Impact of pranayama and yoga on lipid profile in normal healthy volunteers

Abstract

The present study was conducted on normal healthy volunteers, 41 men and 23 women, to evaluate the impact of Pranayama and Yoga asanas on blood lipid profiles and free fatty acids, in two stages. In stage-I, Pranayama was taught for 30 days and in stage-II, yogic practices were added to Pranayama for another 60 days. A Significant reduction was observed in triglycerides, free fatty acids and VLDL-cholesterol in men and free fatty acids alone were reduced in women at the end of stage-I. A significant elevation of HDL-cholesterol was seen only in the men at the end of stage-I. At the end of stage-II, free fatty acids increased in both men and women, and women demonstrated a significant fall in serum cholesterol, triglycerides, LDL-and VLDL-cholesterol. The results indicated that HDL-cholesterol was elevated in men with Pranayamam, while triglycerides and LDL-cholesterol decreased in women after yoga asanas. The results of the present study indicate that Pranayama and yoga asanas can be helpful in patients with lipid metabolism disorders such as coronary artery disease, diabetes mellitus and dyslipidemia etc.

Full text

Exercise and Health
IMPACT OF PRANAYAMA AND YOGA ON LIPID
PROFILE IN NORMAL HEALTHY VOLUNTEERS
K.V.V. PRASAD, MADHAVI SUNITA, P. SITARAMA RAJU,
M. VENKATA REDDY, B.K. SAHAY AND K.J.R. MURTHY.
Department of Medicine, Govt. Vemana Yoga Research
Institute, Hyderabad, India
ABSTRACT
Prasad KVV, Sunita M, Raju PS, Reddy MV, Sahay BK,
Murthy KJY. Impact Of Pranayama And Yoga On Lipid Profile In
Normal Healthy Volunteers. JEPonline 2006;9(1):1-6. The
present study was conducted on normal healthy volunteers, 41
men and 23 women, to evaluate the impact of Pranayama and
Yoga asanas on blood lipid profiles and free fatty acids, in two
stages. In stage-I, Pranayama was taught for 30 days and in
stage-II, yogic practices were added to Pranayama for another
60 days. A Significant reduction was observed in triglycerides,
free fatty acids and VLDL-cholesterol in men and free fatty acids
alone were reduced in women at the end of stage-I. A significant
elevation of HDL-cholesterol was seen only in the men at the
end of stage-I. At the end of stage-II, free fatty acids increased in
both men and women, and women demonstrated a significant
fall in serum cholesterol, triglycerides, LDL-and VLDL-
cholesterol. The results indicated that HDL-cholesterol was
elevated in men with Pranayamam, while triglycerides and LDL-
cholesterol decreased in women after yoga asanas. The results
of the present study indicate that Pranayama and yoga asanas
can be helpful in patients with lipid metabolism disorders such as
coronary artery disease, diabetes mellitus and dyslipidemia etc.
Key Words: Pranayama, Yoga, Cholesterol, Triglycerides, Lipoproteins
INTRODUCTION
Journal of Exercise Physiologyonline
(JEPonline)
Volume 9 Number 1 February 2006
Managing Editor
Robert Robergs, Ph.D.
Editor-in-Chief
Robert Robergs, Ph.D.
Review Board
Todd Astorino, Ph.D.
Julien Baker, Ph.D.
Tommy Boone, Ph.D.
Lance Dalleck, Ph.D.
Dan Drury, DPE.
Hermann Engals, Ph.D.
Eric Goulet, M.Sc.
Robert Gotshall, Ph.D.
Len Kravitz, Ph.D.
James Laskin, Ph.D.
Jon Linderman, Ph.D.
Derek Marks, Ph.D.
Cristine Mermier, Ph.D.
Daryl Parker, Ph.D.
Robert Robergs, Ph.D.
Brent Ruby, Ph.D.
Jason Siegler, Ph.D.
Greg Tardie, Ph.D.
Chantal Vella, Ph.D.
Ben Zhou, Ph.D.
Official Research Journal of
The American Society of
Exercise Physiologists
(ASEP)
ISSN 1097-9751

Coronary heart disease (CHD) is one of the major causes of death in United States (1) for both men and
postmenopausal women in western world (2). A study conducted in India suggests that the prevalence of
CHD is about 10% (3). Dyslipidemia is one of the important modifiable risk factors in CHD (4). It initiates
atherosclerotic plaque formation, finally resulting in degeneration of endothelial cell function, which
enhances the coagulability of blood by activation of various factors for which apolipoproteins have been
implicated. Hypercholesterolemia (increase in LDL-cholesterol), combined hyperlipidemia (increase in
triglycerides and LDL-cholesterol) and hypertriglyceridemia are three important risk factors for CHD (5).
The modification of lipid profile may be important in both prevention and control of CHD (6).
Various attempts such as physical exercises (7-9) and dietary modifications (10-11) and combined diet
and exercise trials (12) have been performed to control the lipid content of the blood in efforts to treat and
prevent coronary artery disease. A study conducted on patients with angina and coronary risk factors (13)
showed a positive response in lipid profile after 4-14 weeks of yogic practices, while another study
conducted on subjects with mild to moderate hypertension reported that yoga can play an important role
in risk modification for cardiovascular diseases (14). Another study had reported that the long and
medium term meditators have better lipid profile when compared to non-meditators in spite of similar
physical activity (15). Our earlier studies conducted to evaluate the effect of Pranayama and yoga, in
normal volunteers, on cardio-respiratory efficiency (16,17) and bone metabolism (18) have resulted in a
significant improvement in numerous physiological systems. While another study conducted on normal
healthy individuals had resulted in an improvement in lean body mass and a reduction in fat skin fold
thickness (19) after yogic practices.
In view of these observations, the present study was undertaken to study the effect of Pranayama and
yoga asanas on the lipid profile in healthy volunteers undergoing yoga training for 90 days.
METHODS
41 Male and 23 female volunteers were selected for the study from the students of a three months yoga
certificate course conducted by the Vemana Yoga Research Institute, Hyderabad, India. These subjects
were aged between 18-30 years and none had a history of lipid metabolism disorders. These volunteers
included housewives, students and executives. All volunteers were normal healthy persons with no history
of smoking and alcohol consumption and were not involved in heavy physical exercises. The scope and
objectives of the present study were explained to the subjects and their written consent was obtained for
participation in the present study. The institutional ethical committee had approved the study protocol and
design.
The subjects were asked to follow their routine diet and exercise pattern during the period of study. None
of them carried out any other physical exercises, based on the information given by the subjects during
admission to the certificate course, except yoga, and maintained an average attendance of 82% to 93% in
the yoga classes. None of the subjects were exposed to yogic practices before joining the yoga course.
Yoga Training
All subjects were taught Pranayama for 30 days (Stage-I) followed by addition of yogic practices for
another 60 days (Stage-II). The duration of practice was for one hour from 6.15 am to 7.15 am, without
prior breakfast.
Pranayama - Rechaka Puraka, Rechaka Puraka with Kumbhaka, Suryabedha Chandrabedha,
Suryabedha Chandrabedha with Kumbhaka, and Kapalabhati was taught for 10 min each, and at the end
Shavasana was practiced for another 10 min. The descriptions of Pranayama practices were given earlier
(18).
After 30 days, Pranayama practices were reduced to 20 min and Yoga asanas were practiced for 40 min
for further 60 days. The yogasanas practiced were Uttanasana, Mandukasana, Ustrasana, Yogamudra,
Matsyendrasana, Paschimottanasana, Bhujangasana, Sarvangasana, Halasana, Uddiyana,
Ardhamatsyendrasna, Dhanurasana, Shalabhasana, Sarpasana and Chakrasana (20).
Blood was drawn from an antecubital vein at the beginning, after 30 days and at the end of study for
biochemical investigations, in post absorptive state. The blood was drawn between 7-30 am to 8.00 am,
without stasis, and the serum was separated within an hour of collection. On the day of blood collection,
the subjects were asked to abstain from the yogic practices. The following investigations were carried out
- serum cholesterol (21), triglycerides (22), free fatty acids (22), HDL-cholesterol (23), LDL-and VLDL-

cholesterol (24) within 4 hours of serum separation. The above parameters were estimated before
commencement of the study (Basal), at the end of 30 days of Pranayama practice (Stage 1) and after 60
days Pranayama and Yoga asanas (Stage 2).
Data are expressed as mean  SD. Analysis of the results were made using Student's paired `t' test
between the initial values and those at the end of stage-I and stage-II and significance was noted at p <
0.05. The differences between male and female volunteers, between initial values and those of stage 1
and stage 2 were assessed by repeated measures ANOVA.
RESULTS:
Descriptive characteristics of the
subjects are presented in Table 1.
There was a significant reduction in
the levels of serum triglycerides, free
fatty acids and VLDL-cholesterol at
the end of stage-I, HDL-cholesterol
and free fatty acids were significantly
increased at the end of stage 1 and 2, respectively, among men (Table 2) while no significant changes
were noted in LDL-cholesterol levels in both stages.
Table 2. Lipid Profile in Men before and After Yogic Practices
Parameter Initial Stage 1 Stage 2
Cholesterol, mmol/L 3.524 1.022 3.553  0.264 3.235  0.641
Triglycerides, mmol/L 1.057  0.582 0.797  0.395* 0.954  0.348
Free Fatty Acids, mEq/L 0.450  0.079 0.358  0.052* 0.524  0.084*
HDL-Cholesterol, mmol/L 1.109  0.169 1.204  0.197* 1.126  0.199
LDL-Cholesterol, mmol/L 1.918  0.986 2.045  0.687 1.708  0.671
VLDL-Cholesterol, mmol/L 0.471 0.262 0.359  0.171 0.418  0153
Values expressed as mean  SD; *significant at p<0.05
For women, there was a significant reduction in the levels of serum free fatty acids at the end of
Stages 1 and 2, whereas cholesterol, triglycerides, LDL-cholesterol and VLDL- cholesterol also
recorded a significant fall at the end of Stage 2I (Table 3I). No changes were observed in HDL-
cholesterol in both stages.
The ANOVA of repeated measures between male and female subjects at different periods of the study
had showed that the levels of serum cholesterol, and HDL-cholesterol were significantly changed in
male subjects, after yogic practices (Table-IV). No other differences were observed between any
other study variables between the genders.
Table 3. Lipid Profile in Women before and After Yogic Practices
Parameter Initial Stage-I Stage-II
Cholesterol, mmol/L 3.972  0.645 3.905  0.649 3.430  0.598*
Triglycerides, mmol/L 1.083  0.527 0.909  0.420 0.804  0.229*
Free Fatty Acids, meq/L 0.530  0.120 0.330  0.050* 0.450  0.070*
HDL-Cholesterol, mmol/L 1.250  0.190 1.271  0.188 1.185  0.217
LDL-Cholesterol, mmol/L 2.306  0.641 2.286  0.697 1.888  0.473*
VLDL-Cholesterol, mmol/L 0.498  0.241 0.414  0.195 0.368  0.105*
Values expressed as mean  SD; *significant at p<0.05
DISCUSSION
The effect of exercise and dietary
modifications on blood lipid profiles
and coronary heart disease (CHD),
has been widely reported (7-12).
The present study showed a
significant fall in total cholesterol in
women at the end of 3 months of
Table 1. Physical Data of the subjects
Age, Yrs Height, cm Weight, kg
MEN
(n=41)
24.60  5.44 165.42  6.34 55.91  11.12
WOMEN (n=23) 23.79  4.94 154.68  5.21 45.72  8.61
Table 4. Differences between genders in relation to Yogic Practices (ANOVA)
Chol TG FFA HDL-C LDL-C VLDL-C
F value 4.16 0.236 1.285 4.932 3.278 0.021
p value 0.045* 0.830 0.261 0.031* 0.076 .887
*significant at p<0.05

Pranayama and yoga practice. Male volunteers who went through the similar program did not show any
significant change in serum cholesterol levels. The studies conducted in western countries had reported a
fall in triglycerides and increase in HDL-cholesterol, after physical activity (7). On the other hand, a
generalized reduction had been associated with dietary restriction or correction, including HDL-
cholesterol. In the present study, a fall in the triglycerides and VLDL-cholesterol was observed in the men
at the end of 30 days of Pranayama practice, whereas in the women it was observed at the end of the
study.
It is known that decreased concentrations of plasma HDL-cholesterol lead to increased risk of coronary
heart disease whereas rise in its value exerts a protective effect (7). It seems quite probable that
increased physical activity leads to lowered plasma triglyceride concentrations and ultimately increased
plasma HDL-cholesterol. Physical activity and HDL appear to be linked via HDL’s role in triglyceride
metabolism (25). A meta-analysis of 59 exercise-training studies reported an average increase in HDL-
cholesterol of only 0.052mmol/L (26). The present study had shown a significant rise in the HDL-
cholesterol level of 0.104 mmol/L in the men at the end of 30 days of Pranayama practice, but not in
women suggesting a possible sex related response. The effect of yogic exercise on body mass showed a
significant decrease in fat fold thickness and a significant rise in the lean body mass in normal volunteers
at the end of study (19), which suggested that yogasanas and Pranayama cause mobilization of fat
deposits.
The diet modifications lead to a generalized fall in cholesterol, triglycerides and both LDL and HDL-
cholesterol (27). Conversely, the practice of low amounts of moderate intensity exercise programs do not
cause significant variations in these variables (10). The present study, consisting of a low intensity muscle
stretches and breathing practices had shown significant changes in the lipid profile at various stages of
study in both men and women. The reduction in triglycerides and increase in HDL-cholesterol could be
due to hydrolysis of TG-rich lipoproteins that simultaneously replace intramuscular fat used during
Pranayama and yogic practices.
The occurrence of significant changes in many of the parameters in men at the end of 30 days of
Pranayama is note worthy. Also significant is the observation that women did not show any change in
HDL-cholesterol, similar to studies conducted on physical exercise. The inclusion of a control group might
have highlighted the efficacy of Pranayama and yogic practices on CHD. A study carried out on
angiographically evident coronary disease patients, the placebo group treated with aggressive dietary and
lifestyle intervention did not show any improvement in their symptoms (28), hence the changes in the
present study are likely to be attributed to Pranayama and yogic practices.
CONCLUSIONS
The present study had demonstrated the efficacy of Pranayama and Yogasanas on blood lipid profiles in
normal healthy volunteers. Yoga practices may be helpful in patients with lipid metabolism disorders such
as diabetes mellitus, coronary heart disease and dyslipidemia.
ACKNOWLEDGEMENTS
The authors acknowledge Mr. C.Bhaskaracharyulu and Mr. K.J.Augustine for their assistance in the
Biochemistry investigations and Mr. Biswajit, Mr. Jaishanker and Mrs. Annapurna and Mrs.Vijayalakshmi
Prasad for teaching yoga to the volunteers. We are thankful to Dr. N Balakrishna, Research Officer, Dept.
of Statistics, National Institute Nutrition, Hyderbad, India for his guidance in advanced statistical analysis.
Address for Correspondence: K.J.R.Murthy, M.D., Research Professor, Govt. Vemana Yoga Research
Institute, 7-1-66, DK Road, Ameerpet, Hyderabad 500106 AP India. Tel: +9140 23408603 e-mail:
kvv@rediffmail.com
REFERENCES
1. Thompson PD, Buchner D, Pina IL, Balady GJ, Williams MA, Marcus BH et al., Exercise and physical
activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the
council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the council
on nutrition, physical activity, and metabolism (Subcommittee on Physical Activity). Circulation 2003;
107:3109-16.

2. Goodman J, Kirwan L. Exercise-induced myocardial ischemia in women. Sports Med 2001;31(4):235-
7.
3. Chadha S, Radhakrishnan S, Ramachandran K, Kaul U, Gopinath N. Coronary heart disease in Urban
Health. Indian J Med Res 1990; 72:424-30.
4. Genest J Jr., Cohn JS. Clustering of cardiovascular risk factors: Targeting high-risk individuals. Am J
Cardiol 1995; 76:8A-20A.
5. Stein Y. Comparison of European and USA guidelines for prevention of coronary artery disease.
Atherosclerosis 1994; 110(Suppl): 541-4.
6. Manninen V, Elo MO, Frick MH, Haapa K, Heinonen OP, Heinsalmi P et al. Lipid alteration and
decrease in incidence of coronary artery disease in the Helsinki Heart Study. JAMA 1988; 260:641-51.
7. Szapary PO, Bloedon LT and Foster GD. Physical Activity and Its Effects on Lipids. Current
Cardiology Reports 2003; 5:488-92.
8. Asikainen TM, Miilunpalo S, Kukkonen-Harjula K, Nenonone A, Panasen M, Rinne M et al. Walking
trials in post Menopausal women: effect of low doses of exercise and exercise fractionization on coronary
risk factors. Scand J Med Sci Sports 2003; 13:284-92.
9. Kraus WE, Houmard JA, Duscha BD, Knetzger KJ, Wharton MB, McCartney JS et al. Effects of the
amount and intensity of exercise on plasma lipoproteins. N Engl J Med 2002; 347(19):1483- 92.
10. Djousse L, Arnett DK, Coon H, Province MA, Moore LL, Ellison RC. Fruit and vegetable
consumption and LDL cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study. Am
J Clin Nutr 2004; 79; 213-217.
11. Berg A, Konig D, Diebert P, Grathwohl D, Berg A, Baumstark MW et al. Effect of an oat bran
enriched diet on the atherogenic lipid profile in patients with an increased Coronary heart disease risk.
Ann Nutr Metab 2003; 47:306-11.
12. Stefanick ML, Mackey S, Sheehan M, Ellsworth M, Haskell WL and Wood PD. Effects of diet and
exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL
cholesterol. N Engl J Med 1998; 339:12-20.
13. Mahajan AS, Reddy KS and Sachdeva U. Lipid profile of coronary risk subjects following yogic
lifestyle intervention. Indian Heart J 1999; 51:37-40.
14. Damodaran A, Malathi A, Patil N, Shah N, Suryananshi and Marathe S. Therapeutic potential of
yoga practices in modifying cardiovascular risk profile in middle aged men and women. J Assoc
Physicians India 2002; 50:633-40.
15. Vyas R and Dikshit N. Effect of meditation on respiratory system, cardiovascular system and lipid
profile. Ind J Physiol Pharmacol 2002; 46(4):487-91.
16. Raju PS, Madhavi S, Prasad KVV, Venkata Reddy M, Eswara Reddy M, Sahay BK et al.
Comparison of effects of yoga & physical exercise in athletes. Indian J Med Res 1994; 100:81-87.
17. Raju PS, Prasad KVV, Venkata Ramana Y, Murthy KJR, Reddy MV. Influence of intensive yoga
training on physiological changes in 6 adult women: A case report. J Altern Complement Med 1997;
3:291-295.
18. Prasad KVV, Raju PS, Reddy MV, Annapurna N and Murthy KJR. Effect of Pranayama and yoga on
bone metabolism in normal healthy volunteers. JEPonline 2004; 7:57-62.
19. Khare KC and Kawathekar G. Lean body mass and lipid profile in healthy person practicing yoga.
Yoga Mimamsa 2002; 34:123-128.
20. Venkata Reddy M. Yogic Practices 1st ed. Secunderabad: Govt. Vemana Yoga Research Institute,
1992.
21. Gottfied SP, B Rosenberg: Spectrophotometric method for determination of serum triglycerides.
Clin Chem, 1973; 19 (9):1077-8.
22. Virella MFL, P Stone. S Ellis, and JA Colwell: Cholesterol determination in high-density lipoproteins
separated by three different methods: Clin Chem 1977;23(5):882-4.
23. Nath RL. Practice of biochemistry in clinical medicine-New Delhi. Oxford and IBH Publishing
Co., 1976, 79.

24. Novak M: Colorimetric ultra micro method for the determination of free fatty acids J Lipid Res
1965; 6:431-3.
25. Thompson PD. What do muscles have to do with lipoproteins? Circulation 1990; 81:1428-30.
26. Tran ZV, Weltman A. Differential effects of exercise on serum lipids and lipoprotein levels seen with
changes in body weight. A meta-analysis. JAMA 1985; 254:919-24.
27. Mensink RP, Katan MB. Effect of dietary fatty acids on serum lipids and lipoproteins: A meta-
analysis of 27 trials. Arterioscler Thromb 1992; 12:911–919.
28. Whitney EJ, Krasuski RA, Personius BE, Michalek JE, Maranian AM, Kolasa MW et al. A random
trial of a strategy for increasing high-density lipoprotein cholesterol levels: effects on progression of
coronary heart disease and clinical events. Ann Int Med 2005; 142(2):95-104.