Friday, May 29, 2009

Kids who can focus grow up to be healthier adults

A recently released study from the Harvard School of Public Health has found that children's ability to focus on a task at age 7 predicted their physical health thirty years later.

Children who persisted longer on a difficult task were less likely to have experienced a serious health problem such as heart disease, diabetes, asthma, or cancer. The same was true for kids who were less easily distressed by, or likely to withdraw from, a difficult situation.

It's not clear whether these kids were simply born with better attention and perseverance, or whether focus is something that can be taught. However, I know a few folks who are betting on the latter--going into schools to teach kids how to focus their attention and regulate their emotions. For example, Little Flower Yoga is teaching kids in inner-city schools in NY and Yoga Calm brings yoga to classrooms in the Midwest and Northwest.

Although yoga is often "sold" to schools and parents as a way to increase physical fitness, the physical practices of most yoga-for-kids programs also do an incredible job teaching relaxation, mental focus, and emotion regulation skills.

Study source: Early manifestations of personality and adult health: A life course perspective. Health Psychology, 13 (1).
Authors: LD Kubzansky, LT Martin, SL Buka.
You can read the full article here.

Thursday, May 28, 2009

Is hugging harmful?

The New York Times today has a feature on a shocking new trend: teenagers hugging each other when they say hello. Not just best friends, boyfriends, and girlfriends, but casual acquaintances.

Schools are cracking down on all this free love. According to the article, "Schools from Hillsdale, N.J., to Bend, Ore., wary in a litigious era about sexual harassment or improper touching — or citing hallway clogging and late arrivals to class — have banned hugging or imposed a three-second rule."

Seriously? Considering the high incidence of depression, social isolation, anxiety, and stress among this generation of teens, schools should consider imposing mandatory hugs. The evidence is clear that friendly, supportive, non-sexual touch is good for you. Even a brief moment of feeling close to someone, of being socially supported and belonging, can reduce stress hormones, lower heart rate and blood pressure, and improve mood.

In my generation, teenagers had to get drunk or take drugs like Ecstasy to overcome hugging inhibitions. Kudos to this generation for wanting to reach out and touch someone without chemically-induced courage.

How Swine Flu is Paving the Way to Gay Marriage

At the beginning of any crisis, it is impossible to predict the final outcome. Every step we take to prevent catastrophe can carry unexpected consequences.

The current hysteria over the H1N1 pandemic may come with a particularly surprising side effect—fear of the flu may be paving the way for gay marriage.

Just how could a pathogen 1000 times smaller than the width of a human hair be accomplishing a political task that until recently seemed impossible?

The answer lies in something innocuous and even virtuous: hand-washing.
Everyone from the World Health Organization to President Obama has begged us to wash our hands thoroughly with soap and hot water. Even Randy Cohen, resident ethicist of the New York Times, has argued that washing your hands is, in times like these, a moral obligation.

A new poll by the Harvard School of Public Health reports that two-thirds of Americans are soaping up more often to ward off the flu. All that hand-washing should slow down the spread of the flu virus—a consequence that is both predictable and positive.

But even actions as simple as washing your hands can have unintended consequences. Case in point: A 2008 study published in Psychological Science found that washing your hands makes you less morally judgmental about other people’s behavior.

Researchers at the University of Plymouth in the United Kingdom asked participants to evaluate a range of morally suspect actions, such as keeping the money in a found wallet, killing a terminally ill plane crash survivor to avoid starvation, and engaging in a deviant sex act. Half were asked to wash their hands before rating the scenarios. These participants rated all of the behaviors as less “wrong” than did the participants with less pure hands.

The connection between clean hands and a forgiving heart was not logical but emotional. Hand-washing reduced participants’ feelings of disgust. That change in emotion tempered participants’ willingness to throw the first stone.

Why would a change in the physical feeling of disgust dampen moral outrage about other people’s actions? Psychologists now believe that many moral judgments are based on feelings, not rational decisions. We use emotions—including disgust—to quickly “know” whether something is right or wrong. We then try to rationalize our feelings by developing a logical explanation.

This may be especially true for political positions that are colored by moral judgments. Opposition to same-sex marriage is often emotional and rooted in a visceral discomfort with homosexuality. Rational discourse on civil rights and the definition of marriage comes later. A study published just this month in the Journal of Personality and Social Psychology found that conservatives are more likely than liberals to use instinctive feelings about “purity” and “sanctity” as the basis for moral judgments.

Changing a person’s views on such matters may be less about logical argument and more about changing that underlying feeling of disgust. In other words: you’re your mouth shut, but carry hand sanitizer.

This leaves us with an improbable but theoretically possible consequence of the H1N1 pandemic. Look around: same-sex marriage legislation is marching forward with far less outrage than conservatives or liberals would have predicted just one month ago.

Gay marriage may not feel right to you yet, but it is starting to look inevitable. So let me be the first to pass the soap and pump the sanitizer. You’ll feel better, and the CDC will thank you.

Studies cited:
Washing away your sins: Threatened morality and physical cleansing. Chen-Bo Zhong and Katie Liljenquist. September 8 2006. Science, Vol 313, 1451-2.

Liberals and conservatives rely on different sets of moral foundations. Jess Graham, Jonathan Haidt, and Brian A. Nosek. May 2009. Journal of Personality and Social Psychology, Vol 96, 1029-46.

Wednesday, May 27, 2009

1st Annual Summit on Yoga, Mindfulness, and Service

I just got back from the 1st Annual Summit on Yoga, Mindfulness, and Service at the Omega Institute in NY (May 17-21 2009). This was a gathering of leaders in the yoga community who are passionate about outreach, activism, service, and research on yoga and meditation. Many run their own non-profits that bring yoga and meditation to underserved populations, from teenagers in prison to women in recovery from addiction, eating disorders, and domestic violence. I was there representing several great organization I work with: the International Association of Yoga Therapists, Yoga Bear (offering yoga to cancer survivors), and the Art of Yoga (teaching yoga to girls in juvenile detention).

Check out this 2-part youtube conversation about service in yoga between summit attendees Mark Lily, founder of Street Yoga in Portland, OR, and Seane Corn, founder of Off the Mat Into the World.

The 12 attendees at the summit officially formed the Yoga Service Council. We look forward to harnessing energy, good will, skills, science, and --oh, yes-- funds to support individuals and organizations that serve communities through yoga and meditation. Stay tuned for more information about our projects and ways to get involved!

STUDY SUMMARY: Yoga of Awareness Program for Menopausal Symptoms in Breast Cancer Survivors

Source: Support Care Cancer. February 2009. [Epub ahead of print]
Authors: Carson JW, Carson KM, Porter LS, Keefe FJ, & Seewaldt VL.
Contact: James Carson, Department of Anesthesiology and Peri-operative Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHS, Portland, OR, 97239. carsonja@ohsu.edu.

Researchers were interested in whether yoga could benefit breast cancer survivors currently experiencing menopause-related hot flashes. 37 female breast cancer surviors (mean age 54.4 ± 7.5, mean time since diagnosis 4.9 ± 2.4 years) were randomly assigned to either an 8-week Yoga of Awareness program (weekly 2-hour group classes, with 5-10 students) or to a wait-list control group (which would receive the yoga program after the initial study period).

The Yoga of Awareness classes 40 min of gentle stretching poses, 10 min of breathing techniques, 25 min of meditation, and 45 min of group study and discussion of various topics (for example, the yoga philosophy idea of non-judgment acceptance, and how this could be applied to the experience of hot flashes). Classes were co-taught by a certified yoga teacher who holds a master’s degree in health behavior and education and a clinical health psychologist. Classes followed two types of posture sequences. The first was a mat-based sequence including warm-ups, child’s pose, table, a downward-facing dog flow, half moon, a warrior 1 flow, extended side angle, modified locust, supine squats, supine big toe, supine sage twist with bolster, and corpse pose. The second was a chair-based sequence including warm-ups, cat/cow, a spine twist flow, sun salutation, standing wide angle fold, standing wide angle fold with twist, prayer flow, seated wide angle fold, head to knee, pigeon, forward fold, modified sage twist, seal of yoga, and corpse pose. Participants were encouraged apply yoga ideas to everyday life and to practice yoga at home. They were given simple homework assignments, CDs, and illustrated guides to help them do so. On average, participants attended of six of the eight classes.

Researchers measured menopausal symptoms and minutes of yoga practice through daily telephone diaries. Participants completed two weeks of daily self-reports at three time points: before the intervention period, during the last two weeks of the intervention, and three months after the intervention. At the end of the intervention, the yoga group showed a significant reduction in both number and severity of hot flashes, whereas the control group showed no change. They also reported being less bothered by the hot flashes when they did occur, which reflects the yoga program’s emphasis on non-judgmental awareness and acceptance. The yoga group showed significant improvements (compared to the control group) in daily joint pain, fatigue, sleep disturbance, and energy. These improvements were maintained at the 3-month follow-up, and the yoga group showed additional improvements in mood, relaxation, and acceptance. Many of these improvements were positively related to number of minutes spent practicing yoga each day.

This study provides encouraging evidence that yoga benefits cancer survivors and women going through menopause. Of particular note is the program’s emphasis on developing a yogic attitude toward physical symptoms and stressful life events, which received as much time as asana practice. This type of yoga program is a good model for the type of interventions many in the yoga community would like to see in both research and healthcare practice.

This research summary was orginally prepared for the International Association of Yoga Therapists. IAYT is a professional organization for yoga therapists, yoga teachers, researchers, and healthcare professionals who use yoga in their practice.

STUDY SUMMARY: Restorative Yoga for Women with Breast Cancer

Source: Psycho-oncology, 18(4): 360-368. April 2009.
Authors: Danhauer SC, Mihalko SL, Russell GB, Campbell CR, Felder L, Daley K, & Levine EA.
Contact: Suzanne C. Danhauer, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157-1082. danhauer@wfubmc.edu.

This study examined the effects of group restorative yoga classes on emotional and physical well-being in women with breast cancer.

44 women with breast cancer (34% still undergoing cancer treatment; mean age of 55.8 ± 9.9 years) were randomly assigned to either the yoga program or a wait-list control group. After the initial 10-week study period, the control group was offered the full yoga program.

The yoga program consisted of 10 weekly 75-minute restorative yoga classes at a local studio, with class size ranging from 3-12 students. The instructor was registered with the Yoga Alliance, had cancer-specific yoga training, and was a cancer survivor.

The classes included asanas (held from 20 seconds to 5 minutes, depending on the pose), pranayama, and deep relaxation in savasana. The principle of ahimsa (non-violence) was emphasized throughout the practice, and participants were encouraged to take care of themselves and modify poses based on their own needs. Most poses could be practiced either in a chair or on a yoga mat, and the teacher offered props to help students become more comfortable. In each pose, the teacher reminded students to breathe.

The researchers provided the following list of practices and postures that were practiced in every class:
(1) centering and meditation (conscious, deep breathing, mental inventory of body, energy, thoughts, and emotions)(15 minutes)
(2) neck and shoulder series (move neck through range of motion, turning head side to
side, dropping ear to shoulder, chin to chest and eyes toward ceiling, roll shoulders forward and back, then squeeze shoulders to ears and release)(5 minutes)
(3) leg stretch (janu sirsasana variation) using a strap and circling ankles slowly in both directions (5 minutes)
(4) side bend (seated parighasana) (2 minutes)
(5) seated twist (ardha matsyandrasana variation) (2 minutes)
(6) simple supported backbend (1–5 minutes)
(7) transition(resting pose to shift into another posture)
(8) legs up the wall (viparita karani or variation) (5 minutes)
(9) supported bound-angle pose (supta badha konasana variation) (5 minutes).

The following poses were in some but not all practices:
(1) mountain pose (tadasana)
(2) arm and shoulder stretch
(3) supported forward fold
(4) seated sun salutation (surya namaskar variation)
(5) reclining twist with a bolster

Researchers measured the following self-reported dimensions of well-being both before and after the 10-week study period: physical well-being, social/family well-being, mental/emotional well-being (including symptoms of depression), functional well-being, spiritual well-being, and other outcomes particularly relevant to cancer concerns, including sleep and fatigue.

Yoga participants, compared to control participants, reported better mental/emotional well-being, physical well-being, spritual well-being, sleep, and energy. The improvement in emotional well-being was strongest for women who entered with higher levels of negative emotions or depression, and the improvement in sleep quality was strongest for women who began the study with more sleep problems. Women attended an average of 5.8 out of the 10 classes (s.d. = 3.4). For both physical and functional well-being, number of classes attended predicted improvement. Participants reported that they enjoyed the classes, and no adverse events were reported.

This study demonstrated some of the most comprehensive benefits of yoga for cancer patients and survivors. Previous studies (by different research groups) have demonstrated benefits for sleep, energy, cancer symptoms, emotional well-being, and social well-being, but none have demonstrated such global positive outcomes. This study should be considered encouraging evidence supporting the use of yoga to support women with breast cancer. In addition, the researchers should be thanked and commended for providing such a detailed description of the yoga classes, allowing other researchers and yoga teachers to replicate or build on their program.

This research summary was orginally prepared for the International Association of Yoga Therapists. IAYT is a professional organization for yoga therapists, yoga teachers, researchers, and healthcare professionals who use yoga in their practice.

STUDY SUMMARY: Yoga Decreases Breathing Distress and Improves Functional Performance in People with Chronic Obstructive Pulmonary Disease

Source: The Journal of Alternative and Complementary Medicine, 15(3): 225-234. March 2009.
Authors: Donesky-Cuenco D, Nguyen HQ, Paul S, & Carrieri-Kohlman V.
Contact: DorAnne Donesky-Cuenco, Department of Physiological Nursing, School of Nursing, Box 0610, University of California, San Francisco, CA 94143-0610, or Virginia Carrieri-Kohlman at ginger.carrieri-kohlman@nursing.ucsf.edu.

This pilot study examined the safety, feasibility, and benefits of a yoga practice in older adults with chronic obstructive pulmonary disease (COPD). 21 women and 8 men (mean age of 69.9 ± 9.5 years) were randomly assigned to either a standard care control group or a yoga therapy intervention. The yoga group participated in a 12-week, twice-weekly yoga program designed specifically for individuals with COPD. The practice included 9 basic asanas and visama vritti pranayama (timed breathing).

To examine the safety of the yoga practice, researchers measured heart rate, oxygen saturation, dyspnea, and pain during the practice. To examine feasibility, researchers recorded participant adherence and asked participants how much they enjoyed the practice and how difficult they found it. To test the benefits of yoga, researchers measured breathing pain and distress before and after the 12-week program, as well as other measures of health, including exercise performance and health-related quality of life.

The yoga practice was both safe and feasible for the participants, providing more evidence that a well-planned yoga intervention is appropriate for individuals with COPD. Compared to the standard-care control group, participants in the yoga group showed a significant reduction in breathing distress. The yoga group also showed improved physical strength and walking speed in a timed exercise test, as well as higher self-reported of life.

This study is limited by its size, and should be interpreted as providing encouraging but modest evidence for the idea that yoga benefits individuals with COPD. However, the number of these small-scale studies is increasing, and being reported by diverse research groups, as illustrated by the two studies reported here.

This research summary was orginally prepared for the International Association of Yoga Therapists. IAYT is a professional organization for yoga therapists, yoga teachers, researchers, and healthcare professionals who use yoga in their practice.

STUDY SUMMARY: Efficacy and Tolerability of Yoga Breathing in Patients With Chronic Obstructive Pulmonary Disease

Source: Journal of Cardiopulmonary Rehabilitation and Prevention, 29(2): 133-137. March/April 2009.
Authors: Pomidori L, Campigotto F, Amatya TM, Bernardi L, & Cogo A.
Contact: Annalisa Cogo, Centro Studi Biomedici Applicati Allo Sport, Via Gramicia 35, 44100 Ferrara, Italy. annalisa.cogo@unife.it

This study investigated whether a traditional and simple yoga breathing technique could benefit individuals with chronic obstructive pulmonary disease (COPD). People with COPD tend to breathe shallowly and rapidly. The researchers hypothesized that yogic breathing could help people with COPD learn to breathe more deeply and slowly.

8 men and 3 women (ages ranged from 59 to 80) with COPD were taught a yoga breathing technique in a single session. None of the participants had any previous yoga experience. A certified yoga teacher taught participants “the complete yoga breathing technique” as described in The Complete Yoga Book: Yoga of Breathing, Yoga of Posture, and Yoga of Meditation (Schoken Book 1978). This technique involves breathing in a way that expands the belly and lower ribs, then the lower chest, and then the upper chest on the inhalation and reverses this pattern on the exhalation. The breath becomes both deeper and slower than habitual breathing.

The researchers monitored the participants’ spontaneous breathing for 30 minutes prior to the yoga session, as well as the participants’ breathing throughout a single 30-minute yoga session. They measured many variables related to healthy breathing, including oxygen saturation, the depth of each breath, breathing rate, the relative length of inhalation compared to exhalation, and the coordination between rib cage and abdomen movement.

Participants took between 5 and 12 minutes to successfully learn the technique, but all were able to perform it comfortably. Compared to baseline breathing, participants showed a decrease in breathing rate, greater depth, and significant lengthening of both inhalation and exhalation. There was no significant change in coordination of the rib cage and abdomen. This was considered a positive finding, as other breathing techniques have increased desynchronization in people with COPD. Participants also showed a small but significant increase in oxygen saturation, with the greatest change among participants who had the lowest saturation at baseline.

This modest study is important for two reasons. First, it demonstrates that this yoga breathing technique can be safely and comfortably performed by individuals with serious respiratory concerns. Participants learned the practice relatively quickly and without respiratory distress. Second, it demonstrates that the technique reliably produces its purported effects (slowing and deepening the breath) in a single session, even among individuals with strong habits to breathe shallowly and rapidly. This study should encourage yoga teachers and healthcare practitioners to share a simple, nonstrenuous breathing technique with a population that they may feel cautious with.

This research summary was prepared for the International Association of Yoga Therapists. IAYT is a professional organization for yoga therapists, yoga teachers, researchers, and healthcare professionals who use yoga in their practice.