1. Tai Chi was shown to be as effective as conventional exercise in reducing waist circumference in adults with central obesity.
2. A 12-week Tai Chi program maintained long-term patient weight loss with further benefits in mitigating reductions in high-density lipoprotein cholesterol (HDL-C) levels.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Tai Chi is a cardiometabolic exercise popular in many Asian countries. The exercise’s health benefits have been studied in the past; however, studies have been limited by their methodological flaws. Therefore, this study evaluated the efficacy of Tai Chi in the management of central obesity. The primary outcome of the study was waist circumference as a surrogate for central adiposity. The study determined a 12-week Tai Chi program reduced waist circumference similar to conventional exercise, and more than in those who did not exercise. Patients in the Tai Chi group also maintained their waist circumference loss and mitigated decreases in HDL-C, which occurred in the control group. This study was limited by the lack of dietary control among participants, high loss to follow-up, and no systematic adverse event assessment. Nonetheless, the results of the study are significant as Tai Chi can be applied as an effective cardiometabolic exercise to reduce and maintain waist circumference.
In-Depth [randomized control trial]: This randomized control trial enrolled 543 patients at a research center in Hong Kong. Patients aged 50 years and older, Chinese ethnicity, and central obesity were included in the study. Patients participating in regular moderate-intensity exercise training or with any physical disability were excluded from the study. The patients were randomized into a 1:1:1 ratio into either Tai Chi, conventional exercise, or no-intervention group, respectively. The primary outcome was waist circumference (WC). These outcomes were assessed at baseline, 12 weeks after intervention, and 38 weeks after intervention. The adjusted mean difference in WC for the control group was 0.8 cm (95% confidence interval [CI], -4.1 to 5.7 cm) at 12 weeks after intervention. Both the conventional exercise (adjusted mean difference, -1.3 cm; 95% CI, -1.8 to -0.9; P < 0.001) and Tai Chi (adjusted mean difference, -1.8 cm; 95% CI, -2.3- to -1.4; P < 0.001) groups had a statistical difference in WC compared to the control group at 12 weeks after intervention. Furthermore, conventional exercise (adjusted mean difference, -3.6 cm; 95% CI, -4.7 to -2.6; P < 0.001) and Tai Chi (adjusted mean difference, -4.3 cm; 95% CI, -5.3- to -3.3; P < 0.001) groups had a statistical difference in WC compared to the control group at 38 weeks after intervention. At 38 weeks after the intervention, there was no statistical difference in WC between Tai Chi and conventional exercise. Finally, the mean HDL-C level in the control group was 1.41 mmol/L (standard deviation [SD], 0.32), the Tai Chi group was 1.52 mmol/L (SD, 0.39), and the conventional exercise group was 1.54 mmol/L (SD, 0.39) at 38 weeks after intervention. When compared to the control group, the adjusted mean difference for the Tai Chi group was 0.10 (95% CI, 0.05 to 0.15; P < 0.001) and for the conventional exercise was 0.05 (95% CI, 0.01 to 0.10; P = 0.027). Altogether, Tai Chi was as effective as conventional exercise in reducing WC and maintaining HDL-C level when compared to a no-intervention group.
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