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Effect of 12 weeks of slow breathing exercise practice on anthropometric parameters in healthy volunteers

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Background: Regular practice of slow breathing technique shows improvement in the cardiorespiratory functions. The previous studies have reported that it is well known to decrease the effect of stress which, in turn, improves the physical and mental health of an individual. Aims and Objectives: This study aims to assess the effect of 12 weeks of slow breathing exercise practice on anthropometric parameters in healthy volunteers. Materials and Methods: A total of 59 young, healthy volunteers of both genders participated in this study. The subjects were allocated to the study group (n = 29) and control group (n = 30) based on simple random technique. Slow breathing exercise training was given to the study group for 20 minutes daily in two sessions for 12 weeks. Height, weight, body mass index (BMI), waist circumference, hip circumference, and waist/hip ratio were recorded at the start of the study and after 12 weeks in both the groups. Longitudinal changes in both the groups were compared by Student's paired t-test. Comparison between the study group and control group was done by Student's unpaired t-test. The statistical analysis was carried out at 5% level of significance and P < 0.05 was considered as statistically significant. Results: The average age of the study group and control group participants was 19.9 ± 1.8 years and 19.2 ± 1.9 years, respectively. BMI was significantly decreased in the study group from 21.75 ± 4.14 to 19.51 ± 3.95 (P < 0.05). There was a trend toward decrease in the waist-hip ratio from 0.77 ± 0.67 to 0.71 ± 0.58 (P > 0.05) which was not statistically significant. Conclusion: Results of our study indicate that 12 weeks of slow breathing exercise training improve the anthropometric parameters in the study group. This indicates that regular, long-term slow breathing exercise training helps in weight reduction among the obese population.
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1 National Journal of Physiology, Pharmacy and Pharmacology 2018 | Vol 8 | Issue 12 (Online First)
RESEARCH ARTICLE
Effect of 12 weeks of slow breathing exercise practice on anthropometric
parameters in healthy volunteers
Dinesh T1, Rajajeyakumar M2, Sakila S1
1Department of Physiology, Government Thiruvarur Medical College, Thiruvarur, Tamil Nadu, India, 2Department of Physiology, Trichy
SRM Medical College Hospital and Research Centre, Tiruchirappalli, Tamil Nadu, India
Correspondence to: Dinesh T, E-mail: sclerombbs@yahoo.co.in
Received: June 10, 2018; Accepted: October 02, 2018
ABSTRACT
Background: Regular practice of slow breathing technique shows improvement in the cardiorespiratory functions. The
previous studies have reported that it is well known to decrease the effect of stress which, in turn, improves the physical
and mental health of an individual. Aims and Objectives: This study aims to assess the effect of 12 weeks of slow
breathing exercise practice on anthropometric parameters in healthy volunteers. Materials and Methods: A total of 59
young, healthy volunteers of both genders participated in this study. The subjects were allocated to the study group (n = 29)
and control group (n = 30) based on simple random technique. Slow breathing exercise training was given to the study
group for 20 minutes daily in two sessions for 12 weeks. Height, weight, body mass index (BMI), waist circumference,
hip circumference, and waist/hip ratio were recorded at the start of the study and after 12 weeks in both the groups.
Longitudinal changes in both the groups were compared by Student’s paired t-test. Comparison between the study group
and control group was done by Student’s unpaired t-test. The statistical analysis was carried out at 5% level of significance
and P < 0.05 was considered as statistically significant. Results: The average age of the study group and control group
participants was 19.9 ± 1.8 years and 19.2 ± 1.9 years, respectively. BMI was significantly decreased in the study group
from 21.75 ± 4.14 to 19.51 ± 3.95 (P < 0.05). There was a trend toward decrease in the waist–hip ratio from 0.77 ± 0.67
to 0.71 ± 0.58 (P > 0.05) which was not statistically significant. Conclusion: Results of our study indicate that 12 weeks
of slow breathing exercise training improve the anthropometric parameters in the study group. This indicates that regular,
long-term slow breathing exercise training helps in weight reduction among the obese population.
KEY WORDS: Anthropometric Parameters; Slow Breathing Exercises; Healthy Volunteers
INTRODUCTION
Anthropometry is dealt with the measurement of an individual
anatomical structure and its application in the form of
proportions, composition, and shape and body maturation. It
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uses non-invasive, portable instruments to calculate height,
weight, and body circumferences which can be performed in
a large sample size.[1]
Regular practice of slow breathing technique shows
improvement in the cardiorespiratory functions. The previous
studies have reported that it is well known to decrease the
effect of stress which, in turn, improves the physical and
mental health of an individual. Slow and deep breathing is
economical which reduces dead space ventilation. Breathing
with maximum contraction of diaphragm and intercostal
muscles massages abdominal viscera, improves venous
return, and stretches all parts of the thorax and lung. Slow,
National Journal of Physiology, Pharmacy and Pharmacology
Dinesh T et al. Effect of 12 weeks slow breathing exercises on anthropometric parameters
National Journal of Physiology, Pharmacy and Pharmacology 2
2018 | Vol 8 | Issue 12 (Online First)
deep breathing renews air throughout the lungs in contrast
with shallow breathing which renews air only at the base of
the lungs.[2-4]
During slow, deep breathing, there is conscious alteration
of cerebral activity with a definite pattern of activity seen in
the respiratory centers which modulates neuronal activity in
cardiovascular and other medullary centers. Breathing with
concentration improves mind-body coordination which helps
to cope up with stress, anxiety, and depression making one
feels relaxed and calm.[5-7] In view of the above background,
this study is aimed to assess the effect of 12 weeks of slow
breathing exercise practice on anthropometric parameters in
healthy volunteers.
MATERIALS AND METHODS
This study was performed in the Human Physiology Laboratory,
Government Thiruvarur Medical College, Thiruvarur, at the
end of approval from the Ethics Committee and Institute
Human Research. The sample size was 59 medical students
(females: 32 and males: 27) who were recruited after meeting
inclusion and exclusion criteria. The volunteers were exposed
about the purpose, procedures, and benefits of the study. They
were informed that they have freedom to withdraw from the
study at any time. After getting informed written consent, the
willing participants were allocated into study group (n = 29)
and control group (n = 30) based on simple random technique
generated through computer.
Inclusion Criteria
Healthy volunteers of age group between 18 and 25 years
(both genders).
Exclusion Criteria
The following criteria were used to exclude subjects from
the study:
• Historyofchronicrespiratoryailments
• Subjectstakingdrugs/medication
• Smokers
• Alcoholics
• Sportsorathleticpersonnel
• Historyofpreviousyogatrainingwithin1year.
Parameters
Height
Wall-mounted stadiometer (easy care, Hong Kong) was
used to measure the height of the study participants. The
calibration of stadiometer was done using standardized
measuring rod. The subjects were instructed to stand erect
on a flat surface with feet flat, heels almost together, legs
straight and knees together, with arms at the side and
looking horizontally straight ahead. Heels, hip, shoulder
blades, and occiput pressing against the vertical bar, then
the slider were brought down to rest on the top of the head
pressing hairs. It is an arrow which accurately measures
height in centimeters.
Weight
Weighing machine with spring balance (to avoid zero and
parallax errors) (Crown, India) was used to measure weight
of the study participants. The accuracy of the machine was
checked routinely with other weighing machines available.
Subjects were asked to wear light clothing with no footwear.
They were instructed to stand erect on the foot bar. The legs
were positioned on each side of the digital scale and weight
was measured in kilograms.
Body mass index (BMI)
BMI is the indirect measurement of nutritional status of
the individual. Quetelet formula is used to calculate BMI =
Weight in Kg/ (Height in m)2.
Waist–hip circumference ratio (WHR)
Waist circumference is a good index of centripetal obesity
and is measured at the midpoint between lower costal
margin and iliac crest, while holding the breath at expiration
(centimeters). The measurements were taken in subjects
using anthropometric tape by asking them to stand straight
with back facing a mirror so that the horizontal placement of
the tape can be assured. The hip circumference is measured at
the level of gluteal region with maximum girth (centimeters).
WHR was obtained by dividing the waist circumference with
hip circumference.
Breathing exercise training
The volunteers were practiced for the breathing technique
as per Pal et al.[8] in comfortable sitting posture and well-
ventilated room. The following are the steps:
• Thesubjectswereinstructedtocloseoneofthenostrils
(e.g., right nostril) by thumb and to slowly inhale through
the opposite nostril (left nostril) in 6 counts.
• Volunteers were asked to close the left nose by little
finger and to hold the respiration for 6 counts. Then, they
were instructed to open the right nose to slowly exhale
for 6 counts.
• They were asked to performed inspiration through the
right nostrils over the period of 6 s, close the right nose
and hold the respiration for 6 s after that open the right
nostril to exhale for 6 s.
These three steps complete one breathing cycle and this was
repeated for 20 minutes. The subjects were motivated to
practice this technique for 5 days in a week (both morning
and evening session) for a total period of 12 weeks under our
direct supervision. Rest of days the subjects were instructed to
practice at their home. Attendance register was maintained for
Dinesh et al. Effect of 12 weeks slow breathing exercises on anthropometric parameters
3 National Journal of Physiology, Pharmacy and Pharmacology 2018 | Vol 8 | Issue 12 (Online First)
training sessions. The post-test parameters were collected only
from the subjects with attendance percentage of at least 80%.
Ethics
The present study was carried out after obtaining clearance
from the Institute Ethics Committee for human studies and
the study caries less than minimal risks.
Statistical Analysis
Data for all parameters were collected and computerized in
Microsoft Excel. Longitudinal changes in both the groups
were compared by Student’s paired t-test. Comparison
between the study group and control group was done by
Student’s unpaired t-test. The statistical analysis was carried
out at 5% level of significance and P < 0.05 was considered
as statistically significant.
RESULTS
After excluding the dropouts, a total number of volunteers
included in the final analysis in the study group and control
group were 29 and 30, respectively. The average age of the
study group and control group participants was 19.9 ± 1.8
and 19.2 ± 1.9. Comparison of anthropometric parameters at
baseline between the study group and control group is given
in Table 1. It shows that there was no significant difference
in the baseline values of age and anthropometric parameters
(P > 0.05). Therefore, both the groups can be considered
comparable.
Table 2 shows the effect of 12 weeks of slow breathing
exercise training (n = 29) on anthropometric parameters
in which BMI of the study group showed a statistically
significant reduction from 21.75 ± 4.14 to 19.51 ± 3.95
(P = 0.03). Furthermore, there was a trend towards decrease
in WHR from 0.77 ± 0.67 to 0.71 ± 0.58 (P > 0.05) which
was not statistically significant.
Table 3 shows the changes in control group (n = 30) after
12 weeks of study period on anthropometric parameters.
BMI of the control group was increased from 21.42 ± 2.91
to 22.13 ± 2.21 and WHR of the control group was increased
and 0.78 ± 0.08 to 0.79 ± 0.24 which were not statistically
significant (P > 0.05).
DISCUSSION
Slow breathing exercises have a pacifying action and it
relaxes the body. The possible mechanism is generation
of inhibitory signals and hyperpolarizing currents within
neural and non-neural tissue by mechanically stretching
tissues during inspiration and holding the breath. This
increases the parasympathetic activity and decreases
sympathetic activity. The shift in autonomic balance towards
parasympathodominance is proposed due to the generation of
hyperpolarization current which initiates the synchronization
of neural elements in the central nervous system, peripheral
nervous system, and surrounding tissues.[9] WHR is used as
an important indicator for the anthropometric component
in all the subjects or patients with risk of cardiometabolic
conditions, for example, prediabetes and cardiovascular
disease.[10]
After 12 weeks of slow breathing exercise training, BMI
was decreased significantly in the study group (P < 0.05).
Our results are in agreement with the previous studies which
reported that integrated yoga practices lead to reduction in
anthropometric parameters such as BMI and WHR. It is
proposed that regular slow breathing exercise practice produces
reduction in body weight due to reduction in stress as well as
parasympathodominance which ultimately causes sense of
well-being and reduces over eating to the individual.[11-13] These
results are also in concordance with the previous research results
by Desika et al. in which Nadi shuddhi pranayama intervention
produced a significant difference (P≤0.05)intheBMI,WHR,
heart rate (HR), systolic blood pressure, and diastolic blood
pressure in both phases of menstrual cycle at the end of the
study period when compared with the control group.[14]
Table 1: Comparison of age and baseline anthropometric
parameters in the study group and control groups
Parameters Study
group (n=29)
Control
group (n=30)
P value
Age 19.9±1.8 19.2±1.9 0.152
BMI 21.75±4.14 21.42±2.91 0.728
WHR 0.77±0.67 0.78±0.08 0.935
BMI: Body mass index, WHR: Waist–hip circumference ratio.
Analysis done by Student’s unpaired t-test. Values are expressed as
mean±SD. *P<0.05, **P<0.01, ***P<0.001
Table 2: Effect of 12 weeks of slow breathing exercise
training (n=29) on anthropometric parameters
Parameters Pre‑test Post‑test P value
BMI 21.75±4.14 19.51±3.95* 0.03
WHR 0.77±0.67 0.71±0.58 0.72
BMI: Body mass index, WHR: Waist–hip circumference ratio.
Analysis done by Student’s paired t-test. Values are expressed as
mean±SD. *P<0.05, **P<0.01, ***P<0.001
Table 3: Changes in control group (n=30) after 12 weeks
of study period on anthropometric parameters
Parameters Pre‑test Post‑test P value
BMI 21.42±2.91 22.13±2.21 0.29
WHR 0.78±0.08 0.79±0.24 0.83
BMI: Body mass index, WHR: Waist–hip circumference ratio.
Analysis done by Student’s paired t-test. Values are expressed as
mean±SD. *P<0.05, **P<0.01, ***P<0.001
Dinesh T et al. Effect of 12 weeks slow breathing exercises on anthropometric parameters
National Journal of Physiology, Pharmacy and Pharmacology 4
2018 | Vol 8 | Issue 12 (Online First)
Very few studies have evaluated the exclusive effect of
pranayama practices on anthropometric parameters. In
a previous study by Telles et al. reported that there was a
significant decrease in BMI even after 1 month of practice
with various pranayama techniques.[6] However, they have
mentioned that the reason for this reduction might be due
to their change in diet as well as increased physical activity
which did not correlate with their reduction in anthropometric
parameters with pranayama practices.
Previous studies have been reported that the effect of yoga
on human system accomplished by decrease in the action of
hypothalamic–pituitary–adrenal axis. Early assessment of
anthropometry which helps to decrease weight and reduces
the cardiovascular mortality and morbidity by increase in HR
variability.[15]
Anthropometric parameters provide indirect assessment of
physical fitness of the individual and it should be carried
out in a multidisciplinary level. Regular weight reduction
sessions include low-fat/carbohydrate diets, cognitive
behavioral therapy programs, and regular exercise. These are
given in an individualized way to maintain anthropometric
parameters within normal range. The yoga-based lifestyle
modification sessions include asana, pranayama, and lifestyle
interventions.[16]
Limitations of the Study
Physical activity, diet pattern, and other adverse lifestyle
factors were not controlled in the study groups as this would
require a residential program.
CONCLUSION
Regular practice of slow breathing exercises improves
the psychosocial and physiological well-being in healthy
as well as obese individuals along with diet and other
lifestyle modifications. Therefore, slow breathing exercise
and relaxation techniques can be prescribed along with
conventional weight reduction techniques to restore
homeostatic set point in obese and overweight individuals.
ACKNOWLEDGMENT
The authors thank the Dean, Faculty members of the Department
of Physiology and 2nd year medical students of Government
Thiruvarur Medical College, Thiruvarur, Tamil Nadu, India.
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Lavanisha K, et al. Impact of nadishuddhipranayam on
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How to cite this article: Dinesh T, Rajajeyakumar M, Sakila S.
Effect of 12 weeks of slow breathing exercise practice on
anthropometric parameters in healthy volunteers. 2018;8 (Online
First). Doi: 10.5455/njppp.2018.8.0620502102018
Source of Support: Nil, Conflict of Interest: None declared.
... Malatova and Drevikovska (2009) demonstrated that weakness and poor coordination of the diaphragm may lead to lumbar instability and impairment of its movement patterns. Conversely, loss of lumbar region stability due to poor posture and improper direction has a negative effect on the function and efficiency of respiration [34]. ...
... The results were consistent with the findings of Bezzoli et al. (2016) that examined the effects of pelvic lung motor control exercises on pulmonary function in obese people [28]. Joshi et al. (1992) and Dinesh et al. (2018) also found that pranayama exercises improve respiratory function by increasing FEV and FEV1 [31,35]. Sivakumar et al. (2011) also investigated the effect of deep interpretation exercises on lung function, which was consistent with the results of the present study (FVC) [33]. ...
... DNS is a functional approach view that integrates brain stimulation with manipulation, mobilization, pos-tural a w areness, breathing training and education to achieve optimal, global body function [33,34]. Moreover, c a n be regarded as a "neutral" and "optimal" alignment of the head and neck, spinal, thorax, and pelvis and strongly recommends that a healthy sensorimotor syst em is required to design an optimal function that sets the joints in centration [22,23]. ...
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Introduction: Dynamic neuromuscular stabilization (DNS) approach is developed based on neurodevelopmental kinesiology and reflex-mediated core stabilization concepts. But the outcomes of this approach remain unclear. So changes in some spirometry indices in response to DNS breathing exercises in sedentary students with poor posture will be explored. Methods: In this single-group pretest-posttest study design, we involved 26 male volunteer sedentary students with poor posture. First, a pretest of the spirometry indices (Maximum voluntary ventilation (MVV), Forced expiratory volume in first second (FEV1), Forced vital capacity (FVC), and FEV1 /FVC ratio) were done each participant in random order. DNS breathing exercise protocol (six times a week, for six weeks) were trained and after completion of training, the post-test of the same parameters was performed. Descriptive statistical and the paired-sample test were used to analyze. Results: The findings of data analysis indicated that the effect of DNS breathing exercise on respiratory function and significant improvements were observed in post-test compared with pre-test in the following parameters: MVV (178.0±21.5 vs 141.0±30.4 l/min, P<0.001), FEV1 (4.7±0.5 vs 4.0±0.5 L, P<0.001), FVC (5.0±0.7 vs 4.4±0.6 L, P<0.001), and FEV1/FVC (0.95±0.05 vs 0.92±0.07 L, P<0.001). Conclusion: It can be concluded that DNS breathing exercise is an effective protocol to significantly improve respiratory function. Moreover, it can be deduced that DNS breathing exercise with a focus on the integrated spinal stabilizing system (ISSS) and breathing techniques can serve as an effective instructive approach to prevent risks of malalignment. Keywords: Dynamic neuromuscular stabilization; breathing exercise; respiratory function
... Malatova and Drevikovska (2009) demonstrated that weakness and poor coordination of the diaphragm may lead to lumbar instability and impairment of its movement patterns. Conversely, loss of lumbar region stability due to poor posture and improper direction has a negative effect on the function and efficiency of respiration [34]. ...
... The results were consistent with the findings of Bezzoli et al. (2016) that examined the effects of pelvic lung motor control exercises on pulmonary function in obese people [28]. Joshi et al. (1992) and Dinesh et al. (2018) also found that pranayama exercises improve respiratory function by increasing FEV and FEV1 [31,35]. Sivakumar et al. (2011) also investigated the effect of deep interpretation exercises on lung function, which was consistent with the results of the present study (FVC) [33]. ...
... DNS is a functional approach view that integrates brain stimulation with manipulation, mobilization, pos-tural a w areness, breathing training and education to achieve optimal, global body function [33,34]. Moreover, c a n be regarded as a "neutral" and "optimal" alignment of the head and neck, spinal, thorax, and pelvis and strongly recommends that a healthy sensorimotor syst em is required to design an optimal function that sets the joints in centration [22,23]. ...
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... The cardiorespiratory functions improve with regular practice of the deep breathing technique. Previous studies have shown that it is well known to reduce the effects of stress, which, in turn, increases an individual's physical and mental health [9] . Incentive spirometer (IS) is intended to help you reach and maintain maximum inspiration. ...
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Background: Yoga produces consistent physiological changes and have sound scientific basis.Practice of Pranayam has been known to modulate cardiac autonomic status during follicular and late luteal phases of menstrual cycle due to fluctuations of serum estrogen and progesterone levels. Aims and Objectives: To study the impact of Nadishuddhi pranayama on perceived stress and vasomotor tone in the different of Phase menstrual cycle before and at the end of study period among young adult females. Materials and Methods: This study was carried out in 66medical students aged between 17–25 years. They were selected by using simple random sampling and informed consent was obtained. A pretested questionnaire perceived stress scale was used to gather the research information. In control group, there was no significant difference in the BMI, WHR, HR, SBP and DBP of both phases of menstrual cycle at the beginning and end of the study period. Results: In yoga group, there was significant difference (p≤0.05) in the BMI, WHR, HR, SBP and DBP of both phases of menstrual cycle at the beginning and end of the study period compare with control group. After yoga, there was significant decreased stress in both phase of study group as compared to control group. Conclusion: However, slow type of pranayama increased parasympathetic activity during follicular phase and decreased sympathetic activity in secretory phase. As a result, decreased stress level of the individual.
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Thirty three normal male and forty two normal female subjects, of average age of 18.5 years, underwent six weeks course in 'Pranayam' and their ventilatory lung functions were studied before and after this practice. They had improved ventilatory functions in the form of lowered respiratory rate (RR), and increases in the forced vital capacity (FVC), forced expiratory volume at the end of 1st second (FEV1%), maximum voluntary ventilation (MVV), peak expiratory flow rate (PEFR-lit/sec), and prolongation of breath holding time.
Autonomic responses to breath holding were studied in twenty healthy young men. Breath was held at different phases of respiration and parameters recorded were Breath holding time, heart rate systolic and diastolic blood pressure and galvanic skin resistance (GSR). After taking initial recordings all the subjects practised Nadi-Shodhana Pranayama for a period of 4 weeks. At the end of 4 weeks same parameters were again recorded and the results compared. Baseline heart rate and blood pressure (systolic and diastolic) showed a rendency to decrease and both these autonomic parameters were significantly decreased at breaking point after pranayamic breathing. Although the GSR was recorded in all subjects the observations made were not conclusive. Thus pranayama breathing exercises appear to alter autonomic responses to breath holding probably by increasing vagal tone and decreasing sympathetic discharges.
Effect of inspiratory and expiratory phases of normal quiet breathing, deep breathing and savitri pranayam type breathing on heart rate and mean ventricular QRS axis was investigated in young, healthy untrained subjects. Pranayam type breathing produced significant cardioacceleration and increase in QRS axis during the inspiratory phase as compared to eupnea. On the other hand, expiratory effort during pranayam type breathing did not produce any significant change in heart rate or QRS axis. The changes in heart rate and QRS axis during the inspiratory and expiratory phases of pranayam type breathing were similar to the changes observed during the corresponding phases of deep breathing.
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To the Editor.— In order to assess the validity of claims of merit, at Banaras Hindu University we have initiated an extensive study on Yogic practices. Some of our observations are being published in Indian medical journals. A carefully conducted physiological, endocrine, metabolic, and neuropsychological study in a group of 12 young, normal, male volunteers (aged 23.0±3.36 years; weighing 123.0± 12.96 lb) undergoing a six-month systematic training course of "Hath Yoga" has shown beneficial effects; reduction in body weight and a significantly improved pattern of respiratory functions, with lowered rate of respiration, increased rate of expansion of the chest, and increased vital capacity and breath-holding time. They also showed evidence of development of resistance against physical stress in terms of stability of respiratory functions.An endocrine and metabolic assessment of these subjects showed enhanced adrenocortical activity, as evidenced by increased 17-hydroxycorticosteroid excretion, reduction in serum cholesterol level, reduction in blood
There is increasing interest in the fact that breathing exclusively through one nostril may alter the autonomic functions. The present study aimed at checking whether such changes actually do occur, and whether breathing is consciously regulated. 48 male subjects, with ages ranging from 25 to 48 years were randomly assigned to different groups. Each group was asked to practice one out of three pranayamas (viz. right nostril breathing, left nostril breathing or alternate nostril breathing). These practices were carried out as 27 respiratory cycles, repeated 4 times a day for one month. Parameters were assessed at the beginning and end of the month, but not during the practice. The 'right nostril pranayama' group showed a significant increase, of 37% in baseline oxygen consumption. The 'alternate nostril' pranayama group showed an 18% increase, and the left nostril pranayama group also showed an increase, of 24%. This increase in metabolism could be due to increased sympathetic discharge to the adrenal medulla. The 'left nostril Pranayama' group showed an increase in volar galvanic skin resistance, interpreted as a reduction in sympathetic nervous system activity supplying the sweat glands. These results suggest that breathing selectively through either nostril could have a marked activating effect or a relaxing effect on the sympathetic nervous system. The therapeutic implications of being able to alter metabolism by changing the breathing pattern have been mentioned.