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Effects of Tai Chi or Conventional Exercise on Central Obesity in Middle-Aged and Older Adults

A Three-Group Randomized Controlled Trial

Parco M. Siu, PhD*, Angus P. Yu, MPhil*, Edwin C. Chin, BScEd, Doris S. Yu, PhD,

https://doi.org/10.7326/M20-7014

Background:

Central obesity is a major manifestation of metabolic syndrome, which is a common health problem in middle-aged and older adults.

Objective:

To examine the therapeutic efficacy of tai chi for management of central obesity.

Design:

Randomized, controlled, assessor-blinded trial. (ClinicalTrials.gov: NCT03107741)

Setting:

A single research site in Hong Kong between 27 February 2016 and 28 February 2019.

Participants:

Adults aged 50 years or older with central obesity.

Intervention:

543 participants were randomly assigned in a 1:1:1 ratio to a control group with no exercise intervention (n = 181), conventional exercise consisting of aerobic exercise and strength training (EX group) (n = 181), and a tai chi group (TC group) (n = 181). Interventions lasted 12 weeks.

Measurements:

Outcomes were assessed at baseline, week 12, and week 38. The primary outcome was waist circumference (WC). Secondary outcomes were body weight; body mass index; high-density lipoprotein cholesterol (HDL-C), triglyceride, and fasting plasma glucose levels; blood pressure; and incidence of remission of central obesity.

Results:

The adjusted mean difference in WC from baseline to week 12 in the control group was 0.8 cm (95% CI, −4.1 to 5.7 cm). Both intervention groups showed reductions in WC relative to control (adjusted mean differences: TC group vs. control, −1.8 cm [CI, −2.3 to −1.4 cm]; P < 0.001; EX group vs. control: −1.3 cm [CI, −1.8 to −0.9 cm]; P < 0.001); both intervention groups also showed reductions in body weight (P < 0.05) and attenuation of the decrease in HDL-C level relative to the control group. The favorable changes in WC and body weight were maintained in both the TC and EX groups, whereas the beneficial effect on HDL-C was only maintained in the TC group at week 38.

Limitations:

High attrition and no dietary intervention.

Conclusion:

Tai chi is an effective approach to reduce WC in adults with central obesity aged 50 years or older.