Cardiovascular disease (CVD) remains the leading cause of death in women. CVD risk rises sharply with menopause and is further elevated among women with type 2 diabetes (DM 2). These increases are likely due to the coincident rise in insulin resistance and other, related atherogenic changes comprising the insulin resistance syndrome (IRS). There is growing evidence that the practice of yoga may offer a safe and cost-effective strategy for reducing IRS-related risk factors for CVD in both diabetic and non-diabetic populations. However, rigorous studies are few. The proposed K-01 award will provide the necessary training, skills, and experience for Dr. Kim Innes, an epidemiologist with a strong background in women's health and chronic disease and recent fellowship training in CAM, to conduct clinical intervention research regarding the effects of yoga on CVD risk reduction in women. Her long-term goal is to establish a successful research program investigating yoga for the prevention and management of CVD and related chronic, insulin resistance conditions. Immediate goals toward this end are, through a rigorous program of didactic training and research, to: 1) gain additional expertise in advanced quantitative methods, chronic disease physiology, and stress biology;2) develop a solid practical and theoretical background in the field of mind-body and behavioral medicine, with a focus on yoga therapy;and 3) strengthen her skills in clinical intervention research and gain needed experience in behavioral intervention studies involving mind-body therapies. The candidate has assembled an exceptional sponsoring committee of investigators with extensive expertise in each of these disciplines, who will guide her activities and progress throughout the award period. The training program will include regular meetings with the lead sponsor and co-sponsors, coupled with participation in selected courses, tutorials, workshops, seminars, professional meetings and research practica relevant to Dr. lnnes's area of research. Dr. Innes will execute two pilot studies that will comprise the focus of the K award and the basis for at least two subsequent RO1 grant applications to be submitted within the award period. Using a randomized controlled design, these pilot studies will investigate the effects of a gentle 8-week lyengar yoga program on insulin sensitivity and related metabolic and psychological indices of CVD risk in two populations at elevated risk for CVD: sedentary, overweight postmenopausal women who are currently healthy and postmenopausal women with DM 2. The proposed studies will yield important information on the potential utility of a safe, inexpensive intervention in reducing CVD risk in both diabetic and healthy women postmenopause. If findings are positive and confirmed in other, larger studies, the use of yoga as a therapeutic intervention and prevention measure for CVD and related comorbidities could potentially save billions of dollars in health care costs and lost productivity due to these disorders.
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