Review: Can yoga breathing exercises improve glycemic response and insulin sensitivity? (2017)

Citation

Wilson T, Kelly KL, Baker SE. Review: Can yoga breathing exercises improve glycemic response and insulin sensitivity. J Yoga Phys Ther. 2017;7:270.

4 FUNDAMENTALS

 

1. Essential Background Material

 

This review examined how yogic breathing (pranayama) might help as a non-pharmacological intervention for improving insulin sensitivity and blood sugar control.

 

(Note that this was not a systematic review or meta-analysis.  It’s more of a general overview article.)

 

Yoga, in general, has been shown to improve diabetes control.  However, yoga involves many aspects other than just breathing (like physical movement).  But not everyone can perform physical activity, especially people with chronic diseases. 

 

Encouragingly, a study published in 2013 showed that a relaxation breathing technique lowered blood glucose in healthy college-aged participants.  This suggests that pranayama alone could benefit insulin sensitivity and blood sugar control.

 

Here, they wanted to examine this proposition further and see if yogic breathing by itself could benefit insulin sensitivity and blood sugar control.  This would be helpful since breathing exercises can generally be performed safely by everyone.

 

 

2. What Did this Research Do?

 

This wasn’t a traditional paper with a “Methods” section.  Instead, it was broken into three subsections, and relevant information was cited for each one.  Here are the areas they examined:

  • Glucose, Insulin Sensitivity, and Stress

  • Effect of Pranayama on Insulin Sensitivity and Glucose

  • Sleep Apnea and Diabetes

 

 

3. What Were the Major Findings?

 

Glucose, Insulin Sensitivity, and Stress

No surprise here: stress and an overactive sympathetic nervous system are two key areas that pranayama techniques help with.  Interestingly, the liver generates glucose via gluconeogenesis, and when the sympathetic nervous system is activated, it increases this process.  We shift out of a sympathetic state and into a more parasympathetic dominant state by breathing slowly.  Thus, slow yogic breathing that promotes relaxation might reduce the amount of glucose produced by the liver and help reduce our blood sugar.

 

Insulin Sensitivity and Glucose Control

Despite their intention to focus solely on pranayama, they referred to several studies that involved pranayama and yoga poses.  Although these studies showed improvements in insulin sensitivity, there was no way to tease out the importance of breathing versus physical exercises.

 

However, one study (their own from 2013, mentioned above) only used breathing.  Here, it was shown that slow breathing for 30 min reduced the blood sugar spike associated with an oral glucose tolerance test.  This provides some evidence that pranayama, independent of physical poses, can benefit blood sugar and insulin sensitivity.

 

Sleep Apnea and Diabetes

There were no concrete results here, just speculation.  The authors suggest that pranayama breathing techniques might reduce the severity of sleep apnea.  This, in turn, would then help improve insulin sensitivity and fasting blood sugar levels (since sleep apnea harms these significantly).  It seems like a reasonable assumption, in my opinion, but there were no studies to back it up.

 

 

4. Why Do These Results Matter?

 

Although the evidence was limited, this overview suggests that breathing exercises could be a beneficial and cost-effective add-on for people suffering from conditions that involve insulin resistance and impaired glucose control.  These pranayama breathing exercises could be particularly helpful in regions of low socioeconomic status.

 

 

1 BIG TAKEAWAY

 

Yogic breathing practices that focus on slow breathing and parasympathetic activation might reduce the body’s endogenous production of blood sugar and help improve insulin sensitivity.

 

 

1 PRACTICAL APPLICATION

 

Use slow breathing (almost any rate and ratio that promotes relaxation will do) to potentially improve insulin sensitivity and reduce blood sugar.

 

In particular, the study that found impressive improvements in blood sugar following an oral glucose tolerance test used the following exercise:

 

  1. Inhale 2 Seconds, Exhale 1 Second

  2. Inhale 2 Seconds, Exhale 2 Seconds

  3. Inhale 2 Seconds, Exhale 3 Seconds

  4. Inhale 2 Seconds, Exhale 4 Seconds

  5. … (Exhale keeps getting longer) …

  6. Inhale 2 Seconds, Exhale 10 Seconds

 

You can count in your head (I sometimes use this to help me fall asleep) or use the Breathwrk app, which has this breath pre-programmed for you.  On the app, it’s called the “Relaxation” breath, and it can be found in the “Calming” section (not to be confused with “Deep Relaxation,” which is an entirely different exercise on the app).

 

Give it a shot and see how you feel.