Influence of yoga on the epigenetics of obesity: a study on its short- and medium-term benefits in the treatment of patients with severe/morbid obesity eligible for bariatric surgery
6 affiliations
- 1Endocrine-Metabolic Nutrition Center, IRCCS, Ospedale Galeazzi-Sant’Ambrogio , ,
- 2National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Ospedale Galeazzi-Sant’Ambrogio , ,
- 3BioCor Biobank, IRCCS Policlinico San Donato , ,
- 4Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University , ,
- 5IRCCS Policlinico San Donato, Scientific Directorate , ,
- 6Department of Clinical Sciences and Community Health, University of Milan , ,
Abstract
Background: Obesity is a growing global health problem characterised by chronic low-grade inflammation and epigenetic dysregulation. Epigenetic mechanisms—potentially reversible changes in gene expression occurring without alteration of the DNA sequence, most notably DNA methylation—are increasingly implicated in obesity-related inflammation. Yoga may act as complementary therapy.
Objective: To explore whether participation in a structured yoga program is associated with changes in DNA methylation of TNF-α, and with clinical, hormonal, metabolic and psychological parameters, in patients with severe obesity awaiting bariatric surgery.
Methods: In this prospective, non-randomised, controlled observational cohort study, 40 patients were analysed (20 yoga, 20 control). The intervention group underwent 36 PRANA_it yoga sessions over the 3 months preceding surgery (mean attendance 26/36, 72.5%). DNA methylation was profiled using a targeted three-gene inflammatory panel (TNF-α, IL-6, CRP). Between-group differences were estimated by baseline-adjusted ANCOVA.
Results: Plasma noradrenaline was significantly lower in the yoga group at T1 after adjustment for baseline [adjusted difference −206.92, 95% CI (−349.62, −64.21), p = 0.0057]. SF-36 physical functioning differed between groups in the unadjusted change-score comparison ( p = 0.0206) but not after baseline adjustment [−8.69, 95% CI (−21.74, 4.36), p = 0.185]. Circulating TNF-α protein changed significantly more in the yoga group in the unadjusted analysis ( p = 0.0452), a finding with high variance. Vitamin D3 showed no significant adjusted difference at T1 ( p = 0.879); the T2 difference was borderline ( p = 0.064). DNA methylation of TNF-α, IL-6 and CRP showed no significant changes after correction for multiple comparisons. Psychological outcomes, a secondary domain, did not differ significantly between groups.
Conclusion: In patients with severe obesity preparing for bariatric surgery, a structured preoperative yoga program was associated with a significant baseline-adjusted reduction in plasma noradrenaline, consistent with reduced sympathetic activation during a demanding phase of care. No epigenetic changes were detected, suggesting that measurable methylation remodelling may require longer exposure, larger samples, or tissue-specific sampling. These exploratory findings support yoga as a feasible, low-risk adjunct within bariatric prehabilitation, while the non-randomised design precludes causal inference. Adequately powered randomised trials with extended follow-up are needed to confirm this neuroendocrine signal.
Related
- Influence of the type of facial pattern on the outcome of treatment of patients with obstructive sleep-disordered breathing with an intraoral appliance.
- Anti-Obesity Medications Versus Metabolic Bariatric Surgery as Pathways to Heart Transplant Eligibility in LVAD-Supported Patients: A Narrative Review
- Parathyroid hormone, vitamin D, and general and abdominal adiposity in bariatric surgery candidates : A cross-sectional analysis of the Tehran Obesity Treatment Study
- Utilization and outcomes of nutrient-stimulated hormone therapies in patients undergoing bariatric surgery
- Supporting Video-Based Psychotherapy While Asking Who Benefits and Who Remains in Treatment.
BibTeX
@article{asteria2026influence,
title = {{Influence of yoga on the epigenetics of obesity: a study on its short- and medium-term benefits in the treatment of patients with severe/morbid obesity eligible for bariatric surgery}},
author = {Carmela Asteria and Giorgia Scichilone and Rosanna Cardani and Dejan Lazarevic and Valentina Milani and Federico Ambrogi and Laura Valentina Renna and Marco Morelli and Francesca Giannese and Anna Sofia Tascini and Nicoletta Caridi and Fabiana Barbieri and Michela Ravelli and Alessandro Giovanelli},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1858629},
url = {https://europepmc.org/article/PMC/PMC13690647},
note = {CC BY},
}
RIS
TY - JOUR
TI - Influence of yoga on the epigenetics of obesity: a study on its short- and medium-term benefits in the treatment of patients with severe/morbid obesity eligible for bariatric surgery
AU - Carmela Asteria
AU - Giorgia Scichilone
AU - Rosanna Cardani
AU - Dejan Lazarevic
AU - Valentina Milani
AU - Federico Ambrogi
AU - Laura Valentina Renna
AU - Marco Morelli
AU - Francesca Giannese
AU - Anna Sofia Tascini
AU - Nicoletta Caridi
AU - Fabiana Barbieri
AU - Michela Ravelli
AU - Alessandro Giovanelli
PY - 2026
DA - 2026/10/09
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1858629
UR - https://europepmc.org/article/PMC/PMC13690647
AB - Background: Obesity is a growing global health problem characterised by chronic low-grade inflammation and epigenetic dysregulation. Epigenetic mechanisms—potentially reversible changes in gene expression occurring without alteration of the DNA sequence, most notably DNA methylation—are increasingly implicated in obesity-related inflammation. Yoga may act as complementary therapy. Objective: To explore whether participation in a structured yoga program is associated with changes in DNA methylation of TNF-α, and with clinical, hormonal, metabolic and psychological parameters, in patients with severe obesity awaiting bariatric surgery. Methods: In this prospective, non-randomised, controlled observational cohort study, 40 patients were analysed (20 yoga, 20 control). The intervention group underwent 36 PRANA_it yoga sessions over the 3 months preceding surgery (mean attendance 26/36, 72.5%). DNA methylation was profiled using a targeted three-gene inflammatory panel (TNF-α, IL-6, CRP). Between-group differences were estimated by baseline-adjusted ANCOVA. Results: Plasma noradrenaline was significantly lower in the yoga group at T1 after adjustment for baseline [adjusted difference −206.92, 95% CI (−349.62, −64.21), p = 0.0057]. SF-36 physical functioning differed between groups in the unadjusted change-score comparison ( p = 0.0206) but not after baseline adjustment [−8.69, 95% CI (−21.74, 4.36), p = 0.185]. Circulating TNF-α protein changed significantly more in the yoga group in the unadjusted analysis ( p = 0.0452), a finding with high variance. Vitamin D3 showed no significant adjusted difference at T1 ( p = 0.879); the T2 difference was borderline ( p = 0.064). DNA methylation of TNF-α, IL-6 and CRP showed no significant changes after correction for multiple comparisons. Psychological outcomes, a secondary domain, did not differ significantly between groups. Conclusion: In patients with severe obesity preparing for bariatric surgery, a structured preoperative yoga program was associated with a significant baseline-adjusted reduction in plasma noradrenaline, consistent with reduced sympathetic activation during a demanding phase of care. No epigenetic changes were detected, suggesting that measurable methylation remodelling may require longer exposure, larger samples, or tissue-specific sampling. These exploratory findings support yoga as a feasible, low-risk adjunct within bariatric prehabilitation, while the non-randomised design precludes causal inference. Adequately powered randomised trials with extended follow-up are needed to confirm this neuroendocrine signal.
SN - 2296-2565
ER -