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Sunday, April 6, 2014

Researchers scandalize yoga as medicine

Fifteen years past, a handful of poorly created, clearly prejudiced studies purported to show that prayer was a legal medical tool. Americans fell for it, and we still have not learned our lesson.

It is hard to oppose something we want to believe, especially when it comes in a science-shaped box. Today, people want to believe that yoga will solve their problems. More than 200 studies were published about the health benefits of yoga last year.

Yoga is supposed to cure everything from low back pain to short attention span to several forms of mental illness. Yoga is the new prayer: the risk-free, cost-free solution to all of your medical problems. The evidence is wonky, and the methodology questionable, but we cannot get enough.

Studies come out on a near weekly basis trumpeting the benefits of yoga for any problem. The quasi-miraculous healing powers of yoga are, I concede, more credible than the truly miraculous healing power of a divine being. At least there is a nexus between health and yoga -- the human body -- which is something you cannot say for therapeutic prayer.
The yoga studies, however, place myriad methodological problems, some similar to those that plagued prayer research.

First, what is yoga? That is not a zen koan, but an honest question. In a real, practical sense, medical researchers have to agree on the elements essential to yoga practice before they can test it as a therapy. Is deep breathing or stretching the source of therapeutic benefit? Or maybe it is simple exercise, which would not exactly be news.

When you test a pill for heart disease, you give some people the pill and others a placebo. Unless they are extremely motivated and expert in chromatography, the patients cannot tell which group they are in. It is not easy to convince someone that they have been doing yoga for six weeks when they have not, so the placebo effect is always a problem.

A systematical review on the treatment of asthma with yoga was published in 2011. The author found that the methodology of the underlying studies was "mostly poor." High dropout rates also biased the results. In the only study that offered a credible placebo control -- a non yogic stretching regimen -- yoga offered no benefit.

A review of yoga for the treatment of schizophrenia, published in 2013, concluded that "no recommendation can be made regarding yoga as a routine intervention for schizophrenia patients." A 2013 review paper on yoga for hypertension found that "a definite conclusion about the ability and safety of yoga cannot be drawn."

Why have not you already heard about all of these anti-yoga studies? They have no constituency, and therefore do not interest the media much.

When a journal article showing that yoga improves quality of life in breast cancer patients came out earlier this month, hundreds of stories trumpeted the results in the mainstream media. Yet it's difficult to find any mention of the review articles discussed above.

There are not many people today who will click on stories about how yoga will not solve their health problems. So the negative studies never make it beyond medical journals.

By all means, do yoga, pray and eat lemons, if those things bring you contentment. Do yoga especially if it is your preferred form of exercise; exercise is a health intervention supported by thousands of clinical trials.

But recognize the "yoga as medicine" craze for what it is: an indicator of the zeitgeist, not a scientific discovery.

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