
Yoga Effects on Brain Health: A Systematic Review of the Current Literature - bookofjoe
https://content.iospress.com/articles/brain-plasticity/bpl190084
======
thomasfedb
I think it's probably non-controversial that exercise (posing, stretching),
and mindful activity (meditation, thoughtful breathing) are good for us.
Certainly it's something I feel happy encouraging patients to do, particularly
if they enjoy it or feel that it benifits then.

What I find thought-provoking though is the use of the phase "health approach"
in the first line of the abstract:

> Yoga is the most popular complementary health approach practiced by adults
> in the United States.

I wonder what exactly qualifies as a "health approach". The paper acknowledges
exercise is well know to be good for people, particularly in ageing - so it's
heathy, but is exercise an "approach"? What about reading, or caring for young
children (both also good for your health) can that be a "health approach"?

I usually try to talk about these practices as being part of a heathy
lifestyle, rather than being therapies. I feel that we're over-medicalising
when we start to say that riding a bicycle or hugging our friends are
therapies, rather than just being healthy.

~~~
ditonal
What I often see is something like “exercise and yoga are good self care, but
for serious mental illness you need professionals.” And “professionals” in
2019 usually translate to psych meds and talk therapy (eg CBT), both of which
have extremely shoddy science but get far less skepticism.

I got involuntarily committed for mania/psychosis, didn’t sleep for weeks,
hallucinations etc so of course I was prescribed the intense cocktail of mood
stabilizers, antipsychotics etc and told I needed that and intense therapy for
the rest of my life. I stopped all meds and therapy and focus on mindfulness,
sobriety, routine etc and feel it’s the stable path.

I entered a super deep depression when released but read everything about
mental health I could get my hands on. And I now believe the best “therapy”
for serious mental health issues is things like yoga and meditation, plus
lifestyle changes.

It gets reduced to stress reduction and mild exercise, but mindfulness is
about developing awareness of feelings which leads to better emotional
regulation. If you can develop more space between your thoughts and feelings
and your consciousness you stop being so controlled by them.

The skeptics will say it’s a bunch of new age mumbo jumbo but they don’t apply
that same skepticism to psych meds even though psych meds are not understood
at all, mostly work by placebo, and have awful side effects. Not so long ago
doctors were ordering lobotomies and overprescribing OxyContin because an
attractive pharmaceutical rep sold it to them but now when they overprescribe
psych meds and talk therapy they are seemingly infallible.

~~~
temporaryvector
The thing that you're missing is that most health professional will still
include things like "exercise and yoga" in their treatment plans because
that's what is required. Usually it's the patients that expect pills and
therapy to show magical, immediate results. Nobody (well, I'm sure there are
doctors that would, but at the risk of invoking a No True Scotsman, some
doctors are pretty bad at their job) is going to tell a depressed person or a
person with severe ADHD to just pop pills and not exercise, meditate or
otherwise not do any self-care. The pills are there to help the ill person get
to a place where they can start working towards those things, pills are step
one of a long process, they're not the only step. The thing psych meds are not
taken with much skepticism is that they can show results incredibly quickly,
even if getting the right results cant take months of fine-tuning and trial
and error due to the fact that the mechanisms aren't well understood.

A very good analogy for mental illness and psych meds is diabetes and insulin.
Most people who are prediabetic or have diabetes will have type 2, adult-onset
diabetes, which can be stopped or reversed with lifestyle changes, but those
are hard. If an obese person is feeling terrible and goes to a doctor and gets
diagnosed with diabetes, the doctor will give them insulin because they need
it to live and function, but it's not actually going to solve the problem.
Insulin is just step one for such a person, step 2 involves exercise and diet,
maybe surgery in severe cases, but many people can't commit to such lifestyle
changes and just keep taking insulin as a stop-gap measure to keep living in
relative comfort, while other people will manage to use their new feeling to
take up the needed lifestyle changes and get cured (or go into remission, as
they say), possibly to a point where they no longer need insulin or other
medication.

In the same vein, just as there is type 2 diabetes, there is type 1 diabetes,
whether it manifested because of environmental factors or was purely
inherited, these people need insulin to live. The state of medical science
today means they will need insulin and other medication for the rest of their
lives, but they still need the diet changes and exercise, nobody is expecting
them to just sit on medication and nothing else.

With mental illness it's the same way, some people can get better with just
exercise and lifestyle changes, but some people need professional help (meds
and therapy) to be able to implement those lifestyle changes and maybe get to
a point where the no longer need the help. Other people, however, will need
meds for the rest of their lives to have a chance at normal life, at least
with the current state of medicine. One can hope for a breakthrough in the
future but people need to live their lives right now, and if that involves
taking a pill or two every day, so be it.

In my particular case, I think that I was pretty lucky that me and my
psychiatrist only took 4 or so months to find the proper combination of meds
for me, but at no point did he tell me that was all I needed. He always
insisted that diet, exercise and mindfulness were part of the treatment and
the meds were there to help me get started. Now it's been roughly a year since
I started and I lost a ton of weight, exercise regularly (including yoga) and
eat healthy. I'm down to only taking my ADHD meds because the others did their
job and I don't need them anymore, but even if I have to take this pill daily
for the rest of my life I'm okay with it because my quality of life
skyrocketed. This was not possible for me a couple of years ago when I thought
that I could power through my issues with yoga and exercise alone and didn't
trust psychiatrists.

I think it's incredibly irresponsible to tell people that things like yoga,
meditation, exercise and diet changes are a replacement for professional
mental health help. This may be true for some people, but I suspect the
percentage is close to the amount of people who are able to stop being
alcoholics without help. The two things are orthogonal, professional medical
help is one thing and a healthy lifestyle is another. Having a healthy
lifestyle may mean that you don't need professional help, but professional
help may be required for a person to be able to get a healthy lifestyle.
Finally, professional help usually involves all those nice things like plenty
of exercise and a good diet, sometimes yoga or mindfulness/meditation (even if
they call it something else the principles are usually the same, CBT for
example is basically mindfulness by another name). You go to the a
professional so he can help you get going with all of that, because sometimes
you just can't by yourself.

~~~
dr_dshiv
> most health professional will still include things like "exercise and yoga"
> in their treatment plans because that's what is required.

Wow, that is not my experience at all. Neither do I think it is irresponsible
to suggest that yoga, meditation, exercise and diet change can substitute for
"serious" mental health treatment -- Anyone who can maintain wellness
activities (exercise, sleep, diet) is in a much better state of wellness than
a person who is seeing a psychiatrist -- by definition. While it may be that
psychiatry could help patients exercise, I have not seen any studies on the
efficacy of psychiatrists in motivating patients to maintain a regular
exercise routine. I'd imagine your average yoga instructor would do better.

------
tyleo
I started yoga two years ago after suffering a small back injury while weight
lifting (I lift 4 times weekly). I was looking for an exercise routine which
was: 1) Easy to do while traveling 2) I could do well into my old age (I can’t
lift heavy weights forever) 3) Would build back strength to counteract the
degeneration of my desk job (developer)

I enjoy yoga immensely and I feel that I have granted myself a gift that will
last a lifetime. I am not spiritual and was not flexible before starting so I
wouldn’t count those are barriers for getting benefit from the practice. I do
try to suspend my beliefs about spirituality as well as I can during practice
which has worked well for me.

I started with the C1 classes at CorePower which I’d recommend to beginners
who are interested.

~~~
chris_st
Similar desires (no back injury, thankfully!) and got into a "Les Mills"-brand
"BodyFlow" class at my gym about eight months ago.

Really glad I did! MUCH improved balance, much less overall pain, stronger in
lots of ways, etc. Nice little guided relaxation exercise at the end, too.
Recommended.

------
flyGuyOnTheSly
I've developed a daily practice over the past 8 months and the two most
important pieces of anecdotal evidence that I have noticed that keep me coming
back are:

1) I am happier. No doubt about it. Situations where my memory recalls that my
self was typically unhappy in have been turned around. I find myself content
when I am "supposed to be" frustrated at various things like traffic, intense
situations, etc.

2) Older people at the studio look younger than me. Not everybody of course.
But a significant number of the elderly people who have a daily practice look
as young and spry as any one of the youngest children who come into the
studio. (They host kids yoga classes occasionally).

I am laying here in half lotus right now actually, counting down the last few
minutes at home here until I leave for today's class.

I can hardly wait!

~~~
lm28469
> Older people at the studio look younger than me.

Not a rebuttal of your experience but don't forget that people doing yoga
regularly are also most likely to eat healthier and exercise more than the
average.

~~~
flyGuyOnTheSly
Absolutely!

And becoming a part of a local community of people who all align with living
that way, makes it really easy to live that way yourself.

Which is just another one of the many reasons that I enjoy going.

Everything from my physical fitness, to my mental health, to my nutrition,
sleeping habits, and everything in between have improved significantly since
committing to a daily practice.

------
dumbneurologist
this is not meaningful work, because there is no "brain health" outcome in the
papers they reviewed that is clinically relevant.

For example: "Increase in right hippocampal GM density among yoga group." Why
is this a good thing? Let's not even talk about the physical inappropriateness
of using "density" to discuss MRI results.

Using meaningless-but-easy measurements as a surrogate / proxy for meaningful-
but-hard measurements is an entire field called "biomarkers". It's incredibly
challenging in neurology, and we don't have many good, validated biomarkers.
If you want to use "MRI density" (sic), or "fMRI activation", then first you
need an entire study to prove that the biomarker is valid. This a subtle
point, but it's as if you're counting lines of code to determine the best
programming language: yes, it's a measure, but how does it relate, and what
does it mean?

We all (including doctors) want things that are natural, wholistic, and give
us a subjective sense of well-being (like exercise and mindfulness) to be
magically effective. But that doesn't change the need for rigorous science in
order to know that it's the case.

And the formula is always the same: a double-blind, placebo-controlled trial
within a representative population using a directly meaningful outcome.

This review failed the "meaningful outcome" part, even if (and I personally
don't care to look further) they got the rest of pieces right.

~~~
jvanderbot
It's not a total wash:

"The studies reviewed also implicate the role of yoga in functioning of the
dlPFC and the amygdala (see Fig. 4). Gothe et al. [24] found that yoga
practitioners demonstrated decreased dlPFC activation during the encoding
phase of a working memory task in comparison to the controls. Froelinger et
al. [30] also found yoga practitioners to be less reactive in the right dlPFC
when viewing the negatively valanced images on the affective Stroop task.
Task-relevant targets activate the dlPFC, whereas emotional distractors
activate the amygdala [49]. Exerting cognitive control over emotional
processes leads to increased activation in the dlPFC, with corresponding
reciprocal deactivation in the amygdala [50, 51]. The studies suggest that
when emotional experience occurred within the context of a demanding task
situation, yoga practitioners appeared to resolve emotional interference via
recruitment of regions of the cortex that subserve cognitive control.
Plausibly, these findings may indicate that yoga practitioners selectively
recruit neurocognitive resources to disengage from negative emotional
information processing and engage the cognitive demands presented by working
memory and inhibitory control tasks demonstrating overall neurocognitive
resource efficiency." [discussion, ¶5]

To a literate outsider, this does not seem like hand-wavey bullshit and seems
to establish the signal->source->implication chain you request. This just
happened to be where I was in the article when I read your comment.

~~~
appleflaxen
none of these things are directly important. it's hard to recognize, because
they sound very advanced and scientific, but it amounts to how bright a spot
is on a brain scan. why is brightness there intrinsically good? well... it's
not. I know the authors then project the actual measurements into some kind of
hand wavy interpretation about how that affects the individual, but it's just
hand waving.

no medication would ever be approved by the FDA using these outcomes, nor
should they be (unless the community first establishes that it's a biomaker of
some kind).

~~~
jvanderbot
Fair enough. But isnt their statement (and citation) that exerting emotional
control directly correlates with measured increases in a particular region ...
exactly what we want to see? If all people exerting emotional control exhibit
red ears, and yoga practcioners have less red ears when under stressful
focused tasks, it does seem reasonable that less emotional control is
required. That logic is sound, right?

------
appleshore
For 60 minutes of hot yoga, the effort and challenge is occasionally so
intense and nearly overwhelming, that it reminds me of the power of doing hard
things. I often think if I just did 2-3 super hard things a day with this
intensity, then I could master various skills, knowledge and perhaps life
itself.

Although it’s harder to study and learn a programming language, even just for
2-3 hours a week, than it is to do something physically intense with group
pressure. I think mostly the ease of studying and practicing is what limits
me. Going to yoga is the hardest part, once there it’s relatively
straightforward to complete it.

If I setup a system to intensely learn with limited technical friction (ie
frustration of a slow environment with a clear path to what to learn), then I
could overcome this. Of course, ultimately it just comes down to my choice.

~~~
Zelphyr
Doing Brazilian Jiu-Jitsu is one of those super hard things I try to do a day.
It's not as "super hard" physically as one might think, especially as one
improves their technique. Rather, for me and many others, it's very mentally
and emotionally challenging in a fun and approachable way. The mental benefits
I have realized since doing it very much speak to what you say about mastering
various other skills, knowledge, and life itself. I've realized that for most
of my life I've really doubted myself and that has held me back. BJJ has
showed me that I _can_ do this thing that I doubt I can do. I need only try. I
might not succeed at first but with focus and persistence I will get there.

That's not to suggest everyone do BJJ. But, to your point, I think everyone
should find things that really challenge them and try to engage in them on a
near daily basis.

~~~
daenz
I did BJJ for 6 months. During that time, the students and my teachers
frequently came in injured (we had rotating teachers). Broken fingers, toes,
sprained things, etc. Then one day one of the teachers was hurt so bad that
she was out for awhile. I concluded that BJJ wasn't worth the risk of these
kinds of injuries, especially ones that prevent me from working with my hands.
Which is a shame because I loved how BJJ engaged the body and the mind, and
the camaraderie with others.

~~~
specialist
Maybe find a different dojo?

I've seen the same with yoga, crossfit, cycling, dance, etc.

I'd argue those teachers shouldn't be teaching.

Yes, the martial arts are way more injury prone. (My SO tore a shoulder muscle
working a punching bag.) But it doesn't have to be the norm.

~~~
Zelphyr
I second this. I rarely see injuries like OP described at my academy.

------
rohinibarla
Here are some research findings related to yoga practices, what difference
does it make to human system is well documented here:
[https://www.innerengineering.com/research](https://www.innerengineering.com/research)
Go through it if you are interested.

------
rtpg
This is super interesting to see.

I try to be open minded about stuff and am always interested in various ways
to take care of ones body. But by far the most difficult part of figuring out
what to do is that information sources touting benefits are also like....
telling me that this jade bracelet is good for my aura or something.

I mean I’m not a geologist but.... pretty sure there’s not much basis in some
of this stuff.

Anyways I try to give the benefit of the doubt to things I don’t know about
but a lot of sources make that realllly tough!

------
tralarpa
As the authors wrote in the discussion section, it is not very surprising that
a combination of light physical activity and meditative mindset has general
positive effects. However, you could probably obtain the same result by
walking and reciting Goethe poems because what people in the west understand
by yoga is not very far from that. Like the Taichi stuff. Nobody knows what
they are doing, but at least it doesn't harm too much and, as noticed in the
paper, it has some positive effects. Anyway, better than doing nothing.

~~~
tcoff91
Not sure how yoga counts as light physical activity similar to walking. If you
go to an advanced class it is a pretty hard workout.

------
kilo_bravo_3
I'm no brain healthologist, but yoga has been absolutely, irrefutably,
amazingly transformative to my mental health.

I started with no prior experience at age 39 nine months ago, and have gone to
140 classes since.

My happiness, attentiveness, and friendliness have all increased to the point
that I am hardly recognizable, mentally, as the same person I was one year
ago.

In addition to the effort and focus you have to put in during class there are
other benefits, like seeing and feeling muscles you never knew existed growing
and strengthening, having better posture and balance, and getting a good
night's sleep every night after practice (because you're so damned tired).

On top of all of that, my studio is full of very friendly and welcoming
instructors and my fellow students are just as nice, so I've made tons of new
friends-- which is really hard to do when you are a working adult.

I've also lost 40lbs since March. Because I'm so tall, one hour of yoga burns
about 580 calories on average for me, and I feel better afterwards-- not worse
like with some other forms of physical activity.

But I didn't go for weight loss so that's just a nice bonus.

I'm relatively sure that the same could be said for many forms of physical
activity, but yoga seems more suited to a variety of people regardless of age
or physical ability.

Having become a bit enamored by yoga, I've started recommending to everyone I
know, including my elderly parents, that they at least try it.

------
jamesbiv
Being a martial arts / sports teacher with about 20 odd years of experience
dealing with both soft and hard styles. I can’t really speak from a formal
medical background but only really from an experience and results based
perspective.

I see more and more people attending these types of activities because of
“doctors orders”. And in many cases I see sports of any from just compliment
whatever regiment the doctor has set out for the patient to begin with. I
guess this is where physio has its place in the medical world as well, where
patients need specific exercises to help with specific injuries.

Anyway, I want to point out the differences between the soft and hard
approaches in the martial arts because I think it’s relevant. Not only are
both approaches pretty much contradictory to each other but I find that what
people find case-by-case within each practice can differ completely, which
makes the whole thing quite subjective and difficult to measure.

The hard approaches are more fueled around explosive movements and repetitive
training. From the students’ perspective the left to right body movement from
this type of training is something that I’ve seen people with strokes or brain
related illnesses use as a tool to help rebalance their motor coordination. In
some cases I’ve heard people recommend dance because of the left right
approach that comes with dancing, so not much to do with the style itself but
rather the constant reshifting from the left to the right during training
helps in this area, which has more to do with training methodology.

Where as for the softer arts, although you usually have to explain the
advantages to the student, soft arts are more geared around slow movement and
are aimed around longevity.

Personally I’m a bigger fan of the softer arts, simply because I prefer low
resistance training myself, plus anyone with an injury who is looking for a
sport, low resistance will be the better approach.

The issue I have with soft styles is that I have read a bit about Tai Chi and
the medical studies surrounding Tai Chi. Sufficed to say the medical studies
in this particular area have not gone well, in many cases citing little to no
evidence that soft styles help with age reduction.

Although the evidence us martial arts teachers rely on are the case studies of
our masters, for instance master x from martial art y lived until he was 100
and that’s because he practiced martial art y since he was 10, and so fourth.
What I’d find interesting is if there are more substantial studies made in
this area, I mean after all finding the fountain of youth is pretty much
everyone’s dream.

------
brenden2
Here's the tl;dr (from the article):

> This review of literature reveals promising early evidence that yoga
> practice can positively impact brain health. Studies suggest that yoga
> practice may have an effect on the functional connectivity of the DMN, the
> activity of the dorsolateral prefrontal cortex while engaged in cognitive
> tasks, and the structure of the hippocampus and prefrontal cortex- all
> regions known to show significant age-related changes [65, 66]. Therefore,
> behavioral interventions like yoga may hold promise to mitigate age-related
> and neurodegenerative declines. Systematic randomized trials of yoga and its
> comparison to other exercise-based interventions, as well as long term
> longitudinal studies on yoga practitioners are needed to identify the extent
> and scope of neurobiological changes.

With studies like this, my reaction is to assume that it's not really about
_yoga_ , but rather just making a habit out of doing exercise and spending
some time focused on something other than your cell phone or a computer.

There are plenty of good ways to get exercise and manage your attention, but
you don't need buzzwords to accomplish that. Taking long walks without
bringing your cellphone along (or leaving it in your pocket with notifications
off) is a simple, cheaper (assuming you pay for yoga classes), and equally
effective way to do this.

~~~
codyb
Something came out in the NYTimes recently that walking three times a week for
a half hour had positive effects.

Can’t remember everything about it.

I love walking.

What I think is nice about yoga is you get mindfulness, flexibility, strength,
balance, and endurance all in one session which seems like a pretty decent
bang for your buck.

~~~
randycupertino
Have you read anything by Cal Newport about the benefits of daily walks? I
loved some of his books and he is always talking about using his walks as a
time to reflect and solve problems:
[https://www.calnewport.com/blog/2015/03/17/deep-habits-
think...](https://www.calnewport.com/blog/2015/03/17/deep-habits-think-hard-
outside-the-office/)

------
mettamage
Edit: I'm a bit long-worded and too heavy with using fancy words. I typed fast
and didn't edit at all. Writing succinctly and in easy to understand English
is more difficult, for me.

\---

I could predict that yoga has a good effect on brain health since I have the
following hypothesis: whatever you do with a serious attentive concentration
will be good for your brain in that specific area.

One question I have left is: to what extent will one be able to go beyond that
area and use their cognitive benefits for similar but different pursuits?

I also have a hypothesis for that (I just don't know to what extent it's true,
I read some research on it but it's all quite tentative). It is: if one
specifically focuses on an area, then the benefit will be specific. However,
if one chooses a meta-topic (e.g. learning as fast as possible, increasing
memory or increasing attention span), then that meta-topic will be trained and
that person will be good in the meta-topic across all cognition. This presumes
they are immersed in training this meta-topic though (i.e. it's everywhere in
their life).

Examples:

1 (normal topic). One chooses to be amazing at chess, and just at chess. Then,
the brain benefits will only be helpful for chess.

2 (meta-topic). One chooses to learn as fast as possible, and chooses chess as
the medium to measure progress. That person will be able to learn as fast as
possible on many more domains. In part, also I presume that such a person is
actively trying to use the meta principles from learning chess as fast as
possible to solve other problems in their life.

So they're not doing the same things. One is learning chess, and the other one
is learning to play chess as fast as possible with the broader scope to learn
anything as fast as possible.

One complicating factor is that the normal chess player can try to organize
the meta-topics they have learned while playing chess. While this helps, I'd
argue it's simply less effective than what the second person would be doing.
It's similar to architecting a software product to do certain things from the
get go (person 2) or patching your software product afterwards to do that same
thing (person 1).

~~~
jakemal
Usually when you learn a topic, you pick up skills in the process that are
useful outside of that specific domain. For example, as a software engineer, I
have refined the skill of being able to break down a problem into smaller,
workable parts. Even if that problem isn't specifically related to software. I
am also much better at reading documentation for products that I am unfamiliar
with and learning how to do things myself. These are not things that I ever
specifically practiced. They are just things that I _had_ to practice in the
process of learning to be effective in my job.

If you learn Chess, it will likely have the benefits on your memory,
reasoning, and ability to hold more information in your head at once.

So, overall I believe that pretty much every topic you learn will have a
positive impact on various meta-topic skills and that's how most people
generally improve those skills.

~~~
mettamage
I would agree as you can see in my final paragraph. I'm simply saying it's not
optimal. Moreover, knowledge transfer is tougher than you think. I have seen
software engineers fail to use their logic they've learned with software
engineering and apply it to other domains on a consistent basis.

But the reason I'm staring it is because the current opinion in academia is
that knowledge transfer is tough.

Edit: in me finding sources, I found something that counteracted my claim [1].
I suppose it's back to the drawing board for me. I remember from serious game
research that expanding general cognitive abilities through games were hard
(I'd need to search for the sources). So I figured if this is true for dual n
back (DNB), then it is most likely to be true for a lot of things. But it
wasn't true for DNB.

[1] [https://www.gwern.net/DNB-meta-analysis#paymentextrinsic-
mot...](https://www.gwern.net/DNB-meta-analysis#paymentextrinsic-motivation)

------
pgt
Meditation is a tribal act in a screentime age: quietly facing the same
direction, obeying a common leader - together. Just like yoga, dancing,
climbing & hiking.

I think tribal socialization is a better explanation for meditation's growing
popularity than “watching your thoughts like a river.”

~~~
shripadk
What you are describing is the "Westernized version" of Yoga. The Yoga
practiced over thousands of years in India did not involve "obeying" a common
leader except for the few months that you spent learning it. There was nothing
tribal about Yoga. Far from it. Most Yogis would retire to forests or caves in
Himalayas to practice Yoga in "solitude". And when Yoga was done for extended
periods of time (months if not for years) it was called Tapasya. None of this
applies to the commercialized Yoga that is practiced in the West. It was
especially not for "freeing your mind" or "mindfulness" or "for calming your
nerves" or "fixing an ailment". Those were side effects. The real goal of Yoga
was achieving Moksha.

Do any of the centers/groups you have seen ever advertise that Yoga is for
achieving Moksha? Never. That would defeat the purpose of commercialization.

