THE SCIENCE OF YOGA

The International Day of Yoga/Yoga for Warriors conference 2018 was held at the Gonzalez Convention Center in San Antonio on June 9. One of the highlights of the conference is the talk titled “The Science of Yoga” by Dr. Sat Bir S. Khalsa, Assistant Professor of Medicine at Harvard Medical School. A search for “yoga” in Pubmed will result in thousands of research articles and one need a good amount of time to browse them. Dr. Khalsa very neatly highlighted the research on yoga from 1955-2018. What an amazing talk! Had I heard his talk earlier in my life, I would have been a long-term yoga practitioner by now.

Before I go into the lecture, let us know few definitions.

What is yoga? The basic elements of yoga practice include physical postures, breathing, deep relaxation and meditation.

What is meditation? Meditation is focusing, losing and getting back the attention.

What is mindfulness? Mindfulness is nothing but awareness of one's body and mind.

Dr. Khalsa started with quotes of Sri Aurobindo and Yogi Bhajan. He also quoted Indian Prime Minister Modi's speech at United Nations General Assembly.

“...a methodised effort towards self-perfection by the expression of the secret potentialities latent in the being...a union of the human individual with the universal and transcendent existence...” -Sri Aurobindo.

“Yoga teaches you the techniques and awareness to stay healthy. You gain strong immune, glandular and nervous systems. This foundation gives you energy and lets you deal with the mental and spiritual facets of your life.” -Yogi Bhajan.

“Yoga is an invaluable gift of our ancient tradition. Yoga embodies unity of mind and body; thought and action; restraint and fulfillment; harmony between man and nature; a holistic approach to health and well being. It is not about exercise but to discover the sense of oneness with yourself, the world and the nature. By changing our lifestyle and creating consciousness, it can help us deal with climate change. Let us work towards adopting an International Yoga Day”.
-PM Modi at United Nations General Assembly, 2014.

Do you know that yoga practitioners in the United States have increased from 15.8 million in 2008 to 36.7 million in 2016?

Before going into the talk, Dr. Khalsa said the research on yoga is not about discovering but about re-discovering the Science of yoga.

He brought the scientific studies on yoga to light. Those include Neurological, Musculoskeletal and Molecular Biological studies. They were done at reputed institutes such as National Institute of Health, Harvard Medical School, Massachusetts General Hospital or University of California, Los Angeles.

Here is the summary of what I grasped from his lecture. For more details, please refer the research articles mentioned under "references".

• Physiologically yogic meditation represents deep relaxation of automatic nervous system. (1)

• Voluntary control of blood flow in the hand and voluntary control of heart was observed in a yogi. (2)

• Stress reduction with yoga. (3)

• Yoga (Pranayama) induces long-term changes in respiratory function and control. (4)

• Gamma-Aminobutyric acid (GABA) related activity is reduced in mood and anxiety disorders. The practice of yoga postures is associated with increased brain GABA levels resulting in improved mood and decrease anxiety. (5)

• The Cerebral blood flow in specific brain regions that are associated with emotion and autonomic function was significantly higher in long-term meditators compared to non-meditators (6)

• Reduction of Default Mode Network (DMN) activity. Brain regions associated with DMN is active during mind wandering. And Salience Network regions are active during awareness of mind wandering. (7)

• Regular and long-term yoga practice improves pain tolerance. (8)

• At the end of a yoga program for youth in a school, the perceived stress is significantly decreased while the resilience is significantly increased. (9)

• Practicing yoga of course is not going to change your genes but it can bring a change in the activity of genes by changing their up-regulation or down-regulation. (10) 

• Highly involved yoga practitioners exhibited a significantly increased amount of mindfulness and spirituality and lower psychiatric symptoms such as depression. (11)

• Yoga has been shown to therapeutic for diabetes, cancer, mental health, lifestyle diseases (cardiovascular system disorders, insomnia), metabolic syndrome, endocrinology disorders. Search in Pubmed.

• Yoga for prevention of lifestyle diseases. Search in Pubmed.

Acknowledgement:
A person like me (with a scientific research background) or a middle school teacher, no matter what the background enjoyed his talk. Thanks to Dr. Nayak for inviting him to the IDY conference and thanks to Dr. Khalsa for accepting the request to give a talk to general audience.

References:
(1) Wenger MA, Bagchi BK, Electro-physiological correlates of some Yogi exercises. Electroencephalography and Clinical Neurophysiology, 7 (Suppl):132-149, 1957.
(2) Green E, Gren A. Beyond Biofeedback, Knoll Publishing Co. inc., 1977.
(3) Lundberg U. et.al. Stress management: A randomized study of cognitive behavioural therapy and yoga. Cognitive Behaviour Therapy, 35(1):3–10, 2006.
(4) Bernasconi C et. al. Reduced hypoxic ventilatory response with preserved blood oxygenation in yoga trainees and Himalayan Buddhist monks at altitude: evidence of a different adaptive strategy? Eur J Appl Physiol. 2007 Mar;99(5):511-8.
(5) Jensen JE et.al. Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. J Altern Complement Med. 2010 Nov;16(11):1145-52.
(6) Alavi A et.al. Cerebral blood flow differences between long-term meditators and non-meditators. Conscious Cogn. 2010 Dec;19(4):899-905.
(7) Barsalou LW et.al. Mind wandering and attention during focused meditation: a fine-grained temporal analysis of fluctuating cognitive states. Neuroimage. 2012 Jan 2;59(1):750-60.
(8) Bushnell MC et.al. Insular cortex mediates increased pain tolerance in yoga practitioners. Cereb Cortex. 2014 Oct;24(10):2732-40.
(9) Khalsa SBS et.al. Effects of a Kundalini Yoga program on elementary ans middle school students' stress, affect and Resilience. Journal of Developmental and Behavioral Pediatrics, 39:210-216, 2018.
(10) Lavretsky H et. al. Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial. Psychoneuroendocrinology. 2013 Mar;38(3):348-55 (11) Unterrainer HF et.al. The relationship between yoga involvement, mindfulness and psychological well-being. Complement Ther Med. 2016 Jun;26:123-7.

CHD AWARENESS

I am posting this to raise awareness about Congenital Heart Defect (CHD). CHD awareness may save a life, it could be you or it could be someone that you know. In the recent years, you might have heard heart related death in middle aged Indian men and women more often. You likely heard the terms “Heart attack” or “Cardiac arrest” more than “Heart failure”. Heart failure happens when the heart cannot keep up with its workload. Lets see in detail.

CONGENITAL HEART DEFECT (CHD)
"Congenital" means "present from birth". CHD is one or more abnormalities in the heart's structure that one is born with.

It may produce symptoms at birth, during childhood and sometimes not until adulthood.

In USA, 1 in 150 adults are expected to have some form of CHD. I believe the statistics is similar in India as well.

There are several (20+) types of defects. Lets learn more about the most frequently diagnosed CHD in adults known as Atrial Septal Defect (ASD). ASDs are twice as common in women as men!

ATRIAL SEPTAL DEFECT (ASD)

Image Courtesy of the Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities.

As you may know, the heart contains 4 chambers. 2 upper chambers: the right atrium RA, left atrium LA and 2 lower chambers: right ventricle RV, left ventricle LV.

The RA receives the deoxygenated blood which it then pumps down to the RV which in turn sends to the lungs. The LA receives the oxygenated blood which it pumps down to the LV which in turn sends to all body parts.

During the baby development inside the womb, the septum (wall) separating the two upper chambers of the heart will have several openings. They usually close during pregnancy or shortly after birth. If the opening does not close, a hole is left and it is called as an ASD.

ASD RISK
Normally, the pressure is higher on the left heart than the right heart, because of this the oxygenated blood gets pushed through the hole from LA and get mixed with the deoxygenated blood in RA, resulting in
1) Pulmonary arterial hypertension leading to arrhythmias.
2) Right-sided heart failure.
3) Stroke...etc,.

CAUSE
Most causes of CHDs are unknown, however multifactorial inheritence (environmental and genetic risk factors) may play a role.

SYMPTOMS
1) Heart murmur (the increased blood flow to the lungs creates a swishing sound)
2) frequent respiratory infections in children
3) shortness of breath
4) increased fatigue
5) fainting
6) irregular heartbeats
7) heart palpitations
8) decreased exercise tolerance or tiring easily.

TREATMENT
1) Cardiac Catheterization – a non-invasive procedure in which the ASD/hole is sealed by implanting a closure device.
2) Open Heart surgery – in which small holes are fixed by sutures, larger defects are fixed with a special patch that covers the hole.

DRINKING WATER AND EATING FERMENTED RICE

Amma has told me “drinking water in the morning is good” and appa has said “eating old fermented rice in the morning is good”. These are two of many other practices that has been practiced for many many years...from my great grandparents to grandparents to parents. Unfortunately not common within my generation.

First thing in the morning, my mom drinks luke warm water, she has been practicing this for a long time. It used to be a difficult task for me. I always gave up in 3-4 days of starting this practice :) After several attempts, now I'm following it on a daily basis. Logically, drinking 1-1.5 liters of water first thing in the morning cleanses our body by removing the toxins which we accumulated the previous day. Today, scientific studies have found that it prevents and controls several diseases. Just type “water therapy” in your search engine and you will find the advantage of drinking water in the morning.

The other good thing is “Pazhya Saadam” (old cooked rice). My dad said that he grew up eating pazhya saadam. He told me that this dish is the daily food for the poor people. He said that the vitamins (if I remember it is “vit B”) in this dish keeps a person in good health. I remember, when I was a kid, during my summer vacation at my relatives home, my cousins used to compete for this simple but delicious dish, I usually don't get the chance to eat it. However, back from my vacation I used to ask my mom to make it for me. It is a simple dish because the leftover rice is soaked in water and allowed to ferment overnight and next day morning little buttermilk and salt is added and eaten along with raw shallots or small onions. Usually, people drink the leftover liquid at the end.

JAGGERY

Jaggery is unrefined natural sugar that is produced without adding any chemicals. More than 70% of the total world jaggery production is done in India. During my vacation in India (2006), I visited a small scale jaggery production site at the outskirts of my hometown. The sugarcane farm belongs to our neighbor. The sugarcane juice along with crushed ginger and lemon is a refreshing drink in India. My parents never allowed me to drink due to the potential contamination by water, flies or air pollutants which may in turn result in diseases like cholera or dysentery. However, we enjoyed the drink at these private small scale jaggery production sites.

In the pictures below, you can see the sugarcane farm as well as the site of the jaggery production. First, the sugar cane is crushed to extract the juice. The impurities from the juice are removed by straining. The juice is then poured into a large open pan and then heated on a huge stove to remove excess water. Finally, it is transfered to a large container and is allowed to cool. Before it completely dries out, the workers make the jaggery into balls or into the desired shapes. By the way, the sugarcane wastes are in turn used as fuel for the stove or used as fertilizers.






Benefits of jaggery
Jaggery is popularly known as the “medicinal sugar” and is nutritionally comparable with honey. It has been used as a sweetener in Ayurvedic Medicine for 3000 years. Indian Ayurvedic medicine considers jaggery to be beneficial in treating throat and lung infections.
While refined sugar mainly consists of glucose and fructose, jaggery contains glucose and sucrose. But jaggery also has minerals and vitamins which is lacking in the refined sugar. The mineral content of jaggery includes calcium, phosphorus, magnesium, potassium and iron and traces of zinc and copper. The vitamin content includes folic acid and B-complex vitamins. Thus, other than that it is a good source of energy, it also prevents rheumatic afflictions; prevents disorders of bile; helps in relieving fatigue, relaxation of muscles, nerves and blood vessels; maintains blood pressure and reduces water retention; increases hemoglobin level and prevents anaemia.

SHOULD WE TRUST FOOD AND DRUG ADMINISTRATION (FDA) ?

Bisphenol A (BPA) is used to make polycarbonate plastics that are shatter-resistant and optically clear. These are found in baby bottles, some water bottles, dental sealants, dinnerware, eyeglasses, and in CDs. BPA is also used to make the resin that lines tin cans. This chemical has been shown to cause breast cancer, testicular cancer, diabetes, obesity, hyperactivity, low sperm counts, miscarriage and a host of other reproductive failures in lab animals. This gave rise to concerns that low-level exposure might cause similar effects in human beings.

Its known that BPA is manufactured by Bayer MaterialScience, Dow Chemical Company, General Electric, Hexion Specialty Chemicals, and Sunoco Chemicals. I read that General Electric Co. sold its plastic section last year.

In 1998, Envirnomental protection agency (EPA) had set a one year deadline for itself to screen 15,000 suspected endocrine disruptors including BPA but failed to do so. Ten years passed and the EPA is yet to screen its first chemical. It should be noted that EPA has already spent $18 million for the endocrine disruptor screening program without screening a single chemical!

In 2007, scientists funded by National institute of environmental health sciences (NIEHS) directly studied BPA and raised great concern for BPA. On the other hand, NTP (National toxicology program) panel of scientists who did not directly study BPA but evaluated the other studies concluded BPA to be safe. The watchdog report of Journal Sentinel found that the studies the NTP panel considered were chosen, in part, by a consultant with links to firms that made bisphenol A. To read the article, click here.

Now, in 2008, the Food and Drug Administration (FDA) says Bisphenol A to be safe. Some of the US senators including John Kerry (D-MA) and Charles Schumer (D-NY) have introduced a bill to ban BPA from children's products and direct the Centers for Disease Control and Prevention to study the chemical's human health effects.

Here are some ways to protect us until the state or federal laws outlaw BPA in consumer products:
1) use baby bottles or water bottles that say BPA-free, or use glass or stainless steel bottles.
2) minimize the consumption of canned food and beverages.
3) do not use the type 7 plastic containers that says #7 in a triangle on the bottom.

At this time I remember what my brother wrote on his blog: only 5 chemicals have been banned in the US in the last 30 years: Polychlorinated biphenyls (PCBs), Chlorofluorocarbons (CFC), Dioxin, Asbestos, and Hexavalent chromium. If you are interested in reading stuff related to harmful chemicals, click here.

CARBON MONOXIDE POISONING IN CARS

I read an incident happened in Chennai on October 28th night. It was a very sad one. A software engineer identified as Balakrishnan (38) along with his colleagues, Balachander (28) and Arumugam (19) died due to Carbon monoxide poisoning in their car. With the engine revving, they waited for rain to stop and the water to recede. When Balakrishnan didn't return home in the night, his nephew Deepak went to G N Chetty Road around 12.30 am and found the car abandoned. He thought Balakrishnan would drive home in the morning after the rain abates. But when he didn't, Deepak went back to the car on Sunday morning to find all three dead. A police officer said, "In their autopsy report doctors have said the death was caused by the inhalation of carbon monoxide."

It was painful when I came to know that Balakrishnan (aka Kumar) is the only son of my father's friend (Prof.M.Lakshmanan) and also my brother's friend during their teenage. I pray for his & his colleagues' atma to attain peace.

The following is a report from "The Hindu" newspaper.

When water & air conspire to kill

Tuesday, Oct 31, 2006

Chennai: A car can be a deadly place to be in an automobile accident. And then, you can die while simply sitting in a parked car, its engine running, the windows up and the air-con running. The freak accident that recently involved three Chennai-based young software engineers in a Santro is an illustration of how death can strike viciously and silently while doing nothing less innocuous than sitting in a car. Now, though knowledge of the circumstances in the incident is still forthcoming, a post mortem report of the three people points a probable finger at the cause of death — a heavy amount of carbon monoxide in the lungs.

Here's a possible reconstruction of the tragedy. The three colleagues decide to head out in the car and find themselves stuck in a logjam of cars stranded in heavy rain and the flooding on G.N.Chetty Road. They decide to wait out the situation with the windows up — the rain otherwise would get into the car. The air-conditioner is running and set on `recirculate' — a mode people normally use to prevent the smellier components of urban air pollution from getting into the car. The engine is running to keep the air con functioning.

In the meantime, water is rising below and around the car, and this means the hot exhaust gas, which normally has a larger volume of air to disperse into, is suddenly crowded up against the undersides of the car's floorboards. The situation might be more adverse if the car's exhaust system has a leak somewhere and all emissions are not properly exiting at the tailpipe as they are meant to. The gases might therefore be building up more heavily than normal under the car and inside the engine bay. And invariably, this gas will get into the car through the tiny access holes present in these regions — the little holes on the floorboard that drain water from inside a car, the innumerable gaps and holes that route wiring, cabling and mechanical controls like the steering column through the engine bulkhead — the wall that separates the engine bay from the passenger cabin. In the meantime, the air-con is steadily recirculating the deadly gases through the cabin of the car — and a silent and deadly killer gas — carbon monoxide — goes to work, poisoning the unwary occupants.

How does CO kill?

Carbon monoxide, or CO, is one of the gases emitted by your car's exhaust system. It is completely imperceptible to the human senses, being odourless, colourless, tasteless. And this poison is doubly deadly, as it gets absorbed into the bloodstream quickly — the haemoglobin in blood has a much greater affinity for this gas than oxygen, forming a strong bond that is devastating in nature — it starves organ tissues in the human body of vital oxygen. Symptoms of CO poisoning are things you'd shake off as the result of a stressful, long day at work — headache, dizziness, nausea and fatigue. And then you might decide to sleep it off for a while...

Note: Is it anything to do with the car "Hyundai Santro"? This incident bears shocking resemblance to the 2005 Mumbai floods tragedy in which two youth died in a centrally locked Hyundai Santro car as floodwaters began to rise. Another incident in Sept 2006 in Faridabad, in which a family of four suffocated to death inside a Hyundai Santro.