This randomized, controlled, assessor-blinded trial sought to examine the therapeutic efficacy of tai chi versus conventional exercise for management of central obesity in adults aged 50 years or older.
Abstract
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.
Primary Funding Source:
Health and Medical Research Fund.
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Author, Article, and Disclosure Information
Parco M. Siu,
The University of Hong Kong, Pokfulam, Hong Kong, China (P.M.S., A.P.Y., E.C.C., D.S.Y., D.Y.F.)
The Chinese University of Hong Kong, Shatin, Hong Kong, China (S.S.H., J.W.)
Chinese Academy of Sciences, Beijing, China (G.X.W.)
University of California, Los Angeles, Los Angeles, California (M.R.I.).
Acknowledgment: The authors thank all of the participants for their contributions to this study; the tai chi instructors (Ms. Wong Hung Wah, Mr. Cheung Wai Kin, and Ms. Ng Kit Yee Angie) for delivering the tai chi training; the fitness instructors (Mr. Tang Wai Hung, Mr. Lam Tak Choi, and Mr. Lam Siu Tong) for delivering the conventional exercise training; and Mr. Lai Hong Chung, Ms. Lam Lok Shan, Mr. Yuen Ming Hay, Ms. Kong Tsoi Ying, and Ms. Cheng Yi Yau for assisting in the management of the study.
Financial Support: By the Health and Medical Research Fund (12131841) of the Food and Health Bureau, Hong Kong SAR.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-7014.
Data Sharing Statement: Individual participant data used in the reported results have been deidentified. The data, study protocol, and statistical analysis plan will be shared beginning 3 months and ending 5 years after publication of this article. Data will be shared with researchers who provide a methodologically sound proposal with achievable aims. Proposals should be directed to pmsiu@hku.
Corresponding Author: Parco M. Siu, PhD, School of Public Health, The University of Hong Kong, Room 3-01C, 3/F, HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China; e-mail, pmsiu@hku.
Current Author Addresses: Dr. Siu: School of Public Health, The University of Hong Kong, Room 3-01C, 3/F, HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China.
Mr. Yu and Mr. Chin: School of Public Health, The University of Hong Kong, Room 3-01, 3/F, HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China.
Drs. Yu and Fong: School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
Dr. Hui: Department of Sports Science and Physical Education, The Chinese University of Hong Kong, G/F, Kwok Sports Building, Shatin, Hong Kong, China.
Dr. Woo: Department of Medicine & Therapeutics, The Chinese University of Hong Kong, 9/F, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China.
Dr. Wei: Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China, 100101.
Dr. Irwin: Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095.
Author Contributions: Conception and design: P.M. Siu, S.S. Hui, G.X. Wei.
Analysis and interpretation of the data: P.M. Siu, A.P. Yu, E.C. Chin, D.S. Yu, D.Y. Fong, M.R. Irwin.
Drafting of the article: P.M. Siu, A.P. Yu, S.S. Hui, J. Woo, M.R. Irwin.
Critical revision of the article for important intellectual content: P.M. Siu, A.P. Yu, D.S. Yu, S.S. Hui, J. Woo, M.R. Irwin.
Final approval of the article: P.M. Siu, A.P. Yu, E.C. Chin, D.S. Yu, S.S. Hui, J. Woo, D.Y. Fong, G.X. Wei, M.R. Irwin.
Provision of study materials or patients: A.P. Yu.
Statistical expertise: A.P. Yu, D.Y. Fong.
Obtaining of funding: P.M. Siu, D.S. Yu, S.S. Hui.
Administrative, technical, or logistic support: P.M. Siu, A.P. Yu, E.C. Chin, S.S. Hui.
Collection and assembly of data: P.M. Siu, A.P. Yu, E.C. Chin.
This article was published at Annals.org on 1 June 2021.
* Dr. Siu and Mr. Yu contributed equally to this work.
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