{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:50:31Z","timestamp":1791521431283,"version":"4.3.4"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obesity is a growing global health problem characterised by chronic low-grade inflammation and epigenetic dysregulation. Epigenetic mechanisms\u2014potentially reversible changes in gene expression occurring without alteration of the DNA sequence, most notably DNA methylation\u2014are increasingly implicated in obesity-related inflammation. Yoga may act as complementary therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore whether participation in a structured yoga program is associated with changes in DNA methylation of TNF-\u03b1, and with clinical, hormonal, metabolic and psychological parameters, in patients with severe obesity awaiting bariatric surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, non-randomised, controlled observational cohort study, 40 patients were analysed (20 yoga, 20 control). The intervention group underwent 36 PRANA_it yoga sessions over the 3\u202fmonths preceding surgery (mean attendance 26\/36, 72.5%). DNA methylation was profiled using a targeted three-gene inflammatory panel (TNF-\u03b1, IL-6, CRP). Between-group differences were estimated by baseline-adjusted ANCOVA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Plasma noradrenaline was significantly lower in the yoga group at T1 after adjustment for baseline [adjusted difference \u2212206.92, 95% CI (\u2212349.62, \u221264.21),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0057]. SF-36 physical functioning differed between groups in the unadjusted change-score comparison (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0206) but not after baseline adjustment [\u22128.69, 95% CI (\u221221.74, 4.36),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.185]. Circulating TNF-\u03b1 protein changed significantly more in the yoga group in the unadjusted analysis (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0452), a finding with high variance. Vitamin D3 showed no significant adjusted difference at T1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.879); the T2 difference was borderline (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.064). DNA methylation of TNF-\u03b1, IL-6 and CRP showed no significant changes after correction for multiple comparisons. Psychological outcomes, a secondary domain, did not differ significantly between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with severe obesity preparing for bariatric surgery, a structured preoperative yoga program was associated with a significant baseline-adjusted reduction in plasma noradrenaline, consistent with reduced sympathetic activation during a demanding phase of care. No epigenetic changes were detected, suggesting that measurable methylation remodelling may require longer exposure, larger samples, or tissue-specific sampling. These exploratory findings support yoga as a feasible, low-risk adjunct within bariatric prehabilitation, while the non-randomised design precludes causal inference. Adequately powered randomised trials with extended follow-up are needed to confirm this neuroendocrine signal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1858629","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:27:19Z","timestamp":1791520039000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of yoga on the epigenetics of obesity: a study on its short- and medium-term benefits in the treatment of patients with severe\/morbid obesity eligible for bariatric surgery"],"prefix":"10.3389","volume":"14","author":[{"given":"Carmela","family":"Asteria","sequence":"first","affiliation":[{"name":"Endocrine-Metabolic Nutrition Center, IRCCS, Ospedale Galeazzi-Sant\u2019Ambrogio","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Scichilone","sequence":"additional","affiliation":[{"name":"National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Ospedale Galeazzi-Sant\u2019Ambrogio","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Cardani","sequence":"additional","affiliation":[{"name":"BioCor Biobank, IRCCS Policlinico San Donato","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejan","family":"Lazarevic","sequence":"additional","affiliation":[{"name":"Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Milani","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico San Donato, Scientific Directorate","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Ambrogi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Valentina","family":"Renna","sequence":"additional","affiliation":[{"name":"BioCor Biobank, IRCCS Policlinico San Donato","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Morelli","sequence":"additional","affiliation":[{"name":"Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Giannese","sequence":"additional","affiliation":[{"name":"Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sofia","family":"Tascini","sequence":"additional","affiliation":[{"name":"Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Caridi","sequence":"additional","affiliation":[{"name":"Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Barbieri","sequence":"additional","affiliation":[{"name":"National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Ospedale Galeazzi-Sant\u2019Ambrogio","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Endocrine-Metabolic Nutrition Center, 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