Original Articles Adiponectin, Interleukin-6, and Cardiovascular Disease Risk Factors Are Modified by a Short-Term Yoga-Based Lifestyle Intervention in Overweight and Obese Men Kumar Sarvottam, MD, Dipti Magan, MSc, Raj Kumar Yadav, MD, Nalin Mehta, MD, and Sushil C. Mahapatra, MD Abstract Objective: To investigate the effect of a short-term yoga-based lifestyle intervention on risk factors for cardio- vascular disease (CVD) and markers of inflammation and endothelial function in overweight and obese men. Design: Nonrandomized prospective lifestyle intervention study with pre–post design. Setting and location: Integral Health Clinic, an outpatient facility providing yoga-based lifestyle intervention programs for prevention and management of chronic diseases. Subjects: Overweight and obese men (n = 51) were enrolled in the study. Subjects who were physically unable to participate and those participating in other interventions were excluded from the study. Intervention: A pretested intervention program including asanas (physical postures), pranayama (breathing exercises), group discussions, lectures, and individualized advice. Outcome measures: The primary outcome measure was weight loss, and the secondary outcome measures were clinical and laboratory correlates of CVD risk, levels of interleukin-6 (IL-6), adiponectin, and endothelin-1 (ET-1). Results: Men (n = 51, body mass index [BMI] 26.26 – 2.42 kg/m 2 ) were enrolled and underwent a yoga-based lifestyle intervention for 10 days. Of 51 subjects, 30 completed the study. There was a significant reduction in weight from Baseline to Day 10 (74.60 – 7.98, 72.69 – 8.37 kg, p < 0.001, respectively), BMI (26.26 – 2.42, 25.69 – 2.47 kg/m 2 , p < 0.001, respectively), and systolic BP (121.73 – 11.58, 116.73 – 9.00, p = 0.042, respectively). There was a significant reduction in plasma IL-6 from Baseline to Day 10 (median 2.24 vs. 1.26 pg/mL, respectively, p = 0.012). There was a significant increase in the plasma adiponectin from Baseline to Day 10 (median 4.95 vs. 6.26 lg/mL, respectively, p = 0.014). Plasma ET-1 level remained unchanged. Conclusion: These findings suggest that even a short-term yoga-based lifestyle intervention may be an important modality to reduce the risk for CVD as indicated by weight loss, reduction in systolic blood pressure, an increase in adiponectin, and decrease in IL-6 in overweight and obese men. Introduction O besity, especially visceral obesity, is a major and independent risk factor for cardiovascular diseases (CVD), 1 the hallmark of which is inflammation and endo- thelial dysfunction. Further, obesity per se is known to be as- sociated with low-grade inflammation 2,3 and may culminate into chronic inflammation as seen in cardiovascular diseases, if it remains unaddressed. 3,4 Interleukin-6 (IL-6), an inflam- matory mediator, is also an independent prognostic marker of CVD risk. 5,6 It is also shown to be an independent predictor of sudden death in asymptomatic European men. 7 IL-6 not only stimulates the production of C-reactive protein, a major risk factor for cardiovascular complications, 8 but it also precipi- tates dyslipidemia. 9,10 It has been shown that production of IL-6 and other inflammatory mediators is enhanced in obesity, 3,4 and about 15%–30% of circulating IL-6 levels are contributed from adipose tissue in the absence of an acute inflammation. 11 Additionally, dysfunctional adipocytes in obese subjects contribute towards systemic blood pressure via the renin-angiotensin system 12 and reduced levels of adipo- nectin, a potential endogenous anti-atherogenic factor. 13,14 The anti-atherogenic ability of adiponectin is derived from its ability to suppress the inflammatory cytokine–mediated inflammation, 15 promoting endothelium-dependent vasor- elaxation 16 and possibly opposing vasoconstriction. 17 It has Department of Physiology, All India Institute of Medical Sciences, New Delhi, India. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 19, Number 5, 2013, pp. 397–402 ª Mary Ann Liebert, Inc. DOI: 10.1089/acm.2012.0086 397