EFFECT OF YOGIC PRACTICES ON BODY MASS INDEX AND LOW DENSITY LIPOPROTEIN AMONG MIDDLE AGED WOMEN SUFFERING WITH HYPOTHYROIDISM

*C. Kamatchi, ** Dr.R.Elangovan *Ph.D Scholar (Full Time), Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University),west K.K.Nagar, Chennai-600078. Email Id:  kamachi12497@gmail.com ** Professor and Head, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research, west K.K.Nagar, Chennai -600078. Email Id: relangovantnpesu@gmail.com .

 

ABSTRACT

The purpose of the random group experimental study was to find out the effect of yogic practices on Body Mass Index (BMI) and Low Density Lipoprotein (LDL) among middle aged women suffering with hypothyroidism. For the purpose of the study, 30 middle aged women suffering with hypothyroidism were selected randomly using random sampling method  from Chennai, between the age group of 35and 45 years and they were divided into two groups A and B with 15 subjects in each.   It was hypothesized that there would be significant differences due to yogic practices on selected physiological and Bio-chemical variables such as Body Mass Index(BMI) and Low Density Lipoprotein(LDL) among middle aged women suffering with hypothyroidism than the control group.  Pretest was conducted for the two Groups (A and B) on the selected dependent variables before the start of the training program.  Group A was given yogic practices; Group B (Control Group) didn’t receive any specific treatment, but in active rest.  After the experimental period of 12 weeks, the two Groups (A and B) were retested again on the same selected dependent variables as post test. Analysis of co-variance (ANCOVA) was used to find out the significant differences between experimental group and the control group. The results of the study proved that the Experimental Group showed significant differences on selected physiological and Biochemical variables such as Body Mass Index (BMI) (decreased) and Low Density Lipoprotein (LDL) (decreased) than the Control Group due to yogic practices. The hypothesis was accepted at 0.05 level of confidence. Hence it was concluded that yogic practices are beneficial to the middle aged women suffering with Hypothyroidism to maintain healthy Body Mass Index (BMI) and decrease Low Density Lipoprotein (LDL).

KEY WORDS: Yogic practices, Body Mass Index (BMI), Low Density Lipoprotein (LDL).

 

INTRODUCTION

     Thyroid diseases are common worldwide. In India too, there is a significant burden of thyroid diseases. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid diseases. (Ambika Gopalakrishnan, 2011).30 percent of the Chennai people are having thyroid problems. The thyroid gland is located in the anterior neck, overlying the inferior border of the larynx; it is fixed to the anterior surface of the upper trachea by loose connective tissue. It consists of two lateral lobes – one on either side of the trachea – connected by a narrow isthmus. The gland is composed of spherical thyroid follicles that contain colloid surrounded by a layer of cubical follicular cells; these cells synthesize the thyroid hormones T4 and T3 Para follicular cells, located between the follicles, secrete the hormone thyrocalcitonin. (Straight A’s in Anatomy & Physiology, 2007)The thyroid gland has an abundant supply of sympathetic and parasympathetic nerves. Some studies suggest that sympathetic stimulation or infusion of epinephrine or   nor-epinephrine    may    increase    secretion    of    thyroid    hormone.  (Goodman, H. Maurice,2003)The thyroid hormones control the metabolism of cells, which is their speed of activity. If there is too little hormone, the body cells work too slowly; too much results in them working too fast. Thyroid hormones regulate the rate of oxygen consumption. This metabolic action influences the utilization of the main components of food: sugars, protein and fat. Although thyroid hormones have a similar effect and influence the proper working of all body cells, their action is particularly evident in certain tissues and for certain functions. For example, the physical and brain development of a baby growing in the womb depends on the presence of the correct amount of thyroid hormones in the mother until the twelfth week of the pregnancy when the baby’s own thyroid gland begins to function. In a child, too little hormone will slow up growth, whereas too much may make the child grow faster than normal. Thyroid hormone balance is essential in order for the body to function properly. Some of the bodily functions that rely on thyroid hormone balance include energy regulation, growth, weight control, body temperature regulation, tissue restoration, carbohydrate, fat, and protein metabolism, digestion, blood flow, hormone secretion, and sexual function. Therefore, it is crucial for the thyroid to perform at an optimal level. Scientists now consider thyroid hormone one of the major “players” in brain chemistry disorders. And as with any brain chemical disorder, until treated correctly, thyroid hormone imbalance has serious effects on the patient’s emotions and behavior. (Arem, Ridha,2007). Yogic practices balance the endocrine system and good for hypothyroidism.

 

OBJECTIVES OF THE STUDY

The objective of the study was to find out whether there would be any significant difference on Body Mass Index (BMI) and Low Density Lipoprotein (LDL) due to yogic practices among middle aged women suffering with Hypothyroidism.

PURPOSE OF THE STUDY

The purpose of the study was to find out the effect of yogic practices on Body Mass Index (BMI) and Low Density Lipoprotein (LDL) among middle aged women suffering with hypothyroidism.

HYPOTHESIS

It was hypothesized that there would be significant differences on Body Mass Index (BMI) and Low Density Lipoprotein(LDL) among middle aged women suffering with hypothyroidism due to yogic practices than the control group.

 

DELIMITATIONS

• The subjects were middle aged women suffering with hypothyroidism from Chennai city only.
• Age of subjects was ranged from 35 to 45 years only.
• Independent variable was yogic practices only.
• The dependent variables were restricted to Body Mass Index (BMI) and Low Density Lipoprotein (LDL) only.

LIMITATIONS

• The Factors like Socio-Economical status were not taken into consideration.
• The climatic conditions were not considered.
• Factors like Life style habits were not taken into consideration.
• Subjects’ day to day activities were not taken into account.
• Diet and Medication followed by subjects was not controlled.

REVIEW OF RELATTED LITERATURE

Amouzegar, A., Kazemianet.al., (2018), investigated a study on inconsistent and conflicting data on associations of thyroid function, within the reference range, with anthropometric measures and metabolic syndrome, this study aimed to investigate the relationship between thyroid function and different obesity phenotypes over nine years of follow-up. This study was conducted on 1938 individuals from an ongoing population-based cohort study, the Tehran Thyroid Study. Participants were categorized into four obesity phenotypes based on body mass index and metabolic status. To investigate the associations of thyrotropin and free thyroxine (fT4) with incidence of different obesity phenotypes across the study period, a multivariate approach based on a generalized estimating equation method was used. At baseline, individuals with the metabolically healthy normal weight (MHNW) phenotype had higher serum fT4 levels (1.2 ± 0.16 ng/dL vs. 1.14 ± 0.14 ng/dL, 1.16 ± 0.14 ng/dL, and 1.17 ± 0.15 ng/dL in metabolically healthy obese [MHO], metabolically unhealthy normal weight, and metabolically unhealthy obese individuals, respectively). The results of the generalized estimating equation analysis after multivariate adjustment for age, sex, smoking, physical activity, education level, thyroid peroxidase antibody status, and homeostasis model assessment-insulin resistance showed that each 1 ng/dL increment in fT4 levels within the reference range was accompanied with a 1.65-fold [confidence interval (CI) 1.09–2.5] increase of developing the MHNW phenotype during 9.2 years of follow-up. Moreover, each 1.0 ng/dL increment in fT4 within the reference range was associated with a 50% decreased risk of developing the MHO phenotype (odds ratio = 0.50 [CI 0.32–0.76]). Meanwhile, a significant positive association was found between serum thyrotropin levels and development of the metabolically unhealthy normal weight phenotype (odds ratio = 1.22 [CI 1.01–1.48]) Serum fT4 concentrations within the reference range are associated with the development of some obesity phenotypes, including the MHNW and MHO phenotypes, after consideration of potential confounders.

Jung, C. H., et.al., (2003)conducted study on Thyroid abnormalities affect a considerable portion of the population, and overt hypothyroidism is associated with an elevated risk of cardiovascular disease and adverse changes in blood lipids. Subclinical hypothyroidism is also associated with an increase risk of cardiovascular disease. So, we undertook this study to investigate the prevalence of overt and subclinical thyroid disorders and their associations with cardiovascular risk factors. This study involved 66260 subjects (43588 men, 22672 women; between 20–80 years of age, mean age 41.5±9.6). Serum free thyroxine (FT4), thyroid stimulating hormone (TSH), total cholesterol, low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were measured by RIA using commercial kits. High sensitivity C-reactive protein (hsCRP) levels were determined by nephelometry. The prevalences of overt thyrotoxicosis, subclinical thyrotoxicosis, overt hypothyroidism and subclinical hypothyroidism were 5/1000 (334 subjects), 6.4/1000 (426 subjects), 1.6/1000 (108 subjects), and 6.4/1000 (375 subjects). Mean plasma total cholesterol and LDL-C were elevated in overt hypothyroidism than in normal controls (202.1 mg/dL and 121.8 mg/dL versus 197.1 mg/dL and 120.1 mg/dL, respectively) (p<0.05). In subclinical hypothyroidism, mean total cholesterol and LDL-C levels were also elevated (201.9 mg/dL and 123.7 mg/dL)(p=0.015, p=0.047). Waist-to-hip ratio (WHR) was lower in overt thyrotoxicosis and higher in hypothyroidism. The prevalence of thyroid dysfunction in Korea is not significantly different from that reported by other countries. It was also age dependent and higher in women, but this elevation in women was lower than expected. Patients with hypothyroidism exhibited higher waist-to-hip ratios, an index of obesity. Patients with subclinical hypothyroidism exhibited elevated atherogenic parameters (Total cholesterol, LDL-C). Therefore screening and treatment for subclinical hypothyroidism may be warranted due to its adverse effects on lipid metabolism.

METHODOLOGY

To achieve the purpose of the study, 30 middle aged women suffering with hypothyroidism were selected randomly for the study from Chennai city, between the age group of 35 and 45 years and they are equally divided into two groups A and B with 15 subjects in each group. Preliminary test was taken for the two groups (A and B) on the selected dependent variable before the start of the training program. Group A was given yogic practices for 60 minutes six days for a total period of 12 weeks. Group B (control group) was permitted to undergo their routine and normal life style during the course of experiment without any specific training. After 12 weeks, the two groups were rested again on the same selected dependent variable, the selected physiological and Bio-Chemical variables such as Body Mass Index (BMI) and Low Density Lipoprotein (LDL). Analysis of co-variance (ANCOVA) was used to find out the significant differences between experimental groups and the control group. The test of significance was fixed at 0.05 level of confidence.

YOGIC PRACTICES

            1. Loosening the joints.

2. Surya Namaskar       

3. Asanas

• Navasana
• Paschimottanasana
• Noukasana
• Ardha matsyendrasana
• Sarvangasana
• Matsyasana
• Ardha halasana
• Savasana

4. Pranayama

• Anulomvilom
• Kapalapathi
• Ujjai

5. Yoga Nidra

RESULTS AND DISCUSSIONS

• The data pertaining to the variable collected from the groups before and after the training period were statistically analyzed by using analysis of covariance (ANCOVA) to determine the significant difference and the hypothesis was tested at 0.05 level of confidence.
• The obtained F-ratio value for the body mass index and low density lipoprotein were greater than the table value, indicating that there was a significant difference among the post test and adjusted posttest means of the yogic practice group than the control group on selected Physiological and Bio-chemical variables.

TABLE I

COMPUTATION OF MEAN AND ANALYSIS OF CO-VARIANCE (ANCOVA) OF BMIOF EXPERIMENTAL AND CONTROL GROUP (Scores in (Weight (kg) / Height (m)2 )

Test	Experimental Group – I	Control group	Source of variance	df	Sum of square	Mean square	F
Pre-test mean	25.38	25.01	Between	1	1.01	1.01	1.67
			Within	28	16.88	0.60
Post-test mean	23.87	25.11	Between	1	11.66	11.66	18.99*
			Within	28	17.19	0.61
Adjusted mean	23.83	25.15	Between	1	12.28	12.28	20.00*
			Within	27	16.57	0.61

* Significant at 0.05 level of confidence. (The table value required for significance at 0.05 with df 1and 28 and 1 and 27 are 4.2 and 4.21 respectively)

 

The obtained F value on pre test scores 1.67 was lesser than the required F value of 4.2 to be significant at 0.05 level. This proved that there was no significant difference between the groups a pretest and posttest and the randomization at the pretest was equal. The post test scores analysis proved that there was significant difference between the groups, as obtained F value 20.00 was greater than the required F value of 4.21. This proved that the differences between the posttest means of the subjects were significant. Taking into consideration the pre and post test scores among the groups, adjusted mean scores were calculated and subjected to statistical treatment.

Figure-1

BAR DIAGRAM SHOWING ADJUSTED POST-TEST VALUES OF CONTROL GROUP AND EXPERIMENTAL GROUP ON BODY MASS INDEX (Scores in Kg/Height m2)

* Significant at 0.05 level of confidence. (The table value required for significance at 0.05 with df 1and 28 and 1 and 27 are 4.2 and 4.21 respectively)

 

The results of the study on the selected physiological variable showed that group I has significant differences on BMI, due to yogic practices. Hence, the hypothesis was accepted at 0.05 level of confidence. The above findings were substantiated by the observations made by experts such as Amouzegar, A., Kazemianet.al., (2018)

 

Table     II

ANALYSIS OF COVARIANCE OF THE MEANS OF TWO EXPERIMENTAL GROUPS AND THE CONTROL GROUP ON ldl (mg/dL)

Test	Exp Group I	Control Group	SOV	Degrees of Freedom	Sum of Squares	Mean Sum of Squares	F-Ratio
Pre	116.07	111.33	B	1	168.03	168.03	1.02
			W	28	4602.27	164.37
Post	90.00	113.67	B	1	4200.83	4200.83	36.49*
			W	28	3223.33	115.12
Adjusted Post	88.53	115.14	B	1	5123.56	5123.56	95.80*
			W	27	1443.96	53.48

* Significant at 0.05 level of confidence.(Table F ratio at 0.05 level, of confidence for df 1 and 28= 4.2, 1    and  27= 4.21)

The obtained F - ratio value for the LDLwas greater than the table value. This indicates that there was a significant difference among the post-test and adjusted post-test means of the Experimental group than the control Group on LDL. The above findings can also be substantiated by the observations of experts. Jung, C. H., et.al., (2003).The pretest, posttest and the adjusted posttest mean values of Experimental group and Control group on LDL are graphically presented in the following table.

 The ordered adjusted means on LDL were presented through bar diagram for better understanding of the results of this study in Figure - 2.

Figure 2

BAR DIAGRAM SHOWING THE MEAN DIFFERENCES AMONG THE

GROUPS ON ldl(mg/dl)

* Significant at 0.05 level of confidence. (The table value required for significance at 0.05 with df 1and 28

         and 1   and 27 are 4.2 and 4.21 respectively)

The results of the study on the selected Bio-chemical variable showed that group Ishowed significant differences on LDL, due to yogic practices. Hence, the hypothesis was accepted at 0.05 level of confidence. The above findings were substantiated by the observations made by experts such as Kumari, N Suchetha et al. (2011)

DISCUSSION ON HYPOTHESIS

It was hypothesized that there would be significant differences on selected Physiological variable such as Body Mass Index (BMI) and Biochemical variable such as Low Density Lipoprotein (LDL) due to yogic practices among middle aged women suffering with Hypothyroidism than the control group. The results proved that there were significant differences on Body Mass Index (BMI) (decreased) and Low Density Lipoprotein (decreased) due to yogic practices than the control group among middle aged women suffering with Hypothyroidism.

CONCLUSION

It was concluded that yogic practices decreased Body Mass Index (BMI) and Low Density Lipoprotein significantly among middle aged women suffering with hypothyroidism. Hence, yogic practices are beneficial to middle aged women suffering with hypothyroidism to maintain healthy Body Mass Index (BMI) and Low Density Lipoprotein (LDL).

REFERENCES

• Jung, C. H., Sung, K. C., Shin, H. S., Rhee, E. J., Lee, W. Y., Kim, B. S., ... & Kim, S. W. (2003). Thyroid dysfunction and their relation to cardiovascular risk factors such as lipid profile, hsCRP, and waist hip ratio in Korea. The Korean journal of internal medicine, 18(3), 146.
• Amouzegar, A., Kazemian, E., Abdi, H., Mansournia, M. A., Bakhtiyari, M., Hosseini, M. S., & Azizi, F. (2018). Association between thyroid function and development of different obesity phenotypes in euthyroid adults: a nine-year follow-up. Thyroid, 28(4), 458-464.