E-ISSN:2456-3110

Review Article

ILD Patients

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Integration of Yoga and Diet for Enhancing Quality of Life in ILD Patients: A Scientific Review

Om AR1*, Komal2, Kushawaha P3, Hardeep4, Arya V5
DOI:10.21760/jaims.10.5.14

1* Acharya Rohit Om, Research Scholar, University of Patanjali, Haridwar, Uttarakhand, India.

2 Komal, Research Scholar, University of Patanjali, Haridwar, Uttarakhand, India.

3 Prabhunarayan Kushawaha, Research Scholar, University of Patanjali, Haridwar, Uttarakhand, India.

4 Hardeep, Community Health Officer, National Health Mission, Government of Haryana, India.

5 Vedpriya Arya, Scientist-E, Herbal Research Division, Patanjali Research Foundation, Haridwar, Uttarakhand, India.

Interstitial lung disease (ILD) encompasses a group of chronic lung disorders characterized by inflammation and scarring of lung tissue, leading to reduced lung function and impaired quality of life (QoL). Conventional treatments focus on symptom management and slowing disease progression, yet complementary approaches like Yoga and dietary interventions have gained attention for their potential to enhance physical, mental, and emotional well-being. This review explores the scientific basis for integrating Yoga and diet as adjunctive therapies in ILD management, synthesizing evidence on their effects on respiratory function, inflammation, and overall QoL, with insights from the latest 2025 research.

Keywords: Interstitial lung disease, Yoga, diet, quality of life, inflammation, complementary therapy, Pranayama, oxidative stress

Corresponding Author How to Cite this Article To Browse
Acharya Rohit Om, Research Scholar, , University of Patanjali, Haridwar, Uttarakhand, India.
Email: 		Om AR, Komal, Kushawaha P, Hardeep, Arya V, Integration of Yoga and Diet for Enhancing Quality of Life in ILD Patients: A Scientific Review. J Ayu Int Med Sci. 2025;10(5):89-95.
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https://jaims.in/jaims/article/view/4303/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-11 2025-04-26 2025-05-06 2025-05-16 2025-05-26
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None Nil Not required 11.63

© 2025 by Om AR, Komal, Kushawaha P, Hardeep, Arya V and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Acharya RO et al. Integration of Yoga and Diet for Enhancing Quality of Life

Introduction

Interstitial lung disease (ILD) affects millions worldwide, with conditions like idiopathic pulmonary fibrosis (IPF) and sarcoidosis presenting significant challenges due to shortness of breath, fatigue, and reduced exercise capacity.[1] These symptoms often lead to anxiety, depression, and a diminished QoL.[2] While pharmacological interventions like corticosteroids and antifibrotic agents address disease mechanisms,[3] they do not fully alleviate the holistic burden of ILD. Yoga, a mind-body practice rooted in controlled breathing (Pranayama), physical postures (Asanas), and meditation, alongside targeted dietary modifications, offers a promising complementary strategy.[4] Recent advancements, including 2025 studies, highlight their evolving role in respiratory health.[5] This paper reviews the physiological and psychological benefits of Yoga and diet, their potential synergy, and their role in improving QoL for ILD patients.

Yoga and ILD: Mechanisms and Evidence

Yoga’s therapeutic potential in respiratory conditions stems from its emphasis on breath control and physical conditioning. Pranayama techniques, such as diaphragmatic breathing and alternate nostril breathing, enhance respiratory muscle strength and oxygen saturation—critical for ILD patients facing restrictive lung patterns.[6] Studies on chronic obstructive pulmonary disease (COPD), a related respiratory condition, show that Yoga improves forced expiratory volume in one second (FEV1) and exercise tolerance,[7] suggesting applicability to ILD. A 2025 trial specifically in ILD patients confirms Yoga’s role, demonstrating improved shortness of breath scores with adaptive Pranayama protocols.[5] Beyond pulmonary benefits, Yoga reduces systemic inflammation - a key driver of ILD progression - by modulating the hypothalamic-pituitary-adrenal (HPA) axis and lowering cortisol levels.[8] Research also highlights Yoga’s role in alleviating psychological distress, with mindfulness-based practices reducing anxiety and depression scores in chronic illness groups,[9] which is particularly relevant for ILD patients where mental health issues worsen QoL decline.[2]

Dietary Interventions in ILD

Nutrition plays a pivotal role in managing inflammation and supporting lung health in ILD.

Diets rich in antioxidants (e.g., vitamins C and E, flavonoids) from fruits, vegetables, and nuts counteract oxidative stress, a hallmark of ILD pathogenesis.[10] Omega-3 fatty acids, found in fatty fish and flaxseeds, exhibit anti-inflammatory properties by reducing pro-inflammatory cytokines like IL-6 and TNF-α.[11]

Conversely, processed foods high in refined sugars and trans fats may worsen inflammation, necessitating dietary restriction.[12] A 2025 study underscores the gut-lung axis’s role, linking high-fiber diets to reduced ILD severity.[13]

Weight management is another key factor, as obesity can worsen shortness of breath by increasing mechanical load on the diaphragm, while malnutrition, common in advanced ILD, impairs respiratory muscle function.[14] A balanced, anti-inflammatory diet, such as the Mediterranean diet, tailored to individual caloric needs could optimize energy levels and physical capacity, indirectly enhancing QoL.[15]

Scientific Studies on Yoga and Diet Related to Respiratory Health

  • Yoga Studies: A 2024 systematic review and meta-analysis found that breathing exercises, including Pranayama, improved lung function (e.g., forced vital capacity [FVC], FEV1), exercise capacity (6-minute walk test [6MWT]), and health-related QoL in ILD patients, with benefits most pronounced in shorter interventions and as part of pulmonary rehabilitation [16]. A randomized controlled trial on COPD patients reported that 12 weeks of Yoga, including Asanas and Pranayama, increased FEV1 by 8% and reduced shortness of breath,[7] suggesting applicability to ILD’s restrictive patterns. Another study showed that Pranayama in asthma patients enhanced vital capacity and peak expiratory flow rate (PEFR),[17] supporting its role in strengthening respiratory muscles relevant to ILD. A 2025 study found that adaptive Yoga protocols in IPF patients improved shortness of breath and 6MWT distances by 10% over 16 weeks.[5]
  • Diet Studies: A 2020 analysis from the Global Burden of Disease Study linked higher intake of fruits and vegetables - rich in antioxidants - to a lower chronic respiratory disease burden, including ILD subtypes.[18]

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  • A clinical trial showed that a diet high in flavonoids (e.g., apples, tea) reduced lung function decline in smokers, a risk group overlapping with ILD.[19] Additionally, a 2023 study found that omega-3 supplementation in COPD patients decreased inflammatory markers (CRP, TNF-α) and improved 6MWT performance,[20] indicating potential benefits for ILD’s inflammatory and functional deficits. A 2025 study reported that high-fiber diets reduced ILD progression markers (e.g., IL-6) by 15% in a cohort of 200 patients.[13]
  • Combined Interventions: A pilot study on COPD patients combining Yoga and a Mediterranean diet reported a 12% improvement in FVC and reduced fatigue compared to controls,[21] hinting at synergistic effects applicable to ILD. A 2025 trial found combined Yoga-diet interventions in ILD patients increased QoL scores by 18% over 6 months, driven by reduced inflammation and better sleep.[22] While ILD-specific trials remain limited, these findings provide a strong foundation for further investigation.

Therapeutic and Preventive Health Benefits of Yoga and Diet

  • Therapeutic Benefits of Yoga: Yoga provides immediate symptom relief in ILD. Pranayama alleviates shortness of breath by enhancing ventilatory control, as evidenced by reduced breathlessness scores in COPD trials post-intervention.[7] Gentle Asanas improve exercise tolerance, countering fatigue, while meditation reduces anxiety and depression - crucial for ILD patients facing chronic breathlessness.[9] A 2022 study found Yoga reduced perceived stress by 25% in chronic illness groups, directly boosting QoL.[23] A 2025 study noted a 20% reduction in fatigue scores with Yoga in ILD.[5]
  • Preventive Benefits of Yoga: Yoga may slow ILD progression by mitigating risk factors. Its anti-inflammatory effects (e.g., reduced IL-6, TNF-α) could delay fibrosis, as suggested by lower inflammatory markers in asthma patients practicing [17] Enhanced oxygenation and lung capacity may prevent deconditioning, a precursor to worsening respiratory failure, and regular practice lowers cardiovascular strain, a common ILD comorbidity, offering long-term protective effects.[24]

  • Therapeutic Benefits of Diet: Diet addresses ILD symptoms by reducing inflammation and supporting energy needs. Omega-3s and antioxidants decrease shortness of breath severity by calming airway inflammation, with COPD patients reporting better breathlessness scores.[20] Protein-rich diets combat muscle wasting, improving physical function and reducing fatigue, while balanced calories prevent obesity-related breathlessness worsening.[14] Fiber improved energy levels in ILD by 12% in a 2025 study.[13]
  • Preventive Benefits of Diet: A nutrient-dense diet may forestall ILD worsening. Antioxidants protect against oxidative stress-induced alveolar damage, with flavonoid intake linked to preserved lung function.[19] Omega-3s and fiber modulate systemic inflammation via the gut-lung axis, potentially reducing fibrotic triggers.[11] Epidemiological data suggest plant-based diets lower ILD incidence,[18] with fiber’s protective effects confirmed in 2025.[13]
  • Combined Impact: Together, Yoga and diet amplify therapeutic relief (e.g., symptom control) and preventive potential (e.g., inflammation reduction), offering a comprehensive strategy for ILD management, as supported by a 2025 trial.[22]

Synergistic Effects of Yoga and Diet

The integration of Yoga and diet offers a holistic approach to ILD management. Yoga’s stress-reducing effects may improve dietary adherence by mitigating emotional eating, a common coping mechanism in chronic illness.[25] Simultaneously, a nutrient-dense diet supports the stamina required for Yoga practice, creating a positive feedback loop. For example, improved oxygenation from Pranayama paired with antioxidant-rich meals could amplify reductions in oxidative stress,[10] while enhanced mental clarity from meditation might reinforce mindful eating habits.[26]

Preliminary studies on integrative interventions in chronic diseases like asthma and heart failure support this synergy, showing greater QoL improvements when lifestyle modalities are combined versus implemented alone.[27] Though ILD-specific trials remain limited, these findings provide a foundation for hypothesis-driven research. The interplay between Yoga and diet amplifies their individual benefits,


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creating a robust framework for ILD management. Physiologically, Yoga’s enhancement of respiratory efficiency complements diet’s anti-inflammatory action. Pranayama increases oxygen delivery to tissues, which, when paired with antioxidants like vitamin C and flavonoids, accelerates reactive oxygen species (ROS) neutralization, reducing oxidative stress.[10] For instance, a patient practicing slow diaphragmatic breathing while consuming a diet rich in blueberries and spinach may experience greater reductions in alveolar damage. Similarly, omega-3 fatty acids, which downregulate TNF-α and IL-6,[20] synergize with Yoga’s cortisol-lowering effects,[8] creating a compounded anti-inflammatory impact that could slow fibrosis progression.
Psychologically, Yoga’s stress-reducing properties enhance dietary adherence. Meditation and mindfulness practices foster awareness of hunger cues and emotional triggers, reducing reliance on processed, pro-inflammatory foods - a common coping mechanism in ILD-related distress.[9] Conversely, a nutrient-dense diet rich in B vitamins (e.g., from eggs, whole grains) and magnesium (e.g., from nuts) supports neurological function and mood stability, amplifying meditation’s anxiety-reducing effects.[28] This two-way reinforcement could improve mental resilience, as evidenced by COPD patients on combined Yoga-diet protocols reporting lower fatigue and higher SF-36 mental health scores.[21]
Practically, this synergy can be applied in tailored programs. A 45-minute session of gentle Yoga (e.g., chair-based Asanas, 10 minutes of Pranayama) followed by a meal of grilled salmon, quinoa, and steamed broccoli leverages immediate respiratory gains with sustained nutritional support.[14] Over time, this could enhance exercise capacity, as Yoga strengthens muscles for daily activities while protein and healthy fats prevent energy depletion. In ILD, where fatigue and shortness of breath limit function, such integration could break the cycle of deconditioning.

Emerging evidence supports this synergy. In a pilot study, COPD patients combining Yoga and a Mediterranean diet showed a 12% FVC improvement and reduced inflammatory markers compared to controls.[21] A 2023 trial on chronic illness patients found combined Yoga-diet interventions increased QoL scores by 15% more than single modalities,

driven by improved sleep quality and energy levels[29] - key concerns in ILD. A 2025 trial in ILD patients reported an 18% QoL increase with combined interventions,[22] suggesting a multiplicative effect warranting further exploration.

Beyond these benefits, the synergy extends to immune modulation and cellular repair. Yoga’s stimulation of the parasympathetic nervous system enhances immune regulation, potentially increasing lymphocyte activity,[30] while dietary polyphenols (e.g., from green tea) promote autophagy - cellular cleanup that may mitigate fibrotic tissue buildup.[31] For example, a weekly routine of alternate nostril breathing paired with turmeric-infused meals might optimize immune balance and reduce oxidative damage. Additionally, Yoga’s improvement in circulation (via Asanas) could enhance nutrient delivery from a diet rich in zinc and selenium (e.g., from seeds, lean meats), supporting tissue repair in damaged alveoli.[32]
This synergy also fosters patient empowerment, a critical QoL factor. By engaging in Yoga and preparing anti-inflammatory meals, ILD patients gain agency over their health, countering helplessness often linked with progressive disease.[2] Community-based programs integrating group Yoga sessions with cooking workshops could build social support networks that boost adherence and emotional well-being. A 2021 study on chronic pain patients found such combined interventions improved self-efficacy by 20%,[33] while a 2025 ILD study reported a 22% increase in self-reported empowerment.[22] Together, these elements highlight the transformative potential of Yoga and diet as a unified strategy in ILD care.

Challenges and Considerations

Despite their promise, Yoga and diet face implementation barriers in ILD care. Severe shortness of breath or fatigue may limit participation in Yoga, requiring modified, low-intensity protocols supervised by trained professionals.[4] Dietary adjustments must account for comorbidities (e.g., diabetes, gastrointestinal issues) and medication interactions, necessitating personalized plans from dietitians.[15] Moreover, the diversity of ILD subtypes complicates standardized recommendations, underscoring the need for robust clinical trials to validate efficacy and safety.


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Limitations and Future Research

  • Limitations: Current evidence on Yoga and diet in ILD relies heavily on extrapolation from COPD, asthma, and broader respiratory studies, with few ILD-specific trials.[16] Small sample sizes and short durations (e.g., 8–12 weeks[7]) limit generalizability and long-term efficacy insights. Variability in ILD subtypes (e.g., IPF vs. sarcoidosis) complicates uniform recommendations, as disease mechanisms and progression rates differ.[1] Studies often lack standardized protocols - Yoga interventions vary in intensity and type (e.g., Pranayama Asanas), and dietary interventions range from supplementation to whole-diet shifts - hindering reproducibility. Patient adherence, influenced by symptom severity, socioeconomic factors, and lack of trained instructors or dietitians, remains understudied.[2]
  • Future Research: Large-scale, ILD-specific randomized controlled trials (RCTs) are needed to assess Yoga and diet’s efficacy, comparing them against standard care and combined modalities. Trials should stratify by ILD subtype, disease stage, and comorbidities to identify responsive populations. Longitudinal studies (e.g., 1-5 years) could evaluate preventive effects on fibrosis progression, using biomarkers like IL-6, CRP, or ROS levels.[10] Standardized protocols - e.g., a 30-minute Pranayama session three times weekly or a Mediterranean diet with defined nutrient targets - would enhance consistency. Research should explore telehealth delivery to overcome access barriers and assess cost-effectiveness. Qualitative studies on patient perceptions and adherence could inform practical implementation, while mechanistic studies (e.g., lung biopsies, microbiome analysis) could clarify how Yoga and diet alter ILD pathology.[11] A 2025 review calls for multi-center ILD trials to validate these approaches over 24 months.[34]

Conclusion

The integration of Yoga and diet holds significant potential to enhance QoL in ILD patients by addressing physical limitations, inflammation, and psychological distress. Yoga improves respiratory efficiency and mental resilience, while an anti-inflammatory diet supports systemic health,

together offering a complementary framework to conventional therapy. Recent 2025 studies (e.g., [5],[13],[22]) reinforce their efficacy and synergy.

Future research should prioritize randomized controlled trials to establish optimal protocols, assess long-term outcomes, and clarify mechanisms specific to ILD. As adjunctive therapies, Yoga and diet empower patients with accessible tools to reclaim agency over their well-being, paving the way for a more integrative approach to ILD management.

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