What influences our health up to epigenetics and how Yoga helps us to be healthy

by Bianca Garms

Most of us only realize how important health is when we are sick. As Arthur Schopenhauer said: "Health is not everything, but without health everything is nothing." We despair when our bodies can't do what we want. We are desperately looking for help to get us back on our feet and make the pain disappear.

Our body is a miracle, because although environmental toxins, e.g. through unhealthy diet, lack of exercise and generally unhealthy lifestyle weaken it, the body compensates for this for a long time. But not forever, and at some point the famous barrel overflowed. We simply haven't paid attention to our body – partly unconsciously due to environmental risk factors, but also often consciously – and we get sick. But there are also other causes that make us sick. Very few people are aware of these causes.

What are these unknown causes that make our bodies sick? In August 2023, DKFZ researcher Dr. Lina Jansen1 published a study on the influence of social disadvantage on health, specifically on the risk of developing cancer. Her study showed that socio-economic factors significantly contribute to developing cancer and the presence of infrastructure in the form of doctors, hospitals, cancer screening does not affect this risk. Socio-economic factors include the level of income, unemployment, receipt of social assistance, but also school dropout. According to the study, these are clearly serious causes of developing cancer. This is because these factors trigger stress in most people, which becomes chronic. In addition, there is often excessive tobacco consumption, lack of exercise and severe obesity due to an unhealthy diet. Chronic stress, on the other hand, is one of the factors that influence our epigenetics, and thus our health, along with environmental risk factors (from the air, water, diet) and drugs (2Moosavi et al., 2016; 3Bakulski et al., 2014; 4Johnstone et al., 2010).

Why is this knowledge important and what is epigenetics anyway? Most of you have heard of our DNA, the famous double helix with all our genes that created us, make us individuals and sustain us. DNA contains our very individual genes, i.e. the codes for the production of our cell constituents (proteins, lipids), hormones, signaling molecules, fibers, blood vessels, hair – in short, all the components that make up us and our body and keep us viable. In the daily production process of our body, it is important that the production of the components is controlled – so that we do not have an excess of hormones, for example. And this is where epigenetics comes into play as a crucial player. Epigenetics is the interplay between genes and the environment, which influences the structure and states of DNA, but does not alter the DNA sequence itself. Epigenetic changes can be permanent and inherited. Our environment is a major driver of epigenetic changes. In simpler terms, epigenetics refers to different types of molecules that are present on DNA and act like door openers. I'll explain this in a simplified way using the example of hormone production, so that it remains understandable: for example, we have a gene 1 to produce a hormone X. If the hormone X is not needed, there is molecule YZ on the gene 1 and keeps the door closed, no hormone X is produced. When the body needs hormone X, the molecule YZ at gene 1 gets a signal, it changes itself or its position and opens the door. Now the door to gene 1 is open and the required hormone X is produced. When enough hormone X has been produced, our door opener (the molecule YZ on gene 1) receives a signal and closes the door on gene 1 again. Hormone production is now stopped.

It is important that the communication between the door opener and the body works well. As soon as the communication is disrupted, the door does not open as required by the body: sometimes there is too little hormone X and then possibly too much of it. In both cases, there are long-term disturbances in our body, as each individual hormone, protein or signaling molecule interacts with other molecules.

Epigenetic alterations are part of our development. Basically, the change in epigenetics due to environmental influences means an adaptation to new conditions that are supposed to ensure our survival. In other words, epigenetics is adaptable and evolving. It is only natural that the "door open, door closed" processes are adapted according to our environmental conditions.

However, when environmental influences become environmental risk factors, it can lead to damaging adaptations that then make us sick. Such environmental risk factors are toxins such as in particulate matter, exhaust gases (soot, black carbon), fine droplets (aerosols) but also pesticides, tobacco smoke and much more (3Bakulski et al., 2014). 5Ladd-Acosta et al., showed in their 2015 study, that epigenetic changes triggered by environmental risk factors can lead to the following diseases: cancer, heart disease, neurodegenerative diseases such as Parkinson's disease, aging processes, autoimmune diseases and mental illnesses such as depression. However, epigenetic changes can be rewritten by integrative medicine such as yoga: 6Kanherkar and colleagues describe in their 2017 study, the ability of integrative medicine to influence healing by acting on epigenetic mechanisms, among other things.

In this study, the association of physical and mental effects of integrative medicine on gene expression and epigenetic status is pointed out. In integrative medicine, complementary and alternative medicine are combined with conventional medicine. Complementary and alternative medicine includes Yoga, meditation, breathing techniques, progressive muscle relaxation, Tai Chi, Qi Gong, Feldenkreis method, Pilates, but also Ayurveda, Traditional Chinese Medicine, homeopathy and naturopathy. In conclusion, 6Kanherkar writes that this complementary and alternative medicine has a positive impact on our epigenetics and improves physical and mental health.

7Mody and colleagues confirm this in their 2018 study, describing in particular the effects of yoga on the body as a significant link between body-mind and genetics. In their investigations, they saw epigenetic changes such as the degradation of epigenetic marks in the cell nucleus in favor of the establishment of other markers, which in turn reduced stress and improved overall well-being. The study by 8Venditti and colleagues (2020) also showed that meditation, Yoga, Tai Chi and other mindfulness exercises have a positive impact on well-being through stress reduction, less fatigue, relief from depression and improved immune response. Here, too, epigenetic changes were found, which were understood as potentially therapeutic effects.

The above-mentioned studies show that stress is also a factor that has been shown to alter our epigenetics and cause disease. Back in 2010, 4Johnstone published in Nature Reviews Genetics his findings on the role of chronic stress in the development of diseases. He was able to show that epigenetic changes triggered by chronic stress lead to cancer, arteriosclerosis (calcification of the blood vessels) and type II diabetesIn 2013,

9Stankiewitz and colleagues showed the results of their study, which examined the different forms of stress and their effects on the brain in rats. This study showed that both psychological stress and physical stress altered epigenetics and gene expression in specific brain regions. The effects were evident in altered behavior, altered brain activity, and altered response to stress. The 2014 study by 10Reul, et al. showed that stress, or a reduced ability to tolerate stress (resilience), leads to mental illness. At the same time, the study showed that regular exercise, mindfulness and meditation have a health-promoting influence. In particular, the influence of yoga has been studied many times in relation to stress and the results in the many studies speak in favor of yoga.

11Benvenutti et al. were able to show in their 2017 study that just 1 single video Hatha Yoga session improved stress response and recovery. At the same time, the subjects who had the chance to experience yoga showed a more pronounced self-confidence, esp. to cope with the stressful task.

In 2018, 12Shohani and colleagues investigated the impact of yoga on stress, anxiety, and depression in women living in Iran. The results showed that yoga is effective in reducing stress, reducing anxiety and relieving depression. The study recommends using yoga as a complementary medicine. In the 2020 review, 13Wang and colleagues showed that yoga has a positive effect on stress reduction in healthy populations. At the same time, this review showed that regular yoga increased the positive effects on stress reduction. Hatha Yoga, Bikram Yoga, Surdarshan Kriya Yoga, breathing exercises and Yoga Nidra (deep relaxation) proved to be better alternatives to medication-based stress treatment.

But it's not just adults who suffer from stress: children who grow up in conditions of poverty experience toxic stress. This toxic stress also affects epigenetics in such a way that the brain develops less strongly. The consequences are a lack of concentration, the children have problems organizing themselves or following processes. They also find it harder to control impulses, anger, or aggression (14McEwen&McEwen, 2017).

In 2021, 15Craig A. McEwen wrote in a review about the links between stress, epigenetics and social structures. His main focus was also on the development of children who grow up in poor social conditions, such as physical and psychological abuse, physical and psychological neglect, experience of violence against the mother, experience of depression in the family. McEwen writes that children who grow up in such conditions develop diseases such as cancer, chronic lung disease, heart disease, obesity, depression, and behavioral disorders such as substance abuse and alcoholism in the long term in adulthood.

In 2022, 16Raffington and colleagues published their findings on the study of social inequalities and their influence on genetics and epigenetics. In this study, Raffington, who now heads the Biosocial-Biology, Social Differences and Development Research group at the Max Planck Institute for Human Development in Berlin, reports on changes in specific epigenetic profiles that can be used to determine the effects of social inequality.

These epigenetic changes have implications for poorer health in adulthood and a faster aging process in children from socially disadvantaged families. The risk of suffering from obesity, diabetes and heart disease is significantly increased. At the same time, school performance, school and vocational training are poorer, which also affects the overall quality of life. Thus, social inequality affects children's development and leads to long-term differences in education, health and well-being.

But: the epigenetic changes triggered by toxic stress with all their consequences can be transformed: 15McEwen shows in his review of 2021 that such a transformation happens through many positive experiences and positive social structures. This is where teachers, mentors, child welfare agencies, educators and politicians are needed to create caring, cordial relationships for the children. He reports on child support programs in the USA that have already been set up in kindergarten for children who grow up in poor social conditions.

Long-term studies of the participating children into young adulthood showed that these well-thought-out and integrated support at school had a positive effect on the development of such children: fewer children attended the special school, misconduct in classroom teaching was reduced and the children had higher school qualifications than the children who had to withstand the toxic stress without support programs.

Positive, nurturing, and loving behaviors can compensate for toxic stress from the home and neighborhood, according to 15McEwen. The children develop better resilience and are also better able to deal with stress on a physical level in the long term. The support at school also helps these children to break out of impoverishment through a higher school leaving certificate.

As researcher 17Magalhaes-Barbosa writes in her 2017 study, it is the task of child research to take the effects of toxic stress in children seriously and to install targeted measures that promote and ensure the health and quality of life of children in early, middle and older age. Regular practice of yoga can also help children reduce toxic stress, generate positive experiences and promote children's holistic health in the long term.

The studies mentioned above (11Benvenutti, 12Shohani, 13Wang) show that yoga helps us humans to cope better with stress, minimizes the effects of stress and also alleviates anxiety and depression. But yoga doesn't just help you deal with stress better. Studies show that yoga also has positive effects on cancer patients. Already in 2005, 18Bower and colleagues showed in a review that 1-2x gentle yoga practice per week for 6-8 weeks improved sleep quality, improved mood, reduced stress and cancer-related suffering and symptoms, and improved overall quality of life.

In his 2005 review, 18Bower made a strong recommendation for further studies on this topic, which many research groups did. In 2016, 19Galliford and colleagues wrote about treatment options for breast cancer using yoga. The review evaluated the results of 38 studies from 2009 – 2014. All studies included in this review included either 3x/week 90 min yoga (Hatha Yoga, gentle restorative yoga or yoga therapy) or mindfulness-based stress reduction (MBSR).

The summary showed that in the breast cancer patients, anxiety, stress and depression were alleviated after regular yoga or mindfulness practice, that emotional and social behavior improved, and that overall quality of life increased. There was also an improvement in sleep quality on a physiological level, cortisol levels decreased and lymphocyte counts increased. A brief explanation of these physiological adaptations: Cortisol is a stress hormone, dampens the immune system and causes tumor cells to grow faster, thus promoting the formation of metastases. Lymphocytes are part of our immune system and can attack tumor cells in particular. They are our natural protective cells against cancer.

19 Galliford writes in the review that breast cancer patients should include yoga therapy in their everyday lives even before radiotherapy. In addition, she writes that yoga therapy should continue even after treatment so that all the health benefits of yoga are fully unfolded. In their 2017 study, 20Danhauer and colleagues were able to show that yoga, practiced during cancer therapy, alleviated depression, anxiety and distress. At the same time, yoga practitioners showed better sleep patterns and less fatigue.

A follow-up study by 21Zetzl and colleagues from 2020 showed that yoga was effective in reducing symptoms of fatigue and depression in patients with various cancers. In this study, 173 cancer patients participated 1x/week for 8 weeks in a 1 hour yoga class. The yoga class included breathing exercises, postures and initial and deep relaxation. In each yoga class, the basic principle of non-harming (ahimsa) was repeated to encourage patients to be gentle with themselves in the yoga class and to accept the limits of the body.

After the 8 weeks with patients of different cancers, the yoga participants showed a significantly reduced fatigue and depression. The patients' quality of life had improved significantly. In the study, 21Zetzl emphasizes that regularity has an important influence on improvements in fatigue and depression: at least 3-4 yoga classes are needed to have a positive effect on fatigue and depression.

Our body is able to compensate for many damaging processes. Our mitochondria, our cell organelles, which are responsible for life and the energy center of every cell, play a very important role in this. 22Gautam et al., published a study in 2021 on the influence of yoga on mitochondrial health. Mitochondria are present in each of our cells and are our power plants, energy suppliers.

When our mitochondria are healthy, they regulate our energy metabolism, cell breakdown, antioxidant mechanisms, free radical breakdown, and other biochemical processes in our cells. If our mitochondria do not function as they should, it leads to a variety of degenerative diseases such as cancer, Alzheimer's disease, Parkinson's disease, heart muscle diseases, forms of epilepsy, eye diseases such as Kearns-Syre syndrome (eye paralysis) and other eye diseases, as well as Huntington's disease (dysfunction of the brain).

Our mitochondria become ill due to unhealthy social habits (including lack of exercise, unhealthy eating, smoking, drug and alcohol use), genetic mutations, epigenetic factors, stress, infections, allergens and toxins. To help mitochondria achieve better health, yoga helps: In this study, 22Gautam and colleagues were able to show that yoga improves mitochondrial and DNA integrity and has a positive effect on the sperm epigenome.

The study further shows that after 8 weeks of regular yoga practice, patients with a specific eye disease (LHON: Leber's Hereditary Optic Neuropathy) had improved vision. Biochemical studies showed that the overall mitochondrial function, including gene expression, had improved significantly. At the same time, the patients showed higher levels of melatonin, which is responsible for the sleep-wake cycle, but also acts as a powerful antioxidant and thus reduces oxidative damage to mitochondrial DNA and mutations.

22 Gautam and colleagues also showed that inflammation parameters could be reduced by yoga and meditation, which in particular often alleviates painful rheumatic diseases. They go on to explain that yoga works at the nucleus level by stimulating functions that normalize DNA repair, control the cell cycle, and downregulate pro-inflammatory genes. Yoga has therefore been shown to be suitable as an additional therapy for patients with rheumatoid arthritis.

Yoga therefore works against stress, also at the cellular level, by reducing oxidative stress. Oxidative stress caused by free radicals damages both mitochondrial DNA and DNA in the nucleus. This, in combination with an unhealthy lifestyle and harmful environmental influences, damages the entire organism.

Yoga is able to improve physical and mental health by keeping the mitochondrial and nuclear genome intact. Yoga helps the body optimize oxidative stress levels, increases gene activity for a stable immune system, improves immune system metabolism, mitochondrial structure, and mitochondrial biogenesis. Yoga is cost-effective and has no side effects. The study by 22Gautam and colleagues shows that yoga has enormous therapeutic potential as an adjunctive therapy for mitochondrial diseases.

Yoga is often described as a fountain of youth. Science proves this: already in 2009, 23Calvanese described the role of epigenetic changes in aging processes and age-related diseases.  In their 2021 study, 24Yang and colleagues report that regular meditation slows epigenetically determined aging, thereby providing long-term health benefits.Auch 25 Tolahunase and colleagues were already able to show in 2018 that yoga alters aging processes by influencing our telomeres: their age-related shortening slows down.

Science has been able to show in many independent studies that yoga actually has the health effects taught by practicing yogis. A small selection of these studies are mentioned in this article. Regularly practising yogis report an improvement in their physical and mental health, which maintains their quality of life even in old age.

Our social diseases such as heart disease, cancer, neurodegenerative diseases, type II diabetes and obesity are often triggered by stress and environmental influences. Toxic stress in children also leads to long-term health impairments. These health impairments, the studies show, can be alleviated and improved through regular yoga practice. Yoga brings body, mind and soul back into harmony with his millennia-old knowledge.

Yoga has its roots in India, where it was practiced as early as 5000 BC. Yoga is an ancient body-and-mind practice that improves and promotes health and prevents the development of diseases. As a result, yoga can be used as an additional therapy in complex diseases.

Yoga is a profound science that works through a well-defined psycho-neuro-immune axis, influencing a variety of bodily processes: metabolism, epigenetics, DNA repair, aging, blood pressure, maintenance of our organ systems, subjective health, and reproductive health.

Western yoga comes in many facets and focuses on health and relaxation with a combination of breathing techniques, special postures, meditation, chanting and wisdom teachings. There are a variety of different yoga styles, which often turn yoga into a sport at the expense of mindfulness and meditation exercises.

The studies show that the best effect is achieved with yoga when it involves breathing exercises, mindful physical exercises, and meditation. Both a face-to-face yoga class and a video yoga class are able to positively influence our organism. Most studies had participants practice yoga regularly, at least 1x/week, over a longer period of 6-8 weeks. The results of the studies are consistent with the observations of practicing yogis who experience noticeable positive changes after regular practice.

There are a variety of yoga teachers, yoga studios, yoga retreats and access to yoga is possible for everyone. The knowledge of the health benefits of yoga is mostly freely available to anyone who knows where to look (some studies, unfortunately, do not): English-language searches on https://scholar.google.com/ or https://pubmed.ncbi.nlm.nih.gov/are possible for everyone. However, too few people are aware of the health benefits that yoga brings.

This article aims to help spread this knowledge. At the same time, it would be desirable if socially disadvantaged people, especially children, were introduced to yoga through support programmes. In the long term, the health of yoga practitioners improves and relieves our health system. For children, there is adapted children's yoga and also teenage yoga, which means that there is also the possibility to offer yoga from kindergarten to the end of school. This makes it possible to positively promote neuronal and physical development in children from socially disadvantaged families. When yoga becomes an integral part of everyday life, these children have a chance at better education and health.

Good education and health form the basis for a good quality of life.

A good quality of life makes people happy, kind, loving and kind.

Therefore, yoga for all should be our common goal.

Bianca Garms from BeGefit offers various Online Hatha Yoga classes and is planning a yoga retreat in Argentina's pre-Andes.

Literature Sources:

 1 (Jansen et al., 2023: Trends in cancer incidence by socioeconomic deprivation in Germany in 2007 to 2018: An ecological registry-based study, Intern. Journal of Cancer 153 (10) DOI: 10.1002/ijc.34662 open access

2Moosavi et al., 2016: Role of Epigenetics in Biology and Human Diseases, Iranian Biomedical Journal (20) 5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075137/

3Bakulski et al., 2014: Epigenetic epidemiology: promises for public health research, Environmental and Molecular Mutogenesis 55(3) https://onlinelibrary.wiley.com/doi/abs/10.1002/em.21850

4Johnstone et al., 2010: Stress and the epigenetic landscape : a link tot he pathobiology of human diseases, Nature Reviews Genetics 11 https://www.nature.com/articles/nrg2881

5Ladd-Acosta et al., 2015: The role of epigenetics in genetic and environmental epidemiology, Epigenomics (2016) 8(2) https://www.futuremedicine.com/doi/full/10.2217/epi.15.102

6Kanherkar et al., 2017: Epigenetic Mechanisms of Integrative Medicine, Evidence-Based Complementary and Alternative Medicine https://www.hindawi.com/journals/ecam/2017/4365429/

7Mody J., 2018: Epigenetics and Yoga, Journal of Clinical Epigenetics 4(2) http://clinical-epigenetics.imedpub.com/epigenetics-and-yoga.php?aid=22446 DOI: 10.21767/2472-1158.100095

8Venditti et al., 2020: Molecules of Silence: Effects of Meditation on Gene Expression and Epigenetics, Frontiers in Psychology 11 (Consciousness Reserach) https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01767/full  DOI: 10.3389/fpsyg.2020.01767

9Stankiewitz et al., 2013: Epigenetics of stress adaptations in the brain, Brain Research Bulletin 98, http://dx.doi.org/10.1016/j.brainresbull.2013.07.003

10Reul, et al. von 2014: Glucocoritcoids, epigenetic control and stress resilience, Neurobiology of Stress 1, http://dx.doi.org/10.1016/j.ynstr.2014.10.001

11Benvenutti et al., 2017: A single session of hatha yoga improves stress reactivity and recovery after an acute psychological stress task – A counterbalanced, randomized-crossover trial in healthy individuals, Complementary Therapies in Medicine 35, https://doi.org/10.1016/j.ctim.2017.10.009

12Shohani et al., 2018: The Effect of Yoga on Stress, Axietey, and Depression in Women, International Journal of Preventive Medicine https://doi.org/10.4103/ijpvm.IJPVM_242_16

13 Wang et al., 2020: Effects of Yoga on Stress Among Healthy Adults: A systematic Review,  Alternative Therapies 26(4) https://pubmed.ncbi.nlm.nih.gov/32088671/

14McEwen&McEwen, 2017: Social Structure, Adversity, Toxic Stress, and Intergenerational Poverty: An Early Childhool Model, Annual Review of Sociology 43 https://www.annualreviews.org/doi/abs/10.1146/annurev-soc-060116-053252

15Craig A. McEwen 2021: Connecting the biology of stress, allostatic load and epigenetics to social structures and processes, Neurobiology of Stress 17 https://doi.org/10.1016/j.ynstr.2022.100426

16Laurel Raffington, MPI für Bildungsforschung, AG Biosozialbiologie, soziale Unterschiede und Entwicklung; Raffington et al., 2022, Current Environmental Health Report (9); https://link.springer.com/article/10.1007/s40572-022-00338-8

17Magalhaes-Barbosa, et al., 2017: Toxic stress, epigenetics and child development, Jornal de Pediatria 98(51) https://doi.org/10.1016/j.jped.2021.09.007

18Bower et al., 2005: Yoga for Cancer Patients and Survivors, Cancer Control 12 (3) https://journals.sagepub.com/doi/abs/10.1177/107327480501200304

19Galliford et al., 2016: Salute tot he sun: a new dawn in yoga therapy for breast cancer, Journal of Medical Radiation Sciences 64 https://onlinelibrary.wiley.com/doi/full/10.1002/jmrs.218

20Danhauer et al., 2017: Review of  yoga therapy during cancer treatment, Supportive Care in Cancer 25 https://link.springer.com/article/10.1007/s00520-016-3556-9

21Zetzl et al., 2020: Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer, Supportive Care in Cancer 29 https://link.springer.com/article/10.1007/s00520-020-05794-2

22Gautam et al., 2021: Yoga – Impact on Mitochondrial Health: Clinical Consequences, Annals of Neurosciences 28(3-4) https://doi.org/10.1177/09727531211009431

23Calvanese et al., 2009: The role of epigenetics in aging and age related diseases, Ageing Research Reviews 8(4) https://doi.org/10.1016/j.arr.2009.03.004

24Yang et al., 2021: Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Ist Effects on Diabetes, International Journal of Molecular Sciences 22 https://doi.org/10.3390/ijms22031317

25Tolahunase et al., 2018: Yoga- and meditation-based lifestyle intervention increases neuroplasticity and reduces severity of major depressive disorder: A randomized controlled trial https://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn170810

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