Ruth Howard

Karma Shala Yoga Teacher Training Course

12 October 2009

Effects of yoga practice on metabolic factors associated with aging

Introduction

We hear of yogis living to a very old age. In his book Autobiography of a Yogi, Yogananda speaks of Trailanga
Swami, who was reputed to be over 300 years old, and Shankari Mai Jiew, who was born in 1826, was still
alive in 1946. Maharishi Raghuvacharya lived to the age of 115, and Devraha Baba was believed to have lived
to over 250 years old. Yogis well known in the west who lived to a very old age include Krishnamacharya
(101), Pattabhi Jois (93) and Indra Devi (103).

Not only are master yogis long lived, but they also maintain excellent health e.g. BKS Iyengar is still going
strong at 91; he was in better shape at 80 than many people at 40. Photos exist of Krishnamacharya doing full
parsvakonasana at 78 years old [], and Pattabhi Jois continued to teach yoga until the age of 90.

So how do we explain this?

There are several fairly obvious physical factors in the yogic lifestyle that would influence health and aging, as
well as more subtle factors.

Calorie restriction (CR) is widely accepted as the only method so far proven to extend longevity and reduce
the physical manifestations of aging.

It has been demonstrated in a wide variety of species, from yeast to monkeys (though not yet in humans), that
a calorie restricted diet (lowering the calorie intake by 20-30%, while providing essential nutrients), increases
lifespan.

CR animals maintained youthful appearances and activity levels longer and showed delays in a range of age-
related diseases. CR reduces age associated neuronal loss, prevents age-associated declines in learning,
psychomotor and spatial memory tasks and improves the brain’s ability for self repair [].

We can find several parallels between the effects of calorie restriction and the metabolic effects associated
with yoga practice.

Physiological changes associated with aging:

These include:

- Loss of muscle mass and tone, decreased muscle to fat ratio

- Loss of bone density
- Loss of flexibility, joint disorders such as arthritis
- Deterioration of lung elasticity and capacity
- Disorders of the circulatory system – decreased sensitivity of baroreceptors
- Degenerative disorders of nervous system – e.g. tremor, Parkinson’s disease
- Sensory and cognitive impairment
- Psychiatric conditions – depression, anxiety, dementia
- Reduced immune function
- Reduced reserve capacity (slower recovery from exertion, injury or disease)
- Sleep disorders
 - Impaired glucose tolerance and insulin sensitivity, strongly linked to abdominal obesity
- Further complications can occur as side effects of medication, or medication may mask symptoms of
new diseases
[]
Why do we age?

There are many and varied theories of aging, among them the following:

The free radical theory of aging states that over time, cells accumulate oxidative damage caused by free
radicals which are the normal by products of metabolism. Aging is characterised by a decline in ability to
neutralise free radicals [].

The rate of living theory states that lifespan is inversely related to metabolic rate. It appears to apply to many
species; however a notable exception is birds.

Another theory suggests that lack of protein turnover may cause aging.

Evolutionary theories of aging suggest that the previous generation age and die to make way for their
offspring, maintaining genetic diversity within the population.

According to the programmed aging theory, aging is genetically programmed, and age related changes in
cellular function result in increasing susceptibility to disease and eventually lead to death [].

Theories of aging based around programmed cell death (apoptosis) imply that as people age, more of their
cells start to “decide” to die.

The cell division limit theory states that there is a specific limitation on the number of divisions that somatic
cells might undergo.

The telomeric theory of aging postulates that as telomeres (regions of repetitive DNA at the ends of
chromosomes) shorten each time a cell divides; this leads damage to essential DNA. This results in cellular
damage due to the inability of the cell to duplicate itself correctly. Elevated levels of oxidative stress and
inflammation further increase the telomere attrition rate [], []. This theory ties in with the free radical theory and
the cell division limit theory.

Other theories ascribe age related problems to the accumulation of random genetic errors over time, also
decline in DNA repair capability of cells.

Many of these theories are interlinked, and all appear to have some validity, but a definitive answer has not
yet been found.

General positive effects of a yogic lifestyle

There are many known benefits to the regular practice of yoga, which would help to minimise many of the
problems associated with aging.

Regular exercise (asana) can help to maintain muscle strength and tone and bone density, joint flexibility, and
improve posture, balance and maintain mobility. Combined with pranayama, regular practice can help to
maintain circulatory and respiratory health.

Yoga has also been shown to be beneficial in the management of stress, anxiety and depression, aiding in the
maintenance of mental health.

A vegetarian diet can also aid in extending life – it has been shown that vegetarians live longer, have less
heart disease and lower rates of cancer [].
Metabolic factors associated with calorie restriction and longevity – Biomarkers of
aging

Caloric restriction in laboratory animals has been shown to have significant impact on that metabolism.

The biological characteristics of animals on CR diets seem to apply to longevity in people. A continuing study
in Baltimore by George Roth of the National Institute of Aging concluded that the same biological markers
produced in CR animals are evident in the men who are living the longest.

These markers include:

- Lower levels of blood glucose and insulin
- Reduced body temperature
- Less fat in the blood, more HDL (high-density lipoprotein –“good cholesterol”)
- A steady level of DHEA (dehydroepiandrosterone - a steroid hormone)
[], []

Plasma melatonin levels may also represent a possible biomarker of aging in primates [].

One of the most popular proposed theories by which CR promotes lifespan extension is the rate of living
theory. It is hypothesized that a lowering of the metabolic rate results in lowering of reactive oxygen species
(ROS) and rate of oxidative damage to vital tissues [].

Parallel effects found in yoga practitioners

Blood glucose and insulin

Type 2 diabetes, heart disease, arteriosclerosis, liver disease, elevated cholesterol and hypertension are
among the medical conditions associated with insulin insensitivity and elevated blood glucose levels [].

Calorie restricted animals show a significantly increased sensitivity to insulin compared to freely fed animals.
CR also has a significant impact on insulin sensitivity in humans [], [].

With normal aging, people tend to develop abdominal obesity. High levels of intra abdominal fat have been
found to be predictive of heart attack risk and also linked to high cholesterol, high blood pressure, high
triglycerides. There is a strong association between increased waist circumference, insulin insensitivity and
type 2 diabetes. Yoga practice seems to weaken this link [].

High levels of stress lead to increased cortisol levels, which is associated with higher levels of abdominal fat.
Any form of exercise would help to reduce visceral fat and thus reduce abdominal circumference.

It has been suggested that relaxation and stress reduction may not cause overall weight loss, but may result
in a healthier distribution of body fat []. It has been found that there were favourable metabolic changes in
overweight and underactive subjects who practiced restorative yoga []. The effect of restorative yoga on body
fat distribution would make an interesting basis for further study.

A recent study found that long term yoga practice was associated with increased insulin sensitivity, and
significantly lowered fasting plasma insulin levels [].

In a 45 day study on people with Type 2 diabetes, all patients continued to take conventional medicines. The
study group practiced asana and pranayama, while the control group did not practice yoga. The yoga group
showed significant improvement in blood glucose, lipid profile and insulin levels and a decrease in BMI (body
mass index). The control group showed an increase in weight, and non significant improvement in the other
parameters [].
Reviews of published studies found that yoga interventions are generally effective in reducing body weight
and glucose levels [], [], []. These studies suggest that yoga can have a beneficial effect on glucose tolerance
and insulin sensitivity.
Blood lipid profile

HDL (high density lipoprotein – “good” cholesterol) helps to remove cholesterol from the blood, protecting from
cardiovascular disease. Higher levels of HDL are correlated with better health outcomes.

LDL (low density lipoprotein – “bad” cholesterol) is thought to deposit cholesterol in artery walls, increasing the
risk of heart disease. High levels of LDL are associated with atherosclerosis. This includes VLDL (very low
density lipoprotein).

Along with reductions in basal metabolic rate (BMR), people on CR diets experienced large reductions in LDL
cholesterol, and had very high levels of HDL cholesterol [].

In a study on normal, healthy volunteers, after 30 days of practicing pranayama, a significant reduction in
triglycerides, free fatty acids and VLDL cholesterol along with significant elevation of HDL cholesterol was
observed in the men. Free fatty acids were reduced in women.

After adding asana exercises to the pranayama for another 60 days, free fatty acids increased in both men
and women, and women demonstrated a significant fall in serum cholesterol, triglycerides, LDL and VLDL
cholesterol [].

It is of interest that free fatty acid levels increased after the subjects started doing asana exercises. It is
possible that their bodies were breaking down fat. Further research would aid in clarifying this somewhat
contradictory effect.

In another study on patients with coronary artery disease, at the end of one year of yoga training, total
cholesterol was reduced by up to 23% in the yoga group of patients, compared to 4.4% in the control group.
LDL cholesterol was reduced by 26% in study group patients as compared to 2.6% in the control group. A
much higher proportion of the yoga group showed regression and arrest of progression of the disease than in
the control group [].

Studies indicate that pranayama and yoga asanas can be helpful in patients with lipid metabolism disorders [],
and have a positive effect on blood lipid profile, reducing cholesterol [], [], [].

Melatonin

Melatonin is produced by the pineal gland, and appears to have anti aging properties [], likely due to its
antioxidant properties. It is also a natural immune enhancer and has been shown to extend longevity in some
animal studies []. Higher melatonin levels are also associated with an increased sense of well being.

Melatonin is released mainly at night during sleep. Moderate physical activity has been shown to increase
production of melatonin [].

Calorie restriction has been shown to prevent the usual age related decline in melatonin levels in monkeys [].

Yoga and meditation have been shown to significantly increase melatonin levels, with regular meditators
found to have a higher level of melatonin than non-meditators [], [], [].

In a 2004 study on normal, healthy volunteers, a yoga group practiced asana, pranayama and meditation
while a control group did body flexibility exercises, slow running, and played games.

Yogic practices for 3 months resulted in an improvement in cardiorespiratory performance and psychological
profile, with an improved sense of well being. The maximum night time melatonin levels in yoga group showed
a significant correlation with well-being score.
The yoga group showed an increase in plasma melatonin, indicating that yoga could be used as a
psychophysiologic stimulus to increase endogenous secretion of melatonin [].

In another study, experienced meditators practising either TM-Sidhi or another form of yoga showed
significantly higher plasma melatonin levels in the period immediately following meditation compared with the
same period at the same time on control nights. It was concluded that meditation, at least in the forms studied
here, can affect plasma melatonin levels [].

Longer term studies are required to ascertain whether the higher melatonin levels in yoga practitioners and
meditators are sustained.

Basal metabolic rate and body temperature

Studies measuring metabolic rate in CR animals indicate that it lowers the BMR. CR in animals is associated
with a robust decrease in energy metabolism, including a lowering of resting metabolic rate, lowering of the
thermic effect of meals and a decrease in the energy cost of physical activity [], [].

Some studies measuring metabolic rate in CR animals give conflicting results [], and lowered metabolic rate
does not necessarily entail a prolonged life span [].

However, specific metabolic rate correlates highly with oxidative DNA damage. This is consistent with the
theory that free radical induced DNA damage may play a central role in the aging process [].

Body temperature, one of the biomarkers of longevity, is linked to metabolic rate; a lowered BMR would be
associated with a slightly lowered core body temperature.

It seems logical to expect that because yoga asana is an energy expenditure activity, it would increase the
resting metabolic rate. However, two different studies using healthy volunteers found that the BMRs of yoga
groups practicing asana, pranayama and meditation were significantly lower than the BMRs of control groups
[] []. Asanas when practiced along with pranayama and meditation over a period of time actually significantly
reduce the metabolic rate [] [].

The metabolic rate is an indicator of autonomic activity. The lower metabolic rates in the yoga subjects may
have been due to decreased sympathetic nervous system activity and probably, a stable autonomic nervous
system response achieved due to training in yoga [] [].

A study on alternate nostril breathing found that breathing selectively through either nostril could have a
marked activating effect or a relaxing effect on the sympathetic nervous system; it is possible to alter
metabolism by changing the breathing pattern [].

Hypometabolic states have been reported in yogic studies, and meditation has been described as a “wakeful
hypometabolic state of parasympathetic dominance” [], []. Reports exist of yogis being buried underground in
pits for many hours, and emerging unscathed. This may be achieved by consciously and voluntarily entering
a hypometabolic state [], [].

This suggests not just a general lowering of BMR as a result of practice, but in advanced practitioners,
eventually a learned ability to control normally involuntary bodily processes []. Krishnamacharya was
apparently able to stop his own heartbeat and breath for several minutes with no ill effects – he demonstrated
this before a panel of doctors at the age of 76 [].

Dehydroepiandrosterone (DHEA)

Higher levels of DHEA are associated with greater feelings of wellbeing, higher muscle to fat ratios, and
enhanced immune function.
DHEA also seems to increase sensitivity to insulin. Low DHEA levels correlate with lower bone mineral
density and higher risk of osteoporosis, and also increased risk of heart disease []. A significant deficiency in
DHEA in patients with several major diseases including cancer, inflammatory diseases, type 2 diabetes,
atherosclerosis, Alzheimer’s disease and cardiovascular disorders has been described [].

Levels of DHEA that occur naturally in the body decline with age.

Calorie restriction has also been shown to increase DHEA levels in animals. DHEA was found to be a very
good marker to measure the rates of aging in control versus calorie restricted monkeys [].

Most forms of exercise will raise DHEA levels [], so practicing yoga asana would play a role in maintaining
DHEA levels.

Studies have shown that meditation is associated with increased levels of DHEA, as well as melatonin and
GABA (gamma aminobutyric acid, which reduces anxiety) [], [].

Older individuals practicing meditation had higher levels of DHEA than an age-matched control group of non-
meditators. [], []

Limitations of this theory

Results of further long term naturalistic studies would be informative as to whether the effects described
above are sustained over time.

Many of these effects could also result from other forms of exercise. Comparative studies measuring these
markers in yogis and athletes of a similar age would be required to find out whether yoga practice has a
greater or different effect than other physical activity.

Larger studies are needed – at present only relatively few exist, involving relatively small numbers of people.
More studies of diverse populations are required.

Several studies found that yoga interventions are generally effective in reducing body weight, blood pressure,
glucose level and high cholesterol, but only a few studies examined long-term adherence.

Animal studies cannot always be directly correlated with humans; the results of animal experiments are
unreliable when attempting to extrapolate to humans. Although I have referred to animal studies, personally I
believe experimentation on animals to be unethical and often very cruel. What we really need is more human
studies.

Furthermore, in her blog [], Sandy Szwarc points out that in a recent CR study on rhesus monkeys [], if
deaths from factors other than age related diseases are taken into account, there is in fact no significant
difference in lifespan between CR and non CR animals. Also, the control group were actually overfed by 20%.

Reviews of other animal CR studies looking at causes of mortality other than old age would be enlightening.

Finally, it may be found that the hypothesised biomarkers of longevity actually have little or no significance in
extending longevity. For example, as we find out more about the SIR2 gene, many currently widely accepted
theories may be discarded.

Conclusion
It is the side effects of CR, the so called “biomarkers of longevity”, that appear to delay the onset of age
related chronic disease and extend longevity.

Insulin resistance seems to be a major factor contributing to age related disease, possibly the most important
factor. However the lowered BMR of yoga practitioners is particularly interesting, as it is a curious and rather
anomalous effect.

There is a high incidence of obesity related disease in westerners; the average western diet is over caloric.
However the more extreme CR has associated health risks.

The risks and possible negative side effects of calorie restriction include hunger, malnutrition, eating
disorders, reproductive issues in women, osteoporosis, sensitivity to cold, and slower healing []. On top of this
there may be as yet unknown long term side effects.

It has been found that some yoga practitioners do in fact practice caloric restriction []. The yogis interviewed
by Dr Bushell at the Kumbha Mela festival in 2001 followed a classic Indian form of CR based on 1-2 small
meals a day consisting of legumes, milk, and augmented with fresh vegetables and fruit.

Simon Borg-Olivier lives on a diet of mostly raw fruit and vegetables, and seems extremely strong and
healthy. He would make a particularly interesting case study; it seems possible that he could live to a very old
age.

All of the physiological factors - a lowered BMR, with increased insulin sensitivity and lower insulin levels,
increased melatonin and DHEA, and better cholesterol levels - appear likely contribute to longevity and health
into old age with consistent yoga practice.

The combined metabolic effect of the practices of asana, pranayama and meditation may work in synergy with
other physical effects, possibly setting yoga practice apart from other forms of exercise in delaying or
preventing the onset of age related disease.

Yoga practice is a natural and healthy way to potentially achieve many of the benefits of CR, without the
associated risks, and in this manner to aid in slowing the aging process.
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Further Reading

Aeron Life Cycles Clinical Laboratory, 2009.

Hormonal Update Volume 3 Number 4.
Available from http://www.aeron.com/volume_3_number_4.htm

Dhahbi, J., 2004.

Reduced Calorie Intake May Prolong Life.
Proceedings of the National Academy of Sciences, March 22, 2004

“Livelonger”. [no date]

SIR2 Gene - Removal of gene in experimental organisms extends lifespan six-fold
Available from http://hubpages.com/hub/Sir2_Gene