Yoga-Based Lifestyle Intervention versus Pharmacological Management in Metabolic Syndrome: A Randomised Controlled Trial Assessing Glycaemic Control, Lipid Profiles, Anthropometric Indices

Metabolic syndrome (MetS) affects approximately 33% of urban Indian adults and constitutes a primary driver of type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease in the Indian subcontinent. While pharmacological management with statins, metformin, and antihypertensives is standard of care, yoga-based lifestyle interventions have demonstrated promising preliminary effects on cardiometabolic risk factors in small uncontrolled studies. This twenty-four-week parallel-arm randomised controlled trial enrolled 312 urban adults (aged 30–60 years) with confirmed MetS by IDF criteria across three AIIMS-affiliated urban centres in Delhi-NCR. Participants were randomised to: Yoga-Based Lifestyle Intervention (YBLI, n=104), Pharmacological Management alone (PM, n=104), or Combined YBLI plus Pharmacological Management (YBLI+PM, n=104). Primary outcomes included fasting blood glucose, HbA1c, lipid panel (LDL-C, HDL-C, TG), waist circumference, and high-sensitivity C-reactive protein (hs-CRP). The YBLI+PM group achieved the greatest reductions in HbA1c (−1.8%, p<0.001), fasting glucose (−32.4 mg/dL), LDL-C (−28.6 mg/dL), and hs-CRP (−2.4 mg/L) compared to either intervention alone. YBLI alone produced clinically meaningful reductions in waist circumference (−6.2 cm) and triglycerides (−38.4 mg/dL), comparable to PM alone, suggesting yoga may serve as a safe and effective non-pharmacological alternative for early-stage MetS management. These findings support the integration of structured yoga programmes into standard MetS management protocols in Indian clinical settings