Does Yoga Help Increase Healthspan and Lifespan?

It is a coincidence that I am writing about yoga just 5 days after the much-hyped International Yoga Day.

There is so much said and written about yoga that culling the information to understand how it can help us is a challenge.

So, I will start with the fundamental question pertinent to atmasvasth.

Does the regular practice of yoga improve our healthspan and lifespan and help us live long, healthy?

I practice some form of yoga at least twice a week or so, on the days that I don’t run or do strength training, but I haven’t been able to find a definitive answer. There are very few high quality randomized controlled trials (RCTs), if at all, that address this question. Most studies are poorly designed and the majority are biased, conducted by those who fervently believe in the power of yoga, which in turn contaminates the results and conclusions.

So, let’s break down yoga into its different parts and see if we can look at the benefits of yoga from another angle.

Yoga has many components, three of which are…physical postures (asanas), breathing techniques (pranayama) and meditation or relaxation (dhyana). We know that any physical activity improves our healthspan. Hence, we can extrapolate and say that if any form of physical activity helps us live long, healthy and if yoga is also a type of physical activity, then yoga should help us live long, healthy. If yoga is your way of being active physically, say instead of walking or strength training, then that should be fine, despite the lack of high quality direct evidence.

As an aside, it is interesting to know that “yoga as exercise” with all its postures and flows is just about 100 years old, popularized by Krishnamacharya and then his disciples including B K S Iyengar. Ancient forms of yoga were much less focussed on yoga as exercise and even then, they were mainly about seated poses. Standing poses are pretty much a modern phenomenon.

Is yoga as exercise, better than just walking? We don’t know, but what we do know is that walking remains the simplest, easiest and cheapest way to be physically active.

The same issue applies to improving balance and reducing falls. Tai-chi [1] has been shown to improve balance and reduce the incidence of falls among the elderly. Yoga is in many ways similar to tai-chi and is also known to improve muscle tone and balance and by extension should reduce falls in the elderly. Luckily, there is an ongoing RCT (the SAGE study) that may help answer this question, though, given that the investigators are fervent yoga acolytes, I am not sure there won’t be bias. Like tai-chi, yoga also improves flexibility, as compared to walking, running or strength training…but whether this increased flexibility helps us live long, healthy is not known.

Is there any other benefit of yoga over and above it’s benefits as a form of physical activity?

What about pranayama and dhyana? Dhyana is a form of meditation and as I mentioned last week, the data on the health benefits of meditation and its ability to help us live long, healthy, are poor. However, given that yoga in some form or the other, like meditation, has been around for about 3000 years, we can use its age as a surrogate to say that it is likely to help, if it has survived this long, and that perhaps the inability to find its usefulness is a fault of modern medicine’s methodology. Hopefully, we will know better in the next decade or two.

What about pranayama? It’s the same story. The data is poor or biased or limited. But breathing exercises do feel good and perhaps sometimes that is all that matters.

So what should you and I do?

If the practice of yoga in all its forms makes you feel good and gives you the ability to integrate physical activity, improved balance and meditation, all together, at least twice a week, without injury, then there is no reason not to incorporate it into your daily lives.

Hopefully, in the years to come, we will have more data on the health benefits of yoga. Until then, we can keep assuming it helps, given that it has been around for so long and will likely be around for centuries to come and practice it as best as we can, preferably with a trainer or expert, to keep ourselves physically and mentally agile as much as is practically possible.

Footnotes:

1. Li F et al. Effectiveness of Tai Ji Quan vs Multimodal and Stretching Exercise Interventions for Reducing Injurious Falls in Older Adults at High Risk of Falling: Follow-up Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2019 Feb 1;2(2):e188280.