Deep Breathing for Healthy Lymphatic System

It is well known that deep breathing reduces stress, lowers blood pressure and helps to relieve hypertension. Pranayama, the fourth limb of yoga, is a practice to control breathing and develop the habit of deep breathing. What is not commonly discussed and highlighted is that deep breathing is one of the foremost tools available for keeping the lymphatic system healthy and flowing. The lymphatic system is a part of our immune system and its health is important for our well-being.

The illustration is from http://veritasradio.blogspot.com.au/2013/02/lymphatic-system-facts-functions.html
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The lymphatic or lymph system is an elaborate network of vessels to drain certain fluids from tissues, very much like the veins that capture blood from tissues and return to the heart. The lymph system serves three main purposes: 1. as a part of the immune system, it captures and eliminates foreign materials and helps to defend against bacteria, 2. facilitates absorption of fat and fat-soluble nutrients in the digestive system, and 3. help maintain fluid balance between blood and tissues [1].  As you can see for our well-being a healthy lymphatic system is essential.

Although the lymphatic system has similarities to that of the blood circulation system (veins) it has no energy source of its own to drive it.  The energy is provided by our musculo-skeletal system (e.g. body movements). As the muscles contract, the lymph vessels contract and the lymph is pushed along to the lymph nodes where they are filtered before joining veins [2].  Yoga is ideally suited for energising the lymphatic system and keeping it healthy for a number of reasons: 1. in asanas contraction and relaxation of muscles occur naturally, enabling lymph flow 2. twists and untwisting asanas are particularly useful for enabling lymph flows, 3. inversions are also enablers of lymph flow (using gravity), and 4. deep breathing is particularly considered useful for enabling lymph drainage. [3][4]

According to Dr Samuel West [5], deep breathing, which involves diaphragm movements and, expansion and contraction of abdominal muscles, stimulates cleansing of the lymph system by creating a vacuum effect which pulls lymph through the blood system by as much as 15 times the standard rate. Although there are many approaches to activate the lymphatic system [3], deep breathing (using the diaphragm and the abdominal muscles) appears to be the most effective approach. Regular practice of pranayama and deep breathing is a way to keep the lymphatic system healthy and to maintain our immune system functioning to the fullest.



[1] www.medicalnewstoday.com/articles/303087.php (accessed 9 Feb., 2017)
[2]  http://www.drdavidwilliams.com/lymphatic-system-drainage-exercises/
[3] https://yogainternational.com/article/view/5-natural-ways-to-relieve-lymphatic-congestion
[4]  https://www.youtube.com/watch?v=gDlvXePYJ9I
[5] https://www.grapegate.com/your-breath-of-life-part-1/

Post Traumatic Stress Disorder (PTSD) - Yoga can help – Scientific studies reveal

The PTSD Epidemic

On 19 June 2016 there was report on ABC (Australia) on how a group of military veterans are using Yoga to manage PTSD [1]. A former soldier who suffers from PTSD started using Yoga as a coping mechanism and now offers Yoga classes to others. At any given time, 1.4 million Australians (6.4 % of the total population) suffer from PTSD, according to the Bureau of Statistics. Quite often the condition is not properly diagnosed and the families suffer terribly. It is estimated that approximately 8.3% of the Australian Defence Force personnel have experienced PTSD. It is a serious problem that needs to be addressed. 

Systematic research based evidence is accumulating to support the view that Yoga can be an effective adjunctive or an alternative intervention to PTSD. In this blog the core idea of using Yoga for PTSD is summarised.

Yoga is ideally suited to help PTSD patients

Extreme trauma, caused by events such as sexual abuse, domestic violence, extreme physical stress, systemic discrimination such as racism, is often followed by dysfunction in stress response and emotion regulation, leading to PTSD. The common symptoms of PTSD include, amongst other things, muscle tightness, rapid heartbeat, difficulty in breathing, chronic pain, mood swings, rapid thoughts, hyper arousal, substance abuse, gambling addiction, inability to relax, low self-esteem and a belief that they are not in control of themselves.  Traumatic memories are often stored in the body (somatic) [11]. In Yoga it is understood that one of the effective ways to the mind is through the body. PTSD is a mind-body disorder and as Yoga is essentially an endeavour to create mind-body-breath harmony, it is ideally suited to help PTSD sufferers.  The traditional therapy for PTSD involves top-down approach promoted from outside, while Yoga approach is bottom up, utilising body and breath experience to influence the mind using self-discovery.

It is claimed, based on scientific research, that just one hour of Yoga, two to three times a week can improve one’s mood and health. Here Yoga includes all branches of Yoga, such as pranayama (breathing techniques), meditation and hatha Yoga [3].  Innes, Bourguignon and Taylor (2005) [6] have reviewed studies conducted between 1970 and 2005 on the effects of Yoga on cardio-vascular disease and they found that eighty-five percent of the studies demonstrated that Yoga reduces sympathetic activation (fight or flight response) and increases parasympathetic activation (nourishing and calming response).

Yoga techniques need to be tailored for PTSD patients

The popular types of Yoga such as power Yoga, hot Yoga, yoga at gyms and even Iyengar Yoga, which insists on highly regimented asanas, are not suitable. The emphasis is on being gentle, empowering and, promoting self-acceptance and self-esteem.  Different protocols on developing Yoga approaches for helping PTSD patients are currently available. For example Emerson, 2015, [5] describes “Trauma Sensitive Yoga”, which includes hatha Yoga, breathing techniques that are gentle, sensitive and empowering to trauma patients.   Jindani et.al.,2015, [7] from the Center for Addiction and Mental Health, Toronto, have demonstrated using a randomised trial that Kundalini Yoga helped PTSD sufferers improve significantly the measures such as sleep, stress, anxiety and resilience.  Shannahoff-Khalsa, 2004 [10] has presented Kundalini Meditation specific for the treatment of psychic disorders.  Kirlin, 2010, [8] has documented that Yoga helped Latina Women in coping with PTSD.

In a pilot study conducted by Nassif et.al. (2014) [9] demonstrated that iRest ® protocol ( a form of Yoga Nidra) clearly helps with the self-managing of chronic pains. In this study the self-management skill is developed through empowerment by acquiring cognitive, behavioural and emotional skills.

Although the above studies have consistently demonstrated the effectiveness of Yoga in helping PTSD patients more definitive studies involving larger samples are needed. Meanwhile, the Yoga community can play a significant role in developing Yoga sets and protocols that are beneficial to PTSD patients in collaboration with the clinical psychology/medical communities. Recognition of these latest research findings by the health departments, various government bodies and health-funds will assist the cause of PTSD patients, and help the communities emotionally and financially.

Further Reading

[1] http://www.abc.net.au/news/2016-06-19/military-veterans-turn-to-Yoga-class-brisbane-run-to-ease-ptsd/7466410

[2] https://www.irest.us/research  on iRest Yoga Nidra  research program and publications

[3] http://harvardguidetoYoga.com/

[4] https://www.irest.us/sites/default/files/Yoganidra%20Birch%20and%20Hargreaves.pdf   on historical perspective on Yoga Nidra

[5] Emerson, D. and Hopper, E., 2015, Overcoming Trauma through Yoga: Reclaiming Your Body . North Atlantic Books. Kindle Edition.

[6] Innes, K.E., Bourguignon, C., Taylor, A.G.,2005, Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with Yoga: A systematic review. Journal of the American Board of Family Practice, 18, 491-519

[7] Jindani, F., Turner N. and Khalsa, S.B.S., 2015, A Yoga Intervention for Posttraumatic Stress:A Preliminary Randomized Control Trial, Evidence-Based Complementary and Alternative Medicine, v.2015, Article ID 351746.

[8] Kirlin, M.,2010, Yoga as an Adjunctive Treatment for PTSD in Latina Women: A Review of the Evidence and Recommendations for Implementation (Master's thesis, Pacific University). Retrieved from: http://commons.pacificu.edu/spp/133

[9] Nassif, TH, Norris, DO, Soltes, KL, Sandbrink, F. Blackman, MR, Chapman, JC. 2014. Using Mindfulness Meditation to Improve Pain Management in Combat Veterans with Traumatic Brain Injury.Society of Behavioral Medicine Annual Meeting. (available at https://www.irest.us/sites/default/files/SBM%20Poster%20Final%20Nassif.pdf)

[10] Shannahoff-Khalsa, D.,2004, An introduction to Kundalini Yoga Meditation techniques that are specific for the treatment of Psychic Disorders, The J. of Alternative and Complementary Medicine,10 (1) pp.91-101.

[11] van der Kolk, B. A. 1994, The Body Keeps the Score,” Harvard Review of Psychiatry 1 (1994): 253– 265

Breathing is Life and Good Breathing is Good Life

For many centuries the discipline of Yoga knew the importance of good breathing for good life. Intuitively we are aware that breathing, when done properly, helps us to control our stress.  Yoga teaches us to control our breathing through appropriate asanas (postures), meditation and pranayama (controlled breathing).

Swami Sivananda – Founder Divine Life Society and author of “The Science of Pranayama”

In the West these techniques were brought to the main stream medical awareness, mainly through the seminal publication “Relaxation Response” of Dr Herbert Benson in 1975. The Relaxation Response is defined as your personal ability to make your body release chemicals and brain signals that make your muscles and organs slow down and increases blood flow to the brain [Ref.1]. There are many techniques for developing Relaxation Response or deep relaxation. In the list of techniques deep breathing, meditation and yoga asanas appear prominently. Breath meditation, in which you focus on your breath while seated in a comfortable position , can relieve stress [Ref. 2].  Yoga Nidra and many variants of the same (for example iRest® Yoga Nidra ) are known to provide deep relaxation and relief to PTSD (Post Traumatic Stress Disorder) sufferers [Ref.3].

Deep relaxation, if practiced regularly can strengthen our immune system and bring a host of other medical benefits. For example, relaxation can ease asthma symptoms by widening respiratory passages. In some cases it can help diabetics by reducing the need for insulin [Ref.4] and provide significant relief to chronic pain sufferers. We are slowly understanding the way stress reduction works in promoting good health. Studies show that Relaxation Response elicits gene expression changes in short term and long term practitioners. It is believed that this might be causing long term physiological changes for good [Ref.5]

Deep Breathing to control Blood Pressure and hypertension

Probably the most prominent benefit of deep relaxation, achieved through deep and slow breathing amongst other techniques, is in controlling high blood pressure [Ref.6].  These days most of us are always on the run and stressed due to the un-ending need to do more and perfectly all the time. This evokes a strong fight or flight response in us and in this process we often forget how to breathe. That is why we need to develop good breathing techniques and we need to use them instinctively.

Yoga provides a wide range of tools for deep relaxation, including breathing to discipline the mind. Pranayama, the fourth limb of Yoga, is a well-developed and elaborate set of techniques to control prana (the vital life force, including breathing). By practicing pranayama one can quickly transform oneself in terms of attitude and feelings [Ref.7].  It is mind boggling to know that people spend huge amounts of money on drugs to control stress, which is temporary any way, while relaxation techniques are available through proper breathing and yoga. It can be used anywhere and anytime and it is free.

Further Reading

[1] http://www.med.umich.edu/painresearch/patients/Relaxation.pdf    (on Relaxation Response)

[2] http://www.health.harvard.edu/mind-and-mood/breath-meditation-a-great-way-to-relieve-stress

[3] Stankovic,L., 2011, Transforming Trauma: A qualitative feasibility study of integrative restoration (iRest) Yoga Nidra on combat related Post-Traumatic Stress Disorder, Int. J. of Yoga Therapy, 21, p.23-37.

[4] http://www.nytimes.com/1986/05/13/science/relaxation-surprising-benefits-detected.html?pagewanted=all

[5] Dusek et.al., 2008, Genomic counter-stress changes induced by the relaxation response, http://www.ncbi.nlm.nih.gov/pubmed/18596974.

[6] http://www.health.harvard.edu/blog/stress-raising-your-blood-pressure-take-a-deep-breath-201602159168

[7] M. Tiwari, 1995, Secrets of Healing, Lotus Press, Wisconsin, 548p.

YOGA HELPS YOU LOOK AND FEEL YOUNGER

 Does yoga help you look younger? This is not a new question and as such not many ask this question any more as people notice that the regular practitioners of yoga look younger, healthier and happier (generalising of course). That is why there are so many scientific studies investigating the effect of yoga on aging. There are a large number of Yoga web-sites that provide you with a list of asanas to do to stay younger. I am more interested in what science says about this subject.

Indra Devi, who is the doyen of Women’s Yoga in the West. She lived a healthy and active life to the age of 102 and authored many books including “Forever young, Forever Healthy”.

A number of factors contribute to the person’s appearance, and hence the determination of the biological age compared to the chronological age.  The biological age measures (estimates) the age of cells, tissues and organs using measures such as near-point vision, acuity of hearing and systolic blood pressure (pressure in  blood vessels when the heart is pumping)[Ref.2]. The biological age is a measure of the health of the body.  Interestingly, in Ayurveda (the Ancient Indian Health Science, which is very much in practice in India and elsewhere) the aging is measured in terms of the loss of intelligence (in our cells).  As we lose the intelligence to self-repair the cells, tissues and organs we age and health deteriorates [Ref.2]. This concept of aging aligns well (but not the same of course) with the latest thinking on telomeres and their role in reproducing healthy cells and slowing aging.

Elizabeth Blackburn, Carol Greider, and Jack Szostak were awarded the 2009 Nobel Prize for discovering how chromosomes are protected by telomeres (DNA cap at the end of chromosomes) and how telomerase enzyme protects telomeres [Ref.3]. The ability to reproduce healthy cells depends on the length of telomeres, which gradually reduces with cell division. As the rate of healthy cell division decreases, the number of senescent cells or dead cells increases and the biological age increases. In other words, longer telomeres keeps us looking healthier and younger.

Various factors affect the rate at which the length of telomeres deteriorate and this is equivalent to a biological clock. It appears that simple things like poor food habits, infections and more importantly chronic stress contribute to the reduction of length of telomeres, causing rapid biological aging [Ref. 1]. This is where yoga contributes significantly by reducing chronic stress and hence reducing the rate of decline of the length of telomeres and providing a good supply of telomerase enzyme.  What is more interesting is that the slowing down of the shortening of telomeres can be achieved at any age and some limited studies have demonstrated that short telomeres can be made to grow. So, there is hope for looking younger at any stage of your life [Ref. 1]. Pessimism is another factor that contributes to the shortening of telomeres [3]. Yoga is well known for bringing balance in our lives and reducing pessimism or helplessness.

Yoga does much more than slowing down the biological aging as described above. A study conducted at Ohio State University found that regular practicing of Yoga reduces inflammation causing compound called IL-6 in the bloodstream. IL-6 normally rises with age and stress. IL-6 is implicated in heart disease, stroke, type-2 diabetes, arthritis and many other diseases. Reducing IL-6 and hence inflammation is possible with regular practice of Yoga [Ref.5]

Yoga helps with good posture, smooth and comfortable movements of joints leading to graceful body movement. More importantly, yoga makes you a more grounded, balanced and satisfied human being. Yoga philosophy develops a sense of service and gratitude within you. I am sure all these things make you a better person and a much younger looking one, both externally and internally. I don’t think biological aging is the only criterion for looking younger and more attractive. Science is slowly uncovering more secrets of Yoga but there is much more to uncover.

Further Reading:

 [1]  Broad, W., The science of Yoga – The risks and rewards

 [2]  Chopra, D., 2000, Perfect Health, Three Rivers Press, NY, 390p.

[3]  Elizabeth Blackburn - https://www.youtube.com/watch?v=Lb6AxaG70GM  On telomeres and telemerase.  DNA capping the chromosomes)  Telemerase protect telomeres from getting shorter as the cells divide.

[4]  Ornish, Dean, 1996, Program for reversing heart disease, Ballantine Books, NY, 638p.

[5] http://www.medicalnewstoday.com/releases/175705.php  (on IL-6, inflammation and Yoga)[6] http://www.healthandyoga.com/html/news/motivational/metabolic_factors.aspx - on metabolic factors affecting aging.

Yoga Meditation, Brain and the Whole of You

A tremendous amount of research is going on to understand the effect of Yoga and Meditation on brain. Interestingly more and more people are doing meditation because they already know that they can reduce stress, improve concentration and improve memory and so on.  Although the popularity of Yoga and Meditation is ever increasing the uptake is still slow. This is partly due to the attitude that Yoga is an Eastern discipline shrouded in mysticism and spiritualism.  Some even argue that it is Hinduism, even though I have never seen anyone teaching Hindusim in Yoga classes.  Science is helping to break this ‘self limiting’ attitude in the society.

On 7^th June on ABC TV in Catalyst (http://www.abc.net.au/catalyst/stories/4477405.htm) Dr Graham Phillips presented the results of eight weeks of meditation. Lo and behold he found that meditation increased grey matter in his brain (indicating increased density of nerve cells), improved his memory, improved his reaction time and even improved the energy efficiency of the brain.  A Harvard research had found that grey matter increased in critical areas, such as the hippocampus (important for memory and emotional balance), prefrontal cortex (important for decision making and social behaviour), and temporoparietal junction (important for attention and social interaction, language processing).

Science is very good in explaining what is happening in parts of our body but, at least at this stage, cannot explain the total transformative effect of Yoga. For example, in the Catalyst the story of a rich criminal Nick Brewer was presented. Yoga totally transformed him to a gentle compassionate human being.  Unfortunately people are afraid of Yoga transforming them and taking them to another world of kindness, compassion and oneness, when we are well accustomed to the self-obsessed societies. They are afraid that they might even become “weird vegetarians”!!

Yoga has much more to offer than what science is able to analyse at this stage. This is because Yoga brings mind-body-spirit-soul together and helps to discover ourselves. A quote from Plato, made over 2000 years ago, is quite telling: “No attempt should be made to cure the body without the soul. Let no one persuade you to cure the head until he has first given you his soul to be cured, for this is the great error of our day, that physicians first separate the soul from the body.” 

As Yoga becomes more popular the intensity of scientific inquiry will also increase, which is good for the society. One day we might be able to explain mind-body-spirit-soul as a whole, but meanwhile Yoga can help.

Is Yoga Exercise? Is this what we should be asking?

People often ask if Yoga is the same as exercise? I often wondered if this is the right question to ask. Is exercise an end in itself or is it a tool for some thing else. For example, what we are after is our wellbeing which includes physical and mental fitness,  and also harmony between mind-body-soul-spirit. Physical exercise works on the body and indirectly on the mind (only to some extent). Yoga by its very fundamental objective is designed to work on mind-body and in advanced practice of yoga on soul and spirit. By its very nature, Yoga is meant for working on our general well-being at a number of levels.

Maharishi Patanjali - Father of Yoga

Why this discussion is important? It is important because our questions determine  answers and answers determine our actions and actions determine who we are. If we ask if Yoga (particularly Hatha Yoga) is an exercise, depending on what you expect from an exercise, the answer may be yes or no.  Instead if the question is whether Yoga is better than exercise for our wellbeing the answer would be quite different. You might actually choose to do yoga with or without other exercises as the scientific  evidences are piling up on the benefits of yoga.

An article published in Calgary Herald by Dr Eddy Lang (Univ of Calgary, Dept of Family Medicine) on 25 May 2016 (http://calgaryherald.com/health/diet-fitness/does-yoga-count-as-exercise) has done the exact thing discussed above. The article discusses the outcomes of 30  studies, involving more than 2000 yogis, conducted by researchers from Australia, Germany and Korea to answer the question if yoga can be counted as exercise. The study has used parameters such as weight loss and body mass index as measures of performance. They found that weight loss was not significant by doing yoga, unless one is obese. This is reported as not that impressive. I would have thought that this is a significant outcome, particularly for obese people.  In addition, the study also found that if you are after wellbeing yoga can provide significant benefits.

This brings me back to the original question. Are we asking the wrong question by comparing exercise with yoga, and that too one branch of yoga - Hatha Yoga? It is like asking if bananas are oranges?  We should be asking if bananas are more nutritious than the oranges. Even for this simple question there is no one answer, as it depends on one's need, but at least it is a useful question. Similarly, we should be asking if yoga is better than exercise for our wellbeing? The answer from the study discussed above appears to be in the affirmative,  

Can Yoga prevent the onset of Alzhimer's disease?

It has been well known for thousands of years that regular practice of Yoga helps with the overall physical and mental health of people. However, rigorous scientific evidence for its effectiveness in preventing or reducing various illnesses is not readily available. Of late, scientific investigations on various aspects of Yoga are steadily increasing. Now,  a research conducted by a team of neuroscientists from UCLA  (which included a scientist from Adelaide, Australia) has concluded that a three month yoga + meditation can help people to minimise the cognitive and emotional problems that often precede the onset of Alzheimer's disease. As such Yoga therapy performed better that the conventional memory enhancing exercises by providing support for other mental issues such as mood, anxiety and coping skills.

Read more on this at: 
http://medicalxpress.com/news/2016-05-yoga-meditation-minimize-cognitive-impairment.html