The Effects of Yoga on Body Fat Loss

Obesity is increasing at an alarming rate in most developed nations with the World Health Organization (WHO) declaring it among its priority in eradicating since 2008. The U.S. is amongst the most affected countries with approximately 66% of its adult population being either obese or overweight. According to the CDC as cited by Ross, & Thomas (2010), body mass index (BMI) is used to measure whether an individual is obese or overweight. The CDC uses the body mass in kilograms is divided by the height in square meters to determine the BMI. The average BMI for a healthy individual is the between 18 and 25 that for overweight is above 25 but below 30 whereas obese people have a BMI of over 30. Obesity is becoming a growing epidemic which is resulting in increased health costs with obesity a critical factor in causing most chronic ailments such Type II diabetes, cardiac arrests and other disorders caused by the fat and cholesterol accumulation in the body.

According to the Wise (2014), the cause of obesity and overweight epidemic in the world today is caused by the physical inactivity, unhealthy meal consumption and stress. These findings are supported by multiple studies. The change in lifestyle of the current generation has also contributed to the more triple rates of children and youths obesity since the 1980s to 2012 from 5% to about 18% (Wise, 2014). The studies demonstrate that exercises are important in enhancing a tremendous physical presence that limits the dangers of weight gain. However, Ross, & Thomas, (2010) notes that obesity and weight gain is caused by unhealthy lifestyles, psychological issues, and genes thus making it difficult to determine the best possible form of exercise that would apply to prevent all the three factors resulting in weight gain.

Yoga is one of the oldest form of spiritual, psychological and physical practice dating from 500 B.C.E. however, for the past two decades, the practice has taken root in America. According to 2008 and 2011 surveys, Yoga practice have increased from 6.9 million to over 7.5 million (Penman, Cohen, Stevens, & Jackson, 2012). Its popularity has led to over 86% of member clubs to offer yoga classes due to the general assumption that the practice it strength and weight loss to enhance the fitness of the individuals.

The growth of yoga and its popularity for the past two decades has led to the increased studies as scholars try to determine where to place yoga among exercises. These complexities are due to the broad scope of yoga and based on the yoke, discipline or union that represent the bound of thought of mind and that of the physical body. Western yoga has been based on breathing exercises, poses and seated meditation that are intended to enhance flexibility while reducing stress. Yoga is broad thus is considered as an eight-limbed path namely; yamas, niyamas, asana, pranayama, pratyahara, dharana, dhyana, and Samadhi. These terms are Indian but can be translated into ethical restraints, proper observances, physical postures, breathing control, and withdrawal of the senses, concentration, meditation, and enlightenment (Cowen and Adams 2007). The eight-limbed path is the benchmark of yoga. However, with the different practice of yoga in the U.S., yoga primarily is based on physical postures, breath control, and meditation. Studies on the ability of these styles of yoga tend to depict that they are imperfect on matters based on weight and body fat loss since they can only be grouped among the low-intensity training that scholars’ term as lacking the intensity needed to facilitate body fat loss.

The practice of Ashtanga and Bikram have demonstrated that moderate and high-intensive training is applicable in these forms of yoga that are being suggested by different physicians and medical practitioners as an alternative treatment to physical and psychological disorders. Cowen and Adams (2007) have tried to analyze the various scopes of yoga and their abilities to improve the lifestyles of people, however, studies on yoga are limited in number, with the issues of gender and age restricting the applicability of studies in broad categories of people. Most of the existing studies on yoga tend to use women as their subjects or older adults. Hence the need to determine, can these practices be used to enhance the lives of younger individuals? However, with the broad aspects of yoga and its popularity among the current population, it is essential to add to the few studies of yoga.

Statement of the Problem 

This study’s purpose was to determine the effectiveness of yoga on body fat loss. The paper addressed the psychological parameter examined was stress management whereas the physical parameters were endurance, flexibility and body composition.

Review of Literature 

The paper is focused on determining the effectiveness of yoga on body fat loss. However, it understands that body fat is a complex issue thus the need first to review articles and studies that address the cause of obesity and overweight. The other section is based on evaluating past studies and literature on yoga based on the categories of the purpose of increased body fat. This study changes the general strategies used by past and recent studies on the topic as it involves both psychological and physiological aspects of yoga. In most studies as will be demonstrated in this paper, the researchers who found success of yoga in reducing body fats, they failed to include the change in nutrients and psychological aspects thus making their studies inadequate to determine whether yoga exercises alone are sufficient for body fat loss or not. It is also important to note that since there are limited studies on any particular type of yoga, this paper will address the significant western society yoga rather than focus on a single form.

The Obesity Epidemic 

Since the 2008 announcement by WHO that obesity is developing in a world crisis, multiple studies and reports have tried to demonstrate the growing epidemic. According to Obesity Update. (2014), it is evident that since the 1980s obesity and growth of overweight have grown from 5% to more than 18%. The high rates of obesity and overweight problems have affected the OECD areas with more than half of their populations being either overweight or obese. The update demonstrated that since 2010, the obesity crisis has stabilized, but it is still high compared to the developing nations. France is the only developed country that has seen its obesity rates increase whereas the U.S., U.K., and Italy have stabilized (OECD 2014). The report demonstrated that the crisis has led to increased costs for the countries due to the rise of chronic ailments that are caused by fat and cholesterol increment. For instance, the growth of obesity in the U.S. has increased expenditure in healthcare sector from 5% to 10%. These statistics are supported by Wise (2014) who claims that the epidemic rise of obesity and overweight individuals in the country is almost two-thirds of the adults. The epidemic is also affecting children and teens with the 17% or 18% of these groups of individuals being either overweight or obese (OECD 2014). The increased of childhood obesity is also said to be the cause of the growing chronic ailments among the youths and younger people than the normal proportions. In all the age categories females were more than their male counterparts with education levels also playing an important role.

Multiple of studies demonstrated that the increase of technology and media impacts through advertisements were the reasons that contributed to people failing to observe their eating habits. For instance, Frias-Mendoza (2018), demonstrate that media advertisements have contributed to the increase of unhealthy food being consumed and produced as children are likely to nag their parents to purchase the delicacies. These factors combined with the lapse and inadequacy of the FDA and CDC to control the production of healthy food have increased the rates of body fats among the children and youths. These claims are supported by Antonio and Mohansrinivasa (2018), in their study to determine the relationship between fast food and obesity rates in the U.S. compared to other countries. The research demonstrated that fast food environment and lifestyle changes towards fast food rather than cooking is a primary cause of the obesity crisis but was unable to differentiate the impacts in the U.S. and abroad. However, it was evident that with the growth of fast food industry, accessibility and cheap food has resulted in a decline in grocery stores. The home deliveries have also increased the lack of inactivity, for example, walking to purchase the food which can be seen as an exercise.

Innovations such as the internet, cable TVs and quick, reliable transportation have contributed to the passiveness of most people with these innovations providing people with an opportunity to spend their leisure time with limited physical activities (Antonio & Mohansrinivasa, 2018). For example growth of social media has changed the mode of interaction among a majority of people. The walks and physical bonding is limited as parks are no longer as pleasing to the people compared to the internet. The high rates of adolescence overweight and obesity issue is due to the transformation of play from the physical aspects towards video games. Teens are more likely to spend most of their time playing their video games than exercising.

Lastly, stress has been claimed to be a cause of overweight and obesity. Surveys on eating habits demonstrated that people are more likely to add weight when they are depressed. The surveys portrayed that depressed people are likely to use the food and passive behaviors rather than deal with their stress (Putterman, & Linden, 2004). These studies claimed that stressed women are more likely to eat and watch TV compared to their male counterparts. These findings demonstrate that weight gain that also attributes to body fats increment can also be caused by stress thus making it essential to determine the psychological aspects of yoga that would reduce such behaviors.

Exercising and body fat loss 

According to Wharton, Adams and Hampl (2008), the 66.3% and 32.2% of U.S. overweight and obesity is strongly related to the unhealthy behaviors adopted by the adults. The authors are critical on the increasing change in preference towards the adoption of healthy behaviors, but they argue that the lack of motivation to exercise following the body fat loss and weight loss is a key issue that needs to be addressed. The ACSM (2014) has made a recommendation on ways to exercise that includes both moderate-intensive physical practices as walking, running, cycling at slow passed speed, cross-country skiing and swimming that an individual should adopt to lose body fats. However, these methods have been more successful in strength with high-intensive interval training (HIIT) being the best in enhancing body fat loss, abdominal fat and weight loss while maintaining muscle mass, and cholesterol profiles. The energy generated from HIIT results in the burning of glucose and fatty acids into energy thus making it essential in reducing the abdominal fats.

Vartanian et al. (2012) echo these findings by demonstrating that exercising enhance the ability of the body to turn the excess calories into energy rather than storing it as fats. Lack of practice lead to the fats in the abdominal body and the visceral fat the liver transforms to cholesterol which thus gaining access to the arteries leading to toughening the arteries. Blood flow and poor absorption of the nutrients due to the limited passage of the blood result in the heart slowing down and increasing the risks of cardiovascular attacks and increased blood pressure which leads to hypertension and stroke. Keating et al., (2013), supports these allegations through their study that demonstrated a clear interrelationship of inactivity with increased health issues arising from obesity. However, Vartanian et al. (2012) claim that physical activities among the youths are affected by appearance rather than health concerns. The prioritizing of appearance among the college students’ results in the use of dieting that can be catastrophic since even when trying to reduce the body fats and weight, the body requires calories to generate the need energy to perform the exercises. Therefore, Vartanian and his colleagues’ calls for the youths to set their priorities based on health when engaging in physical training. Lack of changing these priorities will only increase the level of dissatisfaction about their body which causes stress or adopting dieting that can lead to malnutrition. The pressure will cause loss of morale to continue exercising which lead to unhealthy eating habits to reemerge as they try to deal with their low self-esteem.

Scholars tend to concur that physical exercises are some of the most successful strategies to reduce body weight and fats but the issue of the type of activity that is most successful differs mainly with some arguing that both moderate and high-intensity interval training are successful whereas others argue that HIIT is the only successful form of practice. In their research, Keating and her colleagues say that the duration of moderate-intensive training is vital in realizing success similar to that achieved by HIIT. The study demonstrated that the lack of comparison of independent continuous exercise training and HIIT in people improved their body fat distribution led to their research. The randomization led to the selection of participants between the age of 18 and 55 years who had a BMI between 25 and 29.9/ the 12 weeks of regular and continuous moderate exercises demonstrated that HIIT had a higher success rate compared to that of mild exercise after the twelve weeks (Keating et al., 2013). However, in both types of activities, there was a change in cardiorespiratory fitness, body fat distribution and work capacity with secondary outcomes of lower body weight as shown by the decline in BMI, waist and hip circumference. Resting blood pressure, blood lips and serum biochemistry demonstrated that continuous moderate training was effective but required more time to achieve similar success rates as those of HIIT. HIIT performed for 30 to 45 minutes resulted in 120% of VO2peak whereas that in consecutive moderate sessions of 30 to 45 minutes caused a 50% and 65% of VO2peak respectively. The percentage body fat reduced by (2.6 ± 1.1%) and (0.3 ± 0.6%) in continuous moderate training and HIIT respectively demonstrating that constant moderate may be below HIIT in other aspects, but it performs better if the primary requirement is to reduce body fats (Keating et al., 2013). The study concluded that the notion of HIIT is better than the continuous moderate exercise in reducing weight and body fats in obese or overweight inactive people is unfounded based on their findings. These findings and the issue of using active but overweight or obese individuals rather than those who do not exercise is recommended by the authors to determine the best mode of practice. These claims are supported by Siqiang (2017) following a study that involved 100 female college students. Following the experiment, it was evident that continuous aerobic exercise was useful in weight loss and promoted both physical and mental health.

Penman, Cohen, Stevens, & Jackson, (2012), research that included undertaking moderate aerobic exercises found out that moderate-intensity aerobic exercises were important in enhancing weight and body fat loss. The study portrayed that following twelve weeks of moderate-intensity training; there was VO2max which demonstrate an increased heart strength and a reduction in skin folds and body fat. The experiment increased the lean body mass.

The lack of studies that only tackled the issue of obesity and body fats is limiting to this study but with the multiple studies on the subject although the studies address problems of cardiovascular health, blood pressure and type II diabetes among other conditions. It is evident that earlier studies mainly from the 1970s to 2000 were critical on the effectiveness of moderate exercises such as walking or jogging as depicted Kelly, Gennat, O’Rouke and Del Mar (2006) in their review of practice for overweight. The study demonstrates that HIIT was termed as the most efficient way to reduce weight and fats since it enhanced higher heartbeat and strength compared to other forms of exercises. However, the American College Sports Medicine (2014) guideline demonstrate that moderate activities are valuable in maximizing the heart’s muscle.

Waistline measurements, BMI, the percentage of fatty tissue and hip volume showed that continuous moderate training was adequate if the individual engages in at least 12-week of training. The 12-week schedule should include a five-days per week of 30 to 45 minutes to realize better results. These claims are supported by Keating et al., (2013) who demonstrated that moderate training is as practical as HIIT if not better. The study also showed that with most of the older-age adults forming more than two-thirds of the overweight and obese population, HIIT is a risky technique to use among such people due to their health conditions and fragile conditions that would increase cardiovascular attacks. These arguments are countered by HIIT proponents who argue that if the exercises are guided by a qualified trainer, the short intervals of HIIT and relaxation improves the bones and enhance the heart conditions. The issue has raised more questions than answers, but in all the studies, it was evident that neither exercise is successful if the participants do not adopt healthy dietary.

Yoga on Body Fat Loss 

As earlier noted, the study of yoga and obesity is narrow but with the past decade; it is easy to generate a detailed review of yoga’s effectiveness in reducing body fat. Most studies claim earlier studies argue that yoga is a low-intensity training since it does not result in the maximum heart beat as proposed by the ACSM (2014). However, these studies tend to argue based on breathing and relaxation forms of yoga which can be considered as low intensity. Bikram for instance as studied by Ross and colleagues demonstrated that yoga is one of the most effective form of physical and psychological training that enhance body fat reduction and enable changes in dietary. Ross et al. (2016) undertook a study to examine the effectiveness of Bikram yoga in obesity and body fat study that used longitudinal vitamin and lifestyle study that included 15,550 adults who had practiced yoga for at least four years had a lower chance of being obese (Ross et al., 2016). The essence that yoga prevented obesity and overweight among the individuals practicing it with two to four times less likely for weight gain and accumulation of body fats is an indication that yoga is effective in preventing obesity.

However, the main issue facing yoga as an alternative treatment for obesity is whether it improves an obese or overweight individual’s BMI, body fat and waist circumference (Yang, 2007). Scholars have indicated that the broad category of yoga from the low-intensity mediation to vigorous yoga such as Bikram and Ashtanga which involve about 23 continuous moderate and relaxation actions for about one hour for five-days a week. The study demonstrated that yoga is an efficient way of reducing body fat and body weight, but it takes a lot of time for the conditions to be realized that ranges from nine months to four years. In a past review of more than 55 studies on yoga and its weight-related outcomes, Rioux and Ritenbaugh (2013) supported findings on the effectiveness of yoga in body fat loss. The authors demonstrated that time and yoga diets made it impossible to determine whether the changes or reduction of body fats were due to exercises or due to both psychological and physiological components. Multiple scholars have raised the same issue because the pathways of yoga include body awareness, reduction of pain, enhanced mindfulness and increased energy expenditure due to the mediation, enlightenment, relaxation, intensity variation and continuous aspects for one hour or more (Chung et al., 2014, Ross et al., & Sherman, 2006). Ross et al. (2016) discovered that yoga down-regulates the hypothalamic pituitary adrenal (HPA) axis and the sympathetic-adrenal medullary (SAM) response to stress.

The study also demonstrated that yoga affects the adipose tissue to limit the binge of eating and preoccupation with food that stressed people are likely to exhibit. The intervention with these hormones reduced the intake of energy and fat storage thus affecting the metabolism with the adiponectin that acts as an anti-inflammatory leads to enhanced insulin sensitivity thus minimizing the risks of type II diabetes. The study also used cross-sectional studies of beginners yoga for at least four years, the levels of leptin was 36% higher than those who practiced yoga with standards of the adiposity lower among the beginners by 28% compared to the expats (Ross et al., 2016). The use of questionnaires in the study by Ross and her colleagues demonstrated that most of the participants had experienced difficulty in reducing their weight and body fats but once they undertook yoga, they changed their diets too and the results were quite exciting for them. The study demonstrates that yoga is an effective way to reduce the weight loss since it improves the physicality of the participant and their mentality in engaging themselves in training and adopting better eating habits. Rioux and Ritenbaugh (2013) support these claims by claiming that the enlightenment and mind-body interaction during meditation enables the individual to connect with his/her body thus creating awareness on what they need to do to ensure they achieve their goals of BMI reduction and body fats loss.

Humans just like machines tend to tear out as they age hence the higher probability of older adults or those above the age of 55 years to get ill more often compared to younger adults. The issue of fragile bones, inactivity, and constant pains result in increased dependency (Ross, & Thomas, 2010). Hence the continued mood changes as they feel that they are burdens to those taking care of them and the depression complemented by the higher risks of other chronic ailments among this group of people. Yoga provides the flexibility, mental stability and reduces the chances of falling thus making these individuals more independent. The relaxation and moderate training enable the older citizens to have stronger bones while minimizing the risks that are involved in HIIT. Many studies as depicted by Roland, Jakobi, and Jones (2011) in their review of studies on yoga efficiency in older adults. The survey demonstrated that duration and the eight-limbed nature of yoga provide the older citizens with the opportunity to enhance their endurance and due to the flexibility and the studies reviewed illustrated that yoga was one of the leading contributors to the reduction of back pain among these individuals and enabled them to reduce stress. The essence that yoga takes a longer duration and involves a different type of exercises made it easier for the participants to remain motivated to continue exercising even after the four years. These claims are supported by statistics that depict that yoga is offered in more than 86% of the member's clubs in Northern America (Chung et al., 2014). Berger, Pargman & Weinberg (2002) had earlier described yoga as an effective way for the older adults to gain self-efficacy that increased their control while trying to understand the impacts of yoga in enhancing the health conditions of these senior citizens.

Stress is one of the three main causes of obesity, therefore, switching from the exercise aspects of yoga, it is important to understand the mental benefits of practicing yoga. According to Knobben (2013), a review of 32 studies on impacts of yoga demonstrated that yoga improved the lifestyles of the people and the use of asanas enabled the participants to understand themselves and live healthier lives. There was a 49% improvement in the mental health of healthy and patients with mental illness. These findings demonstrate that while yoga is mainly studied on while using females or older adults, it is viable in being used by younger men.

Research Hypothesis 

The literature reviewed was skeptical but encouraging, however, the lapses in conclusions and disparities in the efficiency of yoga in body fat loss, this paper was able to formulate the hypothesis below;

H01 : There will be no difference in fat mass lost based on yoga exercise. 

H02: There will be a difference in fat mass lost based on yoga exercise. 

The two different hypothesis with one showing no change whereas the other stating that there is change following yoga practices will help draw the line that is useful in determining the effectiveness of yoga in body fat loss. The hypothesis will help determine the methodology in the bid to answer determine the true statement and in so doing, it will be easy to decide on whether yoga helps in reducing the body fats or whether it should not be recommended as an alternative form of treatment for obese and overweight individuals.

Need For the Study 

Obesity is among the top five goals of the WHO since it is becoming an epidemic that if not tackled may result in the increased morbidity and mortality. Studies reviewed in the literature review demonstrate that the obesity is the main cause of the most chronic ailment and the continued ignorance of the dangers posed by this condition is a major factor that the vice is spreading even among the children above two years. In the 1980s, doctors and citizens would be shocked when a child was diagnosed with type II diabetes. It was unheard-of with most people believing that the disease was reserved for the older adults. However, the changes in eating habits, inactivity, and ignorance towards one’s health has led to childhood obesity and chronic ailment dominating the world reports. According to Frias-Mendoza (2018), the current generation tends to assume most matters concerning healthy lifestyles. People tend to ignore the critical issues due to assumptions hence the continued increase in the number of obese and overweight individuals. The study demonstrates that by 2030, over 7 million people in the world will die from obesity and overweight caused ailments. These non-transferable diseases are proliferating with over 2.8 million people succumbing to these ailments (Frias-Mendoza, 2018). The abnormal accumulation of fats is becoming a problem that everyone must take a step to eliminate before we all fall victims to it. The focused 7 million deaths and the essence that OECD holds the most substantial number of obese and overweight citizens predicts doom if no change is made. The economic constraints with the rise of chronic ailments hailing from obesity problem prove that the paper will provide a lasting solution to eliminate the increase of the obesity.

Yoga, on the other hand, is becoming one of the most advanced therapies for obesity and overweight patients. However, the broad aspects and divisions of yoga tend to limit the landscape and depth of most studies focusing on the topic. It is almost impossible to gain access to over 20 studies that focus on a particular type of yoga. For instance, before choosing to undertake this study, I thought about focusing on a single kind of yoga such as Bikram but could only gain access of two or three reviews that focused entirely on Bikram with only one that based its experiments on determining the effectiveness of Bikram in reducing body fats. Therefore this study rather than focusing on a single type of yoga focused on the essential components of yoga that reduces stress, and enhance activity thus reducing the body fats. It is inclusive of the psychological and physiological thus adding to the limited number of journals. This paper offers a more in-depth and broader aspect of yoga that is essential in educating the older citizens and other groups of people on whether the health practitioners are correct to propose yoga as a treatment for the obese and overweight patients.

Lastly, this paper will be crucial in solving the debate on whether yoga is an effective way to reduce body fats while not focusing on other issues such as diabetes and blood pressure. It is solely focused on addressing the success of yoga on body fats unlike all other studies reviewed. It will also prove whether yoga is applicable to children and youths both male and female. Therefore the paper will determine whether yoga taking a longer duration to exhibit success is the way to go by in ensuring continuous exercising after the acknowledgment that the obesity crisis has erupted due to the lack of continuity after weight loss is achieved.

Proposed Methodology 

Scholars agree that the best form of scientific experiment is randomized experimental design since it sets the strategy to determine the participants, the approach to use in collecting, analyzing and translating the findings (Streubert, 2010). It also emphasizes the ethical aspects and ensuring that the research is focused on addressing a critical issue rather than wadding off from the objectives. H01 and H02 are the guidelines to this paper, therefore demonstrate that the study must be focused on determining the effectiveness of yoga on body fat loss. Most clinical experiments such as this one must use quantitative and qualitative research methods. Quantitative analyses offer data in numerical form making it easier to demonstrate and support the conclusion made on a particular subject. Qualitative research methods, on the other hand, helps understand the past studies and their findings in ensuring that this paper does not follow the limitations and biased assumptions influence the conclusions of the study. The use of mixed research method that includes both quantitative and qualitative research methods will enhance the reliability and validity of the paper.

Data collection 

The time and finance needed to undertake a questionnaire and experiments that include obese or overweight individuals from different races, gender, age, locations, education background and economic status among other social aspects demonstrate that undertaking an entirely quantitative study with raw data is impossible. Therefore, use of Facebook and Twitter is proposed with five questions being open-ended to ensure that we can gain as much information about the participants and their personality. BMI and their views on yoga since to participate in the questionnaire they must answer that they are either overweight or obese and must have used yoga for at least two years. The data collected will be grouped according to the type of yoga and period with gender and age differences used to group the participants. The data will then be filtered by eliminating the extreme figures before randomly calling the participants who demonstrated that they were serious. The telephone calls will enable the determination of the mean changes or impacts of the yoga on body fat loss. The use of mathematics and statistical equations such as regression will be used to determine the correlations and relationships of the data and enable interpretation.

Qualitative data, on the other hand, will include about 50 studies on the topic of obesity and yoga interventions. The studies reviewed will be accessed from Google Scholar, PUBMED, journals on yoga and obesity as well as those from sporting journals. The journals must be within 20 years that is journals and peer reviews from 1998 to 2018. The journals will be analyzed and their quantitative data compared to the quantitative data from this experiment. The journals must also discuss the shortcomings and assumptions made to be credible for this study. Errors such as typing errors and biased assumptions or failure to include the ethical or validity of the paper will result in the journal being dismissed for further study. The data derived from the two approaches will be compared and evaluated to generate a valid and reliable conclusion.

Limitations of the Study 

As earlier stated, the success of yoga was identified after four years which poses a significant challenge as the paper does not have the time to collect a lab-based clinical examination. The bias assumptions and the lack of multiple studies that focus on yoga and body fat loss will affect the success of this paper. Social media platforms also offer the threat of fake users who may lie or refusal to engage in the study which will limit the access of raw data and impact the findings and conclusion of the paper.

Costs problem to engage in face to face questionnaires that are more informative also limits the credibility of this paper. Lastly, the essence that most people ignore such surveys and the low self-esteem associated with overweight and obese individuals may also lead to false answers. Written questionnaires also result in varied responses based on the understanding and interpretation of the questions, therefore, leading to a wide variety of responses that may be too broad to gain any similarity. Analysis of grouping and interpretation of raw data is also time-consuming, and a mathematical error may change the results leading to false conclusions.

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