The pandemic outbreak of coronavirus disease 2019 (COVID-19) infection caused by severe acute respiratory syndrome-coronavirus 2 has led to profound public health crisis. In particular, individuals with preexisting conditions of heart disease, diabetes, cerebrovascular diseases and the elderly are most vulnerable to succumb to this infection. The current COVID-19 emergency calls for rapid development of potential prevention and management strategies against this virus-mediated disease. There is a plethora of evidence that supports the add-on benefits of yoga in stress management, as well as prevention and management of chronic noncommunicable diseases. There are some studies on the effect of yoga in communicable diseases as well but very few for acute conditions and almost none for the rapidly spreading infections resulting in pandemics. Based on the available scientific evidences on yoga in improving respiratory and immune functions, we have formulated very simple doable integrated yoga modules in the form of videos to be practiced for prevention of the disease by children, adults, and the elderly.

This multicentre retrospective study examined the effects of adjunct yoga-treatment in achieving composite cardiovascular goals for type 2 diabetes (T2D), set forth by the American Diabetes Association (ADA) in rural Indian settings. Records were extracted for 146 T2D patients, aged ≥20–70 years, and treated under the “Apollo Total Health Programme” for rural diabetes management, for the period April 2016 to November 2016. The study cohort comprised of two treatment groups (n = 73 each); non-yoga group (standard of care) and yoga group (adjunct yoga-treatment). Propensity score matching was applied between the study groups to define the cohort. Composite cardiovascular scores were based on the combination of individual ADA goals; A1c < 7%, blood pressure (BP) < 140/90 mmHg, stringent BP (<130/80 mmHg) and lipid, LDL-C < 100 mg/dl [risk factor for atherosclerotic cardiovascular disease]. Logistic regression was used to compare between the two treatment groups. Compared to standard of care, adjunct yoga-treatment was found to significantly facilitate the attainment of ADA composite score by 8-fold; A1c, ~2-fold; LDL-C, ~2-fold; BP < 140/90 mmHg and <130/80 mmHg by ~8-and ~6-fold respectively. This study provides the first evidence for significant efficacy of adjunct yoga-treatment for the attainment of favourable treatment goals for T2D in rural Indian settings. Clinical Trial Registration Number: CTRI/2020/02/0232790

Background: The impact of hypothyroidism on quality of life is extensively documented, highlighting its substantial physical, psychological, and social burden. Yoga has demonstrated promising therapeutic benefits in improving hypothyroidism outcomes. Leveraging telehealth’s growth, this study used a rigorously designed scientific yoga module specifically tailored for digital delivery for patients with hypothyroidism undergoing levothyroxine treatment. Objective: This study aimed to assess the impact of a 6-month tele-yoga intervention in patients with hypothyroidism by comparing outcomes between those receiving levothyroxine combined with tele-yoga and those receiving only levothyroxine treatment. Methods: A single-blinded, 2-arm, parallel-group randomized controlled trial was conducted for 6 months (April 1, 2022-September 30, 2022) with 134 clinically diagnosed patients with hypothyroidism recruited from the Arogyadhama Holistic Health Home registry (2013-2021). Participants were randomized to either a yoga intervention group or a waitlist control group with 67 in each group and assessed at 3 time points (before, in the middle of, and after the intervention) for primary and secondary outcomes. The 36-Item Short Form Health Survey for health-related quality of life was used as a primary measure, whereas secondary measures included thyroid profile, BMI, blood pressure, the Fatigue Assessment Scale, the Perceived Stress Scale, and the Gita Inventory of Personality. Clinical data were collected via online questionnaires, and laboratory data (thyroid profile blood pressure and anthropometric measurements) were obtained in person using standardized instruments. A generalized linear model with repeated-measure ANOVA was used to evaluate both within- and between-group effects. In addition, in the yoga intervention group, performance was assessed using a yoga performance assessment scale, and satisfaction was measured through a structured feedback survey. Results: The intervention showed highly significant effects across all domains of the primary outcome measure (P<.001), with the most notable effects on mental health (F2, 118=425.88; η2=0.88), energy and vitality (F2, 118=371.73; η2=0.86), and role limitations—emotional (F2, 118=335.45; η2=0.85). Secondary measures also showed significant improvements (P<.001), except for thyroxine (P<.014). Average yoga performance assessment scores increased significantly from 65.08 (SD 10.97) to 88.62 (SD 11.18; P<.001), indicating that most participants could easily perform the practices. Overall, 95% (64/67) of the participants in the yoga intervention group expressed high satisfaction with the tele-yoga intervention. Conclusions: This clinical trial is the first to demonstrate the benefits of a digitally delivered scientific yoga module combined with levothyroxine treatment for hypothyroidism. It highlights the efficacy of instructor-led tele-yoga as a scalable eHealth intervention, enhancing accessibility, long-term engagement, and sustainable health outcomes. Patients receiving tele-yoga alongside levothyroxine showed significantly greater improvements than those on levothyroxine alone, highlighting the value of integrating eHealth into thyroid care for a more comprehensive, patient-centered approach. Trial Registration: Clinical Trials Registry–India CTRI/2022/03/041047; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NjY5NzI

Background: Social isolation measures are requisites to control viral spread during the COVID-19 pandemic. However, if these measures are implemented for a long period of time, they can result in adverse modification of people’s health perceptions and lifestyle behaviors. Objective: The aim of this cross-national survey was to address the lack of adequate real-time data on the public response to changes in lifestyle behavior during the crisis of the COVID-19 pandemic. Methods: A cross-national web-based survey was administered using Google Forms during the month of April 2020. The settings were China, Japan, Italy, and India. There were two primary outcomes: (1) response to the health scale, defined as perceived health status, a combined score of health-related survey items; and (2) adoption of healthy lifestyle choices, defined as the engagement of the respondent in any two of three healthy lifestyle choices (healthy eating habits, engagement in physical activity or exercise, and reduced substance use). Statistical associations were assessed with linear and logistic regression analyses. Results: We received 3371 responses; 1342 were from India (39.8%), 983 from China (29.2%), 669 from Italy (19.8%), and 377 (11.2%) from Japan. A differential countrywise response was observed toward perceived health status; the highest scores were obtained for Indian respondents (9.43, SD 2.43), and the lowest were obtained for Japanese respondents (6.81, SD 3.44). Similarly, countrywise differences in the magnitude of the influence of perceptions on health status were observed; perception of interpersonal relationships was most pronounced in the comparatively old Italian and Japanese respondents (β=.68 and .60, respectively), and the fear response was most pronounced in Chinese respondents (β=.71). Overall, 78.4% of the respondents adopted at least two healthy lifestyle choices amid the COVID-19 pandemic. Unlike health status, the influence of perception of interpersonal relationships on the adoption of lifestyle choices was not unanimous, and it was absent in the Italian respondents (odds ratio 1.93, 95% CI 0.65-5.79). The influence of perceived health status was a significant predictor of lifestyle change across all the countries, most prominently by approximately 6-fold in China and Italy. Conclusions: The overall consistent positive influence of increased interpersonal relationships on health perceptions and adopted lifestyle behaviors during the pandemic is the key real-time finding of the survey. Favorable behavioral changes should be bolstered through regular virtual interpersonal interactions, particularly in countries with an overall middle-aged or older population. Further, controlling the fear response of the public through counseling could also help improve health perceptions and lifestyle behavior. However, the observed human behavior needs to be viewed within the purview of cultural disparities, self-perceptions, demographic variances, and the influence of countrywise phase variations of the pandemic. The observations derived from a short lockdown period are preliminary, and real insight could only be obtained from a longer follow-up.

Introduction The conceptualisation of healthy ageing phenotype (HAP) and the availability of a tentative panel for HAP biomarkers raise the need to test the efficacy of potential interventions to promote health in older adults. This study protocol reports the methodology for a 24-week programme to explore the holistic influence of the yoga-based intervention on the (bio)markers of HAP. Methods and analysis The study is a two-armed, randomised waitlist controlled trial with blinded outcome assessors and multiple primary outcomes. We aim to recruit 250 subjects, aged 60–80 years from the residential communities and old age clubs in Bangalore city, India, who will undergo randomisation into intervention or control arms (1:1). The intervention will include a yoga-based programme tailored for the older adults, 1 hour per day for 6 days a week, spread for 24 weeks. Data would be collected at the baseline and post-intervention, the 24th week. The multiple primary outcomes of the study are the (bio)markers of HAP: glycated haemoglobin, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and forced expiratory volume in 1 s for physiological and metabolic health; Digit Symbol Substitution Test, Trail Making Tests A and B for cognition; hand grip strength and gait speed for physical capability; loneliness for social well-being and WHO Quality of Life Instrument-Short Form for quality of life. The secondary outcomes include inflammatory markers, tumour necrosis factor-alpha receptor II, C reactive protein, interleukin 6 and serum Klotho levels. Analyses will be by intention-to-treat and the holistic impact of yoga on HAP will be assessed using global statistical test. Ethics and dissemination The study is approved by the Institutional Ethics Committee of Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore (ID: RES/IEC-SVYASA/143/2019). Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. Trial registration number CTRI/2021/02/031373.