Dr.P.

Saranyan
Principal Sant Hirdaram Medical College of Naturopathy & Yogic Sciences Bhopal 462030 principal@shmcnys.in www.shmcnys.in

Obesity : a serious problem

The prevalence of obesity has nearly doubled in the last 3 decades. All the practitioners in every type of healthcare settings are looking for creative strategies to achieve safe, effective care for this patient population. This increase in the prevalence of obesity in recent years has prompted research into alternative methods of modulating body weight and body fat.

Why treat Overweight and Obesity ?

Obesity is clearly associated with increased morbidity and mortality. There is strong evidence that wt. loss reduces risk factors for diabetes and cardiovascular disease. Strong evidence exists that wt. loss reduces blood pressure in both overweight hypertensive and non-hypertensive individuals; reduces serum triglycerides and increases HDL.

Alternative Medicine in Obesity

Therapies implemented in management of Obesity in Naturopathy & Yoga, following patient education and counseling.

Naturopathic Diet pattern Therapeutic Juice Fasting Hydrotherapy Mud Therapy Acupressure & Acupuncture

Alternative Medicine in Obesity .

Manipulative Therapies including therapeutic Swedish Massage Yoga Therapy ( Integrated approach) Therapeutic Lifestyle Modification Age and Disease Specific Exercise program

A systematic review on use of Chinese medicine and acupuncture for treatment of obesity.

The effectiveness and safety of traditional Chinese medicine including Chinese herbal medicine (CHM) and acupuncture provide an alternative established therapy for this medical challenge. CHM and acupuncture were more effective than placebo or lifestyle modification in reducing body weight.

Sui Y, Zhao HL, Wong VC, Brown N, Li XL, Kwan AK, Hui HL, Ziea ET, Chan JC, ,Obes Rev. 2012 Feb 1. doi: 10.1111/j.1467-789X.2011.00979.x

Prevention of diet-induced obesity by dietary black tea polyphenols extract in vitro and in vivo.

BTP and BTPE inhibited pancreatic lipase activity with an IC(50) of 15.5 and 36.4 g/mL in vitro, respectively. BTPE suppressed increases in rat plasma triglyceride levels in a dose-dependent manner after oral administration of a lipid emulsion. Furthermore, administration of the 5% BTPE suppressed increases in body weight (P < 0.05), parametrial adipose tissue mass, and liver lipid content (reduced to 56.9% and 81.7% of control mice, respectively, P < 0.05) in mice fed a high-fat diet.
Uchiyama S, Taniguchi Y, Saka A, Yoshida A, Yajima H. Nutrition. 2011 Mar;27(3):287-92. Epub 2010 Jun 3.

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months.

A randomised controlled trial of two intervention groups, a group-based cognitive behaviour therapy lifestyle intervention, Fat Booters Incorporated--(FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). The intervention groups involved weekly contact for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting. RESULTS: Change in weight in the IDT group did not differ from the FBI group at any time point. For all groups, waist circumference was significantly less than baseline at all time points (P<0.001). Significant differences in self-efficacy were observed over time (P=0.02), with both intervention groups having greater selfefficacy than the BO group. Significant drop-outs occurred over time for all three groups. CONCLUSIONS: A cognitive behaviour-based lifestyle intervention was more effective than providing an information booklet alone and as effective as intensive individualised dietetic intervention in weight loss and improvements in self-efficacy.
Ash S, Reeves M, Bauer J, Dover T, Vivanti A, Leong C, O'Moore Sullivan T, Capra S,Int J Obes (Lond). 2006 Oct;30(10):1557-64. Epub 2006 Mar 14.

Integrative approach to obesity

Integrative medicine blends conventional medicine with carefully evaluated complementary therapies and considers all elements of a patient's lifestyle (physical, mental, spiritual). Integrative medicine therapies and philosophies have characteristics similar to those of successful treatment programs for pediatric obesity. It also updates the practitioner on selected integrative approaches as they relate to prevention and treatment of pediatric obesity.
Pediatr Clin North Am. 2007 Dec;54(6):969-81; xi.,McClafferty HH. The Center for Children's Integrative Medicine, 55 Vilcom Circle, Chapel Hill, NC 27514, USA. hmcclafferty@earthlink.net

Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women.

OBJECTIVE: To examine whether yoga practice is associated with lower mean 10-year weight gain after age 45. PARTICIPANTS: Participants included 15,550 adults, aged 53 to 57 years, recruited to the Vitamin and Lifestyle (VITAL) cohort study between 2000 and 2002. MEASUREMENTS: Physical activity (including yoga) during the past 10 years, diet, height, and weight at recruitment and at ages 30 and 45. All measures were based on self-reporting, and past weight was retrospectively ascertained.

METHODS: Multiple regression analyses were used to examined covariate-adjusted associations between yoga practice and weight change from age 45 to recruitment, and polychotomous logistic regression was used to examine associations of yoga practice with the relative odds of weight maintenance (within 5%) and weight loss (> 5%) compared to weight gain.
RESULTS: Yoga practice for four or more years was associated with a 3.1-lb lower weight gain among normal weight (BMI < 25) participants [9.5 lbs versus 12.6 Ibs] and an 18.5-lb lower weight gain among overweight participants [-5.0 lbs versus 13.5 Ibs] (both P for trend <.001). Among overweight individuals, 4+ years of yoga practice was associated with a relative odds of 1.85 (95% confidence interval [CI] 0.63-5.42) for weight maintenance (within 5%) and 3.88 (95% Cl 1.30-9.88) for weight loss (> 5%) compared to weight gain (P for trend .026 and .003, respectively). CONCLUSIONS: Regular yoga practice was associated with attenuated weight gain, most strongly among individuals who were overweight. Although causal inference from this observational study is not possible, results are consistent with the hypothesis that regular yoga practice can benefit individuals who wish to maintain or lose weight.

Altern Ther Health Med. 2005 Jul-Aug;11(4):28-33. Kristal AR, Littman AJ, Benitez D, White E.

Short term health impact of a yoga and diet change program on obesity.

BACKGROUND: Obese persons often find physical activity difficult. The effects of a yoga and diet change program, emphasizing breathing techniques practiced while seated, was assessed in obese persons. MATERIAL/METHODS: A single group of 47 persons were assessed on the first and last day of a yoga and diet change program, with 6 days of the intervention between assessments. The assessments were: body mass index (BMI), waist and hip circumferences, mid-arm circumference, body composition, hand grip strength, postural stability, serum lipid profile and fasting serum leptin levels. Participants practiced yoga for 5 hours every day and had a low fat, high fiber, vegetarian diet. Last and first day data were compared using a t-test for paired data. RESULTS: Following the 6-day residential program, participants showed a decrease in BMI (1.6 percent), waist and hip circumferences, fat-free mass, total cholesterol (7.7 percent decrease), high density lipoprotein (HDL) cholesterol (8.7 percent decrease), fasting serum leptin levels (44.2 percent decrease) and an increase in postural stability and hand grip strength (p<0.05, all comparisons). CONCLUSIONS: A 6-day yoga and diet change program decreased the BMI and the fat-free mass. Total cholesterol also decreased due to reduced HDL levels. This suggests that a brief, intensive yoga program with a change in diet can pose certain risks. Benefits seen were better postural stability, grip strength (though a 'practice effect' was not ruled out), reduced waist and hip circumferences and a decrease in serum leptin levels. Med Sci Monit. 2010 Jan;16(1):CR35-40. Telles S, Naveen VK, Balkrishna A, Kumar S. Patanjali Yogpeeth, Haridwar, India. shirleytelles@gmail.com