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Who practices yoga? A systematic review of demographic, health-related, and psychosocial factors associated with yoga practice



Yoga has become increasingly popular in the US and around the world, yet because most yoga research is conducted as clinical trials or experiments, little is known about the characteristics and correlates of people who independently choose to practice yoga. We conducted a systematic review of this issue, identifying 55 studies and categorizing correlates of yoga practice into sociodemographics, psychosocial characteristics, and mental and physical well-being. Yoga use is greatest among women and those with higher socioeconomic status and appears favorably related to psychosocial factors such as coping and mindfulness. Yoga practice often relates to better subjective health and health behaviors but also with more distress and physical impairment. However, evidence is sparse and methodological limitations preclude drawing causal inferences. Nationally representative studies have minimally assessed yoga while studies with strong assessment of yoga practice (e.g., type, dose) are generally conducted with convenience samples. Almost all studies reviewed are cross-sectional and few control for potential confounding variables. We provide recommendations for future research to better understand the correlates of yoga practice.
Who practices yoga? A systematic review of demographic,
health-related, and psychosocial factors associated with yoga
Crystal L. Park Tosca Braun Tamar Siegel
Received: December 13, 2013 / Accepted: January 11, 2015 / Published online: January 29, 2015
ÓSpringer Science+Business Media New York 2015
Abstract Yoga has become increasingly popular in the
US and around the world, yet because most yoga research
is conducted as clinical trials or experiments, little is
known about the characteristics and correlates of people
who independently choose to practice yoga. We conducted
a systematic review of this issue, identifying 55 studies and
categorizing correlates of yoga practice into sociodemo-
graphics, psychosocial characteristics, and mental and
physical well-being. Yoga use is greatest among women
and those with higher socioeconomic status and appears
favorably related to psychosocial factors such as coping
and mindfulness. Yoga practice often relates to better
subjective health and health behaviors but also with more
distress and physical impairment. However, evidence is
sparse and methodological limitations preclude drawing
causal inferences. Nationally representative studies have
minimally assessed yoga while studies with strong
assessment of yoga practice (e.g., type, dose) are generally
conducted with convenience samples. Almost all studies
reviewed are cross-sectional and few control for potential
confounding variables. We provide recommendations for
future research to better understand the correlates of yoga
Keywords Yoga Mental well-being Physical
well-being Psychosocial correlates
Yoga’s increased visibility in media, advertising and com-
mercial enterprises is paralleled by increased practice as evi-
denced in national surveys (Barnes et al., 2008). Research is
also proliferating on the practice of yoga for myriad health
conditions, ranging from postmenopausal symptoms and low
back pain to cancer and heart disease (Field, 2011). Most
research on yoga has focused on determining its effects, often
relying on experimental designs or clinical trials. Other studies
have relied on case reports or surveys of convenience samples
some outcome measure. While important for understanding the
effects of yoga on health and well-being, these studies do not
provide information on a more general question: who does
yoga? That is, what do we know about the characteristics of
individuals who elect to practice yoga when they have not been
assigned to do it as part of a trial or experiment?
Yoga is complex, comprising many different elements,
including physical poses, breathwork, concentration, and
meditation, ethical tenets, spirituality, inward attention, and
self-knowledge. When considering results across studies, it
is important to note that the yoga studied may vary greatly
in terms of specific tradition and style, location, class level,
teacher characteristics, and relative vigor and intensity of
aerobic and musculoskeletal exercise. Little research has
systematically examined different types of yoga and, in
fact, most provide little information on the specific types of
yoga practiced by participants.
Characterizing yoga practitioners in terms of demograph-
ics, psychosocial factors and physical and emotional well-
being is important, because understanding who practices yoga
may be useful in developing yoga interventions tailored to
appeal to different groups, and suggest future research
directions regarding the effects of yoga on various aspects of
Electronic supplementary material The online version of this
article (doi:10.1007/s10865-015-9618-5) contains supplementary
material, which is available to authorized users.
C. L. Park (&)T. Braun T. Siegel
University of Connecticut, Box 1020, Storrs, CT 06269, USA
J Behav Med (2015) 38:460–471
DOI 10.1007/s10865-015-9618-5
well-being as well as potential mechanisms through which
such effects are achieved. Further, given that yoga is
increasingly demonstrating efficacy for various health con-
ditions, knowing more about who is not practicing yoga may
influence efforts for promotion and outreach as well as for
improving maintenance of yoga practice over time.
Finally, the complex interplay between selection and
causal effects with regard to yoga practice is a little-dis-
cussed but important consideration. For instance, those
self-selecting to yoga may evidence more health concerns
prior to initiating practice, while yoga could also facilitate
improvements relative to personal baseline. Reporting on
convenience samples in addition to clinical, large, and
nationally representative samples affords better character-
ization of selection effects (i.e., individual characteristics
that facilitate self-selection to yoga practice) versus causal
effects. Most data reported here are cross-sectional, ren-
dering causality impossible to infer. However, where
available, we report on demographics data, data comparing
yoga novices to advanced practitioners, and studies
exploring dose-related effects to facilitate consideration of
selection versus causal effects. We aimed to aggregate the
published evidence regarding the correlates of unsolicited
yoga practice in the general population as well as in con-
venience and clinical samples. Specifically, we address the
question: Which demographic characteristics, psychosocial
variables, and health-related characteristics are related to
the practice of yoga and to the amount of yoga practiced?
This systematic review is based on a literature search
conducted using four scholarly databases (MedLine, Psy-
cInfo, CINAHL, Google Scholar). We attempted to iden-
tify all studies that documented statistical associations
between the practice of yoga and demographic, psycho-
social, or well-being variables in non-intervention trials
published in English in peer-reviewed journals through
October, 2014. The keyword searched was ‘‘yoga’’, pro-
ducing large numbers of abstracts. For example, the Pub-
Med search yielded 2,637 potential sources and the
PsychInfo search yielded 1,678, many of which were
overlapping. All abstracts were read for potential inclusion;
for those that potentially met criteria, full articles were read
for relevance to the research questions listed above.
Articles were included if they met the following criteria:
(1) was an original empirical study (i.e., not an editorial or
other commentary), (2) examined people who elected to do
yoga on their own rather than describing people recruited
into a clinical trial or experiment, (3) examined yoga
explicitly and singularly (rather than aggregated with other
CAM modalities), (4) assessed demographic, psychosocial,
or well-being variables, and (5) presented inferential sta-
tistics (i.e., not just percentages or frequencies of yoga
practice by demographic or health-related factors).
In total, 55 published articles were located that met all
inclusion criteria, despite the broad definitions of demo-
graphic, psychosocial factors, and health behaviors applied.
Many articles were excluded because even though they
assessed yoga separately, they reported only on general
CAM use (e.g., Van Tilburg et al., 2008) or CAM use by
categories, combining yoga with other mind–body modal-
ities such as meditation (e.g., Penman et al., 2012) or other
types of exercise, such as Pilates (e.g., Neumark-Sztainer
et al., 2011). For detailed information on included articles,
see Appendix Table 1 (online).
Description of included articles
Sixteen (29.1 %) articles comprised analyses of six nation-
ally representative datasets: the 2002 and 2007 NHIS, a
1997/1998 telephone survey on CAM use, the Nurse’s
Health Study (Buettner et al., 2006), American Cancer
Society’s cancer survivor studies (Stein et al., 2009), the
Study of Women’s Health Across the Nation (Gold et al.,
2007), and the Health Survey for England (HSE; Ding &
Stamatakis, 2014). Recently, the NHIS included a CAM
component; 10 (18.2 %) articles were sub-analyses of spe-
cific populations drawn from the NHIS, nine from the 2002
report (Bertisch et al., 2008,2009;Birdeeetal.,2008;
Fouladbakhsh & Stommel, 2010;Garrow&Egede,2006;
Graham et al., 2005; Mao et al., 2010; Mehta et al., 2007;
Shah et al., 2008) and one from the 2007 report (Wells et al.,
2011). Two (3.6 %) analyses of a 1997/1998 telephone
survey on CAM use were published (Conboy et al., 2005;
Saper et al., 2004). Three (5.5 %) articles were subanalyses
from other national samples: cancer survivors from the
Nurse’s Health Study (Buettner et al., 2006), disease-free
colorectal cancer survivors in the US by the American
Cancer Society (Stein et al., 2009), and women from the
Study of Women’s Health Across the Nation (SWAN Study;
Gold et al., 2007). The Health Survey for England (HSE)
refers to a series of independent cohort studies implemented
between 1997 and 2008 (Ding & Stamatakis, 2014). Prev-
alence rates from the NHIS are non-comparable to the HSE
due to differences in definition of current yoga practice
(within past year or past 4 weeks, respectively).
The next most representative articles report on data from
a national survey of Iyengar practitioners, resulting in two
publications (3.6 %), with demographic norms that closely
J Behav Med (2015) 38:460–471 461
approximate yoga practitioner norms observed in nationally
representative studies (Ross et al., 2012,2013). Next are
three moderately-sized international and regional US sam-
ples that represented a low proportion of yoga- relative to
non-practitioners, resulting in four publications (7.3 %).
These include a comparison of yoga practitioners and non-
practitioners in a large Northwestern US cohort (Kristal
et al., 2005) and an investigation of sexual orientation and
CAM use in Pittsburgh, PA (Smith et al., 2010). Finally, a
study from Germany employing a large convenience sample
of internal and integrative medicine patients resulted in two
published comparisons (Cramer et al., 2013a,b).
The majority of articles (63.6 %) comprised US and
international convenience samples. Nineteen (34.5 %)
compared yoga practitioners to non-practitioners (e.g.,
Monk-Turner & Turner, 2010; Prichard & Tiggemann,
2008; Yoshihara et al., 2011); six (10.9 %) compared
practitioners and non-practitioners within a group with
specific health concerns (e.g., Desai et al., 2010; Park et al.,
2013; Wells et al., 2011); five (9.1 %) assessed within-group
characteristics of yoga practitioners (e.g., Dale et al., 2011;
Delaney & Anthis, 2010); three (5.5 %) compared those
with less experience to those with more (Brisbon & Lowery,
2011; Kiecolt-Glaser et al., 2010,2012; ); one (1.8 %)
dichotomized the sample into those who practiced for psy-
chospiritual versus physical reasons (Dittmann & Freedman,
2009); and one (1.8 %) compared yoga practitioner norms to
UK population norms (Hasselle-Newcombe, 2005).
Sixteen articles (29.1 %) explored dose (i.e., frequency or
duration of yoga practice), including one large national
sample of practitioners of a particular style of yoga (Iyengar;
Ross et al., 2012), one regional sample (Kristal et al., 2005),
and eleven convenience samples (e.g., Dale et al., 2011;
Kiecolt-Glaser, et al., 2012; Moliver et al., 2011,2013).
Seventeen articles (30.9 %) were conducted with samples
outside of the US (e.g., Zajac & Schier, 2011; Vera et al.,
2009), fourteen (25.5 %) were conducted with ill or survivor
populations (e.g., Fouladbakhsh & Stommel, 2010;Garrow&
Egede, 2006), and three (5.5 %) examined samples of Iyengar
practitioners (Ross et al., 2012,2013; Hasselle-Newcombe,
2005). We divided the studies’ heterogeneous array of cor-
relates into three categories: Yoga and sociodemographics,
psychosocial characteristics, and mental/physical well-being.
Many studies contributed findings in all three areas.
Relationships between yoga practice and
In virtually all of the research conducted in the US, women
practice yoga more than do men (Ross et al., 2013). In the
2002 NHIS, 76 % of yoga practitioners were women
(Birdee et al., 2008). Similar ratios are reported for cancer
survivors (Fouladbakhsh & Stommel, 2010), colorectal
cancer survivors (Stein et al., 2009), and those with med-
ical conditions (Bertisch et al., 2009). Other data from
nationally (Conboy et al., 2005; Saper et al., 2004; Stein
et al., 2009) and internationally representative studies
(Ding & Stamatakis, 2014) and national surveys (Ross
et al., 2012,2013) have observed a similar pattern.
Convenience samples also generally reflect this pattern
(e.g., Carbonneau et al., 2010), as well as the general
tendency to conduct studies of female yoga practitioners
only (e.g., Kiecolt-Glaser et al., 2012), unless they are
specifically gender-balanced (e.g., Venkatesh et al., 1994).
A greater proportion of females has also been observed in
international convenience samples (Cramer et al., 2013a;
Lafaille, 1997; Vera et al., 2009; Carbonneau et al., 2010),
excepting two samples in India skewed towards males
(Balakrishanan et al., 2007; Bankar et al., 2013).
Yoga practice in the US has been consistently linked with
being White and, to a lesser extent, Asian.The most thorough
examination of race/ethnicity and yoga use (yes/no) to date in
the US is the 2002 NHIS, which indicates that yoga use is
positively related to being White and negatively related to
being Black (Birdee et al., 2008; Bertisch et al., 2009 Graham
et al., 2005;Upchurchetal.,2010). A smaller nationally
representative sample found yoga practice was positively
associated with Japanese, Chinese, and White race/ethnicity
(Gold et al., 2007).These findings are consistentwith those of
convenience samples linking yoga practice to White race
(Desai et al., 2010; Kraemer & Marquez, 2009; Moliver et al.,
2011,2013; Satin et al., 2014). No differences in race or
ethnicity were shown in a smaller nationally representative
sample of CAM practitioners in 1997–1998 (Saper et al.,
2004) or in cancer survivors drawn from theNational Nurses
Health Survey (Buettner et al., 2006) nor in the nationally
representative sample of English yoga practitioners (Ding &
Stamatakis, 2014).
Some studies suggest a fairly equitable distribution of yoga
practitioners across the lifespan, while others indicate a
greater proportion of the middle-aged. In the 2002 NHIS,
the most representative survey of age among US yoga
practitioners to date, 26 % of yoga practitioners were under
age 30; 27 % aged 30–39; 23 % aged 40–49; 20 %, aged
50–64; and 4 %, aged 65 or greater (Birdee et al., 2008).
This pattern was also present in the 2002 NHIS subsample
of people with medical conditions (Bertisch et al., 2008), in
462 J Behav Med (2015) 38:460–471
a smaller nationally representative sample (Conboy et al.,
2005) and in a convenience sample of breast cancer sur-
vivors (Park et al., 2013. However, nationally representa-
tive samples have indicated higher rates of middle-aged
yoga practitioners (Saper et al., 2004), including among
breast cancer survivors in the US (Fouladbakhsh &
Stommel, 2010) and English yoga practitioners in the HSE
(Ding & Stamatakis, 2014). Similar findings were observed
in medical patients in Germany (Cramer et al., 2013a). The
greater prevalence of the middle-aged among yoga prac-
titioners in patient populations may be, in part, attributable
to older age of onset for health-related concerns.
Existing evidence suggests no substantive relationship
between yoga practice and income. However, the most recent
NHIS (2002) indicates that 48 % of yoga practitioners (Birdee
et al., 2008) earned a household income of at least $65,000 per
year, but did not test for statistical significance. The median
income appeared substantially higher among yoga practitio-
ners, given that the median U.S. household income in 2002
was $42,409 (DeNavas-Walt et al., 2003), however no rela-
tionship between income and yoga practice was found inother
studies reviewed here (e.g., Conboy et al., 2005; Saper et al.,
2004). While studies testing for significance did not find an
association, and studies analyzing the 2002 NHIS lack sig-
nificance testing (Birdee et al., 2008; Bertisch et al., 2009),
there may be an association, given the apparently much higher
income of yoga practitioners in the 2002 NHIS.
Yoga practice is strongly and consistently linked with edu-
cation. According to the 2002 NHIS, 50 % of yoga practi-
tioners (Birdee et al., 2008) and yoga practitioners with
medical conditions (Bertisch et al., 2009) have a college
degree relative to 23 % of all non-practitioners (Birdee et al.,
2008). This pattern been replicated in other representative
(Saper et al., 2004) and internationally representative studies
(Ding & Stamatakis, 2014), national (Ross et al., 2012,2013),
regional (Kristal et al., 2005) and convenience samples (e.g.,
Cramer et al., 2013a; Desai et al., 2010;Fouladbakhsh&
Stommel, 2010; Kiecolt-Glaser et al. 2012).
Marital status
Most studies reporting on marital status found no association
with yoga practice (e.g., Buettner et al., 2006;Conboyetal.,
2005; Park et al., 2013). However, one study found yoga
was more likely to be practiced among men who had never
married or who were unmarried but living with a partner
(Kristal et al., 2005). Male yoga practitioners have also been
shown to be about 60 % less likely than females to be
married or living with a partner (Ross et al., 2013).
Sexual orientation
Only one study has explored the relationship between sexual
orientation and yoga use. In a large Northeastern study that
explored CAM use in heterosexual- and lesbian women,
heterosexual women participated in yoga at higher rates than
did lesbian-identified women (Smith et al., 2010).
Summary of demographics and yoga practice
In aggregate, these studies present a picture of the typical yoga
practitioner as female, upper socioeconomic status, educated,
middle-aged and White. The predominance of this profile
among yoga practitioners selecting to practice is likely due to a
combination of opportunity and culture. However, it is impor-
tant to note that only 6.1 % of people in the US reported any use
of yoga for health in the past year in the 2007 NHIS (Barnes
et al., 2008) and on the HSE, only .46 % of people in the UK
reported any use of yoga in the prior 4 weeks (Ding & Sta-
matakis, 2014), indicating that even among predominant
groups, yoga practice has substantial room to grow. Demo-
graphic characteristics may be considered selection effects of
yoga, given that they are unlikely to change due to yoga practice.
Given the increasing evidence of yoga’s potential to
promote health and alleviate suffering associated with
many physical and mental conditions (e.g., Field, 2011),
attention to these demographic factors may elucidate bar-
riers to participation. Investigation of factors both practical
(e.g., financial concerns) and sociocultural (e.g., lack of
role models) associated with low rates of yoga participation
(e.g., among men, some racial minorities, lower income)
may suggest strategies to make yoga more accessible and
appealing to broader swaths of the population. Future
investigation is needed to better understand and capitalize
on the facets that promote yoga in the demographic groups
documented here that most commonly practice yoga. Such
knowledge can inform efforts to encourage greater practice
among diverse groups and those of lower socioeconomic
backgrounds and to develop culturally-appropriate modes
of delivery for yoga practice and interventions.
Relations between psychosocial characteristics and
yoga practice
Interpersonal relationships and social support
Little research has explored links between yoga and social/
relational outcomes. In one convenience sample, Indian
J Behav Med (2015) 38:460–471 463
college students, relative to yoga practitioners, reported
having more satisfying interpersonal relationships and
greater tolerance of others (Monk-Turner & Turner, 2010).
And in a convenience sample yoga practitioners did not
differ significantly in levels of social support from runners
or sedentary controls (Satin et al., 2014).
Three convenience samples have explored relations
between personality and yoga practice, one finding that
Indian yoga practitioners demonstrated lower scores on
neuroticism relative to non-practitioners (Venkatesh et al.,
1994). The second, of German medical patients, found that
high internal health locus of control was positively and
external-fatalistic health locus of control was negatively
associated with yoga practice (Cramer et al., 2013a).
Finally, higher internal locus of control was reported
among college students in India who practiced yoga (Gill
& Kumar, 2014).
In the national survey of Iyengar yoga practitioners, yoga
practice frequency and years of practice independently
predicted mindfulness in multivariate analyses (Ross et al.,
2012). These findings are consistent with findings from one
convenience sample in the Northeastern US in which
beginning yoga practitioners evidenced lower mindfulness
scores than advanced practitioners (Brisbon & Lowery,
2011). A comparison of yoga practitioners to runners and
sedentary individuals found no differences in trait mind-
fulness (Satin et al., 2014).
Life stressors and coping
The few studies that examined stress, coping and yoga
found that yoga may be related to less stress and less
maladaptive coping. In India, yoga practitioners reported
experiencing fewer stressful life events during the past year
than non-practitioners (Venkatesh et al., 1994). However,
among college students, yoga practice was unrelated to a
history of one specific major life stressor, abuse (Dale
et al., 2011). Only one small convenience sample examined
coping styles, reporting that higher dose of yoga practice
was negatively related to dysfunctional coping, but unre-
lated to adaptive coping (Dale et al., 2011).
Several studies report higher levels of spirituality among
yoga practitioners compared to general population norms.
In a UK study of Iyengar practitioners, 83 % described
themselves as having a spiritual life compared to 45 % of
the overall population (Hasselle-Newcombe, 2005). In a
study comparing yoga practitioners to college students, a
higher percentage of yoga practitioners reported expressing
their spirituality appropriately and in a healthy way. No
differences were observed on measures of experiencing
harmony within, being in touch with the soul within,
experiencing self-satisfaction or being content with them-
selves (Monk-Turner & Turner, 2010). Another study of a
convenience sample of yoga practitioners found increasing
length of time practicing was positively correlated with
meaning in life and with gratitude (Ivtzan & Papantoniou,
While UK Iyengar practitioners were more likely to
report being spiritual, they were less likely to report being
‘religious’’ compared to national norms (1 vs. 11 %;
Hasselle-Newcombe, 2005). Among breast cancer survi-
vors, those who practiced yoga were less likely to have a
religious affiliation than were non-practitioners (Buettner
et al., 2006). While all rates of Christian denominations
were lower among yoga practitioners in the UK Iyengar
practitioner study compared to UK national norms, 13 % of
practitioners were Buddhist, as compared to only 1 % of
the UK population (Hasselle-Newcombe, 2005). In a
nationally representative US survey, ‘‘Christian’’ affiliation
was inversely related to yoga practice (Saper et al., 2004).
In contrast, a study in Holland reported that new yoga
practitioners did not differ from the general population in
terms of religious affiliation (Lafaille, 1997).
The relatively high level of spirituality reported among
yoga practitioners is not surprising given yoga’s historical
development within Eastern spiritual traditions. It does,
however, raise the question of whether yoga attracts the
spiritually inclined or whether yoga enhances spirituality.
The literature on spirituality as a motivation for yoga is
limited, although one study reported that 67 % of their
West Coast sample practiced yoga for ‘‘psychospiritual’
reasons (Dittmann & Freedman, 2009), and a convenience
sample of yoga practitioners found that with continued
practice, primary motives for practicing yoga shifted
towards the spiritual (Park et al. in press). Future research
should explore this notion further, perhaps by examining
novice yoga practitioners’ spirituality levels pre and post-
initiation to a yoga practice.
Summary of psychosocial characteristics and yoga practice
Studies reviewed here are generally consistent with the
notion that yoga relates favorably to many psychosocial
factors such as social support, coping, and mindfulness,
but the evidence is based on a handful of results from
464 J Behav Med (2015) 38:460–471
convenience samples. Further, given the current body of
literature, it not possible to determine whether these per-
sonal characteristics are causally related to yoga practice or
whether the relationships are spurious and due to some
underlying third variable.
More research is needed to determine the psychosocial
characteristics of those who choose to practice and how
these characteristics may change with continued practice.
For example, yoga is related to spirituality and religious-
ness, but the nature of these relationships has been seldom
studied empirically. Yoga as it is presently practiced may
not appeal to people of some religious backgrounds, or
might even be perceived as counter to their religion
(Nicholson, 2013). Others who start practicing yoga may
find its spiritual aspects increasingly appealing as they gain
yoga experience (Hasselle-Newcombe, 2005). Under-
standing the role of psychosocial factors is especially
important for developing yoga interventions and creating
outreach programs that appeal to and are effective for
different populations.
Relations between physical and mental health and yoga
Physical health
Health conditions The relationship between yoga and
health conditions is complex, with yoga practice frequently
associated with higher levels of health conditions that it
may also benefit. In a large regional survey (Kristal et al.,
2005) and in the HSE (Ding & Stamatakis, 2014), yoga
practitioners reported being in better overall health than
Nationally representative studies have linked yoga
practice to higher levels of food or odor allergy and hyper-
tension (Bertisch et al., 2008), rheumatoid arthritis (Buettner
et al., 2006), and asthma (Birdee et al., 2008). However, in
the 2002 NHIS, hypertension was inversely related to yoga
practice in multivariate analyses, with no relation observed
between yoga use and neurologic or cardiovascular condi-
tions (Birdee et al., 2008). Among yoga practitioners with
medical conditions in the 2002 NHIS, yoga use was not
associated with history of bowel disease, irregular heartbeat,
or thyroid conditions (Bertisch et al., 2009). In the HSE,
fewer yoga participants than non-yoga participants reported
having physician diagnosed hypertension, diabetes, and
cardiovascular disease (Ding & Stamatakis, 2014).
Several nationally representative studies suggest yoga is
not related to pulmonary conditions (Bertisch et al., 2009;
Birdee et al., 2008; Buettner et al., 2006), but one (Saper
et al., 2004) found yoga practice positively related to lung
problems. In the 2002 NHIS, yoga practice was unrelated
to recency of diagnosis or pain among cancer survivors;
breast cancer survivors were less likely to practice yoga
than were other cancer survivors (Fouladbakhsh & Stom-
mel, 2010) and diabetes patients were less likely to practice
yoga than were those without diabetes (Garrow & Egede,
2006). Several studies have found breast cancer or treat-
ment variables unrelated to yoga practice (Buettner et al.,
2006; Mao et al., 2010).
Yoga may provide relief from some physical symptoms
(e.g., hypertension, asthma), which may partially explicate
both the positive relationship between yoga use and self-
rated health status as well as the number of health condi-
tions with which yoga practice is positively associated. In
attempting to interpret these contrary findings, it should be
noted both that many people turn to yoga for relief of
health problems (Birdee et al., 2008), and that intervention
research generally suggests yoga may be beneficial for a
range of health concerns (Field, 2011).
Musculoskeletal conditions The relationship between
yoga and musculoskeletal conditions is complex. While
some studies indicating generally higher rates of muscu-
loskeletal complaints among yoga practitioners, interven-
tion studies suggest yoga can alleviate such conditions. The
2002 NHIS linked yoga use to higher levels of sprains and
musculoskeletal conditions, even after controlling for a
number of sociodemographic variables (Birdee et al.,
2008). In the subsample of the 2002 NHIS of adults with
medical conditions, yoga practice was associated with
higher levels of neck pain but not joint or back pain
(Bertisch et al., 2009). Compared to non-practitioners, one
study found that yoga practitioners reported more neck and
back pain (Saper et al., 2004). These primarily positive
associations between musculoskeletal conditions may be
because people with these conditions self-select to the
practice as a means of relief or because increased rates of
these health issues result from practice.
Pain unrelated to a specific condition Few studies have
explored non-specific pain in the context of yoga. In the
subsample of 2002 NHIS of adults with medical condi-
tions, yoga use was associated with face pain but not dental
pain or headache (Bertisch et al., 2009). In a recent fMRI
study, North American yoga practitioners tolerated pain
over twice as long as well-matched controls, evidencing
more grey matter in multiple brain regions and increased
left intrainsular white matter integrity (involved in pain
processing). Insula size in yoga practitioners correlated
positively with yoga experience, suggesting a causal rela-
tionship. Relative to controls, yoga practitioners employed
cognitive strategies to tolerate pain, which may have
facilitated the observed increase in insular volume
J Behav Med (2015) 38:460–471 465
(Villemure et al., 2014). Finally, fibromyalgia patients
reported greater pain catastrophizing and pain ratings than
did yoga practitioners and controls. The yoga group did not
differ from healthy volunteers in pain ratings but were
lower in pain reactivity (Bradshaw et al., 2012).
Sleep Research generally suggests that yoga practice is
related to improved sleep. The national survey of Iyengar
yoga practitioners found favorable levels of sleep distur-
bance when compared to the general population and more
frequent yoga practice was positively associated with better
sleep quality, especially when practice was vigorous (Ross
et al., 2013). Convenience samples in India (Bankar et al.,
2013) and Spain (Vera et al., 2009) had better sleep quality
and less sleep disturbance than did controls. However, US
studies found no differences in sleep quality (Kiecolt-
Glaser et al., 2012; Satin et al., 2014).
One analysis of 2002 NHIS data in yoga practitioners
with medical conditions found no association with insomnia
(Bertisch et al., 2009), but analysis of the cancer survivor
subset of these data found that female cancer survivors with
insomnia were less likely to do yoga than those without,
while male cancer survivors with insomnia were more likely
to do yoga than were those without (Fouladbakhsh &
Stommel, 2010). This gender discrepancy may be partially
explicated by the moderating role of depression; for men
with cancer, depression was related positively to yoga
practice, while the opposite was the case for women.
Medication use In several convenience samples, yoga
practitioners reported taking fewer prescribed medications
than did the non-yoga group (Bankar et al., 2013; Moliver
et al., 2011), although one study found no differences
(Kiecolt-Glaser et al., 2012). Adjusting for covariates,
medication use was unrelated to calendar years of yoga
practice, but was inversely related to lifetime hours of
practice (Moliver et al., 2011).
Smoking status Yoga practice has been linked to lower
rates of smoking. One nationally representative study found
17 % of yoga practitioners were current smokers relative to
21 % of smokers in the US population (Bertisch et al., 2009),
while another showed yoga practitioners were less likely
than non-practitioners to use tobacco (Birdee et al., 2008).
This has also been demonstrated in national (Birdee et al.,
2008; Gold et al., 2007; Kristal et al., 2005; Ross et al., 2013)
and convenience (e.g., Cramer et al., 2013a) samples.
Lower rates of smoking among yoga practitioners are
consistent with smoking reductions observed in yoga pro-
gram participants relative to controls following yoga
training (Bock et al., 2010). Yoga may prompt reductions
in smoking through a number of pathways. For example,
breathwork (pranayama) may render practitioners more
mindful of limited lung capacity and engender an increased
desire to quit. Alternately, selection effects may play a role,
with those drawn to yoga practice being more oriented to
healthy lifestyles and less likely to use tobacco.
Alcohol consumption The relationship between alcohol
consumption and yoga practice is unclear. In the 2002
NHIS, yoga practitioners reported higher alcohol con-
sumption than non-practitioners, particularly moderate and
heavy use (Birdee et al., 2008). However, in the national
survey of Iyengar practitioners, higher frequency of prac-
ticing gentle poses—but not other aspects of yoga prac-
tice—was associated with less alcohol consumption (Ross
et al., 2012). In a convenience sample (Kiecolt-Glaser
et al., 2012), investigators found no differences in alcohol
intake between experienced and novice yoga practitioners.
Additionally, the 2002 NHIS findings indicate a strong
positive link between yoga practice and alcohol con-
sumption. It is unclear whether there is a causal linkage and
if so, in which direction it runs.
Diet Multiple national and regional surveys (Gold et al.,
2007; Kristal et al., 2005; Palasuwan et al., 2011; Ross
et al., 2012) have linked yoga participation to healthy
dietary habits. However, this association was not observed
in a convenience sample comparing yoga novices to
experts (Kiecolt-Glaser et al., 2012), suggesting selection
rather than causal effects.
In a large sample of middle-aged adults, yoga practi-
tioners consumed greater energy (Kristal et al., 2005). In
the national survey of Iyengar yoga practitioners, nearly
10 % followed a vegetarian diet (no meat, fish, or poultry),
nearly four times the general US population (Ross et al.,
2013). A third nationally representative study found higher
rates of the beneficial soy phytoestrogen genistein among
yoga practitioners relative to non-practitioners (Gold et al.,
2007). Data from a convenience sample of mind–body
practicing females in Thailand indicated that yoga practi-
tioners also consumed less fat than did those who were
sedentary or who practiced Tai Chi (Palasuwan et al.,
2011). Yoga practitioners reported consuming a signifi-
cantly higher proportion of recommended servings from
each food group than did a comparison group of college
students (Monk-Turner & Turner, 2010). Compared to
runners and sedentary individuals, yoga practitioners were
significantly less likely to eat meat (Satin et al., 2014).
Healthy dietary behaviors have been related to
frequency of yoga practice (Kristal et al., 2005;
466 J Behav Med (2015) 38:460–471
Ross et al., 2012) and longer practice duration (Kristal et al.,
2005). In the national survey of Iyengar practitioners, daily
fruit and vegetable servings were positively associated with
frequency of home practice and gentle and standing yoga
postures. More frequent practice of gentle postures, home
practice, and study of yoga philosophy were positively
linked to vegetarian status (Ross et al., 2012).
Exercise The HSE observed a lower likelihood of occu-
pational physical activity but higher non-occupational
moderate to vigorous physical activity among English yoga
practitioners when compared to non-practitioners in a
multivariable model (Ding & Stamatakis, 2014). Other
studies generally report positive associations between yoga
practice and non-yoga exercise. In a nationally represen-
tative study of US adults with medical conditions, 65 % of
yoga practitioners engaged in vigorous and 25 % in mod-
erate exercise, while 10 % were sedentary (Bertisch et al.,
2008). Studies of large regional and smaller convenience
samples suggest that yoga practitioners report higher rates
of exercise than do non-practitioners. In a large sample of
adults from the Northwestern US, yoga practitioners
engaged in substantially more non-yoga physical activity
than did non-practitioners (Kristal et al., 2005). A higher
percentage of yoga practitioners than college students
reported maintaining fitness through exercise and weight
control and doing exercises to maintain range of motion
(Monk-Turner & Turner, 2010). Yoga practitioners have
also been found to exercise more than healthy controls or
fibromyalgia patients (Bradshaw et al., 2012).
In a comparison of female aerobics and yoga class
participants from Poland and Canada, Polish yoga students
reported less exercise motivation in terms of weight man-
agement relative to all other groups, and yoga students of
both nationalities reported more exercise motivation for
stress management and positive health relative to both
aerobics groups (Zajac & Schier, 2011). In an Australian
sample of exercisers, yoga practice was inversely related to
exercise motives related to appearance, positively to
health/fitness motives, and unrelated to mood/enjoyment
motives (Prichard & Tiggemann, 2008). Finally, yoga
practice was unrelated to physical activity rates or exercise
self-efficacy in a convenience sample of older adults
(Kraemer & Marquez, 2009), but yoga practice frequency
related positively to levels of non-yoga physical activity in
a large sample of adults from the Northwestern US (Kristal
et al., 2005).
BMI and body weight In analyses of the 2002 NHIS
(Birdee et al., 2008; Bertisch et al., 2008) and HSE (Ding
& Stamatakis, 2014), national/regional surveys (Ross et al.,
2012,2013; Kristal et al., 2005), and convenience samples
(Desai et al., 2010; Palasuwan et al., 2011; Moliver et al.,
2011), yoga practitioners reported lower BMI relative to
non- practitioners. These findings have generally replicated
in the US convenience samples (Daubenmier, 2005; Desai
et al., 2010; Framson et al., 2009; Moliver et al., 2011) and
Thailand (Palasuwan et al., 2011). Among breast cancer
survivors, yoga use predicted lower BMI in multivariate
regression analysis (Desai et al., 2010). Three notable
exceptions failed to observe differences in weight or BMI:
yoga experts versus novices (Kiecolt-Glaser et al., 2012),
those practicing yoga for physical versus psychospiritual
reasons (Dittmann & Freedman, 2009), and walkers versus
yoga practitioners (Kraemer & Marquez, 2009).
Most studies indicate that yoga practice was linked to
lower BMIs and attenuated weight gain over time, but data
are unclear on selection versus causal effects. That is, yoga
may facilitate weight loss among the overweight, or people
of lower BMI may be more attracted to yoga practice.
Suggestively, in the national survey of Iyengar yoga
practitioners, frequency of yoga practice, yoga philosophy
study, home practice, and engagement in vigorous postures
each independently predicted BMI (Ross et al., 2012).
Mental health status
Disordered eating, body image, and related outcomes In
convenience samples, yoga practice is consistently linked
with body satisfaction. Compared to aerobic exercisers and
controls, yoga practitioners demonstrated greater body
awareness, responsiveness, and satisfaction and less self-
objectification. Practitioners also had lower disordered
eating attitudes than did the aerobics group (Daubenmier,
2005). Higher body satisfaction was also observed among
women practicing yoga for psychospiritual relative to
physical reasons in a sample of yoga practitioners from the
Western US, although no differences were observed
between groups on body image issues (Dittmann &
Freedman, 2009). These findings are consistent with lower
body image dysphoria observed among Polish yoga prac-
titioners, compared to Canadian yoga practitioners and
Canadian and Polish yoga aerobic exercisers (Zajac &
Schier, 2011). In a Northeastern US sample, self-rated yoga
expertise was not related to satisfaction with body parts,
but did positively relate to body awareness and shape
(Delaney & Anthis, 2010).
Several studies have also linked length and frequency of
yoga practice to body and eating-related constructs. In yoga
practitioners from the Northeastern US, frequency of
practice was negatively related to objectified body con-
sciousness but unrelated to eating attitudes or satisfaction
with body parts. Additionally, length of time participants
J Behav Med (2015) 38:460–471 467
had been attending class positively with body awareness
(Delaney & Anthis, 2010). Less self-objectification and
greater body satisfaction was linked with yoga experience
(weekly hours practiced and expertise) (Daubenmier,
2005). Similarly, amount of yoga practice was negatively
related to self-objectification but unrelated to body esteem
or disordered eating in an Australian sample (Prichard &
Tiggemann, 2008). Frequency of practice also predicted
more positive bodily experience in new practitioners in
Holland (Lafaille, 1997). Finally, length and frequency of
yoga practice have been linked to higher mindful eating
scores (Framson et al., 2009).
Anxiety, depression, distress, subjective well-being, and
life satisfaction Data on mental health and subjective
well-being in relation to yoga is complex. In the 2002
NHIS, yoga practice was inversely related to general
mental health in the entire sample (Birdee et al., 2008) and,
in the subsample with medical conditions, was positively
linked to anxiety and depression (Bertisch et al., 2009). In
cancer survivors in the 2002 NHIS, yoga practitioners had
higher contacts with mental health professionals than did
non-practitioners (Fouladbakhsh & Stommel, 2010).
Convenience samples yield contradictory findings: In
the German medical patient sample, anxiety was positively
associated with yoga (Cramer et al., 2013a), but a follow-
up of the same sample comparing the sub-sample of yoga
practitioners to well-matched controls, no differences in
anxiety, depression, life satisfaction, or health satisfaction
were observed (Cramer et al., 2013a). Comparisons with
non-practitioners found lower anxiety among yoga practi-
tioners in India (Venkatesh et al., 1994), and lower tension-
anxiety, anger-hostility, fatigue, and overall mental dis-
turbance (but not depression or confusion) in Japan (Yo-
shihara et al., 2011). In the US, yoga practitioners had more
depression than did walkers (Kraemer & Marquez, 2009)
and sedentary individuals, but not runners (Satin et al.,
2014). With respect to dose, in Iyengar practitioners, fre-
quency of philosophy study and meditation positively
correlated with subjective wellbeing and lower fatigue
(Ross et al., 2012).
Relations between mental health and yoga are complex.
Some studies associated yoga practice with elevated rates
of mental health conditions, while others demonstrated the
opposite. Existing data are inadequate to determine whe-
ther relationships are due to initiation of yoga practice to
alleviate distress, yoga practice resulting in distress, or
some underlying third variable. Lending support to the
former, the 2002 NHIS found that one of the most com-
monly-cited reasons for yoga use was treatment of mental
health conditions (Birdee et al., 2008).
Stress These results indicate that yoga practitioners gen-
erally have higher HRQOL, although the samples on which
this conclusion is drawn are highly select. These findings
contrast with other studies showing higher levels of mental
and physical dysfunction in yoga practitioners. This dis-
crepancy may be due to the tendency of quality of life
measures to tap a subjective sense of satisfaction with
one’s status rather than an objective index of functionality
(Cella, 1994).
Health-Related Quality of life (HRQOL) Yoga practitio-
ners generally report better HRQOL. In a large, nationally
representative sample of breast cancer survivors in the US,
yoga practice was associated with higher physical HRQOL
but unrelated to mental HRQOL (Buettner et al., 2006).
The nationally representative HSE also indicated higher
self-reported health in yoga practitioners (Ding & Sta-
matakis, 2014). Consistent with these findings, a conve-
nience sample of middle-aged adult cancer survivors found
that those who practiced yoga had poorer mental HRQOL
than non-users, although physical HRQOL did not differ
between groups (Park et al., 2013), However, frequency of
yoga practice related positively to mental, but not physical,
HRQOL (Park et al., 2013). Among medical patients in
Germany, yoga practitioners reported better general health
status and higher physical HRQOL (Cramer et al., 2013b).
Finally, a convenience sample found Indian yoga practi-
tioners had better physical functioning, self-care, social
functioning, and cognitive functioning scores than non-
practitioners (Bankar et al., 2013).
These results indicate that yoga practitioners generally
have higher HRQOL, although the samples on which this
conclusion is drawn are highly select. These findings
contrast with other studies showing higher levels of mental
and physical dysfunction in yoga practitioners. This dis-
crepancy may be due to the tendency of quality of life
measures to tap a subjective sense of satisfaction with
one’s status rather than an objective index of functionality
(Cella, 1994).
Summary of physical and mental health of yoga practitio-
ners Findings in this area are contradictory. Yoga prac-
tice often relates to subjective variables such as HRQOL or
life satisfaction, yet also with higher levels of depressive
symptoms, anxiety, and physical impairment. However,
yoga practice favorably relates to most health behaviors.
The few studies examining length or frequency of practice
suggest that a stronger ‘‘dose’’ of yoga might be related to
better health and that cross-sectional studies demonstrating
inverse relations between yoga and health may reflect
468 J Behav Med (2015) 38:460–471
turning to yoga in a search for relief from specific health
General discussion
In spite of the hundreds of published empirical studies of
yoga, only 55 studies reported correlates of yoga practice
in naturalistic contexts. Of these, a number of nationally
representative studies (of the US and England) have
reported on sociodemographics and health; far fewer have
examined psychosocial correlates, and of these, most used
very select samples, limiting generalizability. In aggregate,
these studies have shown that yoga practitioners are gen-
erally White, of upper socioeconomic status, and middle-
aged. There is evidence of higher levels of mindfulness and
spirituality and lower levels of conventional religiousness.
Yoga use relates to better life satisfaction and HRQOL but
inversely to some indices of physical and mental health.
However, upon closer scrutiny, these studies provide lim-
ited meaningful information on correlates of yoga aside
from basic demographics. The largest and most represen-
tative studies have dichotomously assessed whether
respondents ‘‘use yoga’’ (yes/no) rather than assessing
characteristics of that use (e.g., length, frequency, type of
yoga). Such studies illustrate demographic correlates, but
are less helpful in understanding other important issues,
such as how yoga practice relates to well-being. Smaller
and less representative studies have included a heteroge-
neous array of psychosocial characteristics, limiting
aggregation. Most studies are cross-sectional and report
bivariate relations rather than controlling for potential
confounds. Magnitude of associations between yoga prac-
tice and other variables are often reduced or disappear
when accounting for education or income (Birdee et al.,
2008). Large national studies, which often do control for
demographics, assess yoga use dichotomously and include
few psychosocial variables, and are thus minimally infor-
mative regarding causal models.
Our summary produced a muddy picture not wholly
consistent with intervention research, which may be due to
the many reciprocal influences of yoga use and well-being.
For example, people commonly begin a yoga practice for
health problems (Birdee et al., 2008). Yoga may be
effective only if practiced regularly; dichotomous measures
capture both regular practitioners and those who tried yoga
once. Mental and physical health problems are often
comorbid, so seeking relief from physical conditions may
partly account for inverse relations with well-being. People
who resolve a particular health condition may discontinue
practice while those with ongoing health problems may
continue to practice. Such complex relationships call
for more complex research methods. The few studies
examining yoga characteristics such as frequency or prac-
tice length suggest that yoga may lead to better health over
time, consistent with much intervention research (e.g.,
Field, 2011). Also encouraging are studies that examined
yoga in a more sophisticated way. Ross et al. (2012,2013)
is exemplary in measuring many components of yoga
practice (e.g., home and class practice; yoga philosophy,
breathwork, meditation, intensity of postures). Many
important questions remain, such as what factors that lead
people to practice yoga or dissuade them from it, or keep
people practicing over time? How do different aspects of
practice relate to physical and mental health? This sum-
mary can serve as a springboard for future research and a
resource for designing and implementing interventions.
Conflict of interest Crystal L. Park, Tosca Braun and Tamar Siegel
declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent All procedures
followed were in accordance with ethical standards of the responsible
committee on human experimentation (institutional and national) and
with the Helsinki Declaration of 1975, as revised in 2000. Informed
consent was obtained from all patients for being included in the study.
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... The findings of the U.S. National Health Interview Survey suggest that women compared with men and non-Hispanic White adults compared with Hispanic and non-Hispanic Black adults were more likely to practice yoga and meditation. 2 A systematic review found that individuals who reported yoga practice were generally White, of upper socioeconomic status, and middle aged, and there were higher levels of mindfulness and spirituality among the yoga practitioners. 21 Contrary to these findings, a large cross-sectional survey from India found that individuals who reported yoga practice were more likely to be male, between 21 and 44 years of age, high school educated, and a student. 22 The systematic review noted that most research on yoga (except the national surveys above) has focused on determining its effects, often relying on experimental designs or clinical trials that failed to provide the characteristics of individuals who elect to practice yoga when they have not been assigned to do it as part of a trial or experiment. ...
... 22 The systematic review noted that most research on yoga (except the national surveys above) has focused on determining its effects, often relying on experimental designs or clinical trials that failed to provide the characteristics of individuals who elect to practice yoga when they have not been assigned to do it as part of a trial or experiment. 21 The understanding of who practices yoga, especially when these characteristics differ across contexts, is useful in developing yoga interventions tailored to appeal to different groups. 21 Of the 55 studies included in the above review, none were related to yoga during pregnancy. ...
... 21 The understanding of who practices yoga, especially when these characteristics differ across contexts, is useful in developing yoga interventions tailored to appeal to different groups. 21 Of the 55 studies included in the above review, none were related to yoga during pregnancy. This might be due to exclusion of studies that assessed yoga practice as part of broader complementary and alternative medicine (CAM) practices. ...
The practice of yoga is beneficial during pregnancy, but we do not know what proportion of pregnant women in India practice yoga. To address this research gap, we conducted a study to address following research questions: (1) What proportion of pregnant women in rural Maharashtra practice yoga? (2) Which sociodemographic factors are associated with the practice of yoga among these women? and (3) What is the perceived acceptability of integrating yoga-based intervention into routine antenatal care? A consecutive sample of pregnant women attending the antenatal clinic of a tertiary care hospital, who could fluently communicate in Marathi and who did not have any serious physical illness or cognitive impairment, were included in this cross-sectional survey. A total of 228 subjects were included in our study. Yoga was practiced by 38 of them (16.7%, 95% confidence interval 12.1–22.1) during the current pregnancy. Older age, higher education, and being a professional (teacher, healthcare provider, or bank official) were associated with practice of yoga. More than half of the participants (53.9%) thought that yoga should be included as part of their antenatal care; this perceived acceptability of yoga was not associated with any of the sociodemographic factors except for the participants’ occupation. This study provides information about the prevalence and sociodemographic factors associated with the practice of yoga among pregnant women in a rural setting in India. It also explores the perceived acceptability of yoga-based interventions among this group. Findings from this study can inform design of future studies to evaluate the effect of yoga-based interventions during pregnancy.
... Additionally, interventions that include mindfulness (and/or self-distancing and/or self-compassion) should be tested as possible interventions for the rumination to health behavior relationship. For example, yoga has been shown to increase self-distancing (Shelov & Suchday, 2009), and is increasing in popularity among college students (Gaskins et al., 2014;Park et al., 2015). Sustainable systems for selecting efficacious intervention approaches are needed. ...
Rumination, self-focused thinking about events and emotions negatively and repeatedly, is a common cognitive process that leads to maladaptive health behaviors. Because mindfulness has been shown to reduce the negative psychological effects of rumination in other studies, we posited that it may buffer the association between rumination and maladaptive health behaviors. We tested this hypothesis in two online daily diary studies with college students. Health behavior outcomes included fruit intake, vegetable intake, exercise, alcohol intake, sexual risk-taking behavior, and cigarette smoking. In Study One (N = 285), multivariate modeling analyses demonstrated that trait mindfulness was not a significant moderator of daily rumination to health behavior relationships. In Study Two (N = 157), daily self-compassion and daily self-distancing—but not daily mindfulness—were significant within-person moderators of daily rumination to daily health behaviors. Self-compassion and self-distancing were buffers of the negative effects of rumination on health behaviors. The implications of this research and application to interventions are discussed, including mindfulness interventions that emphasize self-distancing or self-compassion component.
... The practices of yoga and mindfulness emphasize a moment-by-moment, non-judgemental awareness of, and connection to, the mind and body through movement, breathing, and meditation (Iyengar, 1977;Kabat-Zinn, 2017;Pascoe et al., 2017). The external aspects of self (i.e., family, community, and culture) are cultivated through psychoeducation on the sociocultural causes of eating disorders, the pillar of embodied intimacy (Cook-Cottone, 2015b;Park et al., 2015;Piran, 2016a) and completion of a service project. The didactic, cognitive elements are focused around increasing individuals' awareness and critical thinking of societal pressures to attain ideals of attractiveness and fostering life skills for improved functioning (i.e., media literacy, stress management, self-regulation; Cook-Cottone, Beck, & Kane, 2008;Scime & Cook-Cottone, 2008;Starkman, 2016;Talebkhah & Cook-Cottone, 2020). ...
Evidence positions yoga as a promising intervention for enhancing positive embodiment and supporting the prevention of, and recovery from, eating disorders (EDs) by reducing ED symptomatology and building skills that facilitate an ongoing, embodied sense of wellbeing. However, yoga-based programs are few and rigorous literature on their efficacy is limited. This study examined the efficacy and feasibility of a yoga-based program called Eat Breathe Thrive (EBT) which aims to prevent EDs and support embodiment. Participants (N = 168, 93.5 % women) from a community sample in the United States and United Kingdom, ages 18–65, were randomly allocated to a 2-h, 7-week EBT program or waitlist-control condition. Compared to controls, EBT participants experienced significant decreases in ED behaviors, depression, and difficulties regulating emotions. They reported significantly greater use of mindfulness skills, such as interoceptive awareness, mindful self-care, and mindful eating. After a single session, participants reported immediate improvement in their sense of well-being, indicating increased state positive embodiment. Most effects were sustained at 6-month follow-up. The majority of individuals attended most sessions. Self-reported treatment integrity was excellent. Directions for future research are proposed. Results support the efficacy and feasibility of an integrated yoga intervention that fosters positive ways of inhabiting the body.
... Yoga ist in die allgegenwärtige Konsumkultur eingebettet. Daten aus einer Umfrage des Yoga Alliance-Yoga Journal 4 porträtiert eine Yoga-Szene in "Westen", die aus überwiegend jungen, weißen (4/5), weiblichen (75-82%) 5 , einkommensstarken, gebildeten, schlanken Nutzerinnen ohne BeHinderungen besteht (Park et al., 2015). ...
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A critical examination of the coloniality of yoga and the search for ways for its decolonization.
... There are several limitations to the current study. First, while our study sought to recruit equal numbers of women and men, men did not participate at the same rate as women, likely a result of yoga appealing mostly to women [38]. Second, we partnered with a company with commercially available mobile apps, which allowed us to evaluate the efficacy of app-delivered programs that can be delivered at scale. ...
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Pneumonia resulting from SARS-CoV-2 infection is characterized by the development of certain radiological patterns such as “ground glass” and others, which can only be detected using high-resolution computed tomography (HRCT) of the chest. The use of CT to combat the coronavirus disease (COVID-19) pandemic varies worldwide. In scientific publications, there is no consensus on the information content of CT for COVID-19 pneumonia, the timing of its implementation at the onset of the disease and control examinations. The long-term consequences of the disease, the possibilities of software processing of CT images of the chest cavity in order to study the dynamics of the process, predict outcomes and evaluate the effectiveness of the therapy, have not been sufficiently studied. The analysis of CT for COVID-19 pneumonia with the “ground glass” pattern showed that standard densitometry does not allow to determine the morphofunctional difference between the studied areas of “ground glass” and to determine the stage of its development. The segmentation histogram based on digital software processing of the same “ground glass” areas of the patient with COVID-19 pneumonia has changed significantly with a clear definition of a significant difference in the density of the pattern in dynamics, on the basis of which it can be concluded that the patient is undergoing a process of recovery and COVID-19 pneumonia is at the resolution stage. Carrying out digital software image processing with a CT segmentation histogram allows you to determine the dynamics and stage of development of COVID-19 pneumonia, evaluate the effectiveness and need for therapeutic measures. In order to conduct an objective control of the inflammatory process in COVID-19 pneumonia, it is necessary to conduct a HRCT of the chest at discharge from the hospital, especially in patients who were treated in the intensive care unit. If there are significant changes, follow-up studies should be carried out after 3 and 6 months, or depending on clinical indications.
... Among these, specifically yoga exercise has found its way into many exercise routines. Considering the last 10 years, there has been a constant increase of people, who self-report to practice yoga regularly as a weekly leisure time activity or as a health routine (e.g., Park et al., 2015;, 2020). In line with these trends, yoga has been implemented as a complementary or adjuvant therapy, for example in the treatment of eating disorders, depression, post-traumatic stress disorder, or anxiety (e.g., Hendriks et al., 2017;Meister and Becker, 2018) to name but a few examples. ...
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Exercise is indispensable for a healthy lifestyle. Yoga exercise can have positive effects on well-being and on cardiac autonomic activity making it an ideal intervention for improving mind-body interactions and resilience to physical and mental stressors. Emotions trigger especially strong bodily and affective-cognitive responses because of their social relevance for the self and their biological relevance of mobilizing the organism for action. This study investigates whether changes in emotion processing related to self-other referential processing and changes in cardiac autonomic activity, reflected by heart rate variability (HRV), occur immediately after already a single session of yoga exercise when yoga postures are practiced with or without breathing- and mindful body awareness instructions. Women, all university students ( N = 34, final sample: n = 30, n = 25 naïve to yoga practice) were randomly assigned to two experimental groups who performed the same yoga exercises with or without controlled breathing and mindfulness instructions. Emotional, self-other referential processing, awareness of bodily signals and HRV indicators were investigated before and after the exercise using standardized experimental tasks, standardized questionnaires, and mobile recording devices. Exercising for 30 minutes changed cardiac activity significantly. HRV measures showed adaptability of cardiac activity during the exercise as well as during the affective task post- to pre-exercise. Exercising with breathing instructions and mindful body awareness had no superior effects on cardiac, particularly parasympathetic activity, compared to practicing the same movements without such explicit instructions. Self-referential processing did not change; however, participants were faster and more accurate in their affective judgments of emotional stimuli [regardless of their reference (self/other)], and showed better awareness of bodily signals after compared to before the exercise session. The results support immediate, adaptive effects of yoga exercise on cardiac and affective-cognitive processing in an all-female healthy sample. Therefore, yoga exercise could be recommended as a physical activity for boosting cardiac and emotional resilience in this target group.
... 12,[17][18][19] , this study showed a positive association between physical activity, daily Yoga practice and SA. In a systematic review Yoga practice was found to be associated with better subjective health and health behaviours 35 . Research has provided evidence that physical activity improves health 19,36 , prevents several chronic conditions 19 , is beneficial to mental health 37,38 , and increases life satisfaction 39 , cognitive functioning 40,41 , and functional ability 19,40 , all of which may contribute to better SA. ...
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This study aimed to determine the prevalence and correlates of successful ageing in older community-dwelling adults in India. The cross-sectional sample included 21,343 individuals (≥ 65 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017–2018. Successful ageing was assessed utilizing a multidimensional concept, including five components: (1) absence of major illness, (2) free of disability, (3) no major depressive disorder, (4) social engagement and (5) life satisfaction. Overall, 27.2% had successful ageing, including 83.3% had no major diseases, 51.0% free from disability, 91.8% had no major depressive disorder, 73.6% were socially engaged and 74.6% had high life satisfaction. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR 1.40, 95% Confidence Interval-CI 1.21–1.26), married (AOR 1.48, 95% CI 1.22–1.79), having formal education (AOR 1.47, 95% CI 1.23–1.74), high subjective socioeconomic status (AOR 1.61, 95% CI 1.29–2.01), urban residence (AOR 1.42, 95% CI 1.19–1.70), Sikhs (AOR 1.76, 95% CI 1.38–2.24), high physical activity (AOR 1.65, 95% CI 1.38–1.97), and daily Yoga practice (AOR 1.34, 95% CI 1.11–1.61) increased the odds of successful ageing, while increasing age (AOR 0.96, 95% CI 0.94–0.79), poor childhood health (AOR: 0.47, 95% CI 0.29–0.75), and underweight (AOR 0.70, 95% CI 0.61–0.81) decreased the odds of successful ageing. Almost one in three older adults in India were successfully ageing. Factors associated with successful ageing included, male sex, married, having formal education, high subjective socioeconomic status, urban residence, Sikhs, physical activity, Yoga practice, younger age, good childhood health, and not having underweight.
This article explores how consumer practices tether Orientalism to wellness. Relying on ethnographic research, the author uncovers how racialization and racialized expressions of gender are produced by and through performative and discursive practices of wellness. Such practices, which are also sometimes described as mindfulness techniques, encourage participants to understand wellness as a state of mind wherein if a person mirrors the behavior or speech of what qualifies as wellness, then they will also become well themselves. Drawing on methods from critical consumer studies as well as critical race feminist theory, the author argues that contemporary wellness practices expose somatic, rather than literary, forms of Orientalism.
Yoga is a spiritual discipline originating from ancient India. Most notably, yoga has links with Hinduism, Buddhism, and Jainism. This research explores UK yoga teachers’ attitudes toward plant-based diets and beliefs about the moral status of farmed animals. It uses qualitative interviews as the second phase of a mixed-methodology study. In the first phase, an online questionnaire found that over two thirds of UK yoga teachers believed a plant-based diet was most aligned with their yoga practice due to the teaching of ahimsa, or non-harm. Nevertheless, over 70 % were not following a plant-based diet. Interviews revealed this dissonance was related to views about the necessity of consuming animal products for health, especially when pregnant, breastfeeding, or nourishing growing children. The communal nature of eating also meant that family moderated dietary ideals. Interviews further revealed an alternative conception of ahimsa, permitting the consumption of animals in order to prioritize personal non-harm.
Background The use of complementary and alternative medicine, particularly yoga is increasing in non-communicable diseases (NCDs). We assessed the overall awareness regarding yoga among patients and their opinion about it as an adjunct therapy for NCDs. Methods We included 384 patients attending the cardiology and neurology clinics at a tertiary care centre in northern India. A questionnaire was developed to assess the knowledge, attitude and practice of yoga as a therapy. Results Ninety per cent of patients were aware of yoga, mainly through print and electronic media. Of the surveyed patients, 22% practised yoga. Lack of time and knowledge were cited as the main reasons for non-practice among the non-practising patients (88%), of which 82% believed that yoga could be practised along with modern medicine. In addition, 61% were ready to accept treatment if offered at the surveyed tertiary care centre. Conclusions Adequate knowledge, awareness and attitude towards yoga appears to be present in contrast to the low practice among the patient population surveyed. If implemented in an integrated fashion, the patients were willing to accept yoga as an adjunct therapy for their cardiac and neurological disorders—an encouraging sign given the burden of NCDs in India.
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Aim. This study examined body image dysphoria and motivation to exercise among canadian and Polish women practicing aerobics or yoga. Participants and method. Female participants (N=138), recruited for this study from fitness centres and yoga studios, completed measures of body image (Situational Inventory of Body Image Dysphoria) and motivation to exercise (Exercise Motivation Inventory-2). results. Results showed that Polish yoga participants scored significantly lower on negative body relat-ed emotions experienced in specific situational contexts than the remainder of participants. Also, motiva-tion to exercise differed between participants of yoga and aerobics. canadian and Polish women were found to pursue exercise for different reasons. Conclusions. These results indicate the interplay of cultural and motivational factors with relation to body image.
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The present study aims to explore the existence of a relationship between the extent of yoga practice and two dimensions of psychological wellbeing: meaning in life and gratitude. Both of the variables are positive psychology constructs; there is theoretical affinity and empirical evidence that they are related to overall psychological wellbeing. One hundred and twenty four participants aged 18 years and above, with yoga experience ranging from none to over six years, responded to a number of scales. The extent of yoga practice was measured by the number of years during which individuals practiced yoga at least two times a week. Participants responded to the following scales: MLQ (Meaning in Life Questionnaire) and GQ-6 (Gratitude Questionnaire). This study hypothesised that the number of years practicing yoga would be positively correlated to the score obtained on the aforementioned scales. Positive correlations were identified between the extent of yoga practice and meaning in life and gratitude. Important implications regarding the contribution of yoga to both hedonic and Eudaimonic happiness are discussed.
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Yoga is a holistic practice that may offer several health benefits. No study has examined the prevalence, temporal trends, or correlates of yoga practice at the population level in a European country and very few such studies exist worldwide. The objective of the study is to examine the prevalence, trends and correlates of yoga practice in England between 1997 and 2008. Analysis was conducted in early 2013 using Health Survey for England data. Independent cohorts, representative of adults living in England, were surveyed in annual cycles in 1997-1999, 2003-2004, and 2006/2008. Prevalence of yoga practice (defined as any practice in the past four weeks) was determined at each time point and multiple logistic regression was used to examine temporal trends (using 1997-1999 as reference time point) and the correlates of yoga practice. The prevalence of yoga practice was 0.46% (95%CI: 0.39%-0.52%) in 1997-1999, 0.94% (0.83%-1.06%) in 2003-2004, and 1.11% (0.95%-1.28%) in 2006/2008. Yoga participants in England were more likely to be older, female, degree educated, of non-manual social class, lower BMI, better self-rated general health, inactive occupation, and higher moderate-to-vigorous physical activity. Adjusted for age, sex, social class, and long standing illnesses, there was a significant increasing trend of yoga practice from 1997 to 2008 (2003/04 OR = 1.93, 95%CI: 1.59-2.34; 2006/08 OR = 2.19, 95%CI: 1.77-2.71). Yoga practice has increased in popularity, though the absolute rates are still relatively low. Future population studies should more comprehensively examine the contexts, settings, styles, correlates and health benefits of yoga practice.
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The evidence of cardiovascular benefits of yoga is promising, but lacks demonstrations of specificity compared to other interventions. The present cross-sectional study examined cardiovascular health markers in long-term practitioners of yoga (yogis), runners, and sedentary individuals. We compared physiological, psychological, and lifestyle variables associated with cardiovascular health across groups. Yogis (n = 47) and runners (n = 46) showed favorable profiles compared to sedentary individuals (n = 52) on heart rate, heart rate variability, depression, perceived stress, and cigarette smoking. Runners and male yogis showed superior aerobic fitness compared to the sedentary group. Runners reported greater social support compared to other groups. Yogis demonstrated a lower respiration rate compared to sedentary individuals and were more likely to refrain from eating meat compared to other groups. Yogis and runners demonstrated several cardiovascular health advantages over sedentary individuals. Our findings raise the possibility that yoga may improve aerobic fitness in men but not women.
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Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50--64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.
This study examined the relationship between women's participation in different types of Yoga classes and different facets of body image. Ninety-two women at five different sites of Yoga instruction completed assessments of Yoga experience, internalization of Yoga principles, body satisfaction, body awareness, body consciousness, and eating attitudes. Yoga experience was coded according to months/years of practice, self-rated expertise, and how much the classes attended emphasized the "mind" aspects of Yoga (e.g., meditation, breathing, mindfulness, and chanting) as well as the "body" aspects (postures, fitness). Participants in Yoga classes that included more emphasis on the mind showed significantly greater levels of internalizing the teachings of Yoga, as well as greater body awareness and satisfaction. Greater experience with Yoga was associated with lower objectified body consciousness. Greater internalization of Yoga principles was associated with greater body satisfaction and sense of control of the body. Greater self-rated expertise in Yoga was associated with greater body awareness and fewer body shape concerns. None of the Yoga measures was significantly associated with the Eating Attitudes Test, which is designed to measure attitudes and behaviors associated with eating disorders. Although correlational, the results of this study suggest that further attention be paid to how the psychological benefits of Yoga differ across different types of Yoga classes. Future experimental research on the psychological benefits of Yoga should examine the importance of emphasizing a fully integrated mind-body practice rather than only the fitness aspects of Yoga.
This contribution to the Common Knowledge symposium “Fuzzy Studies” explores the boundaries between religions by exploring the ambiguous place of yoga in various religious traditions, both modern and premodern. Recently, certain Hindus and Christians have tried to argue that yoga is an essentially Hindu practice, making their case by appealing to the Yoga Sutras, a text by the Sanskrit author Patanjali. However, on closer examination, the Yoga Sutras seem to exist in a fuzzy, indeterminate space that is not quite “Hindu” in the way the word is understood today. For instance, other Sanskrit authors of the first millennium CE criticized Patanjali’s yoga teachings for not being properly theistic and for having strong affinities to Buddhism and Jainism. Yoga was also integrated into at least one of the “religions of the book” in the medieval period: in India in the second millennium, yoga was practiced widely among Sufis, who adapted it in surprising and idiosyncratic ways to make it compatible with their own Islamic philosophies. Nicholson concludes with an appeal for a more nuanced understanding of religious contact that goes beyond the pejorative term syncretism to acknowledge that religious mixing has been a central force in the development not only of Hinduism and Islam, but also of Christianity.
To describe yoga practice and health characteristics of individuals who practice yoga, and to explore their beliefs regarding the effects of their yoga practice on their health. A cross-sectional design with anonymous online surveys. 4307 randomly selected individuals from 15 US Iyengar yoga studios (n=18,160), representing 41 states; 1087 individuals responded, with 1045 (24.3%) surveys completed. Freiberg Mindfulness Inventory, Mental Health Continuum (subjective well-being), Multi-factor Screener (diet), PROMIS sleep disturbance, fatigue, and social support, International Physical Activity Questionnaire. Age: 19-87 years (M=51.7±11.7), 84.2% female, 89.2% white, 87.4% well educated (≥bachelor's degree). Mean years of yoga practice=11.4 (±7.5). BMI=12.1-49.4 (M=23.1±3.9). Levels of obesity (4.9%), smoking (2%), and fruit and vegetable consumption (M=6.1±1.1) were favorable compared to national norms. 60% reported at least one chronic/serious health condition, yet most reported very good (46.3%) or excellent (38.8%) general health. Despite high levels of depression (24.8%), nearly all were moderately mentally healthy (55.2%) or flourishing (43.8%). Participants agreed yoga improved: energy (84.5%), happiness (86.5%), social relationships (67%), sleep (68.5%), and weight (57.3%), and beliefs did not differ substantially according to race or gender. The more they practiced yoga, whether in years or in amount of class or home practice, the higher their odds of believing yoga improved their health. Individuals who practice yoga are not free of health concerns, but most believe their health improved because of yoga. Yoga might be beneficial for a number of populations including elderly women and those with chronic health conditions.