YOGA FOR THE MANAGEMENT OF HIV-METABOLIC SYNDROMES

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The introduction of highly active antiretroviral therapy (HAART) has dramatically improved quality of life, and substantially reduced morbidity and mortality rates for people living with HIV. But, HIV-infection and HAART have been associated with a cluster of metabolic and anthropomorphic syndromes (HIV-metabolic syndrome; HIV+MS) that jeopardize long-term cardiovascular disease (CVD) risk profiles for people living with HIV. The cause of these complications is multifactorial. Few safe and effective traditional treatments (drugs, changing anti-HIV medications) have been identified. The ancient practice of a Yoga lifestyle has been re-popularized as a complementary, non-traditional treatment for metabolic, anthropomorphic, and cardiovascular disorder. Yoga provides integrated control and harmonious balance among eating habits, exercise, and rest, breathing style, and the mind-body relationship through the practice of postures, muscle contraction, controlled breathing, and meditation. Holistic balance among physiologic processes provides relief from disease. We propose to objectively examine the safety and efficacy of a yoga lifestyle intervention in 26 women and 26 men infected with HIV, treated with HAART and experiencing metabolic syndromes that increase CVD risk. We hypothesize that a yoga lifestyle intervention will be safe and enhance (complement) the benefits of standard-of-care therapy for HIV+MS. Participants will be randomly assigned to continue standard-of-care therapy, or add a supervised yoga lifestyle intervention to standard-of-care therapy. Yoga lifestyle intervention will be taught and supervised by trained and experienced yoga instructors employed by Living By Design Inc., a St. Louis-based healthcare program that provides complementary and alternative rehabilitative therapies to people living with HIV (and other chronic disorders). Standardized and objective measurements of oral glucose tolerance, insulin sensitivity, serum lipid/lipoprotein levels, serum markers of fibrinolysis and inflammation, adipose tissue distribution, cardiovascular function adn CVD risk will be quantified before and at the end of 4-months of therapy. Yoga lifestyle practices have not been objectively tested in alternative management strategy for a chronic infection with lifelong implications for CVD and other health risks.