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Yoga in women with abdominal obesity -- do lifestyle factors mediate the effect? Secondary analysis of a RCT [with consumer summary]
Anheyer D, Koch AK, Thoms MS, Dobos G, Cramer H
Complementary Therapies in Medicine 2021 Aug;60:102741
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: The reduction of obesity is an important challenge for health policy. Although dietary interventions are widely available, patient adherence is usually low. A promising alternative is yoga. We hypothesized that weight reduction through yoga is mediated by aspects related to eating habits as well as physical aspects. METHODS: This is an exploratory secondary analysis of a randomized controlled trial comparing the effects of yoga to waiting list in women with abdominal obesity. Body mass index (BMI) and waist circumference were assessed as outcomes; physical exercise habits, physical activity habits at leisure time, physical activity habits at work time, daily fruit and vegetable intake, nutrition self-efficacy, and physical self-efficacy were captured as mediators. Measures were assessed at weeks 0 and 12. The original trial was conducted between April and August 2015. The secondary analysis was performed December 2019. RESULTS: Forty patients were randomized to the 12 weekly yoga sessions (48.5 +/- 7.9 years) and 20 patients to the waitlist group (46.4 +/- 8.9 years). Physical exercise habits fully mediated the effect of yoga on BMI (B -0.26; CI -0.56 to -0.07). Daily fruit and vegetable intake partially mediated the effect of yoga on BMI (B -0.13; CI -0.38 to -0.01). No further mediation effects were found. CONCLUSIONS: Yoga supports people with overweight in eating healthier and increasing their physical activity which in turn leads to a reduced BMI. Yoga's effects on waist circumference seem to be due to other mechanisms.

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