28 ALTERN ATIVE TH ERAPIES, Ju l y / a u g 20 0 5, VO L. 11, N O . 4 Yoga and Weight Maintenance YOGA PRACTICE IS ASSOCIATED WITH ATTENUATED WEIGHT GAIN IN HEALTHY, MIDDLE-AGED MEN AND WOMEN Alan R. Kristal, DrPH, Alyson J. Littman, PhD, Denise Benitez, BFA, Emily White, PhD index [BMI] >30 kg/m 2 ), a 74% increase since 1991. 3 Developing programs to prevent obesity could reduce morbidity and prema- ture mortality for millions of Americans. Conventional medical therapies are, at best, only moderate- ly effective in treating obesity. 4 Many forms of complementary and alternative medicine, including use of dietary supplements, radical diets, and mind-body therapies, also have been proposed for weight management. 5 Hatha yoga, which emphasizes pos- tures, breathing, and meditation, is an increasingly popular spir- itual and physical practice that is widely promoted in books, videotapes, magazine articles, and programs for weight loss and maintenance. 6 A typical hatha yoga session lasts 60 to 90 min- utes and is performed in a group led by an experienced teacher. The practice begins with a short period of centering or medita- tion, followed by a series of yoga poses ( asanas ) that are designed to build flexibility and strength. During the practice, there is an emphasis on the breath to enhance focus and aware- ness. Sessions generally end with a five-to-10 minute rest, during which a variety of techniques are used to enable deep physical and mental relaxation. Although a 90-minute, vigorous yoga practice would expend more than of 250 kcal 7 and thus meet American College of Sports Medicine guidelines for weight con- Alan R. Kristal, DrPH, is a Member in Public Health Sciences in the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Wash, and a Professor in the Department of Epidemiology, University of Washington, Seattle. Alyson J. Littman, PhD, is a Post-doctoral Fellow in the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, and a Post-doctoral Fellow in the Department of Epidemiology, University of Washington. Denise Benitez, BFA, is a Certified Anasara Instructor and Director of Seattle Yoga Arts. Emily White, PhD, is a Member in Public Health Sciences in the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, and a Professor in the Department of Epidemiology at the University of Washington. O besity is a major public health concern in the US. Obesity increases one’s risk of developing hyper- tension, diabetes, and breast cancer and may exacerbate other chronic conditions, such as osteoarthritis, gallstones, dyslipidemia, and mus- culoskeletal problems. 1,2 In 2001, an estimated 21% of American adults (more than 44 million) were considered obese (body mass O Ri gin al Resear ch Background • Yoga is promoted for weight maintenance, but there is little evidence of its efficacy. Objective • To examine whether yoga practice is associated with lower mean 10-year weight gain after age 45. Participants • Participants included 15,550 adults, aged 53 to 57 years, recruited to the Vitamin and Lifestyle (VITAL) cohort study between 2000 and 2002. Measurements • Physical activity (including yoga) during the past 10 years, diet, height, and weight at recruitment and at ages 30 and 45. All measures were based on self-reporting, and past weight was retrospectively ascertained. Methods • Multiple regression analyses were used to examined covariate-adjusted associations between yoga practice and weight change from age 45 to recruitment, and polychotomous logistic regression was used to examine associations of yoga practice with the relative odds of weight maintenance (within 5%) and weight loss (>5%) compared to weight gain. Results • Yoga practice for four or more years was associated with a 3.1-lb lower weight gain among normal weight (BMI <25) participants [9.5 lbs versus 12.6 lbs] and an 18.5-lb lower weight gain among overweight participants [–5.0 lbs versus 13.5 lbs] (both P for trend <.001). Among overweight individu- als, 4+ years of yoga practice was associated with a relative odds of 1.85 (95% confidence interval [CI] 0.63-5.42) for weight maintenance (within 5%) and 3.88 (95% CI 1.30-9.88) for weight loss (>5%) compared to weight gain (P for trend .026 and .003, respectively). Conclusions • Regular yoga practice was associated with attenuated weight gain, most strongly among individuals who were overweight. Although causal inference from this observational study is not possible, results are consistent with the hypothesis that regular yoga practice can benefit individuals who wish to maintain or lose weight. (Altern Ther Health Med. 2005;11(4):28-33.)