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The most cited study around--Ornish's in 1990--tested 94 patients with angiographically documented coronary heart disease, of whom 53 were prescribed yoga, group support and a vegetarian diet extremely low in fat--only 10% of total daily calories (most Americans consume 35% in fat; the American Heart Association recommends 30%). Cholesterol changes among the experimental group were about the same as if they had taken cholesterol-lowering drugs. After a year in the program, patients in this group showed "significant overall regression of coronary atherosclerosis as measured by quantitative coronary arteriography." Those in the control group "showed significant overall progression of coronary atherosclerosis." The findings were well received but open to a major challenge: that the severe diet, rather than yoga, may have been the crucial factor.
In 1998 Ornish published a new study, in the American Journal of Cardiology, stating that 80% of the 194 patients in the experimental group were able to avoid bypass or angioplasty by adhering to lifestyle changes, including yoga. He also argued that lifestyle interventions would save money--that the average cost per patient in the experimental group was about $18,000, whereas the cost per patient in the control group was more than $47,000. And this time, Ornish says, he is convinced that "adherence to the yoga and meditation program was as strongly correlated with the changes in the amount of blockage as was the adherence to diet."
Ornish hoped for more than the respect of his peers: he wanted action. "I used to think good science was enough to change medical practice," he says, "but I was naive. Most doctors still aren't prescribing yoga and meditation. We've shown that heart disease can be reversed. Yet doctors are still performing surgery; insurance companies are paying for medication--and they're not paying for diet and lifestyle-change education." (Medicare, however, recently agreed to pay for 1,800 patients taking Ornish's program for reversing heart disease.)
Why have so few studies tested the efficacy of yoga? For lots of reasons. Those sympathetic to yoga think the benefits are proved by millenniums of empirical evidence in India; those who are suspicious think it can't be proved. (Says Coble: "There seem to be no data to substantiate the argument that yoga can heal.") Further, its effects on the body and mind are so complex and pervasive that it would be nearly impossible to certify any specific changes in the body to yoga. The double-blind test, beloved of traditional researchers, is impossible when one group in a study is practicing healthy yoga; what is the control group to practice--bad yoga? Finally, the traditional funders of studies, the pharmaceutical giants, see no financial payoff in validating yoga: no patentable therapies, no pills. (Ornish's prostate-cancer study was funded by private organizations, including the Michael Milken Foundation.)
At the heart of the western medical establishment's skepticism of yoga is a profound hubris: the belief that what we have been able to prove so far is all that is true. At the beginning of the 20th century, doctors and researchers surely looked back at the beginning of the 19th and smiled at how primitive "medical science" had been. A century from now, we may look back at today's body of lore with the same condescension.