Objective: To conduct a systematic review of published literature regarding the effects of yoga, a promising mind-body therapy, on specific anthropometric and physiologic indices of cardiovascular disease (CVD) risk and on related clinical endpoints.Methods: We performed a literature search using 4 computerized English and Indian scientific databases. The search was restricted to original studies (1970 to 2004) evaluating the effects of yoga on CVD or indices of CVD risk associated with the insulin resistance syndrome (IRS). Randomized controlled trials (RCTs), nonrandomized controlled trials, uncontrolled (pre and post) clinical trials, and cross-sectional (observational) studies were included if they met specific criteria. Data were extracted regarding study design, setting, population size and characteristics, intervention type and duration, comparison group or condition, outcome assessment, data analysis and presentation, follow-up, and key results, and the quality of each study was evaluated according to specific predetermined criteria.Results : ing number of developing countries. [5][6][7] Leading to premature morbidity and mortality, and to preventable losses of employment, earnings, and quality of life, CVD is clearly of pressing clinical and economic significance, underscoring the need for effective primary prevention efforts that target common, modifiable risk factors. Prominent among these are the physiologic and anthropometric risk factors associated with the insulin resistance syndrome (IRS), and the neuroendocrine and psychosocial alterations that may both predispose to and result from these IRS-related abnormalities. The IRS, also referred to as syndrome X or the metabolic syndrome, is a cluster of metabolic and hemodynamic abnormalities that both collectively and independently predict the development of atherosclerosis and CVD. 4,8 -11 Core features of the IRS are insulin resistance, glucose intolerance, atherogenic dyslipidemia, high blood pressure, and

It has become increasingly evident that bidirectional ("top-down and bottom-up") interactions between the brain and peripheral tissues, including the cardiovascular and immune systems, contribute to both mental and physical health. Therapies directed toward addressing functional links between mind/brain and body may be particularly effective in treating the range of symptoms associated with many chronic diseases. In this paper, we describe the basic components of an integrative psychophysiological framework for research aimed at elucidating the underlying substrates of mind-body therapies. This framework recognizes the multiple levels of the neuraxis at which mind-body interactions occur. We emphasize the role of specific fronto-temporal cortical regions in the representation and control of adverse symptoms, which interact reciprocally with subcortical structures involved in bodily homeostasis and responses to stress. Bidirectional autonomic and neuroendocrine pathways transmit information between the central nervous system (CNS) and the periphery and facilitate the expression of affective, autonomic, hormonal, and immune responses. We propose that heart rate variability (HRV) and markers of inflammation are important currently available indices of central-peripheral integration and homeostasis within this homeostatic network. Finally, we review current neuroimaging and psychophysiological research from diverse areas of mind-body medicine that supports the framework as a basis for future research on the specific biobehavioral mechanisms of mind-body therapies.

VINCENT, HEATHER K., CHERYL BOURGUIGNON, AND KEVIN R. VINCENT. Resistance training lowers exercise-induced oxidative stress and homocysteine levels in overweight and obese older adults. Obesity. 2006;14: 1921-1930. Objective: To compare exercise-induced oxidative stress and levels of homocysteine and cholesterol in normalweight and overweight older adults after resistance exercise (RX). Research Methods and Procedures:This interventional study was conducted at a wellness center. Forty-nine older adults (age range, 60 to 72 years) were stratified by BMI (Ͻ25 kg/m 2 normal weight, Ն25 kg/m 2 overweight/obese) and then randomly assigned to either a control non-exercise group or an RX group. The RX group completed a 6-month training program. Exercise-induced lipid hydroperoxides (PEROXs) and thiobarbituric-reactive acid substances, homocysteine, lipoprotein a, cholesterol, and high-density lipoprotein cholesterol were measured before and after the 6-month RX program. Results: PEROXs and thiobarbituric-reactive acid substances were lower in both the overweight/obese and normal-weight RX-trained groups compared with control groups (p Ͻ 0.05). Homocysteine levels were lower in both overweight/obese and normal-weight RX groups compared with control groups (p Ͻ 0.05). Lipoprotein a, total cholesterol, and high-density lipoprotein cholesterol were not different in normal-weight and overweight/obese groups before or after RX. The change in muscle strength was correlated with homocysteine at 6 months (r ϭ Ϫ0.452, p Ͻ 0.05), whereas the change in PEROXs was correlated with the change in body fat (r ϭ Ϫ0.329). Discussion: To our knowledge, these data are the first to show that RX reduces exercise-induced oxidative stress and homocysteine regardless of adiposity, indicating that this protection can be afforded in an older, overweight/obese population as effectively as in healthy older adults. These data suggest that RX may afford some protection against emerging cardiovascular risk factors using a mode of exercise that supports body weight.

Objectives-(1) To investigate the effects of a 6-week intervention of guided imagery on pain level, functional status, and self-efficacy in persons with fibromyalgia (FM); and (2) to explore the dose-response effect of imagery use on outcomes.Design-Longitudinal, prospective, two-group, randomized, controlled clinical trial.Setting and subjects-The sample included 48 persons with FM recruited from physicians' offices and clinics in the mid-Atlantic region.Intervention-Participants randomized to Guided Imagery (GI) plus Usual Care intervention group received a set of three audiotaped guided imagery scripts and were instructed to use at least one tape daily for 6 weeks and report weekly frequency of use (dosage). Participants assigned to the Usual Care alone group submitted weekly report forms on usual care.Measures-All participants completed the Short-Form McGill Pain Questionnaire (SF-MPQ), Arthritis Self-Efficacy Scale (ASES), and Fibromyalgia Impact Questionnaire (FIQ), at baseline, 6, and 10 weeks, and submitted frequency of use report forms.Results-FIQ scores decreased over time in the GI group compared to the Usual Care group (p = 0.03). Ratings of self-efficacy for managing pain (p = 0.03) and other symptoms of FM also increased significantly over time (p = <0.01) in the GI group compared to the Usual Care group. Pain as measured by the SF-MPQ did not change over time or by group. Imagery dosage was not significant.Conclusions-This study demonstrated the effectiveness of guided imagery in improving functional status and sense of self-efficacy for managing pain and other symptoms of FM. However, participants' reports of pain did not change. Further studies investigating the effects of mind-body interventions as adjunctive self-care modalities are warranted in the fibromyalgia patient population.

Major depressive disorder (MDD) is a common, debilitating chronic condition in the United States and worldwide. Particularly in women, depressive symptoms are often accompanied by high levels of stress and ruminations, or repetitive self-critical negative thinking. There is a research and clinical imperative to evaluate complementary therapies that are acceptable and feasible for women with depression and that target specific aspects of depression in women, such as ruminations. To begin to address this need, we conducted a randomized, controlled, mixed-methods community-based study comparing an 8-week yoga intervention with an attention-control activity in 27 women with MDD. After controlling for baseline stress, there was a decrease in depression over time in both the yoga group and the attention-control group, with the yoga group having a unique trend in decreased ruminations. Participants in the yoga group reported experiencing increased connectedness and gaining a coping strategy through yoga. The findings provide support for future large scale research to explore the effects of yoga for depressed women and the unique role of yoga in decreasing rumination.