The Effectiveness of Healthy Lifestyle Education Combined with Yoga Therapy on Sedentary Behaviors and Social Well-Being Among Overweight Individuals at Risk of Developing Type 2 Diabetes
Keywords:
yoga therapy, healthy lifestyle, sedentary behavior, social well-being, overweight, type 2 diabetesAbstract
The present study aimed to investigate the effectiveness of healthy lifestyle education combined with yoga therapy in reducing sedentary behaviors and improving social well-being among overweight individuals at risk of developing type 2 diabetes. A quasi-experimental method was employed using a pretest–posttest design with a two-month follow-up and a control group. The statistical population consisted of overweight individuals with a body mass index of 25 or higher who were at risk of developing type 2 diabetes and had attended healthcare and counseling centers in Tehran. Following screening and confirmation of the eligibility criteria, 40 participants were selected through purposive sampling and randomly assigned to an experimental group (n = 20), which received healthy lifestyle education and yoga therapy over 10 sessions, or a control group (n = 20), which received no intervention. Sedentary behavior was assessed using the Sedentary Behavior Questionnaire developed by Rosenberg et al. (2010), while social well-being was measured using Keyes’s (2004) Social Well-Being Scale, which comprises five dimensions: social actualization, social integration, social coherence, social acceptance, and social contribution. The data were analyzed using repeated-measures analysis of variance in SPSS version 26. The findings indicated that the effects of time and the group-by-time interaction were statistically significant for both sedentary behavior, F = 1186.201, p = .001, η² = .985, and social well-being, F = 397.400, p = .001, η² = .956. Specifically, sedentary behavior decreased significantly and social well-being increased significantly in the experimental group, whereas no significant changes were observed in the control group. Bonferroni post hoc tests demonstrated significant differences between the pretest and both the posttest and follow-up assessments. However, the difference between the posttest and follow-up assessments was not statistically significant, indicating that the intervention effects were maintained throughout the follow-up period. Based on these findings, healthy lifestyle education combined with yoga therapy may be used as a complementary nonpharmacological intervention to reduce sedentary behaviors and enhance social well-being among individuals at risk of developing type 2 diabetes.
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1. Collaboration NCDRF. Worldwide Trends in Underweight and Obesity from 1990 to 2022: A Pooled Analysis of 3663 Population-Representative Studies with 222 Million Children, Adolescents, and Adults. The Lancet. 2024;403(10431):1027-50. doi: 10.1016/S0140-6736(23)02750-2.
2. Rooney MR, Fang M, Ogurtsova K, Ozkan B, Echouffo-Tcheugui JB, Boyko EJ, et al. Global Prevalence of Prediabetes. Diabetes Care. 2023;46(7):1388-94. doi: 10.2337/dc22-2376.
3. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. New England Journal of Medicine. 2002;346(6):393-403. doi: 10.1056/NEJMoa012512.
4. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, et al. Sedentary Behavior Research Network (SBRN): Terminology Consensus Project Process and Outcome. International Journal of Behavioral Nutrition and Physical Activity. 2017;14:75. doi: 10.1186/s12966-017-0525-8.
5. Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, et al. Sedentary Time in Adults and the Association with Diabetes, Cardiovascular Disease and Death: Systematic Review and Meta-Analysis. Diabetologia. 2012;55(11):2895-905. doi: 10.1007/s00125-012-2677-z.
6. Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, et al. Sedentary Behaviour and Risk of All-Cause, Cardiovascular and Cancer Mortality, and Incident Type 2 Diabetes: A Systematic Review and Dose Response Meta-Analysis. European Journal of Epidemiology. 2018;33(9):811-29. doi: 10.1007/s10654-018-0380-1.
7. Yuan S, Li X, Liu Q, Wang Z, Jiang X, Burgess S, et al. Physical Activity, Sedentary Behavior, and Type 2 Diabetes: Mendelian Randomization Analysis. Journal of the Endocrine Society. 2023;7(8):bvad090. doi: 10.1210/jendso/bvad090.
8. Smith S, Salmani B, LeSarge J, Dillon-Rossiter K, Morava A, Prapavessis H. Interventions to Reduce Sedentary Behaviour in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis. PLOS ONE. 2024;19(7):e0306439. doi: 10.1371/journal.pone.0306439.
9. Timkova V, Mikula P, Nagyova I. Psychosocial Distress in People with Overweight and Obesity: The Role of Weight Stigma and Social Support. Frontiers in Psychology. 2025;15:1474844. doi: 10.3389/fpsyg.2024.1474844.
10. Caldwell AE, Baldwin M, Ptomey LT, Bock BC. The Impact of Yoga on Components of Energy Balance in Adults with Overweight or Obesity: A Systematic Review. Obesity Science & Practice. 2022;8(2):219-32. doi: 10.1002/osp4.552.
11. Wasityastuti W, Pramaningtyas MD, Wibowo RA, Adnan ML, Prabowo R, Tsurayya Z, et al. Impact of Yoga on Cardiometabolic Health in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLOS Global Public Health. 2026;6(4):e0006174. doi: 10.1371/journal.pgph.0006174.
12. McDermott KA, Rao MR, Nagarathna R, Murphy EJ, Burke A, Nagendra RH, et al. A Yoga Intervention for Type 2 Diabetes Risk Reduction: A Pilot Randomized Controlled Trial. BMC Complementary and Alternative Medicine. 2014;14:212. doi: 10.1186/1472-6882-14-212.
13. Ramamoorthi R, Gahreman D, Skinner T, Moss S. The Effect of Yoga Practice on Glycemic Control and Other Health Parameters in the Prediabetic State: A Systematic Review and Meta-Analysis. PLoS ONE. 2019;14(10):e0221067. doi: 10.1371/journal.pone.0221067.
14. Kaur N, Majumdar V, Nagarathna R, Malik N, Anand A, Nagendra HR. Diabetic Yoga Protocol Improves Glycemic, Anthropometric and Lipid Levels in High Risk Individuals for Diabetes: A Randomized Controlled Trial from Northern India. Diabetology & Metabolic Syndrome. 2021;13:149. doi: 10.1186/s13098-021-00761-1.
15. Chattopadhyay K, Mishra P, Singh K, Singh K, Harris T, Hamer M, et al. Yoga Programme for Type 2 Diabetes Prevention (YOGA-DP) among High-Risk People in India: A Multicenter Feasibility Randomized Controlled Trial. Diabetes Therapy. 2023;14(7):1137-54. doi: 10.1007/s13300-023-01395-4.
16. Thind H, Lantini R, Balletto BL, Donahue ML, Salmoirago-Blotcher E, Bock BC, et al. The Effects of Yoga among Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Preventive Medicine. 2017;105:116-26. doi: 10.1016/j.ypmed.2017.08.017.
17. Dutta D, Bhattacharya S, Sharma M, Khandelwal D, Surana V, Kalra S. Effect of Yoga on Glycemia and Lipid Parameters in Type-2 Diabetes: A Meta-Analysis. Journal of Diabetes & Metabolic Disorders. 2021;20(1):349-67. doi: 10.1007/s40200-021-00751-0.
18. Singh VP, Khandelwal B. Effect of Yoga and Exercise on Glycemic Control and Psychosocial Parameters in Type 2 Diabetes Mellitus: A Randomized Controlled Study. International Journal of Yoga. 2020;13(2):144-51. doi: 10.4103/ijoy.IJOY_45_19.
19. Subramani P, Mohan AR, Satish L, Karthikeyan S, Ravi P, Ulagamathesan V, et al. The Impact of Yoga Intervention on Physical and Mental Health of Adults with Type 2 Diabetes. International Journal of Yoga. 2025;18(1):67-73. doi: 10.4103/ijoy.ijoy_219_24.
20. Keyes CLM. Social Well-Being. Social Psychology Quarterly. 1998;61(2):121-40. doi: 10.2307/2787065.
21. Keyes CLM. The Mental Health Continuum: From Languishing to Flourishing in Life. Journal of Health and Social Behavior. 2002;43(2):207-22. doi: 10.2307/3090197.
22. Keyes CLM. Mental Illness and/or Mental Health? Investigating Axioms of the Complete State Model of Health. Journal of Consulting and Clinical Psychology. 2005;73(3):539-48. doi: 10.1037/0022-006X.73.3.539.
23. Keyes CLM, Shapiro AD. Social Well-Being in the United States: A Descriptive Epidemiology. In: Brim OG, Ryff CD, Kessler RC, editors. How Healthy Are We? A National Study of Well-Being at Midlife: University of Chicago Press; 2004. p. 350-72.
24. Teo AR, Benton MC, Hooker ER, Zaccari B, Hidalgo NJ, Newell S, et al. Effect of Telehealth Yoga on Loneliness and Social Isolation among Rural Older Adults: A Randomized Controlled Trial. Aging & Mental Health. 2025;29(5):824-32. doi: 10.1080/13607863.2024.2449126.
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Copyright (c) 2026 Maryam Abdolkarimy Nazary (Author); Mojgan Agahheris; Ezzatolah Kordmirza Nikoozadeh, Mahdieh Rahmanian , Amir Abdolhoseini (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
