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CVD Intervention Showdown: Yoga>Walking>Mediterranean diet

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Sthira, you'll love this one [1] posted by Al Pater (thanks Al!) to the CR email list. It compared various group lifestyle interventions, including yoga, walking, Mediterranean diet and group smoking cessation classes for their effect over the following 10 years on risk of cardiovascular disease. It found:


[Y]oga was associated with the largest 10-year cardiovascular disease risk
reductions (maximum absolute reduction 16.7% for the highest-risk
individuals). Walking generally ranked second (max 11.4%), followed by
Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%).


Of course, the effectiveness of a treatment is dependent on subject compliance and treatment efficacy. That's why smoking cessation treatments were almost completely ineffective - almost nobody quits for very long. The authors acknowledge this, saying: 


We have presented a rank order of strategies that do not include taking any pills or medication. As such,
non-adherence with lifestyle change and other health behaviors, including pill-taking, is of concern and may dilute
intervention effects. Our calculations are based on intention to-treat rates from the clinical trials, which incorporate


For a current smoker, successfully quitting smoking is the most effective lifestyle change. Smoking cessation is, however,
difficult to achieve and group therapy for stopping smoking has only a small probability of success. From an
intention-to-treat perspective, if yoga is as effective as reported in currently published meta-analyses, then yoga
could be considered among the strongest lifestyle interventions for reducing CVD risk.

Too bad they didn't include a dance intervention group. Based on the benefits of dance discussed here, I bet it might have done best of all!





[1] Comparative Effectiveness of Personalized Lifestyle Management Strategies
for Cardiovascular Disease Risk Reduction.
Chu P, Pandya A, Salomon JA, Goldie SJ, Hunink MG.
J Am Heart Assoc. 2016 Mar 29;5(3). pii: e002737. doi:
PMID: 27025969 Free Article



Evidence shows that healthy diet, exercise, smoking interventions, and
stress reduction reduce cardiovascular disease risk. We aimed to compare the
effectiveness of these lifestyle interventions for individual risk profiles
and determine their rank order in reducing 10-year cardiovascular disease


We computed risks using the American College of Cardiology/American Heart
Association Pooled Cohort Equations for a variety of individual profiles.
Using published literature on risk factor reductions through diverse
lifestyle interventions-group therapy for stopping smoking, Mediterranean
diet, aerobic exercise (walking), and yoga-we calculated the risk reduction
through each of these interventions to determine the strategy associated
with the maximum benefit for each profile. Sensitivity analyses were
conducted to test the robustness of the results. In the base-case analysis,
yoga was associated with the largest 10-year cardiovascular disease risk
reductions (maximum absolute reduction 16.7% for the highest-risk
individuals). Walking generally ranked second (max 11.4%), followed by

Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If
the individual was a current smoker and successfully quit smoking (ie,
achieved complete smoking cessation), then stopping smoking yielded the
largest reduction. Probabilistic and 1-way sensitivity analysis confirmed
the demonstrated trend.


This study reports the comparative effectiveness of several forms of
lifestyle modifications and found smoking cessation and yoga to be the most
effective forms of cardiovascular disease prevention. Future research should
focus on patient adherence to personalized therapies, cost-effectiveness of
these strategies, and the potential for enhanced benefit when interventions
are performed simultaneously rather than as single measures.


cardiovascular risk reduction; comparative effectiveness; lifestyle

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Thanks, Dean. You're right, I love yoga. I know it's trendy, but hey, people with a regular, consistent, longterm, daily strong yoga practice are like duh of course it's the healthiest activity to give to not only the heart, CVD, but for other body dynamics, too.


Explore yoga, yoga is for everyone, all ages, all abilities, all levels of fitness, strength, flexibility, stamina. Asana -- any school or style -- Ashtanga, Iyengar, Power, Hot, all the hybrid vinyasas, Yin Yoga, all of them work your entire body -- head to tail to feet. Yoga will kick your ass. The practice requires no fancy, expensive tools or gimmicks, no machines, and no one needs the stupid sexy clothes, nor a mat, we just need some space, some community, our own bodies and the willingness to explore edges.


Its obvious pranayama benefits, deep, mindful breathing, conscious relaxation, stress reduction are what most people who don't actually have a consistent yoga practice associate with yoga. These stress-reduction benefits -- enormous -- are a stereotype. Yoga is more than peace, love, and incense, it's more than beads and sitars and hot chicks upside down dripping sweat, it's more than pretzel shapes, flexibility, more than bearded old scrawny Indian dudes chanting sutras. Yoga is huge. So huge that I'm totally unconcerned with the commercialization of western yoga -- because yoga can encompass capitalism and crass, sexual stereotypes and greed, envy, stupidity, commodification... It's a wide, deep, well-trodden system of healthy living -- fuck yeah it's good for your heart -- and it can be a lifelong friend and companion. Yoga is a precious gift. Explore it.


Ballet is amazing. Yet ballet is art. It's about the appearance of external beauty, it's about giving a hungry audience the physical beauty they paid to watch. It's also easier to hurt thyself in ballet -- particularly feet take a terrible beating -- and ankles, toes, shins, knees, hips...


But yoga? Yoga and CR are fine companions. They sync well together. CE and yoga, dance, I'm not so sure... Willing to try CE, though, to see if it negatively affects contortion.

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