Impact of yoga on cardiometabolic health in adults with overweight or obesity: A systematic review and meta-analysis of randomized controlled trials

This systematic review examined the effects of yoga interventions on various cardiometabolic health outcomes in adults with overweight or obesity. Seven major electronic databases and two clinical trial databases were searched from inception to November 2024. The search strategy combined keywords related to yoga, blood pressure, lipids, glucose, redox, and inflammation. Two authors independently screened the articles to identify randomized controlled trials that compared yoga alone with either an inactive control group or other types of physical activity interventions among adults with overweight or obesity. Outcome changes were analyzed using a random-effects meta-analysis model. We assessed the risk of bias in individual studies using the Risk of Bias 2 tool and evaluated the quality of evidence for each outcome using GRADEpro. We identified 30 randomized controlled trials comprising a total of 2,689 participants that met our eligibility criteria. Although most studies (25/28) did not explicitly recruit individuals with obesity, the mean baseline BMI of participants met our inclusion criteria for overweight or obesity. Twenty-three randomized controlled trials involving 2,313 participants were included in the meta-analyses, which demonstrated that yoga practices likely have substantial beneficial effects on systolic blood pressure (-4.35 mmHg), diastolic blood pressure (-2.06 mmHg) and modest effects below the minimal clinically important differences on lipid profiles (low-density lipoprotein cholesterol -0.08 mmol/L, high-density lipoprotein cholesterol +0.06 mmol/L) with moderate quality evidence. Yoga may also have positive effects on glucose, redox, and inflammation parameters, although the evidence remains uncertain. Ethnic differences and dose‒response effects were found in subgroup analyses. Further high-quality studies among Asian populations, as well as additional research in non-Asian populations, are needed to strengthen the evidence base and enhance generalizability. This study provides evidence supporting the inclusion of yoga in clinical guidelines for the treatment of individuals with overweight or obesity. Protocol registration: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) (ID: 2023100068).