|Year : 2015 | Volume
| Issue : 3 | Page : 133-134
The influence of lifestyles on obesity: The impact of diet, sleep, exercise, and yoga
Ashok D.B. Vaidya
Chief Editor, Journal of Obesity and Metabolic Research, 102, Vasudha Clinic, Madhuvan C.H.S, Santacruz (W), Mumbai, Maharashtra, India
|Date of Web Publication||6-Aug-2015|
Ashok D.B. Vaidya
Chief Editor, Journal of Obesity and Metabolic Research, 102, Vasudha Clinic, Madhuvan C.H.S, Santacruz (W), Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Vaidya AD. The influence of lifestyles on obesity: The impact of diet, sleep, exercise, and yoga. J Obes Metab Res 2015;2:133-4
When one does a Google search for the words "lifestyle changes for obese people," there are about 1,780,000 results.  The same search words on the PubMed gave 2400 results.  However, if one searches the PubMed for "impact of diet, sleep, exercise, and yoga on obesity," we are told "no item found."  But a Google search for the same words get about 48,800,000 results.  "Yoga for weight loss" as search words, on Google, led to about 29,100,000 results.  On PubMed, the same words gave 35 results.  What are the reasons of such a dramatic disparity on the search engines? One obvious reason is that to get a citation on the PubMed, there has to be a publication in a peer-reviewed journal, which has fulfilled the criteria needed to be acceptable to PubMed. The Google search engine has no such compulsions. One other reason is the possibility that the relatively lesser number of studies may be available with such an integrated and multimodal approach to weight management. The latter approach, intuitively, would be very appropriate for a long-term weight management. However, the current designs of controlled clinical trials are not often suitable for evaluation of such multiple and simultaneous interventions. There is a need to evolve novel clinical trial designs for observational studies and therapeutic epidemiology. , In the absence of such approaches, the debates on the relative weightage of diet versus exercise, yoga versus stress management, and genes versus environment will continue to crowd the journals.
The present issue of Journal of Obesity and Metabolic Research (JOMR) has an interesting article, from the US, on the role of diet in cardio-metabolic parameters in obese prediabetic women.  In the present issue, Vaidya and Udupi have reviewed the role of dietary substrates as inflammatory markers, particularly in menopausal metabolic syndrome.  In an earlier issue of JOMR, there was a case report of a long-term control of obesity with conjoint naturopathy and yoga.  In literature too, there are studies on the efficacy of yoga in primary prevention of cardiovascular disease, which have been subjected to meta-analyses by a Cochrane review.  But there are not as many large sample-sized and long-term interventional studies, of multimodal/multisystem measures, as there are of diet and exercise. However, in 2012, Thomas Wadden et al. critically reviewed the role of lifestyle modification for obesity with a focus on the new developments in diet, physical activity, and behavioral therapy.  The review has a critical evaluation of 139 references and is strongly recommended to the readers of JOMR. The authors concluded, "a comprehensive program of lifestyle modification produces a 7-10% reduction in initial weight that is associated with clinically meaningful improvements in several cardiovascular disease risk factors, including the prevention of type 2 diabetes." In a recent article, in the American Journal of Lifestyle Medicine, Janet Rankin, while citing the review, stated emphatically, "in summary, consumption of a low-fat diet (20-25% of energy), moderately high-protein (1.2 g/kg and up to 20-25% of energy) diet with modestly reduced energy (500-1000 kcal/day) combined with aerobic (3-5 day/week, at least 250 min/week) and resistance exercise (2 day/week) can improve body composition to reduce clinically relevant risks associated with obesity."  But one would wonder about the degree of compliance to such a long-term and fairly intense intervention! Is body composition only a major target for the reduction of the cardio-metabolic risk factors? Would not the behavioral and yoga therapy, adopted as a lifestyle, add further benefits to cardio-metabolic health with a less rigorous but more acceptable diet-exercise schedules? In a recent multi-author book, on a multidisciplinary approach to obesity, Riccardo et al. have shown that there is increasing adherence to the regimen of diet and exercise when cognitive behavioral strategies are used and persevered in.  Is it time to explore a multisystem and integrative approach to the prevention and management of obesity?
Recently, a major book has been published on "Integrative Approaches for Health: Biomedical Sciences, Ayurveda, and Yoga" by Patwardhan et al. The authors have stressed that lifestyle disorders like obesity cannot be prevented by pharmaceutical drugs; the root causes need to be addressed in an integrated manner. They state, "we cannot go on consuming junk food, do less physical work, pollute environment, and in doing so hope to cure obesity, diabetes, and cancers with drugs alone." Is it not amazing that Charak had mentioned in the first millennium:
The shloka means, "the adipose tissue gets vitiated due to lack of exercise, daytime sleep, excessive intake of fatty foods and alcohol."  The obvious preventive strategy is to eschew the causative factors. Yoga was a part of daily life in India and has made a global comeback. And for the benefits of yoga to accrue, Geeta advised balanced diet, enough exercise, adequate sleep and right thoughts, speech and actions.  There is a need to introduce education of yoga, nutrition, exercise/games, proper sleep, and good work habits for children, at home and in schools. We can also do large scale comparative surveys for overweight/obesity between people with a Yogic way of life and their age/sex matched non-yogic controls. The emergent data may reinforce the strategy to initiate integrative and multimodality approach in the prevention and management of obesity. Some years back, the editor had contributed a review on the Ayurvedic management of obesity. The approach and modalities mentioned therein are still relevant to integrative weight management.  The recalcitrance of obesity and the well-known see-saw effect in weight have discouraged many from the current status of care. Even the recourse to bariatric surgery in morbid obesity is emerging strongly. It is likely that the long-term significant results of bariatric surgery may give us insights into the etiological factors. Then we may strive for their reversal with integrative healthy lifestyle. Such a lifestyle would incorporate the best of yoga with the best of current modalities for weight control.
| References|| |
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