MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Prince Charles has claimed that people struggling to return to full health after having the coronavirus should practice yoga. This is what the GUARDIAN reported about it on Friday:

In a video statement on Friday to the virtual yoga and healthcare symposium Wellness After Covid, the heir apparent said doctors should work together with “complementary healthcare specialists” to “build a roadmap to hope and healing” after Covid. “This pandemic has emphasised the importance of preparedness, resilience and the need for an approach which addresses the health and welfare of the whole person as part of society, and which does not merely focus on the symptoms alone,” Charles said. “As part of that approach, therapeutic, evidenced-informed yoga can contribute to health and healing. By its very nature, yoga is an accessible practice which provides practitioners with ways to manage stress, build resilience and promote healing…”

… Charles, who has previously espoused the benefits of yoga, is not the only fan in the royal family. His wife, the Duchess of Cornwall, has said “it makes you less stiff” and “more supple”, while Prince William has also been pictured doing yogic poses. In 2019, the Prince of Wales said yoga had “proven beneficial effects on both body and mind”, and delivered “tremendous social benefits” that help build “discipline, self-reliance and self-care”.

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Yoga is a complex subject because it entails a host of different techniques, attitudes, and life-styles. There have been numerous clinical trials of various yoga techniques. They tend to suffer from poor study design as well as incomplete reporting and are thus no always reliable. Several systematic reviews have summarised the findings of these studies. A 2010 overview included 21 systematic reviews relating to a wide range of conditions. Nine systematic reviews arrived at positive conclusions, but many were associated with a high risk of bias. Unanimously positive evidence emerged only for depression and cardiovascular risk reduction.[1] There is no evidence that yoga speeds the recovery after COVID-19 or any other severe infectious disease, as Charles suggested.

Yoga is generally considered to be safe. However, a large-scale survey found that approximately 30% of yoga class attendees had experienced some type of adverse event. Although the majority had mild symptoms, the survey results indicated that patients with chronic diseases were more likely to experience adverse events.[2]  It, therefore, seems unlikely that yoga is suited for many patients recovering from a COVID-19 infection.

The warning by the Vatican’s chief exorcist that yoga leads to ‘demonic possession’[3] might not be taken seriously by rational thinkers. Yet, experts have long warned that many yoga teachers try to recruit their clients into the more cult-like aspects of yoga.[4]

Perhaps the most remarkable expression in Charles’ quotes is the term ‘EVIDENCE-INFORMED‘. It crops up regularly when Charles (or his advisor Dr. Michael Dixon) speaks or writes about so-called alternative medicine (SCAM). It is a clever term that sounds almost like ‘evidence-based’ but means something entirely different. If a SCAM is not evidence-based, it can still be legitimately put under the umbrella of ‘evidence-informed’: we know the evidence is not positive, we were well-informed of this fact, we nevertheless conclude that yoga (or any other SCAM) might be a good idea!

In my view, the regular use of the term ‘evidence-informed’ in the realm of SCAM discloses a lack of clarity that suits all snake-oil salesmen very well.

 

[1] Ernst E, Lee MS: Focus on Alternative and Complementary Therapies Volume 15(4) December 2010 274–27

[2] Matsushita T, Oka T. A large-scale survey of adverse events experienced in yoga classes. Biopsychosoc Med. 2015 Mar 18;9:9. doi: 10.1186/s13030-015-0037-1. PMID: 25844090; PMCID: PMC4384376.

[3] https://www.social-consciousness.com/2017/06/vaticans-chief-exorcist-warns-that-yoga-causes-demonic-possession.html

[4] https://www.theguardian.com/lifeandstyle/2020/jun/26/experience-my-yoga-class-turned-out-to-be-a-cult

 

2 Responses to Prince Charles: “evidenced-informed yoga can contribute to health and healing”

  • The Guardian piece quoted by Prof. Ernst is worthy of repetition, and analysis: “In a video statement on Friday to the virtual yoga and healthcare symposium Wellness After Covid, the heir apparent said doctors should work together with “complementary healthcare specialists” to “build a roadmap to hope and healing” after Covid.

    Dr Adrian James, the president of the Royal College of Psychiatrists, who is giving a talk at the event titled “The Unseen Crisis: Mental Health Consequences of a Global Pandemic and How Yoga Can Help”, said yoga, group gardening, art classes and other physical activities and training courses improve patients’ physical and mental wellbeing.”

    There are two dimensions here: (i) The opinions of an eminent psychiatrist that ‘yoga’ and other activities can help with the psychological effects of the pandemic, as well they might.
    The Guardian does not advise us to what extent Dr James distinguishes between the wide varieties of ‘yoga’ – some of which delve into the realm of the supernatural and are overladen with pretentious references to ‘chakras’, medians’ and ‘vital energy’, whilst many varieties stay with the simple and no doubt beneficial concept of relaxation and stretching.

    (ii) The opinions of a celebrity with no scientific training who has a long history of trying to railroad ‘complementary healthcare’ (by definition, being unevidenced), into regular progressive modern medical practices.

    And as the professor points out, we see here the expression “evidence-informed” – a meaningless term, because any thought, idea or concept is informed by evidence, even if that evidence is bad, useless and gets nowhere near a level of plausibility to be taken seriously.

    ‘Evidence-based’ denotes “an approach to medicine, education, and other disciplines that emphasizes the practical application of the findings of the best available current research.” (Oxford Languages). Note: “best available”.
    David Eddy used “evidence-based” in 1987, “explicitly describing the available evidence that pertains to a policy and tying the policy to evidence instead of standard-of-care practices or the beliefs of experts. The pertinent evidence must be identified, described, and analyzed. The policymakers must determine whether the policy is justified by the evidence. A rationale must be written.”
    The term EBM was popularised by Gordon Guyatt in 1990.

    If Charles does not recognise the difference, between EB and EI, and is blind to the use being made of the term ‘evidence -informed’ to take advantage of the gullible and vulnerable, he should be better informed, and seek wiser advisors.

    If, as I suspect, he knows perfectly well what he is up to, pressing on with his agenda to have SCAMs insinuated into the NHS, he should be ashamed.
    He is no worthy successor to King Charles II, who patronised the foundation of the Royal Society: “the fundamental purpose, reflected in its founding Charters of the 1660s, is to recognise, promote, and support excellence in science and to encourage the development and use of science for the benefit of humanity.”

    Quite why the RS made Charles Windsor a FRS is obscure – he clearly has made little progress in advancing the Society’s objectives. Meanwhile he is content to associate with one of the oldest cons in the swindlers’ handbook – The Gold Brick. Dress up an article, or concept, in a fancy covering, con marks to attend conferences, and then when they whip the covers off, they find little of substance, and most presentations wedded to anachronistic metaphysical concepts which should have no place in the modern world. And certainly not in healthcare.

    These scams have been left behind by the modern world for a very good reason: reason.

    • Couldn’t agree more Richard. Medical/Science journalist seem very happy to bandy about the notion of complementary medicine without pointing out the term contains a rag tag and bob tail of practices for which the evidence base supporting their efficacy is non existent.

      In my view any reputable journalist should stick to the line that we have evidence based medicine that works any other practices that don’t.

      Yoga of course has all sort of high faultin’ mystical connotations but as far as I know the benefits come from as you say – stretching and being concentrated on something other than our quotidian concerns.

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