Effect of 12-Week Sequential Yoga Protocol (Pranayama-Core Asanas) on Neuro-Endocrine-Metabolic Axis in Young Students: A Randomized Controlled Trial Evaluating Sympathetic Tone, Anxiety, and Remnant Cholesterol

Abstract

Introduction: Chronic stress activates the neuro-endocrine-metabolic axis, leading to sympathetic overactivity, anxiety, and adverse lipid profiles including elevated remnant cholesterol. Yoga may modulate this axis, but integrated evidence is limited.
Objective: To evaluate the effect of a 12-week sequential yoga protocol (pranayama and core asanas) on sympathetic tone (via Cold Pressor Test and Hand Grip Test), anxiety (HAM-A), and remnant cholesterol levels in young students.
Methods: A randomized controlled trial was conducted on 94 students (18-25 years) allocated to yoga (n=47) or control (n=47) groups. The yoga group received 30-minute sessions, 5 days/week for 12 weeks. Assessments were performed at baseline and 12 weeks.
Results: The yoga group showed significant reduction in HAM-A scores (10.6±3.56 vs. 22.8±4.97; p<0.001), improved sympathetic responses (CPT-SBP: p=0.001; CPT-DBP: p<0.001; HGT-SBP: p=0.003; HGT-DBP: p<0.001), and favorable lipid changes including reduced remnant cholesterol (calculated as TC minus HDL-C minus LDL-C) from 23.0±15.2 to 15.1±12.4 mg/dL (p<0.001).
Conclusion: A 12-week sequential yoga protocol positively modulates the neuro-endocrine-metabolic axis, reducing sympathetic tone, anxiety, and remnant cholesterol in young students.