New evidence shows that yoga may support heart and metabolic health in people with excess weight, but its effects are modest, population-specific and far from a stand-alone solution.
study: Effects of yoga on cardiometabolic health in overweight or obese adults: A systematic review and meta-analysis of randomized controlled trials. Image credit: PeopleImages/Shutterstock.com
Scientists recently conducted a comprehensive systematic review and meta-analysis to evaluate the effects of yoga interventions on cardiometabolic health outcomes in overweight or obese adults. This review was published in PLOS Global Public Health.
The challenges of high BMI and the role of physical activity
High BMI, indicative of overweight and obesity, is a major public health problem associated with increased morbidity and mortality from cardiovascular, pulmonary, metabolic, and musculoskeletal diseases. Lack of exercise further increases metabolic and cardiovascular risks through chronic inflammation and lipid imbalances, leading to decreased mobility and quality of life. Therefore, non-drug interventions such as exercise are prioritized to address the health and economic consequences of obesity.
Physical activity (PA) is a safe and effective approach to prevent and manage excess weight and related conditions such as sarcopenia in obese individuals. However, adults who are obese are generally less active than those who are not obese. Pain from inflammation and stress from excess weight often limit activity and are a major barrier for people with a high BMI. Low to moderate intensity physical activity is generally preferred as it supports fitness and weight loss while minimizing pain and discomfort.
Yoga is a low-risk, accessible, and cost-effective form of exercise that combines movement, breathing, and relaxation. It provides a low-to-moderate intensity option for people with a high BMI to enhance fitness and aid weight loss, especially for those with low baseline fitness. Additionally, yoga may improve cardiometabolic health by lowering blood pressure, optimizing lipid and glucose levels, and reducing inflammation.
Previous reviews have shown that yoga improves lipid profiles, blood pressure, blood sugar levels, and inflammation, but did not consider the potential influence of high BMI on these effects. This is a major gap in research, as excess weight can alter metabolic processes, indicating that people with a higher BMI may respond differently to yoga interventions.
Evaluating the effects of yoga in overweight and obese people
The current systematic review evaluates the effects of yoga on cardiometabolic outcomes in individuals with high BMI. Studies assessing blood pressure, lipid profile, glucose homeostasis, inflammation, and antioxidants as continuous variables were considered. Only randomized controlled trials (RCTs) on the chronic effects of yoga were included.
The authors included studies that evaluated yoga as a multicomponent intervention (posture, breathing, meditation). Therefore, those that focused on only one element of yoga were excluded.
We considered studies that included participants with a high BMI (≥23 for Asians and ≥25 for others) according to the World Health Organization (WHO) and WHO Asia-Pacific guidelines. Studies including participants with comorbidities such as diabetes, kidney disease, cancer, and heart failure were excluded due to potential confounding effects.
Meta-analyses used random-effects models and calculated mean or standardized mean differences as appropriate. Missing standard deviations were estimated using available data or correlations.
Research characteristics and overview
A comprehensive search across seven databases yielded 17,024 records. A total of 30 studies met the eligibility criteria and were considered. The majority of selected studies were conducted in Asia, primarily India, with the remainder conducted in Indonesia, South Korea, the United States, Germany, and Australia. The study involved 2,689 participants, with intervention and control group sizes ranging from 8 to 383 and 8 to 375, respectively.
Most studies included both genders, but some enrolled only men or only women. However, most studies did not explicitly recruit overweight or obese individuals and instead included participants whose average BMI met the inclusion criteria, potentially introducing participants with normal BMI into the analysis. Few studies have specifically targeted overweight or obese individuals. Blood pressure results were primarily reported in prehypertensive participants.
Redox status was assessed using markers such as MDA (malondialdehyde), homocysteine, GSH (glutathione), vitamin E, vitamin C, SOD (superoxide dismutase), and catalase. Inflammatory markers evaluated included hs-CRP (high-sensitivity C-reactive protein), TNF-α (tumor necrosis factor alpha), IL-1, IL-6, IL-10, sIL 2R, and adiponectin. Adiponectin and sIL-2R were each reported in one study.
Meta-analysis suggests modest cardiometabolic benefits of yoga in overweight or obese adults
A meta-analysis showed that yoga slightly improved glucose metabolism in people who were overweight or obese, particularly in precise measures such as HbA1c (hemoglobin A1c) and HOMA-IR (Homeostasis Model Assessment of Insulin Resistance), but had no significant effect on fasting or postprandial blood glucose levels.
These effects are generally small, participants often have normal baseline blood glucose levels, and observable improvements may be limited. Although the findings were observed across populations, considerable variation remained, with no significant improvement in fasting blood glucose levels observed in either Asian or non-Asian groups.
Yoga generally improved lipid profiles by decreasing VLDL (very low density lipoprotein) and triglycerides and increasing HDL (high density lipoprotein). However, these changes were modest and often below clinically meaningful thresholds. These effects were primarily observed in Asian populations. No significant changes were observed in total cholesterol or LDL (low-density lipoprotein) among non-Asians.
Additionally, yoga reduced systolic and diastolic blood pressure in people with high BMI, especially Asians, but had no significant effect on non-Asian groups. Blood pressure reductions were more consistent, but many of the combined effects across outcomes did not exceed minimal clinically important differences.
Additionally, most pro-inflammatory markers decreased and the anti-inflammatory marker IL-10 increased. but, The overall certainty of the evidence regarding inflammation and redox outcomes is low to very low and should be interpreted with caution.
Most studies have significant risks of bias, primarily due to unclear randomization, baseline imbalances, missing data, and missing protocols, raising concerns about selection, attrition, and detection bias. Subgroup and sensitivity analyzes assessed how intervention dose and study quality influenced heterogeneity.
Due to limited data, analysis by participants’ baseline health status or yoga intensity was not possible. Findings showed that intervention duration, session length, frequency, and study quality influenced the effects of yoga on cardiometabolic outcomes.
Stronger effects were observed in studies with lower risk of bias and higher doses of yoga (60-minute sessions, three times a week for at least 12 weeks), particularly for lipid and blood pressure outcomes in Asians. These characteristics did not affect fasting or postprandial blood glucose levels or HbA1c. Further analysis of the low-dose intervention was not possible due to limited data.
Yoga shows potential as adjunctive therapy for obesity
A systematic review and meta-analysis highlighted the potential and generally modest positive effects of yoga on cardiometabolic health in overweight or obese adults. The results of this study show that yoga It may help improve key health factors such as insulin resistance, lipid metabolism, and blood pressure, especially blood pressure and some lipid outcomes.
This supports the inclusion of yoga as a complementary or adjunct treatment for managing metabolic health issues. However, further research is needed to clarify the optimal parameters for yoga practice and to strengthen the evidence regarding glucose, inflammation, and redox outcomes, and current findings remain uncertain. Such insights can help medical professionals provide customized yoga recommendations to overweight people to achieve meaningful health improvements.
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Reference magazines:
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Wasityastuti W, Pramaningtyas MD, Wibowo RA, Adnan ML, Prabowo R, Tsurayya Z, et al. (2026). Effects of yoga on cardiometabolic health in overweight or obese adults: A systematic review and meta-analysis of randomized controlled trials. PLOS Global Public Health. 6(4): e0006174. Doi: https://doi.org/10.1371/journal.pgph.0006174. https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006174
