Yoga for Health: Considerations beyond Energy Cost and Isolated Asanas (Poses)

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Dear Editor-in-Chief,
The issue of energy expenditure of yoga is of clinical importance because position stands of the American College of Sports Medicine do not include yoga as a viable form of moderate-intensity physical activity to elicit health benefits (2). The systematic review published by Larson-Meyer (4) provides commentary on the energy cost and metabolic intensity of yoga. We provide additional perspectives on the information in this review as it applies to the application of yoga for health-related fitness.
Data in Figure 1 represent the “average METs from all participants for full yoga sessions.” However, close examination of these studies reveals that not all the components of a traditional full yoga session are included in these energy expenditure estimates. For example, “Hatha standing asanas” and “surya namaskar” are components of a yoga session. Therefore, it is important that health fitness professionals not interpret this information as reflecting a full traditional yoga session.
Figure 2 reports on the MET value for individual asanas (poses), yet yoga is to be a series of asanas performed in an appropriate sequence that allows the body to be prepared for the next movement in the series. It needs to be emphasized that yoga does not constitute the performance of selective poses that have the greatest energy expenditure, which may be inferred based on how the data are presented in this review, but rather is to be performed in an authentic yoga sequence. Relying solely on components of yoga with the greatest energy expenditure may expose individuals to injury and will likely not result in all health benefits that may be associated with yoga when performed according to the appropriate movement sequence and when containing all components of a full yoga session.
The author also suggests that the data in this systematic review “may prove useful to the exercise, nutrition, and medical professionals prescribing yoga as a fitness activity or recommending yoga practice for weight loss and/or weight maintenance.” However, there are limited data on the contribution of yoga to weight management efforts compared with other forms of physical activity. Moreover, suggesting that only the energy cost of yoga is an important contributor to weight management may cause some to prescribe only those components of yoga with the highest energy expenditure and minimize the potential contribution of the other components of yoga that may be especially key to weight management efforts (1,3,5–8).
This review addresses the potential importance of yoga as a form of physical activity that can elicit health fitness benefits, and the author is commended on synthesizing this information. However, caution is warranted with how health fitness and medical professionals use the information contained in this review when teaching yoga or prescribing it for patients. Additional well-designed studies are needed to quantify the energy expenditure of traditional full yoga sessions, with the style of yoga clearly defined, to study the impact on health-related outcomes.
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