Study Background Establishing an evidence-informed expert consensus on the use of acupuncture for managing chronic musculoskeletal pain at the primary care level in Hong Kong, using the GRADE Evidence to Decision (EtD) framework. Two-rounds of Delphi study were conducted guided by the GRADE-ADOLOPMENT approach and informed by systematic review. Methods Sixteen local experts, including eight traditional Chinese medicine practitioners and eight biomedically trained doctors, were purposively sampled based on their clinical experience in pain management. A structured questionnaire was developed based on seven chronic musculoskeletal conditions and aligned with the six GRADE EtD criteria. Experts rated the appropriateness of acupuncture for each condition using a 4-point Likert scale. Consensus was defined as ≥75.0% agreement. Participants reviewed diagnostic criteria and selected core outcomes for evaluating treatment effectiveness. Results Positive consensus supported acupuncture for adhesive capsulitis, knee osteoarthritis, lumbar spinal stenosis with neurogenic claudication, and non-specific low back pain. Full agreement was reached on diagnostic criteria for all seven conditions. Pain relief, functional improvement, and health-related quality of life were identified as core outcomes. No consensus was reached for hip osteoarthritis, cervical radiculopathy, or lumbar radiculopathy. Experts highlighted the need for individualised treatment plans and further research on implementation and patient preferences. Conclusion This study presents the first expert-endorsed list of acupuncture recommendations for chronic musculoskeletal pain in Hong Kong. The findings support interprofessional collaboration and provide a foundation for developing referral pathways and clinical guidelines. However, the study is limited by reliance on expert opinion and indirect evidence, a potentially non-representative panel, and the absence of physiotherapist and patient perspectives. Future research should focus on implementation strategies and incorporate input from various stakeholder groups to strengthen the clinical integration of acupuncture.
Background Crocus sativus (Saffron) and its bioactive constituents, crocin and crocetin have gained attention for their neuroprotective and antioxidant properties in ocular health. This review synthesises clinical evidence from extracted studies evaluating their efficacy, safety and dosing across Age-related Macular Degeneration (AMD), Primary Open-Angle Glaucoma (POAG), Diabetic Macular Edema (DME), Central Serous Retinopathy (CSR), Stargardt Disease (STGD1) and Paediatric Myopia (PM). Methodology A systematic literature review was undertaken assessing randomized trials, observational or cohort studies, case studies or series written in English between January 2015 to January 2025. Studies were identified using PubMed, AMED, CINHAL, ScienceDirect and Scopus as well as the grey literature. Results Ten clinical trials were identified from 529 citations. Interventions involved oral supplementation of saffron (20-50mg/day), crocin (5-15mg/day) and crocetin (7.5mg/day) over durations ranging from 6 weeks to 12 months. Primary outcomes included visual acuity, retinal electrophysiology, intra-ocular pressure, macular thickness, and safety profiles. Conclusion Saffron, crocin and crocetin, demonstrate consistent efficacy and exceptional safety profiles across a range of ocular conditions. Saffron’s dose-dependent therapeutic effects are a promising adjunctive therapy in ophthalmology. Further large-scale trials are warranted to confirm these findings and refine condition specific dosing.
Metabolic and hormonal disturbances are common during the climacteric period and contribute to an increased risk of chronic diseases. Yoga has emerged as a promising complementary approach to promote women's health during midlife; however, long-term evidence remains limited. This longitudinal, community-based controlled study evaluated the effects of regular yoga practice over 24 months on anthropometric, metabolic, and hormonal parameters in climacteric women. A total of 182 Brazilian women aged 40-65 were followed; participants who chose to engage in yoga formed the intervention group, while sedentary women served as controls. Data were collected at baseline and after 6, 12, and 24 months. After 24 months, the yoga group showed significant reductions in BMI (-2.24 kg/m2; p = 0.008) and body fat percentage (-4.29%; p = 0.008), as well as decreases in systolic (-11.4 mm Hg; p = 0.012) and diastolic blood pressure (-5.5 mm Hg; p = 0.044). Improvements were also observed in fasting glucose (-9.1 mg/dL; p = 0.024), QUICKI (+0.03; p = 0.046), HDL-c (+9.6 mg/dL; p = 0.012), and non-HDL-c (-23.4 mg/dL; p = 0.018). Estradiol levels increased by 24.4 pg/mL in the yoga group and were significantly higher than in controls at 24 months (+40.9 pg/mL; p < 0.001), suggesting an endocrine-modulating effect. These findings support yoga as a promising nonpharmacological strategy to promote metabolic and hormonal health during the climacteric phase.
Background Crocus sativus L. is a culturally significant herbal remedy used by pregnant women in many regions, particularly in South Asia and the Middle East. Despite its widespread use, evidence regarding its clinical efficacy and safety profile remains limited and inconclusive. Objectives This integrative review aims to synthesize cultural beliefs, reported use, and clinical evidence on saffron use during pregnancy and childbirth, and to critically evaluate evidence regarding its maternal and fetal safety and therapeutic potential. Methods A systematic search of PubMed, Google Scholar, Scopus, and Web of Science was conducted to identify English-language articles from inception to June 2025. Included studies comprised clinical trials, observational studies, systematic reviews, and cultural accounts. Data were extracted on cultural beliefs, use patterns, clinical outcomes, and potential risks. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework guided study selection. Results Twelve studies were selected. Cultural practices strongly influence saffron use, with women consuming it to improve fetal complexion, maternal strength, and labor readiness. Clinical evidence indicates low-dose saffron (approximately 250 milligrams daily) may facilitate cervical ripening, reduce labor pain and anxiety, and shorten labor duration in term pregnancies. These effects are dose-dependent, with higher doses or occupational exposure linked to uterine stimulation and increased miscarriage risk. Conclusions Low-dose saffron shows promise for improving labor outcomes, though excessive consumption poses significant risks. Saffron use is deeply rooted in cultural beliefs, underscoring the need for respectful, dialogue-based approaches to guide patients safely. Standardized preparations and long-term safety data are needed before clinical recommendations can be made.
BackgroundAromatase inhibitor-induced arthralgia (AIA) is a frequent adverse effect of endocrine therapy in breast cancer survivors, often leading to treatment modification or discontinuation. Non-pharmacological interventions have been proposed to manage AIA, but evidence remains fragmented.ObjectiveTo synthesize recent randomized controlled trials (RCTs) evaluating the efficacy of non-pharmacological interventions for AIA.MethodsA systematic search of PubMed, Scopus, and Web of Science identified RCTs published between 2010 and 2025 assessing non-pharmacological strategies for AIA. Two reviewers independently performed study selection, data extraction, and quality appraisal using standardized criteria.ResultsEight RCTs met inclusion criteria, encompassing interventions such as acupuncture, structured exercise (aerobic, resistance, and Pilates), progressive relaxation, and neuromuscular taping. Acupuncture produced clinically meaningful reductions in pain intensity (mean differences 0.9-1.1 points on the Brief Pain Inventory), while exercise programs yielded moderate improvements in pain, function, and quality of life. Relaxation and taping interventions demonstrated smaller or less consistent effects. No eligible trials evaluated occupational therapy-based interventions.ConclusionsAcupuncture and structured exercise show the strongest evidence of benefit for managing AIA, though overall methodological quality remains moderate. Further well-designed trals with standardized outcomes and longer follow-up are needed to guide clinical implementation and to explore underrepresented approaches such as occupational therapy.
ObjectiveIn Traditional Chinese medicine (TCM), syndrome differentiation is considered to be an essential diagnostic process for tailoring Chinese herbal medicine (CHM) treatments to individual patients. We conducted a meta-epidemiological study to evaluate the potential impact of syndrome differentiation on improving effect estimates in randomized controlled trials (RCTs).Study Design and SettingSeven databases were searched to identify systematic reviews (SRs) published between 2021 and 2022 that pooled RCTs evaluating CHM treatment effects or side effects. Meta-epidemiological analyses were conducted using a two-step approach. Subgroup analyses were performed based on the disease category, outcome nature, and funding.ResultsWe included 137 SRs comprising 2,064 RCTs. The results demonstrated small and statistically nonsignificant differences in both treatment effects (ROR: 0.93, 95% confidence interval (CI): 0.86 to 1.00, P = .04 for binary outcomes; dSMD: -1.44, 95% CI: -3.95 to 1.08, P = .26 for continuous outcomes) and side effects (ROR: 1.13, 95% CI: 0.66 to 1.92, P = .66) between RCTs that incorporated syndrome differentiation and those did not. Subgroup analysis showed RCTs of gastrointestinal disease that incorporated syndrome differentiation exhibited a larger magnitude of side effects than that did not. For binary outcomes, subgroup analyses of RCTs of circulatory diseases or those reporting subjective outcomes showed that syndrome differentiation led to a statistically significantly smaller treatment effect.ConclusionIndividualizing CHM treatments through syndrome differentiation provide no significant evidence of improvement in TCM practice outcomes in RCTs. Furthermore, subgroup analyses suggest that syndrome differentiation may be associated with a smaller treatment effect among RCTs of CHM for circulatory diseases and a possible trend toward increased side effects in patients with gastrointestinal diseases.
Artemisia sieberi (Asteraceae) is a grey, dwarf, dry woolly shrub, locally known as "Shih" in Arab countries, with significant medicinal properties due to its content of up to 160 active compounds with anti-cancer activity. A. sieberi has been investigated for its potential effects in various cancer types, including breast cancer. The aim of this systematic review is to examine the in vitro evidence on the potential activity of A. sieberi extracts against breast cancer, specifically in MCF-7 and MDA-MB-231 cells. A search of PubMed, ScienceDirect, Scopus, Web of Science, and Google Scholar electronic databases was conducted for studies published from inception to 2024, following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews. The search strategy applied was ((Artemisia sieberi) AND (anti-breast cancer)). The Quality Assessment Tool (QUIN tool) was used to assess the risk of bias for in vitro studies. Six in vitro experimental studies were included. These studies suggested that A. sieberi extracts may exert anti-breast cancer effects via multiple mechanisms, including apoptosis induction, cell growth inhibition, and gene expression modulation. However, the anticancer potential of A. sieberi against breast cancer has been explored only at a preliminary in vitro level. Future research should evaluate different A. sieberi extracts across diverse breast cancer cell lines, particularly treatment-resistant types such as triple negative breast cancer (TNBC), and extend to in vivo and clinical investigation.
This pilot study examines the impact of guided imagery hypnotherapy (GIH) on symptoms of job-related burnout in medical professionals. Nine adults (eight female) involved in direct medical care in the region of San Diego, California participated in eight consecutive weekly GIH sessions. Subjective measures of burn-out, compassion, and self-compassion were recorded roughly one week before the start of the hypnotherapy series (baseline session zero) and after the first, fourth, and final GIH sessions. Resting state electroencephalographic data (EEG) was also recorded at each of these measurement times. Additionally, EEG was recorded for the duration of the hypnotherapy protocol during sessions one, four, and eight. Two sets of frontal alpha asymmetry (FAA) scores were computed for each participant. First, for each session, FAA was derived from the cleaned, preprocessed EEG recorded for the full duration of the GIH protocol. Additionally, FAA was computed from segments of EEG centered on eleven key events associated with hypnosis and visualization during the protocol. Linear mixed model analysis revealed a reliable increase in self-compassion and a decrease in emotional exhaustion across the four measurement times. Further, a reliable shift toward left over right hemispheric dominance, indicated by increases in FAA, was observed both across and within sessions, suggesting an evolution toward approach-related self-regulation at short and longer time scales. These outcomes indicate the promising potential of GIH for alleviating symptoms of job-related burnout and improving self-regulation in response to challenging work situations.
Background/ObjectivesHarp music has long been used for comfort and healing, yet its neural mechanisms remain unclear. This study examined how major and minor harp sounds influence frontal alpha activity, mood, and reaction times, with a focus on depression-related individual differences.MethodsParticipants listened to 3-min major and minor harp excerpts while EEG alpha activity was recorded. Subjective ratings of arousal, stress, comfort, and mood were assessed, followed by auditory and visual reaction-time tasks.ResultsIndividuals with lower depression scores showed marked frontal alpha suppression during harp listening, which was associated with faster auditory reaction times. Those with higher depression scores exhibited consistently lower frontal alpha power with minimal modulation by harp sounds.ConclusionsFrontal alpha suppression during harp listening may reflect enhanced auditory attentional processing in individuals with lower depression levels. These findings suggest that depression-related traits shape neural responsiveness to harp music and should be considered when evaluating its therapeutic potential.
BackgroundTacca chantrieri (Andre), or the black bat flower, is commonly found in Southeast Asia; however, its effects on immunity have not been studied. This study aimed to investigate the effects of T. chantrieri crude extract on CD4+ T cell phenotypes and on the phagocytosis and oxidative burst of polymorphonuclear neutrophils (PMNs) in the elderly (ex-vivo). Its ability to inhibit opportunistic and pathogenic bacteria was also evaluated.MethodsT chantrieri crude extract was obtained by ethanolic extraction. A total of eight elderly (age ≥65 years) were enrolled in the study. Investigations used flow cytometric analysis. Antimicrobial effects were explored by agar well diffusion and minimum inhibition concentration (MIC) testing.ResultsCD4+ T cell proportion significantly decreased at the 100 μg/ml concentration (p = 0.015). CD4+NKG2D+ T cells decreased at all concentrations (50, 100, 200, 300 μg/ml). Regarding PMNs, phagocytosis and oxidative burst in the treated group were significantly increased at 15 min compared with the untreated group (p = 0.039 and 0.015, respectively). Regarding antimicrobial effect, 100 mg/ml crude extract inhibited Staphylococcus epidermidis, Staphylococcus aureus, Neisseria sicca, and Acinetobacter lwoffii. MIC values were 1.23, 3.70, 33.33, and 100 mg/ml, respectively.ConclusionsThis work reports preliminary findings of immunity promotion in the elderly following treatment with T. chantrieri crude extract. In future, the extract may be developed into a natural herb product or a form of alternative medicine for immune status enhancement, as well as a potential antimicrobial agent, particularly in the elderly.
ObjectiveThis review synthesizes current evidence on the efficacy of acupuncture in managing chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients, focusing on its mechanisms, clinical applications, and future research directions.MethodsThis narrative review synthesizes and critically appraises findings from randomized controlled trials (RCTs), meta-analyses, and preclinical studies, evaluating acupuncture's impact on pain relief, neurological function, and quality of life. Key databases were searched for studies published up to 2024.ResultsNineteen RCTs (n = 1174) demonstrated significant improvements in CIPN symptoms with acupuncture, particularly in reducing neuropathic pain (eg, via endogenous opioid modulation) and enhancing sensory function (eg, BDNF-mediated neuroplasticity). Optimal protocols involved 2-3 sessions/week for 4-12 weeks, targeting acupoints such as ST36 and LI4. Acupuncture outperformed pharmacotherapy (eg, duloxetine) in safety and patient-reported outcomes.ConclusionAcupuncture is a promising adjunctive therapy for CIPN, offering multimodal mechanisms and clinical benefits. Standardization of protocols and further high-quality RCTs are needed to strengthen evidence and guide integration into oncology care.
The Qing-Re-Yi-Liu decoction (QRYLD) is a clinically effective prescription for treatment of breast cancer. Our preliminary studies found that QRYLD treatment interfered with the Warburg effect in breast cancer cells. However, its chemical components and molecular mechanisms have not been clarified. This study analyzed the bioactive components of QRYLD aqueous extracts by HPLC. The effects of QRYLD on the malignant behaviors of MCF-7 cells and potential mechanisms were analyzed by CCK-8, transwell invasion, wound-healing assays, flow cytometry, Western blot assays and transcriptomic analysis as well as in vivo mouse tumor model. QRYLD aqueous extracts contained several bioactive components. Transcriptomic analysis indicated that QRYLD treatment altered the expression of several genes involved in biological processes and signaling pathways, such as manganese superoxide dismutase (MnSOD). Functionally, QRYLD, similar to MnSOD silencing, inhibited the malignant behaviors of MCF-7 cells and enhanced their apoptosis, whereas MnSOD overexpression had the opposite effects. Moreover, QRYLD treatment inhibited the Warburg effect by limiting glucose uptake and lactic acid production, and decreasing the relative expression of glucose transporter-1, hypoxia-inducible factor 1α, c-Myc, hexokinase-2, phosphofructokinase 1, lactate dehydrogenase A, pyruvate kinase isozyme 2, MnSOD, calmodulin-dependent kinase II (CaMKII), and AMP-activated protein kinase (AMPK) in MCF-7 cells. Finally, treatment with QRYLD significantly inhibited the growth of xenografted MCF-7 tumors in mice and reduced the tumor expression of MnSOD, CaMKII, and AMPK. These data suggest that QRYLD may target MnSOD to attenuate the MnSOD/CaMKII/AMPK signaling, inhibiting the Warburg effect and malignant behaviors in breast cancer.
The Qing-Re-Yi-Liu decoction (QRYLD) is a clinically effective prescription for treatment of breast cancer. Our preliminary studies found that QRYLD treatment interfered with the Warburg effect in breast cancer cells. However, its chemical components and molecular mechanisms have not been clarified. This study analyzed the bioactive components of QRYLD aqueous extracts by HPLC. The effects of QRYLD on the malignant behaviors of MCF-7 cells and potential mechanisms were analyzed by CCK-8, transwell invasion, wound-healing assays, flow cytometry, Western blot assays and transcriptomic analysis as well as in vivo mouse tumor model. QRYLD aqueous extracts contained several bioactive components. Transcriptomic analysis indicated that QRYLD treatment altered the expression of several genes involved in biological processes and signaling pathways, such as manganese superoxide dismutase (MnSOD). Functionally, QRYLD, similar to MnSOD silencing, inhibited the malignant behaviors of MCF-7 cells and enhanced their apoptosis, whereas MnSOD overexpression had the opposite effects. Moreover, QRYLD treatment inhibited the Warburg effect by limiting glucose uptake and lactic acid production, and decreasing the relative expression of glucose transporter-1, hypoxia-inducible factor 1α, c-Myc, hexokinase-2, phosphofructokinase 1, lactate dehydrogenase A, pyruvate kinase isozyme 2, MnSOD, calmodulin-dependent kinase II (CaMKII), and AMP-activated protein kinase (AMPK) in MCF-7 cells. Finally, treatment with QRYLD significantly inhibited the growth of xenografted MCF-7 tumors in mice and reduced the tumor expression of MnSOD, CaMKII, and AMPK. These data suggest that QRYLD may target MnSOD to attenuate the MnSOD/CaMKII/AMPK signaling, inhibiting the Warburg effect and malignant behaviors in breast cancer.
BackgroundTraditional Thai herbal medicine represents an alternative and complementary approach for managing hyperlipidemia, according to its low toxicity and advantageous benefits. However, there is limited clinical data for Thai herbal medicine formulations for hyperlipidemia.ObjectivesThe present study aimed to evaluate the biological and clinical efficacy of Thai herbal formulation for lowering blood lipids in patients with borderline hyperlipidemia.Materials and methodsThe chemical profile, in vitro antioxidant activity, pancreatic lipase inhibition, and cytotoxicity tests were evaluated in the aqueous and ethanol extracts of Thai herbal formulation. The clinical efficacy and safety of Thai herbal formulation for reducing blood lipids were assessed in patients with borderline hyperlipidemia during a 12-week period.ResultsThe main chemical constituents of Thai herbal formulation, including (+)-chebulic acid, 4-glucogallic acid, gallic acid, ellagic acid, piscidic acid, and 6-gingerol, demonstrated anti-oxidant and pancreatic lipase inhibitory effects. In cytotoxicity testing, the aqueous extracts exhibited no inhibitory effect on L929 cells and Vero cells (IC50 values above 80 μg/mL), whereas the ethanol extracts presented IC50 values of 18.59 ± 0.58 µg/mL in Vero cells and 39.86 ± 0.02 µg/mL in L929 cells. The clinical investigation revealed that the Thai herbal formulation significantly decreased total cholesterol and low-density lipoprotein levels (P < 0.05), and additionally reduced triglycerides and elevated high-density lipoprotein cholesterol, in comparison to the control group after 12 weeks, thereby demonstrating its efficacy in hyperlipidemia management.ConclusionThe findings indicated that the Thai herbal formulation exhibited potential as a herbal therapeutic approach for borderline hyperlipidemia management.
BackgroundThe Tibetan medicine Ershiwuwei Guijiu Pill (EWGP), a classic Tibetan medicine prescription for the treatment of postmenopausal osteoporosis (PMOP) in the Qinghai-Tibet region, has attracted extensive attention due to its curative effects on gynecological diseases. However, its chemical ingredients and molecular mechanism are still unclear.Aim of the studyTo analyze the chemical constituents and effective serum chemical metabolites of EWGP and to explore the molecular mechanism of EWGP in treating PMOP through network analysis and experimental validation.MethodsThe ethanol extract of EWGP and its drug-containing serum were detected by liquid chromatography-mass spectrometry (LC-MS), and the chemical constituents were analyzed and identified. SwissTarget prediction was used to predict the corresponding potential target genes of the identified chemical components. Thereafter, a visualization network of the components and corresponding targets was constructed with Cytoscape software. Moreover, a specific disease database for animals was used to search and filter for osteoporosis (OP) targets, and a drug-disease target protein-protein interaction (PPI) network was constructed. Cytoscape 3.7.0 was used for visualization and cluster analysis, and R Studio was used for GO and KEGG enrichment analysis. AutoDock Tools were applied for molecular docking of the serum metabolites and specific target proteins. The potential mechanism of EWGP in preventing and treating PMOP was predicted by network pharmacology analysis and was experimentally studied and verified in vivo and in vitro.ResultsA total of 199 chemical substances were identified in the ethanol extract, and 11 were found in the serum. A total of 419 predicted targets and 128 target genes related to osteoporosis were screened. There were 16 common targets identified between the predicted targets and OP genes. Following the enrichment analysis, 16 KEGG signaling pathways and 63 GO biological process items were identified. The results of molecular docking showed that the main active compounds may be Protopine, Hetisine, Piperine, Visaminol, Boldine, and Trigonelline, and the specific targets may be CYP17A1, ESR2, MAPK14, and the vitamin D receptor (VDR). The results of cell and animal experiments showed that EWGP may improve bone metabolism via estrogen and calcium signaling pathways regulated by estrogens and calcium ions.ConclusionsEWGP contains multiple herbal drugs and treats PMOP through multiple targets and signaling pathways. We preliminarily tested the chemical compounds of EWGP, especially in the serum, to determine the chemical metabolites of EWGP and revealed the molecular mechanism of EWGP in preventing and treating PMOP; moreover, we used computer-virtual molecular docking and experiments for preliminary verification of the core targets of network pharmacology analysis.
ObjectiveTo find out the effect of high-intensity interval training (HIIT) and mindfulness breathing on the levels of sex hormones, insulin resistance, lipid profiles, and tumor biomarkers in postmenopausal obese women.DesignSeventy obese postmenopausal women (aged 55-65 years, with a body mass index (BMI) ranging from 35-44.9 kg/m2) were allocated into two groups for this prospective, randomized, controlled study: the experimental group, which received HIIT and mindfulness breathing in addition to their medications, and the control group, which only received medication. Serum sex hormone levels (estradiol, total testosterone [TT], free testosterone [FT], and sex hormone-binding globulin [SHBG]), insulin resistance assessment using the homeostasis model [HOMA-IR], lipids (total cholesterol [TC], triglycerides [TGs], high-density lipoprotein [HDL], and TC/HDL), and tumor markers (Carcino Embryonic Antigen [CEA] and Cancer Antigen [CA125]) were among the pre and post assessments conducted after 12 weeks.ResultsAfter 12 weeks of the study, the HIIT and mindfulness breathing group showed significant decreases in weight, BMI, FT, TT, estradiol, HOMA-IR, CEA, CA125, TC, TGs, and TC/HDL and increases in SHBG and HDL (all p < 0.001). In contrast, the control group had increases in weight, BMI, FT, TT, estradiol, HOMA-IR, CEA, CA125, TC, TGs, and TC/HDL and decreases in SHBG and HDL (all p < 0.001).ConclusionHIIT and mindfulness breathing were efficient approaches for lowering metabolic, hormonal, and tumor-related risk factors in obese postmenopausal women.
Modifiable and non-modifiable risk factors in Type 2 Diabetes (T2D) contribute to chronic inflammation characterized by elevated pro-inflammatory mediators and constitutively activated immune cells. Chronic inflammation in T2D leads to perturbations in metabolism, resulting in altered immuno-metabolic axis and further vascular complications. Hence, reducing inflammation by targeting modifiable risk factors such as adiposity, sedentary lifestyle and psychological stress in T2D may facilitate efficient clinical management. Yoga has been shown to improve glucose metabolism, reduce psychological stress, and decrease obesity, hence we sought to review the role of Yoga on cellular mechanisms regulating the immuno-metabolic axis in T2D. Elevated levels of inflammatory mediators such as IL-1b, IL-6, TNF-a, and CRP contributing to insulin resistance are reduced upon practicing Surya Namaskara, Pranayama, and meditation and further improved glycemic index in T2D individuals. Specific Asanas and Pranayama significantly decreased adipokines including leptin, adiponectin, and vaspin in subjects with high BMI, triglycerides and HOMA-IR values, and concomitantly reduced inflammation. Bidirectional activation of inflammatory mediators and stress hormones including epinephrine, catecholamines and cortisol manifesting in diabetes are also reduced upon practising meditation and Yoga. Yoga practices such as Pranayama, Asanas and Mudras improve insulin sensitivity, contribute to weight management, mitigate stress levels in T2D, and maintain immuno-metabolic homeostasis.
Objectivethis meta-analysis evaluates the effects of mind-body exercise (MBE) on cognitive function in older adults with or without mild cognitive impairment (MCI). We examined the impact of different MBE, including yoga, tai chi, qigong, and meditation, on six cognitive domains: attention, executive function, working memory, verbal memory, processing speed, and visual-spatial construction.MethodsWe searched eight electronic databases from inception till August 2024. The literature search, study selection, data extraction, methodological quality assessment and statistical analyses were performed.ResultsA total of 45 studies, comprising 4602 participants, were included. Results indicated that MBE had a moderate positive effect on visual-spatial construction (Hedges' g = 0.46) and small effects on other domains such as verbal memory (Hedge's g = 0.24), processing speed (Hedge's g = 0.26), working memory (Hedges' g = 0.15) and executive function (Hedges' g = 0.10). However, there was no improvement in attention (Hedge's g = 0.08, 95% CI = -0.07 to 0.23). The meta-regression analysis further revealed that participants with MCI experienced greater improvements in visual-spatial construction and executive function than healthy participants. Additionally, significant differences were observed among intervention types, with yoga and tai chi showing stronger effects on visual-spatial construction and verbal memory than meditation.ConclusionsThese findings suggest MBE is an effective intervention for improving cognitive function, especially in MCI populations and with certain types of interventions. Utilization of validated modules for MBE intervention and inclusion of long-term follow-up assessments to establish conclusive findings were also suggested.
