Feeling Sluggish? Tired? Slow?

How are your energy levels these days? Are you feeling energized when you wake up? What about the rest of the day? How efficient is your digestion? Are you having two bowel movements a day? Yes….two !! Now how does one do that?

One reason your body might feel a bit slow or off is because the process of autophagy could be slackening

What is Autophagy?

Autophagy is an important and natural process within cells. It’s generally thought of as a cellular recycling factory. The etymology of ‘autophagy’ comes from the Ancient Greek autóphagos, which means “self-devouring” or “self-eating”. It was coined by a Belgian biochemist Christian de Duve, in 1963. He discovered the lysosome, while he observed unneeded cellular structures and degraded proteins being engulfed in a big bubble and transported to this waste disposal unit in the cell.

Typically, autophagy works quietly behind the scenes in maintenance mode. It plays a more active role when your body responds to stress and regulates cellular function (1). Autophagy helps to recycle unnecessary cellular components, such as damaged mitochondria or proteins, which may prevent cells from dividing and functioning normally. It also helps to eliminate pathogens and toxins at the intracellular level.
This clearing helps your body to regenerate new and healthy cells more effectively (2).

Studies on Autophagy

Only as recent as 2016, autophagy was found to have a key role when the body responds to starvation and infection, and it has become linked with specific conditions, including cancer and neurological disease (2). Years of impressive research and study by Yoshinori Ohsumi led him being awarded the Nobel Prize in this emerging field.

It’s hardly surprising that autophagy is important for long-lived cells such as neurons. Unlike other cells, neurons do not cellularly divide and do not die off to be replaced by new ones. This makes them vulnerable to degradation and may negatively impact learning and memory (3).

A recent UCLA study, printed in Toxicological Sciences in May 2020, investigated the effects of diesel exhaust on the risk of Parkinson’s disease. It showed that increased exhaust exposure increased the prevalence of Parkinson’s, and decreased the efficacy of autophagy (4). What was really interesting with this study is that these researchers were able to investigate the process of autophagy in real time by using transparent zebrafish as their subjects. They could actually watch the process of autophagy, or lack thereof, happen right before their eyes. With such novel techniques, the future of research in this area is full of promise.

Mitāhara – moderate eating – then becomes the clarion call of how to manage food with a yoga practice, whether your aim is a healthier physical body or a wish to progress in meditative practice.

There is no direct advice given in any older yoga teaching that demands being a vegetarian or vegan. Though you may interpret some other aspects, as in non-violence, to mean vegetarianism, but that is a full debate of its own.

• What matters most is you eat natural, non-processed food items

• In moderate quantities
• At certain times of the day
  AND
• You only eat when you are hungry

Such an approach respects food as a contributor to prāna, your own level of energy.

If you eat too much or too little you will either be bloated and heavy or weak and shaky. The Bhagavad Gita emphasizes this point: “yoga is neither for those who eat too much or eat too little.”

Again we are advised the middle path. Balance. If you have a hard time figuring this out look at your own energy level. It is an indicator right in front of you. If you are not feeling light, bright and energetic every day then some part or parts of your lifestyle are off. Look at:

• Food quality and quantity
• Sleep quality and quantity
• Physical activity quality and quantity

I followed a very involved path of yogic meditative practice that included specific dietary advice in terms of how much to eat and when:

• Only eat after practice late in the morning or even by lunchtime
• One main meal in the day. Usually it was lunch but depends on family life
• If lunch was the main meal then evening was very light – a smoothie or, back then, a cup of warm organic raw milk
• Some evenings nothing so a 24-hour period of fasting took place – lunch to lunch
• Essentially eating within a window of 11am to 7pm – including coffee, smoothie, chocolate timing
• Good news in all of this – coffee was and still is great. Now a coffee with cocoa butter and MCT oil is all I have before 1pm. Then a good lunch. A smoothie in the evening. Or if with my children in the US it changes to coffee, smoothie, and then the main meal as an early dinner. Plus wherever I am I squeeze in an afternoon coffee. And dark chocolate.
• Since day one I was advised good fats are essential. I continue to take everyday. They keep me lean, healthy and energized. Butter, ghee, MCT oil, olive oil, and omega 3s are my main oil inputs. In the early days I lived almost on ghee.
• Then wake up in the morning able to have a full, healthy bowel movement, fresh and full of energy

If you do not wake up fresh, need to nap a few times in the day, get tired easy, have a hard time with morning bowel movement then, regardless of yoga practice, you need to really look at the what and when, but above all how much, you eat.

If you are confused and don’t know what to do then simply EAT LESS and especially at night.

It’s so amazing and powerful that it is now in the news (1). I found when I ate less my body cleaned out more efficiently – healthier and better bowel movements. It’s like less emails in your inbox so you can finally clear what is there. In today’s scientific language we would relate that to how each cell naturally detoxifies, through “self-eating”, autophagy (2).

Not only can you assess the effects in daily energy levels and bowel movements, but if you do yoga body or breath practices you will notice a veritable difference, hence the advice. Light at night means a morning asana practice is super light and more open, a pranayama practice experiences a different level of breath holding. To aid it Hatha yogic practices of Nauli and Agni Sara are advised (3).

The approach to food I highlight above, that I have spent over 20 years doing and can vouch for based on my overall level of energy, have now caught the scientific attention of a few and made it to the public domain in quite an impressive way – impressive because they are good advice:

• Intermittent fasting: every second or third night no food so a 24-hour fasting period happens
• Time restricted eating (TRE): eat within a 6 or 8 or 10-hour window. Ideally not too late.
• Good fats: the rise of the keto movement, only 1,000 years behind Hatha yoga advice !!
• Fasting mimicking as opposed to caloric restriction: not every calorie is the same so you can eat less but more nutritious, calorie dense. If doing a yoga-meditative type practice or just using your brain in multiple ways then being sufficiently nourished is essential

In addition to the body cleaning out better the cycling of eating-to-not-eating takes your body and every cell through feast and famine, clean out and restore, a mild stressor (hormesis) followed by a re-feed (which activates a pathway to build up your body anew and better).

• For better health, better thinking, more energy, deeper meditation:
• Eat less
• Eat light at night
• Eat within an 8-hour window
• Eat things you like
• Eat more natural than processed

And drink good water, enough throughout the day

PART TWO: drugs, infrastructure, and yogic self-awareness

Yoga, Breath and COVID-19: lifestyle behavioral support mechanisms. Approaches to manage the physical and psychological burden of stress from living through and after the current global pandemic

A. Non-Behavioral Approaches Dominate the Literature

1. Inflammation Mitigating Drugs and Vaccine Trials
   Howard Hughes investigator Vogelstein and colleagues at Johns Hopkins are one of the first to trial a drug approach, in this case using the alpha-1 adrenergic receptor antagonist (1), to mitigate symptoms of inflammation before a full blown cytokine response takes place (2). Meanwhile in the ongoing confusion around the efficacy of certain drugs a major journal’s publication on May 22, 2020, concluding chloroquine an antimalarial drug and its analog, hydroxychloroquine, used to treat autoimmune diseases including lupus and arthritis does not benefit patients with COVID-19 (3). Had to be retracted due to what appears to be fabricated statistical evidence. Science reports on May 15th, 2020, that several African governments are investing in an unproven herbal tonic, branded Covid-organics, using the chief ingredient in the antimalarial drug artemisinin, the plant sweet wormword (Artemesia annua). Such speedy opportunistic product development may also have its own consequences as scientists warn it could fuel drug-resistant malaria (5a). Science also reports on Operation Warp Speed that ignores the conventional wisdom timeline needed over at least a year to responsibly develop a vaccine for COVID-19. Instead it aims to have 300 million vaccines in place by January 2021, initially for US use only (5b). Such a timeline represents a heroic effort to pull resources together across development, supply and manufacturing, and distribution but will no doubt fall far short of adequate efficacy and safety testing protocols only fueling the antivaccine debate about products rushed to market inadequately. However, the Lancet on May 22, 2020 published an article that details the first COVID-19 vaccine to reach phase 1 clinical trial and is able to generate an immune response against the virus SARS-CoV-2 in humans, being found to be safe and well tolerated in a 28-day trial in 108 healthy adults (6). Though it will take six months to fully evaluate the results and more trials needed to tell if the immune response it reports is actually effective against infection of SARS-CoV-2.
2. Institutional and Infrastructural Advice to Mitigate COVID-19 Effects
   There have been several responses to the current pandemic and the mounting mental health burden both arising now in healthcare workers and expected to exacerbate amongst the general public in coming months to years. The majority of advice and recommendations are targeted at the institutional and infrastructural level. Sasangohar et al. offer several recommendations to reduce provider burnout and fatigue (7). Holmes et al., a collective team of academics and researchers across multiple countries and disciplines, position a call for action for mental health and neuroscience research priorities now, to be reviewed and evolve with the pandemic (8). One of their long term strategic program objectives is to understand how to harness positive social resources, employ lifestyle and behavioral mechanisms to enhance stress resilience and coping such as altruistic and prosocial behavior, adequate sleep, family-and-friends support networks, and anxiety mitigating immediate and long term strategies. Lifestyle and behavioral mechanisms are essential moving ahead.

B. General Yogic Behavioral Support Mechanisms: the value of SELF-AWARENESS

A requirement for the development of a vaccine for SARS-CoV-2 through Controlled Human Infection studies (CHIs) needs to demonstrate high social value (9). Behavioral approaches need to be assessed under similar criteria. A reasonable account of the social value can be demonstrated via ease of doing, low cost of entry for the consumer, low risk-high benefit outcome in terms of effectiveness in aiding prevention of symptoms and supporting the psychological burden of a pandemic. This can range from mass action social distancing to a greater cultivation of awareness in terms of personal behavior with ourselves, with others, and with the environment. The CDC’s recommendations to manage stress in such a challenging time highlights personal and social care and awareness, in essence a yogic meditative approach as an extremely balanced way forward for us all (10). They specifically draw attention to limiting social media exposure, bodily care with breath and meditation, healthy food, relaxation and recreational time, adequate sleep and exercise, and time to connect with others.

1. Behavioral Change in Touch
   In addition to social or physical distancing three personal protective behaviors of handwashing, not touching the T-zone of the face, and tissue use, have almost become required to control the pandemic. Holmes et al. discuss the necessity of ensuring people know what to do, are motivated to do it, and have the skills and opportunity to enact the changed behaviors (8). In a society conditioned on handshakes, questionable handwashing use, supermarket open food free sampling, indiscriminate handle and button touching the almost orthodox and Eastern approaches are potential remedies. In many South and Southeast Asian countries, such as India and Thailand, a handshake is considered crude and instead the prayer hand pose acknowledgement to the other party, often associated with the Hindi greeting of Namaste, is both an extremely polite and non-contact greeting. Similarly, a slightly more orthodox approach in these regions limits open-hand touching of common objects. A door can be opened using the edge of one’s sleeve or directly with a handkerchief. Though many supermarkets, delis and restaurants right now will limit or cut out open food and buffet counters be aware of the return of the indiscriminate public consumption, open air, free sample tray that is both unclean and extremely unhygienic. An awareness on food contamination by multiple hands is ideally motivational enough to engender self-control.
2. Prioritize Sleep
   A lack of proper sleep or staying in bed too long increases brain inflammation, changes prefrontal activity, which is a pure stress response, and reduces emotional resilience whereby reactionary responses such as anger or frustration become frequent. Good sleep and rest can aid brain inflammation and support psychological resilience of such a stress burden (11). Our modern society undervalues the need of and for relaxation and instead focuses on more work time or more physical workouts. A comprehensive yoga practice both emphasizes quality sleep and aids it as well as employing direct relaxation to manage fatigue and thereby improve psychological and physiological conditioning.
3. Improve Responsiveness with a Partner
   Though lock-downs have forced family units to spend more time together, a cause of anxiety, conflict or psychological stress for some, there is potential for couples to deepen their relationship. Several studies carried out by Ong and Slatcher reveal the nature of relationship within a couple and the positive outcomes of increased partner responsiveness in terms of stress resilience and improved sleep lead to reduced anxiety. Support from a spouse can be the most effective resource in stressful times if each partner validates, cares, and conveys understanding to the other. Opportunities exist daily in the current uncertain climate to share and ideally respond enthusiastically, leading potentially to greater intimacy and trust (12). A behavioral approach starts with the awareness of the nature and quality of a response.
4. Vitamin D levels through Awareness of Diet and Sun Exposure
   Bachman et al. analyzed COVID-19 publicly available patient data globally and discovered a strong correlation between the cytokine storm and vitamin D levels as well as mortality and vitamin D deficiency

Read the other parts of this article:

Yoga, Breath and COVID-19: lifestyle behavioral support mechanisms
Approaches to manage the physical and psychological burden of stress from living through and
after the current global pandemic

PART ONE: the initial facts
PART THREE: Yogic Behavioral Support via Body, Breath and Mind
PART FOUR: the Power in Yoga’s Approach to Upgraded Breathing

Increase your understanding about the breath and explore the recommended practices

9 Benefits of Correct Breathing and Doing Breathing Exercises

Breathwork for Anxiety and Other Difficulties

Breathwork in Times of Stress

Breathwork and Savasana

Specific Guided Ratio controlled Breathing Exercises:

Bi-Ratio Breath Exercise
Tri-Ratio Breath Exercise
Quad-Ratio Breath Exercise

PART ONE: the initial facts

Approaches to manage the physical and psychological burden of stress from living through and after the current global pandemic

The emergence of a novel coronavirus SARS-Cov-2, the cause of the disease now known globally as COVID-19, has infected over 6 million people in 188 countries, of whom at least 369,433 have died as of May 31, 2020 (1). As a result governments around the world have taken unprecedented measures socially and economically, deemed appropriate to “flatten the curve” of this pandemic. With the goal to curb the spread of infection and help prevent healthcare systems from being overwhelmed social distancing, stay-at-home orders, mandatory mask wearing, travel restrictions, and isolated ways of living and daily behavior have become both the norm and a necessary mass action to tame a global crisis.

A. The Broader Psychological and Physiological Impact of the COVID-19 Pandemic

The description so far only tells us of the physical cost in terms of disease risk, infection, and mortality and the measures countries have taken to prevent this from infecting more people. Given the number of countries that have implemented shut-downs and similar actions the true number of people affected by the crisis is more likely over 6 billion. Everyone is deemed at risk for infection and so are all candidates for the ongoing physical measures and upcoming vaccines. What is not reported in the data charts for this disease are the lifestyle challenges, the psychological stress burden, and the possible future mental health crises that may emerge in the coming months to years.

Beyond the economics of the global crisis, what is the psychological and emotional burden of these events now, a year from now, and even a generation from now, and how can they be addressed from the point-of-view of the living individual? The latest Stress in America 2020 report from the American Psychological Association predicts long lasting and serious negative mental health effects from the coronavirus pandemic (2). It particularly highlights the stress burden on parents of children under 18 who are faced with childcare, work and schooling demands. Certain sub-populations have been shown to be more vulnerable, such as lower socio-economic groups, the elderly, and males to name a few.

B. Yoga as Comprehensive and Regular: beyond yoga’s ‘pose’ and ‘flow’ dilution

Yoga as a philosophy and body of practice techniques is referenced and documented in more or less greater detail across primarily Sanskrit-based texts for the past 2,500 years (3). The traditional explanation of yoga and delivery of its teachings has been most frequently presented in a context of human psychological and physiological suffering: mental difficulty, emotional instability, psychological burden, uncontrolled senses, a distracted mind, an inability to focus, an incapacity for situational appraisal, anxiety and stress, and physical illness. A consistent description of the experience of yoga throughout the literature at different historical timepoints is mental equilibrium, a centered state of being, the meditative state. The Sanskrit word for meditation (‘dhyana’) is deeply embedded within yogic philosophy and teachings whereby it is quite clear that the yogic process and meditative process are the same: a skillful management of the mental faculties till the yogic, or meditative, experience is reached, a complete centeredness, which we may translate as mental equilibrium and harmony within a normal range of change across physical and psychological aspects of being.

The process of yoga involves yogic-meditative practices that cultivate this experience and state. However, the shifting emphasis on different practice techniques over the centuries was in response to societal needs rather than the efficacy and value of one technique over another. The past 100 years has witnessed the main attention on practices cultivated in the previous 700-900 years on body and breath meditative practices, known as Hatha yoga. Starting 90 years ago, but most commercially and popularly effective in the past 20 years, a minor element of this approach gained strong association with the physical activity market and as such has seen worldwide growth where a diluted translation of yoga has become synonymous with ‘pose’ (posture, asana) and ‘flow’ (erroneous interpretation of vinyasa).

Yoga identified as ‘pose’ and ‘flow’, often executed in terms of physical fitness, is only one element of a comprehensive yoga practice approach outlined in the original texts to manage and balance both the physiological and psychological aspects of our being. ‘Yoga’ as a popularly engaged in recreational activity has been published in the scientific literature with documented benefits to health and well-being. As a recreational activity it is a subjective decision with no greater efficacy and value than walking, running, chess, free-diving to satisfy and achieve a degree of personal well-being. If we are to discuss yoga practice as a behavioral lifestyle aid to the current psychological burden of stress then it needs to be framed within a comprehensive approach that engages the practitioner across a mixture of techniques capable as a whole to cultivate physiological and psychological resilience, not at just one measured time point of a typical body-based approach at the end of four weeks, for example, but developing over the long term. This is the position of the original teachings.

The key elements of such an approach are one, comprehensiveness with mental awareness, and two, regularity. Any guidance from a qualified instructor should be on the specifics of what to do and the encouragement to build a regular routine for it. Therefore, it can still occupy a recreational equivalent time commitment but with an emphasis on quality over quantity, ‘how’ more so than ‘what’. To reliably advise yoga practice, which includes breath and meditative techniques, for lifestyle behavioral effects, either through therapy or as part of research, to both relieve the burden of, and increase the resilience to, stress then these key elements are the focus and not the popularly perceived ‘pose’ and ‘flow’ effort. In short, 7 days of 10 minutes of a comprehensive yoga practice is worth more than 70 minutes one day in that week. The remaining challenge is having the skillful guidance to instruct 10, 20, 40-minute practices to be done very regularly incorporating a correct approach to posture, breath, and inner awareness.

C. COVID-19 Disease Burden: high inflammation, organ dysfunction, psychological trauma

Wang et al. recently identified three primary drivers of cardiac injury that can occur when infected (4): direct infection of cardiac tissue possibly due to the increased expression of ACE2 receptors in the heart; an excessive immune response that triggers a cytokine storm that can lead to multiple organ dysfunction; pre-existing cardiovascular morbidities that become aggravated and can lead to some of the aforementioned serious issues. This and other recent studies indicate inflammation as both an initial outcome of an overzealous immune response and a prime culprit in worsening the condition further. Infected individuals can experience high fever, blood clotting, blood vessel leakiness, abnormally low blood pressure and a lack of oxygen which leads to excessive acidity of the blood, to a potential pleural effusion where fluid builds up in the lungs (5). The majority of deaths due to COVID-19 are a result of respiratory failure originating in the inflammatory response. Inflammation ultimately affects healthy tissue leading to Multiple Organ Dysfunction Syndrome (MODS) eventually causing the lungs to shut down under Acute Respiratory Distress Syndrome (ARDS). Complicating the scenario even further is that COVID-19 can cause serious cardiovascular issues such as heart attacks, heart failure, and strokes due to blood clots (6).

This burden of health care handling by professionals has led to added stress on health care workers from multiple areas. Longer shifts, greater loss of life, a lack of personal protective equipment, increased isolation from a typical support structure of family out of fear of infecting them, and anxiety over job security has led to increased mental strain and greater burnout and fatigue (7). Attention is now being drawn to the impending psychological trauma amongst health care workers as the next crisis (8).

Read the other parts of this article:
Yoga, Breath and Covid-19: lifestyle behavioral support mechanisms
Approaches to manage the physical and psychological burden of stress from living through and
after the current global pandemic

PART TWO: drugs, infrastructure, and yogic self-awareness
PART THREE: Yogic Behavioral Support via Body, Breath and Mind
PART FOUR: the Power in Yoga’s Approach to Upgraded Breathing

Increase your understanding about the breath and explore the recommended practices

9 Benefits of Correct Breathing and Doing Breathing Exercises

Breathwork for Anxiety and Other Difficulties

Breathwork in Times of Stress

Breathwork and Savasana

Specific Guided Ratio controlled Breathing Exercises:

Bi-Ratio Breath Exercise
Tri-Ratio Breath Exercise
Quad-Ratio Breath Exercise