Kim Innes began taking Kundalini Yoga classes 20 years ago as a way to unwind after long days in the laboratory. Today, she combines her love of yoga with her passion for science. As an assistant professor at the Center for the Study of Complementary and Alternative Therapies at the University of Virginia Health Systems, Innes studies how yoga affects chronic disease. "It was my personal experience with yoga and the benefits I felt, like reduced stress and better sleep, that sparked my interest in studying yoga as a disease intervention," she says.
To say her interest was "sparked" is putting it mildly. Last year, she wrote the most comprehensive review to date on yoga and metabolic syndrome. "I wanted to find an alternative approach—for women, especially—to managing and preventing these conditions," she says.
A Deadly Trifecta
The conditions Innes refers to fall under the umbrella diagnosis "metabolic syndrome." The syndrome is so named because its interrelated maladies—abdominal obesity, high cholesterol, high blood pressure, high triglycerides, and insulin resistance—are handcuffed to the body's metabolism. A person who has three or more of these is considered to have the syndrome. The American Heart Association estimates that 50 million Americans suffer from it, and the number is growing in lockstep with the country's waistlines.
The sum of the disorder is worse than its individual parts. Like members of a dysfunctional clique, all of metabolic syndrome's components travel together, feed off each other's destructive habits, and generally wreak havoc on the body. As each piece falls into place, the risk to your health climbs higher. Metabolic syndrome is like a one-way ticket to three of the most disabling diseases of the 21st century: heart disease, stroke, and diabetes. Every clique has a leader, and in this case, the power player is insulin resistance.
Insulin's role in the body is carefully choreographed. As food enters the stomach and is broken down, the pancreas releases insulin into the bloodstream to help cells convert the food's energy (glucose) into fuel. The process goes awry, however, in bodies padded with extra pounds. Fat tissue, especially around the abdomen, decreases the body's sensitivity to insulin. Unable to use insulin efficiently, the body demands more than the pancreas can easily produce. The pancreas gets exhausted and can't keep up. Without enough insulin to regulate blood sugar, glucose builds up in the bloodstream. The result is insulin resistance and prediabetes.
Astoundingly enough, nearly half the adult population in the United States suffers from prediabetes, a condition in which blood glucose levels are above normal. Most people develop full-blown diabetes within 10 years of being told they have the precursor to it.
But the prognosis doesn't have to be dire. Studies show that shedding just a few pounds, only 5 to 7 percent of your body weight (a mere 10 to 15 pounds for a 200-pound person), can turn the metabolic tide. It makes sense, then, that yoga's slimming effects might hold a key to reversing insulin resistance and, therefore, metabolic syndrome. And they do—but not in the way you might think.
Yoga to the Rescue
Innes knew that in India, yoga was a common prescription for conditions associated with insulin resistance such as diabetes and hypertension. Curious about whether the practice could reverse metabolic syndrome's progression into chronic illness, she went on a hunt for clinical evidence. Digging through mounds of research, much of it published in India, Innes uncovered 70 solid, albeit small, studies on the impact of yoga on the disorders of metabolic syndrome. "The beauty of yoga is that it doesn't target just one marker of metabolic syndrome, like glucose control or blood pressure," she says. "They are all interrelated."
In the end, Innes gathered convincing evidence that yoga could increase insulin sensitivity and lower cholesterol by as much as 19 and 25 percent, respectively. Last but not least, she saw a connection between yoga and weight loss. In 13 studies of body composition and yoga, the practice reduced body weight by as much as 13.6 percent.
Although the exact means by which yoga placates metabolic syndrome is still unclear, Innes surmises that stress relief and feelings of well-being fostered by a regular yoga practice serve to rebalance the nervous system. "The chronic activation of our flight-or-fight response may be at the root of many of the so-called modern ills," she says. Although she wasn't surprised that yoga turned out to be helpful, she was caught off guard by how fast its benefits appeared. "Even the short-term interventions—some as short as nine days—had dramatic effects on the symptoms of metabolic syndrome," she says. "That was eye opening."
The Stress Connection
Meanwhile, on the other side of the country, researchers were making their own inquiries into how yoga might affect markers of metabolic syndrome. Alka Kanaya, an internist at the University of California at San Francisco, first stumbled on the connection while reviewing an Indian study. Kanaya studies how people store their fat and what impact it has on their health. She knew that people under chronic stress secrete hormones that cause their bodies to sock away fat around their bellies.
"Metabolic syndrome is tightly associated with an apple-shaped body," says Kanaya. "Anything you can do to shrink visceral [aka belly] fat helps." And so, Kanaya hatched an idea: What if yoga could undo one of the biggest bugaboos of metabolic syndrome, stress-related weight gain?
Mention doing yoga for weight loss, and people tend to imagine rows of yogis sweating through a Bikram or Ashtanga class. But it's restorative yoga that experts hope will shrink the abdomens of people with metabolic syndrome. Unlike fat that lands on thighs and buttocks, giving one a pear-shaped body, abdominal fat is irrevocably linked to stress. Could a yoga class that has students reaching for bolsters instead of water bottles be the answer to whittling down a stubborn paunch?
The notion of relaxing as a weight-loss technique seems ripe for a Jay Leno one-liner, but the idea has serious scientific merit. Here's how it works: Chronic stress makes the body churn out too much cortisol, the body's primary stress hormone. Cortisol affects both the adrenal glands and the immune system. Ultimately, the extra cortisol nudges the abdomen into opening its fat depots and storing more fat than it would otherwise.
"Restorative yoga isn't aiming to get you to lose weight per se, but by reducing stress, you'll automatically be putting less weight on your belly," Kanaya says.
In the end, however, the biggest challenge in establishing yoga as an antidote to metabolic syndrome may be undoing yoga's reputation as a practice limited to the lithe and willowy. "When people think of yoga, they think of difficult postures that aren't accessible for people who are overweight," Kanaya says. To address that misconception, Kanaya went straight to one of restorative yoga's biggest advocates, Judith Hanson Lasater.
Healing Through "Real" Rest
Lasater sees restorative yoga as a way to fill a yawning gap in the national psyche—an inability to rest. Americans, she says, mistake resting for vegging out in front of the TV: "That's not restful; that's dull." Restorative yoga, with its emphasis on supported poses, allows the body to enter the deep, restful state it craves. "When you stop agitating it, the body starts to repair itself," Lasater says.
Some cardiologists are beginning to see the value of restorative yoga for their patients. Mehmet Oz, M.D., backs the notion of yoga for the treatment of metabolic syndrome.
"We know that meditation is effective in managing metabolic syndrome, but meditation is really, really hard for most Americans," he says. "Yoga is the next best way to get that Zen experience." He agrees with Innes's hunch that the secret is yoga's soothing effect on the jangled nervous system. "By relaxing your joints, you create that metaphor for your mind to relax too."
But aren't all styles of yoga relaxing? Lasater says any yoga is better than no yoga, but she thinks today's yoga has lost touch with its restful roots. "Restorative yoga is a formal way of getting people to just stop and be."
4 Ways to Relax
Judith Hanson Lasater—who helped design the yoga program used in a study of yoga and metabolic syndrome at the University of California at San Francisco—recommends the following poses.
Reclining Twist with a Bolster
Sit on the floor with your right hip close to the end of the bolster. Bend your knees and slide your feet to the left so the outside of your right leg rests on the floor. You can rest your left leg on the right one, or you can open the space between them. Turn to your right and put your hands on the floor, one on either side of the bolster. Gently press your hands into the floor to lengthen the front of your body. Then bend your elbows and lower yourself onto the bolster. Place your arms comfortably on the floor. Stay for a minute and a half. Switch sides.
Elevated Legs-up-the-Wall Pose
Place the long side of a bolster parallel to a wall, leaving 6 to 10 inches between the wall and the bolster. Place a single-fold blanket on the floor at a 90-degree angle to the middle of the long side of the bolster.
Sit on one end of the bolster with the length of it behind you and one shoulder near the wall. Roll back and swing your legs up the wall. Your legs should be almost vertical, your pelvis supported by the bolster, and your shoulders and head on the floor. Cover your eyes; stay for up to 15 minutes.
Give yourself enough floor space to spread out. Before you lie down, position a standard-fold blanket for your head and neck to rest on. Begin by sitting on the floor. Now turn to one side and lean on your elbow and forearm as you slide onto your side. Roll onto your back. (Coming into the pose in this way is easier on your back.) Roll the long edge of your blanket slightly to support the curve of the neck. Place two rolled blankets under your knees and cover yourself with a blanket. Your chin should be slightly lower than your forehead. Cover your eyes; stay for 5 to 20 minutes.
Reclining Supported Pose
Place a yoga block on the floor and prop the end of a bolster on it. Add a single-fold blanket on one end to support your head. Next, roll two blankets into one roll and place it nearby. Place two more rolled blankets on either side of the bolster to support each elbow and forearm. Sit in front of the short side of your bolster with your tailbone pressing the bolster. Bend your knees and place the large blanket roll under them. Lean back and rest your torso on the bolster and your head on the single-fold blanket. Make sure your chin is lower than your forehead. Let your legs and feet roll out and the heels rest on the floor. Place your forearms on the blankets at your sides, palms up. Close your eyes and cover them; stay for at least 10 minutes.
Catherine Guthrie is a writer in Bloomington, Indiana.
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