical activity (24%) and muscle mass (3%) without any increase in bone pain or adverse events. 

"The findings clearly show that patients with bone metastatic cancer can benefit from a targeted program, provided it is closely monitored by an exercise physiologist and tailored to their medical and physical requirements," he said. 

"What we're moving towards now is exercise medicine. A patient is diagnosed, their key issues are determined, then we prescribe the exercise so that they're internally producing a medicine to improve their chances of surviving the cancer." 

COSA President, Associate Professor Sandro Porceddu, said the findings could prove promising for the future treatment of cancer patients with bone metastases. 

"We've long encouraged cancer patients to remain active and exercise, but have always made an exception when it came to bone metastatic cancer. It's encouraging to see that appropriate exercise is safe and effective for a population traditionally instructed to be sedentary. With results demonstrating improved quality of life and no adverse events, this study holds the potential to create great change and progress within the oncology community."

Sitting time at work linked to obesity in women

Are you at work? Are you sitting down? You may want to get on your feet, as a new study has found a link between occupational sitting and increased risks of obesity, particularly among black women.

A new study reveals that occupational sitting increases obesity risk in women - but not in men.

 

The researchers - from the School of Medicine and the Brown School at Washington University in St. Louis, MO - publish their findings in Preventing Chronic Disease, a journal of the National Center for Chronic Disease Prevention and Health Promotion. 

Health guidelines in the US suggest that adults undertake at least 150 minutes of moderate physical activity - such as brisk walking - or 75 minutes of vigorous intensity physical activity - such as jogging - each week.

Individuals who have a sedentary lifestyle are at risk of several conditions, including high blood pressure, anxiety, depression and certain cancers. Additionally, overweight and obesity are recognized risk factors for several chronic diseases. 

Unfortunately, prevalence of overweight and obesity in the US is on the rise, with trends in obesity expected to increase medical costs by $48-66 billion each year during the next 20 years. 

Researchers from the latest study - led by Lin Yang, postdoctoral research associate at the Prevention Research Center in St. Louis - say until now, few studies have focused on the link between occupational sitting and body mass index (BMI). 

Given that many of us spend so much time at work, the team thought it was important to investigate further. "The objective of this study was to quantify the association between self-reported occupational sitting time and BMI by gender and race," says Yang, "independent of time spent in physical activity outside of work."

Link differed by gender and race

To conduct their study, between 2012-2013, the researchers interviewed 1,891 participants from four Missouri metropolitan areas, who were between the ages of 21-65 years old and who were employed outside the home for 20 or more hours per week. All participants were free of physical limitations that prevented walking or bicycling. 

The four metropolitan areas were St. Louis, Kansas City, Springfield and Columbia. 

Participants answered questions on socio-demographic characteristics and time spent sitting at work, and the researchers compared the link between occupational sitting and BMI between men and women, as well as between black and white women. 

The team notes that the proportion of obese participants in their study (33.6%) was similar to the proportion unveiled in a recent national study (35.7%). Both men and women sat for an average of 3-6 hours at work. 

After adjusting for potential confounders, the researchers found that, compared with women who spent 30 minutes or less of daily sedentary time at their jobs, women who spent 31-180 minutes sitting were 1.53 times more likely to be obese, and women who spent more than 360 minutes sitting were 1.70 times more likely.

 

However, the team notes that further stratification revealed this link differed by race and held true for black women but not white women. And this association was consistently observed across different amounts of sitting time. 

Additionally, the team did not observe any associations among men. Commenting on this finding, the researchers write:

"The lack of association between occupational sitting and weight status among men might be explained by the differences between men and women in physical activity preferences. Men are more active in leisure-time physical activity than women, and women tend to do less vigorous and more moderate activity compared with men."

Limitations to the study

Though the study had a fairly large sample size, there were several limitations. Firstly, the researchers admit they were unable to conduct race-stratified analyses for men, given that there was an insufficient number of black men in their study. 

Additionally, because of the cross-sectional design, the researchers were unable to identify a causal relationship between occupational sitting and weight. And the self-reported data means the results could "be subject to response bias." 

A further limitation lies in the location of the study sample; because all participants lived in Missouri, the generalizability of the findings to wider populations could be limited. 

Still, Yang notes that only a few studies have so far examined the link between occupational sitting and weight status, adding that, to the best of their knowledge, "this is the first study to examine differences in the association between occupational sitting and weight status among African American women and white women." 

The researchers conclude their study by writing:


"Sedentary time is accumulated in various settings, such as in the home and workplace and during transit. Given that adults can spend 8 or more hours per day at work, workplaces may be an ideal setting to reduce sedentary time through implementation of worksite policies or changes to the physical work environment."

Head blows measured in girls' lacrosse

As debate increases about whether female lacrosse players should wear headgear, a new study reports measurements of the accelerations that stick blows deliver to the head. The study also measured the dampening effect of various kinds of headgear. 

Lacrosse players swing hard, which is why errant stick blows are the leading cause of concussion in girls' and women's lacrosse. In a new study, researchers measured how much the worst blows accelerate the head and how much different kinds of headgear could reduce those accelerations. 

Girls' and women's lacrosse is a different game from the version played by males, said Joseph Crisco, the Henry Frederick Lippitt Professor of Orthopaedic Research in the Alpert Medical School of Brown University and a researcher at Rhode Island Hospital. Females wear far less protective equipment than males do, and injuries - especially severe head injuries - are comparatively rare. But recently the debate about whether female players should wear headgear has gained prominence. 

"The goal of our study was to answer the question of what types of head accelerations would you see if you were hit in the head with a stick," said Crisco, who used to coach his daughters in girls lacrosse and also sits on the Sports Science and Safety Committee of US Lacrosse, the national governing body of lacrosse. 

To conduct the study, published online in the Journal of Applied Biomechanics, Crisco's team asked seven female lacrosse players aged 12 to 14 to deliver at least 36 whacks each, as hard as they possibly could, to various places on two dummy headforms in the lab. 

"The kinds of hits recorded were basically aggressive street fights," Crisco said. "They were really whacking at it, every shaft was broken by the end of the study, which would never happen in a game. The goal was just to give US Lacrosse and the manufacturers some baseline information on the types of accelerations they could expect to see in a worst-case scenario." 

They used six different sticks, each outfitted with motion capture markers. The headforms had embedded accelerometers. In a second set of experiments the headforms donned one of four different kinds of protective headgear. 

On average across 508 successful blows in the first experiment, the girls swung their sticks about 18 miles an hour, enough to complete two revolutions in less than a second. (One of Crisco's prior studies showed, perhaps not surprisingly, that high school and college players swung their sticks even faster). The peak acceleration the girls delivered to the headforms when they struck them with the shafts of their sticks averaged 60 times the acceleration of Earth's gravity (60g). 

That's about three times more force than, say, football players with the kind of celebratory head butt that teammates exchange after a big play, Crisco said. 

Headgear dampens blows

The second set of experiments examined what effect headgear might have on the girls' harder whacks (those with speeds around 23 miles an hour). Crisco's team measured the accelerations delivered by 20 whacks from the shaft of each volunteer's stick on both the back and the side of each headform. The headforms wore either nothing, a hard-sided men's lacrosse helmet, a rugby scrum cap, mixed martial arts headgear, or soft headgear designed for girls' and women's field hockey and lacrosse. 

The average peak accelerations measured on bare headgear were 81.6g for blows to the side and 150.7g for blows to the back. The men's lacrosse helmet brought the average peak acceleration all the way down to 28.2g on the side and 23.1g on the back. The martial arts and girls lacrosse/field hockey headgear each reduced the accelerations significantly as well, but not nearly as much as the men's helmet. The rugby cap failed to reduce acceleration for blows to the side but dampened blows to the back a little better than the martial arts or lacrosse/field hockey gear. 

Headgear, therefore, significantly reduced head accelerations. But Crisco cautioned against a run on headgear at the sporting goods store based on the study. 

Generally research has shown that helmets do not protect against concussion - only against skull fractures and traumatic brain injury. Indeed very little data connects accelerations to concussion risk, and individual susceptibility varies widely. Though some research hints at a figure around 100g, only the hard-sided men's helmet brought accelerations for blows to the back significantly below that figure. And in many game situations, given how little other protective equipment female players wear, Crisco said, a hard-sided helmet could easily cause more injuries that it prevents. 

"It could actually make the game more aggressive," Crisco said.

What is yoga? What are the health benefits of yoga?

Yoga is a mind and body practice with historical origins in ancient Indian philosophy. Various styles of yoga combine physical postures, breathing techniques, and meditation or relaxation.

 

In 5,000 years of yoga history, the term "yoga" has gone through a renaissance in current culture, exchanging the loincloth for a leotard and pair of leggings. 

Yoga has become popular as a form of physical exercise based upon asanas (physical poses) to promote bodily or mental control and well-being.

You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.

Fast facts on yoga
 
Here are some key points about yoga. More detail and supporting information is in the main article.

• The word "yoga" is derived from the Sanskrit root yuj meaning "to yoke or join together."
• A 2008 market study in Yoga Journal reports that some 16 million people in the US practice yoga and spend $5.7 billion a year on equipment.
• Hatha yoga is the type of yoga most frequently practiced in Western culture. Ha means "sun" and tha means "moon."
• There are many styles of yoga. The type of yoga class considered should be based on personal fitness level.
• According to the US Consumer Product Safety Commission, there were more than 7,369 yoga-related injuries treated in doctors' offices, clinics, and emergency rooms in 2010.
• Common yoga injuries include repetitive strain to and overstretching of the neck, shoulders, spine, legs, and knees.
• The American Academy of Orthopaedic Surgeons (AAOS) believes the rewards of basic yoga outweigh the potential physical risks.
• Yoga is defined as having eight branches or limbs: Yama, Niyama, Asana, Pranayama, Pratyhara, Dharana, Dhyana, Samadhi.
• Practicing yoga has many potential health benefits including relieving low back pain, assisting with stress management and increasing balance and flexibility.
• There is some evidence to suggest that pregnant women taking yoga classes are less likely to experience problems in later pregnancy and labor.

What is yoga?

History

There is no written record of the inventor of yoga. Yogis (yoga practitioners) practiced yoga long before any written account of it came into existence. Yogis over the millennia passed down the discipline to their students, and many different schools of yoga developed as the practice widened in global reach and popularity.⁶²

The postures that are now practiced in yoga classes were not originally a dominant component of yoga traditions in India. Fitness was not traditionally a chief aim of the practice.

Sanskrit, the Indo-European language of the Vedas, India's ancient religious texts, gave birth to both the literature and the technique of yoga.¹

 

The "Yoga Sutra," a 2,000-year-old treatise on yogic philosophy by the Indian sage Patanjali is a type of guidebook that gives guidance on how to gain mastery over the mind and emotions and advice on spiritual growth, providing the framework upon which all yoga practiced today is based. The Yoga Sutra is the earliest written record of yoga and one of the oldest texts in existence 

The Sanskrit word "yoga" has several translations and can be interpreted in many ways. Many translations point toward translations of "to yoke," "join," or "concentrate" - essentially a means to unite or a method of discipline. A male who practices this discipline is called a yogi or yogin and a female practitioner, a yogini. 

The postures that are now an integral part of health and fitness in many centers around the world were not originally a dominant component of yoga traditions in India. Fitness was not a chief aim of practice; focus was placed on other practices like pranayama (expansion of the vital energy by means of breath), dharana (focus, or placement of the mental faculty), and nada (sound).²

 

Yoga began to gain popularity in the West at the end of the 19th century, with an explosion of interest in postural yoga in the 1920s and 1930s, first in India and later in the West.

Philosophy

Yoga, in ancient times, was often referred to in terms of a tree with roots, trunk, branches, blossoms and fruits. Each branch of yoga has unique characteristics and represents a specific approach to life. The six branches are:³

1. Hatha yoga - physical and mental branch - involves asana and pranayama practice - preparing the body and mind
2. Raja yoga - meditation and strict adherence to the "eight limbs of yoga"
3. Karma yoga - path of service to consciously create a future free from negativity and selfishness caused by our actions
4. Bhakti yoga - path of devotion - a positive way to channel emotions and cultivate acceptance and tolerance
5. Jnana yoga - wisdom, the path of the scholar and intellect through study
6. Tantra yoga - pathway of ritual, ceremony or consummation of a relationship.

The 'eight limbs of yoga'

Raja yoga is traditionally referred to as ashtanga (eight-limbed) yoga, because there are eight aspects to the path to which one must attend. The eight limbs of ashtanga yoga are:⁴

1. Yama - ethical standards and sense of integrity. The five yamas are: ahimsa (nonviolence), satya (truthfulness), asteya (non-stealing), brahmacharya (continence) and aparigraha (non-covetousness)
2. Niyama - self-discipline and spiritual observances, meditation practices, contemplative walks. The five niyamas are: saucha (cleanliness), samtosa (contentment), tapas (heat, spiritual austerities), svadhyaya (study of sacred scriptures and of one's self) and isvara pranidhana (surrender to God)
3. Asana - integration of mind and body through physical activity
4. Pranayama- regulation of breath leading to integration of mind and body
5. Pratyahara - withdrawal of the senses of perception, the external world and outside stimuli
6. Dharana - concentration, one-pointedness of mind
7. Dhyana - meditation or contemplation - an uninterrupted flow of concentration
8. Samadhi - the quiet state of blissful awareness.

Chakras

The word chakra means "spinning wheel." According to the yogic view, chakras are a convergence of energy, thoughts, feelings, and the physical body. They determine how we experience reality from our emotional reactions, our desires or aversions, our level of confidence or fear, even the manifestation of physical symptoms. 

When energy becomes blocked in a chakra, it is said to trigger physical, mental, or emotional imbalances that manifest in symptoms such as anxiety, lethargy, or poor digestion. The theory is to use asanas to free energy and stimulate an imbalanced chakra. 

There are seven major chakras, each with their own associations:

Chakras are said to determine how we experience reality from our emotional reactions, our desires or aversions, our level of confidence or fear, even the manifestation of physical symptoms.

1. Sahasrara: the "thousand petaled" or "crown chakra" represents the state of pure consciousness. This chakra is located at the crown of the head and signified by the color white or violet. Sahasrara involves matters of inner wisdom and death of the body.
2. Ajna: the "command" or "third-eye chakra" represents a meeting point between two important energetic streams in the body. Ajna corresponds to the colors violet, indigo or deep blue, though it is traditionally described as white. The chakra is connected to the pituitary gland, growth and development.
3. Vishuddha: the "especially pure" or "throat chakra" is symbolized by the color red or blue. This chakra represents the home of speech and hearing, and the endocrine glands that control metabolism.
4. Anahata: the "unstruck" or "heart chakra" is related to the colors green or pink. Key issues involving Anahata involve complex emotions, compassion, tenderness, unconditional love, equilibrium, rejection and well-being.
5. Manipura: the "jewel city" or "navel chakra" is symbolized by the color yellow. This chakra is associated with the digestive system, along with personal power, fear, anxiety, opinion formation and introversion.
6. Svadhishthana: "one's own base" or "pelvic chakra" represents the home of the reproductive organs, the genitourinary system and the adrenals.
7. Muladhara: the "root support" or "root chakra" is located at the base of the spine in the coccygeal region. It is said to hold our instinctual urges around food, sleep, sex, and survival. It is also the realm of our avoidance and fears.

What are the types of yoga?

Modern forms of yoga have evolved into exercise focusing on strength, flexibility, and breathing to boost physical and mental well-being. There are many styles of yoga, and no style is more authentic or superior to another; the key is to choose a class appropriate for your fitness level. Types and styles of yoga may include:^5,6

Classes should be chosen depending on your fitness level and how much yoga experience you have.

• Ashtanga yoga: based on ancient yoga teachings but popularized in the 1970s, each of the six established sequences of postures rapidly link every movement to breath.
• Bikram yoga: held in artificially heated rooms at temperatures of nearly 105 degrees and 40% humidity, Bikram is a series of 26 poses and sequence of two breathing exercises.
• Hatha yoga: a generic term for any type of yoga that teaches physical postures. When a class is labeled as "hatha," it is usually a gentle introduction to the basic yoga postures.
• Iyengar yoga: focused on finding the proper alignment in each pose and using props such as blocks, blankets, straps, chairs and bolsters to do so.
• Jivamukti yoga: meaning, "liberation while living," jivamukti yoga emerged in 1984, incorporating spiritual teachings and vinyasa style practice. Each class has a theme, which is explored through yoga scripture, chanting, meditation, asana, pranayama, and music, and can be physically intense.
• Kripalu yoga: teaches practitioners to get to know, accept and learn from the body. In a Kriplau class, each student learns to find their own level of practice on a given day by looking inward. The classes usually begin with breathing exercises and gentle stretches, followed by a series of individual poses and final relaxation.
• Kundalini yoga: the Sanskrit word kundalini means coiled, like a snake. Kundalini yoga is a system of meditation directed toward the release of kundalini energy. A class typically begins with chanting and ends with singing, and in between features asana, pranayama, and meditation designed to create a specific outcome.
• Power yoga: an active and athletic style of yoga adapted from the traditional ashtanga system in the late 1980s.
• Prenatal yoga: yoga postures carefully adapted for expectant mothers. Prenatal yoga is tailored to help women in all stages of pregnancy or assist with getting back in shape post-birth.
• Restorative yoga: a relaxing method of yoga, spending a class in four or five simple poses using props like blankets and bolsters to sink into deep relaxation without exerting any effort in holding the pose.
• Sivananda: a system based on a five-point philosophy that proper breathing, relaxation, diet, exercise, and positive thinking work together to form a healthy yogic lifestyle. Typically uses the same 12 basic asanas, bookended by sun salutations and savasana poses.
• Vinyasa yoga: meaning, "flow," vinyasa classes are known for their fluid, movement-intensive practices. Classes are often choreographed to have smooth transitions from one pose to another, in an almost dance-like manner.
• Viniyoga: intended to be adaptable to any person, regardless of physical ability, viniyoga teachers much be highly trained and tend to be experts on anatomy and yoga therapy.
• Yin: a quiet, meditative yoga practice, also called taoist yoga. Yin yoga enables the release of tension in key joints: ankles, knees, hips, the whole back, neck, and shoulders. Yin poses are passive, meaning the muscles are to relax and let gravity do the work.

What are the health benefits of yoga?

Scientific trials of varying quality have been published on the health benefits and medical uses of yoga. Studies suggest that yoga is a safe and effective way to increase physical activity, especially strength, flexibility and balance. However, can the practice of yoga benefit other medical conditions? We take a look at medical evidence and current scientific research below.

Scientists and medical doctors pursuing yoga-related research are focusing on its potential ability to help prevent, heal, or alleviate specific conditions, such as heart disease, high blood pressure, carpal tunnel syndrome, asthma, diabetes, and symptoms of menopause, and its benefits as a technique for relieving stress and coping with chronic conditions or disabilities.⁷

Anxiety and depression

Mind-body medical interventions are commonly used to cope with depression, and yoga is one of the most commonly used mind-body interventions. Studies have taken place to assess systematically and meta-analyze the effectiveness of yoga for depression. 

Yoga may be a promising way to reduce music performance anxiety and perhaps even prevent it in the future.

A 9-week course of yoga in veterans observed significant reductions in anxiety, depression, and suicidal ideation. Mental health functioning scores were also improved, but pain intensity and physical health functionality did not show improvements.³²

 

Hypercortisolemia is well-known in depression, and yoga has been demonstrated to reduce the parameters of stress, including cortisol levels. A study into the cortisol and antidepressant effects of yoga found that yoga might act at the level of the hypothalamus by its 'anti-stress' effects (reducing cortisol levels), to bring about relief in depression.³³

 

A systematic review and meta-analysis investigating yoga for depression examined 12 randomized controlled trials, including 619 participants. The researchers concluded that despite the methodological drawbacks of the included studies, yoga could be considered an ancillary treatment option for patients with depressive disorders and individuals with elevated levels of depression.³⁴

 

Professional musicians often experience high levels of stress, music performance anxiety (MPA), and performance-related musculoskeletal disorders (PRMDs). Given the fact that most professional musicians begin their musical training before the age of 12, it is important to identify interventions that will address these issues from an early age.³⁵

 

Results from a study suggest that yoga may be a promising way for adolescents to reduce MPA and perhaps even prevent it in the future. These findings also suggest a novel treatment modality that potentially might alleviate MPA and prevent the early disruption and termination of musical careers.

Arthritis

A systematic review of 9 studies regarding yoga as a complementary approach for osteoarthritis found positive changes in psychological or physiological outcomes related to arthritis. 

Despite the limitations of not all of the studies using randomized controlled design or having smaller sample sizes, having different outcomes, having non-standardized yoga intervention, not using behavioral theory, and having varying lengths, yoga appears to be a promising modality for arthritis.⁴⁸

Asthma

When comparing asthmatics in a yoga group with those in a control group, those in the yoga group had a significant improvement in the proportion of hemoglobin and antioxidant superoxide, and significant decrease was found in total leukocyte count (TLC) and differential leukocytes count in comparison to control group. 

The yoga group had more significant improvements in biochemical variables than the control group. Results show that yoga can be practiced as adjuvant therapy with standard inhalation therapy for a better outcome of asthma.¹⁵

 

However, in a systematic review assessing the effectiveness of yoga as a treatment for asthma, the researchers found the belief that yoga alleviates asthma is not supported by sound evidence and they indicate that further, more rigorous trials are warranted.¹⁶

Balance and falls

Falls amongst older people are a global health concern. Whilst falling is not a typical feature of aging, older people are more likely to fall and falls are a leading cause of death and disability.¹³

Yoga has been shown to help improve balance and prevent falls in older adults.

Yoga and tai chi have shown potential to improve balance and prevent falls in older adults. They also have potential to improve pain and quality of life. 

In a 14-week yoga program, yoga demonstrated a decrease in fall incidence and a reduction in average pain scores, though not statistically significant. The results show positive changes to balance, pain and quality of life and a high level of interest through attendance amongst older participants. The results support offering tai chi and yoga to older people who are frail and dependent with physical and cognitive limitations. 

Another study observing body balance and postural control in young adults determined that a 5-month hatha yoga training program could improve postural control significantly in healthy adults.¹⁴

Bipolar disorder

In a study of the benefits and risk of yoga in individuals with bipolar disorder, the participants reported positive emotional effects, particularly reduced anxiety, positive cognitive effects (e.g., acceptance, focus, or "a break from my thoughts"), or positive physical effects (e.g., weight loss, increased energy). Some respondents considered yoga to be significantly life changing. The most common negative effect of yoga was physical injury or pain.³⁶

 

Five respondents gave examples of specific instances of a yoga practice that they believed increased agitation or manic symptoms; five respondents gave examples of times that yoga increased depression or lethargy.

Breast cancer cognitive problems

Cancer survivors often report cognitive problems. Furthermore, decreases in physical activity typically occur over the course of cancer treatment. Although physical activity benefits cognitive function in non-cancer populations, evidence linking physical activity to cognitive function in cancer survivors is limited.⁴⁰

 

A study comparing a group with and without yoga intervention found that those who practiced yoga more frequently reported significantly fewer cognitive problems at a 3-month followup than those who practiced less frequently. 

These findings suggest that yoga can effectively reduce breast cancer survivors' cognitive complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems.

Breast cancer disability

Secondary arm lymphedema continues to affect at least 20% of women after treatment for breast cancer, along with pain and a range of motion restrictions requiring lifelong professional treatment and self-management.⁴¹

 

A pilot trial was aimed at determining the effect of yoga on women with stage one breast cancer-related lymphedema. 

The 8-week yoga intervention reduced tissue induration of the affected upper arm and decreased the QOL subscale of symptoms. Arm volume of lymphedema and extra-cellular fluid did not increase. These benefits did not last on cessation of the intervention when arm volume of lymphedema increased. Further research trials with a longer duration, higher levels of lymphedema and larger numbers are warranted before definitive conclusions can be made.

Cancer-related fatigue

Fatigue is one of the most frequently reported, distressing side effects reported by cancer survivors and often has significant long-term consequences. Research indicates that yoga can produce invigorating effects on physical and mental energy, and thereby may improve levels of fatigue.

Studies have suggested that yoga interventions may be beneficial for reducing cancer-related fatigue in women with breast cancer.

An 8-week yoga exercise program assessed whether yoga can decrease anxiety, depression and fatigue in patients with breast cancer. Fatigue was effectively reduced in the study but did not reduce depression or anxiety.³⁷

 

The authors of the study conclude that oncology nurses should strengthen their clinical health education and apply yoga to reduce the fatigue experienced by patients with breast cancer who undergo adjuvant chemotherapy. 

Another 12-week study with restorative Iyengar yoga intervention reduced inflammation-related gene expression in breast cancer survivors with persistent fatigue. These findings suggest that a targeted yoga program may have beneficial effects on inflammatory activity in this patient population, with potential relevance for behavioral and physical health.³⁸

 

A systematic review of yoga interventions on fatigue in cancer patients and survivors suggest that yoga interventions may be beneficial for reducing cancer-related fatigue in women with breast cancer; however, conclusions should be interpreted with caution as a result of levels of bias and inconsistent methods were used across studies.³⁹

Cardiovascular disease

A sedentary lifestyle and stress are major risk factors for cardiovascular disease. Since yoga involves exercise and is thought to help in stress reduction, it may be an effective strategy in the primary prevention of cardiovascular disease. 

Across 11 identified trials with 800 participants, researchers found that the limited evidence in this field comes from small, short-term, low-quality studies. There is some evidence that yoga has favorable 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.⁴²

 

A meta-analysis on the subject revealed evidence for clinically important effects of yoga on most biological cardiovascular disease risk factors. Despite methodological drawbacks of the included studies, yoga can be considered as an ancillary intervention for the general population and patients with increased risk of cardiovascular disease.⁴³

Chronic neck pain

Assessment of the effects of a 9-week yoga intervention on chronic nonspecific neck pain found that neck-related disabilities were improved for at least 12 months after intervention completion. Sustained yoga practice was deemed the most important predictor of long-term effectiveness.²³

Chronic heart failure

A meta-analysis of the effects of yoga in patients with chronic heart failure suggested that yoga compared with control had a positive impact on peak VO2 and health-related quality of life.⁴⁴

 

Yoga could be considered for inclusion in cardiac rehabilitation programs. Larger randomized controlled trials are required to investigate the effects of yoga in patients with chronic heart failure further. 

A randomized controlled trial indicated that the addition of yoga therapy to standard medical therapy for heart failure patients has a markedly better effect on cardiac function and reduced myocardial stress measured using N terminal pro B-type natriuretic peptide in patients with stable heart failure.⁴⁵

Chronic obstructive pulmonary disease

Currently, several studies have assessed the effect of yoga training on the management of chronic obstructive pulmonary disease. Five randomized controlled trials involving 233 patients suggested yoga training has a positive effect on improving lung function and exercise capacity and could be used as an adjunct pulmonary rehabilitation program in COPD patients. 

However, further studies are needed to substantiate these preliminary findings and to investigate the long-term effects of yoga training.²⁴

Flexibility

Research on the effects of selected asanas in Iyangar yoga on flexibility over 6 weeks showed a significant increase in flexibility, indicating 6 weeks of single session yoga training may be effective in increasing erector spinae and hamstring flexibility.⁴⁷

Gastroesophageal reflux disease (GERD)

A case report assessed the effects of yoga on gastroesophageal reflux disease (GERD). The researchers indicate regular and proper use of yoga along with over-the-counter or prescribed proton pump inhibitors (PPI) can control the severe symptoms of GERD and can avoid or delay the necessity of invasive procedures. 

The case report showed that with the regular practice of Kapalbhati and Agnisar kriya along with PPI, patients with hiatal hernia had improvement in severe symptoms of GERD which were initially refractory to PPI alone.⁴⁷

Hypertension

A few systematic reviews have scrutinized the quality of evidence and the strength of recommendation for yoga as a therapeutic means in the management of prehypertension and hypertension. Researchers have found that the effectiveness of yoga as a treatment of hypertension is encouraging but inconclusive.^25-27

 

Compared with exercise, no evidence was found for effects of yoga on systolic or diastolic blood pressure, and researchers point out that future research needs to focus on high quality clinical trials along with studies on the mechanisms of action of different yoga practices.

Low back pain

Several studies suggest yoga may be effective for chronic low back pain and have shown that yoga intervention in populations with chronic low back pain may be more effective than usual care for reducing both pain and medication use.¹⁷

Studies have indicated that 6 weeks of uninterrupted medical yoga therapy is a cost-effective early intervention for non-specific low back pain.

A randomized controlled study investigating medical yoga, exercise therapy and self-care advice concluded that 6 weeks of uninterrupted medical yoga therapy is a cost-effective early intervention for non-specific low back pain, when treatment recommendations are adhered to.¹⁸

 

The effect of yoga on pain, brain-derived neurotrophic factor, and serotonin in premenopausal women with chronic low back pain was investigated in a study. Participants practiced yoga three times a week for 12 weeks. The researchers propose that brain-derived neurotrophic factor may be one of the key factors mediating beneficial effects of yoga on chronic low back pain.¹⁹

 

A comparison trial monitored changes in pain intensity and health-related quality of life in nonspecific low back pain in those participating in Iyangar yoga or general exercise. The results suggest Iyengar yoga provides better improvement in pain reduction and improvement in quality of life than general exercise.²⁰

 

Virtual reality-based yoga programs such as Wii Fit Yoga have been shown to have positive effects on physical improvements in middle-aged female patients with low back pain. This program can be employed as a therapeutic medium for prevention and cure of low back pain.²¹

 

A meta-analysis of randomized controlled trials regarding the use of yoga for chronic low back pain agrees that yoga may be an efficacious adjunctive treatment for chronic low back pain. However, the researchers add that before any definitive conclusions can be drawn, a number of methodological concerns need to be addressed to determine whether yoga has specific treatment effects or offers any advantages over traditional exercise programs.²²

Menopause

In a community-based interventional study, the quality of life in menopausal women was greatly improved after an 18-week course of yoga practice. The researchers concluded that yoga is an effective complementary health approach for those suffering menopausal symptoms.⁸

Mental health

Physical activity has a positive effect on mental health and well-being. The aim of one study was to compare the effects of hatha yoga and resistance exercises on mental health and well-being in sedentary adults.³¹

Hatha yoga improved fatigue, self-esteem, and quality of life, whilst resistance exercise training improved body image. Hatha yoga and resistance exercise decreased depression symptoms at a similar level.

Hatha yoga and resistance exercise may affect different aspects of mental health and well-being.

Metabolic syndrome

An explorative study investigated metabolic responses to mental stress and yoga practices in yoga practitioners, non-yoga practitioners and individuals with metabolic syndrome (the medical term for a combination of diabetes, high blood pressure and obesity).³⁰

 

The results of the study support the findings of previous randomized trials that suggest regular yoga practice may mitigate against the effects of metabolic syndrome.

Migraine

A comprehensive study examining the effect of yoga on migraine showed significant clinical improvement in frequency and intensity of migraines in those taking part in yoga therapy. The researchers concluded that yoga therapy could be effectively incorporated as an adjuvant therapy in migraine patients.²⁸

 

Another study investigated the preventive effects of a three-month yoga intervention on endothelial function in patients with migraine. 

The study revealed that yoga exercises, as a complementary treatment beside pharmacological treatments, could be potentially an effective way of improving vascular functions in migraineurs.²⁹

Mother and baby

Mother and baby yoga is becoming more and more popular as postpartum mothers discover the benefits of being able to "work out," bond with their baby and relax, all in one session.

Postnatal yoga or mother and baby yoga can help rebuild the weakened pelvic floor, strengthen the abdominal muscles and even alleviate back and neck pain while bonding with baby.

According to The Practicing Midwife, postnatal yoga can offer calm and a sense of well-being, helping mothers to improve and stabilize their emotional health and to bond. Additionally, the mother can focus on her relationship with her baby, rebuild the weakened pelvic floor, strengthen the abdominal muscles and even alleviate back and neck pain. For babies, yoga can aid digestion and alleviate colic, help to strengthen tiny limbs, improve sleep patterns, and enhance their ability to interact with their mother and other people.⁵⁵

Oxidative stress

Hypertension, especially in the elderly, is a strong risk factor for cardiovascular mortality and morbidity. Oxidative stress has been implicated as one of the underlying causes of hypertension.⁴⁵

 

A study found yoga to be an effective means to reduce oxidative stress and to improve antioxidant defense in elderly hypertensive individuals.

Posttraumatic stress

More than a third of the approximately 10 million women with histories of interpersonal violence in the US develop posttraumatic stress disorder (PTSD). 

A study exploring the efficacy of yoga to increase affect tolerance and to decrease PTSD symptomatology found yoga significantly reduced symptoms of PTSD and improved the functioning of traumatized individuals.¹²

Pregnancy

Yoga is used for a variety of immunological, neuromuscular, psychological, and pain conditions. Recent studies indicate that it may be effective in improving pregnancy, labor, and birth outcomes. 

The breathing and meditation techniques keep pregnant mothers healthy and relaxed, and provide the mental focus to aid childbirth. Some postures are chosen specifically to help encourage an optimal fetal position.⁵⁰

 

In a survey ascertaining the opinions, practices and knowledge about exercise, including yoga, during pregnancy:⁵¹

Yoga may help improve stress levels, quality of life, and labor parameters such as comfort, pain, and duration in pregnant women.

• 86% of women responded that exercise during pregnancy is beneficial
• 83% felt it was beneficial to start prior to pregnancy
• 62% considered walking to be the most beneficial form of exercise
• 64% of respondents were currently exercising during pregnancy
• 51% exercised 2-3 times a week
• 65% considered yoga to be beneficial
• 40% had attempted yoga before pregnancy.

Another study tested the efficacy of yoga as an intervention for reducing maternal anxiety during pregnancy.

A single session of yoga reduced both subjective and physiological measures of state anxiety and this class-induced reduction in anxiety remained at the final session of the intervention. Antenatal yoga seems to be useful for reducing women's anxieties toward childbirth and preventing increases in depressive symptomatology.⁵²

 

Yoga group participants show fewer postpartum but not antepartum depressive symptoms than control group participants. Findings indicate that prenatal Hatha yoga may improve current mood and may be effective in reducing postpartum depressive symptoms.⁵³

 

A systematic review of yoga for pregnant women showed that studies indicate that yoga may produce improvements in stress levels, quality of life, aspects of interpersonal relating, autonomic nervous system functioning, and labor parameters such as comfort, pain, and duration. However, they conclude that more randomized controlled trials are needed to provide more information regarding the utility of yoga interventions for pregnancy.⁵⁴

Restless legs syndrome

Restless legs syndrome is a common and highly burdensome sleep disorder. 

Women aged 32-66 years with restless legs syndrome completed 16 yoga classes. At follow-up, participants demonstrated striking reductions in restless syndrome symptoms and symptom severity, with symptoms decreasing to minimal/mild in all but one woman and no participant scoring in the severe range by week 8. Participants also showed significant improvements in sleep, perceived stress, and mood.⁵⁸

Sleep

The aging process is associated with physiological changes that affect sleep. In older adults, undiagnosed and untreated insomnia may cause impaired daily function and reduced quality of life. Insomnia is also a risk factor for accidents and falls that are the main cause of accidental deaths in older adults. 

Compared with controls, the yoga group showed significant improvements in a range of subjective factors, including:⁵⁷

• Overall sleep quality
• Sleep efficiency
• Sleep latency and duration
• Self-assessed sleep quality
• Fatigue
• General well-being
• Depression
• Anxiety
• Stress
• Tension
• Anger
• Vitality
• Function in physical, emotional, and social roles.

Yoga was shown to be safe and improved sleep and quality of life in a group of older adults with insomnia. Outcomes depended on practice compliance.

Stress management

Several studies have looked at yoga as a model for stress management. In a study observing the effects of 10 weeks of classroom-based yoga on cortisol and behavior in second and third-grade students, cortisol decreased significantly and improvements in students' behavior improved. The results suggest that school-based yoga may be advantageous for stress management and behavior.⁹

Studies suggest that school-based yoga may assist with stress management and the behavior of children.

Equally, another study addresses how children and young people in today's world face numerous expectations and constant stimulation through the Internet and other media and communication technologies. One reason children experience stress and mental health challenges is that globalization exposes the youth all over the world to various new demands, standards, and options. The researchers examined yoga as a potential tool for children to deal with stress and found that yoga may help children and young people cope with stress and as a result, contribute positively to balance in life, well-being, and mental health.¹⁰

 

One study evaluated the influence of hatha yoga practice on the distress of women before beginning a course of in vitro fertilization (IVF). Of the 143 female participants, 45 attended hatha yoga and 75 did not. Data suggest that psychological support and practice of hatha yoga before IVF is associated with distress reduction.¹¹

Urinary incontinence

Yoga has been shown to reduce inflammation and may help improve symptoms of urge urinary incontinence. More research is necessary to demonstrate the effectiveness of yoga to reduce urge urinary incontinence symptom burden and improve quality of life.⁴⁶

Weight management

A comparative controlled trial compared the effects of yoga and walking for overweight and obese adults.

Both groups showed a significant decrease in BMI, waist circumference, hip circumference, lean mass, body water, and total cholesterol. The yoga group increased serum leptin and decreased LDL cholesterol. The walking group decreased serum adiponectin and triglycerides.⁴⁹

 

Both yoga and walking improved anthropometric variables and serum lipid profile in overweight and obese persons. 

The prevalence of yoga research in western health care is increasing. The marked increase in volume indicates the need for more systematic analysis of the literature in terms of quality and results.⁶¹

What are the risks and side effects of yoga?

Yoga is low-impact and safe for healthy people when practiced appropriately under the guidance of a well-trained instructor.

Yoga should never be used to replace standard medical care. If you have a medical condition, check with your doctor before beginning yoga classes.

Injury due to yoga is an infrequent barrier to continued practice, and severe injury due to yoga is rare.^58,59

Women who are pregnant and people with certain medical conditions, such as high blood pressure, glaucoma, and sciatica, should modify or avoid some yoga poses. 

Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing.

Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.⁶⁰

 

Do not use yoga to replace conventional medical care or to postpone seeing a health care provider about pain or any other medical condition. If you have a medical condition, talk to your health care provider before starting yoga.