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. 2025 Jul 1;15:20919. doi: 10.1038/s41598-025-06285-2

The effects of Tai Chi exercise on body composition and cardiorespiratory fitness in Chinese university students with obesity: A quasi experiment study

Yali Xu 1,#, Feng Wang 2,✉,#, Lei Yang 1, Wei Qiao 3, Hutkemri Zulnaidi 4, Annisaa Basar 5, Syed Kamaruzaman Syed Ali 5
PMCID: PMC12216844  PMID: 40594594

Abstract

Obesity is an increasingly serious public health problem in China. This trend has surged in the population of university students and harmed their physical health. To identify the effects of Taichi exercise on lean body mass (LBM), waist circumference (WC), and maximal oxygen consumption (VO2max) for university students with obesity (USO). A total of 46 eligible participants were enrolled in this experiment, which involved a 12-week intervention. The participants had a mean age of 18.38 ± 0.73 years and a BMI of 31.50 ± 2.93. The sample consisted of 83.76% males and 16.24% females. LBM, WC, and VO2max were measured at both baseline and post-test. The instruments used included a body composition analyzer, measuring tape, and the VO2max formula. Data analysis was conducted using SPSS software. Tai Chi had a significant positive effect on WC, reducing it by 3.38 cm (P = 0.004, 95% CI, d = − 0.274), and on LBM, increasing it by 0.87 kg (P = 0.030, 95% CI, d = 0.081). However, it had no significant effect on VO2max, which increased by 1.7 mL/kg/min (P = 0.284, 95% CI, d = 0.326) in USO. Similarly, stretching exercises significantly reduced WC by 4.68 cm (P = 0.007, 95% CI, d = − 0.467) but had no significant effects on VO2max, which increased by 0.12 mL/kg/min (P = 0.991, 95% CI, d = 0.227), or on LBM, which increased by 0.40 kg (P = 0.547, 95% CI, d = 0.050) for USO. Additionally, there was no statistically significant difference between the Tai Chi and control groups in WC, VO2max, or LBM (p = 0.057) among USO. Besides of the significant positive effects on waist circumstance, Taichi exercise also shown optimism benefits on lean body mass. Taichi exercise is better than normal exercise on physical health for university students with obesity.

Keywords: Taichi exercise, University students with obesity, LBM, WC, VO2max

Subject terms: Weight management, Cardiovascular diseases, Outcomes research, Clinical trials

Introduction

Nowadays, obesity has become an increasingly serious public health problem in China1. Based on a survey of 50 universities in China, 9.5% college students are suffer from the prevalence of overweight and obesity2. The prevalence of obesity among university students is a growing concern, as it not only impacts physical health but also influences psychological well-being and academic performance. University students, a demographic group experiencing significant lifestyle transitions, often face challenges such as irregular eating habits, increased stress, and reduced physical activity. Physical inactivity has a close association with college students’ overweight and obesity. Therefore, undergraduate students should actively engage in sports and physical exercise to mitigate the adverse effects of rising obesity trends3. Given these challenges, there is a clear need for effective, engaging, and sustainable exercise interventions tailored to this group.

According to the latest survey by ACSM, exercise for weight loss ranked fourth in the 2025 ACSM Worldwide Fitness Trends4. Among the numerous exercise modalities, mind-body fitness activities such as Pilates, yoga, Taichi, and qigong can be an appropriate and safe choice for individuals with obesity by promoting muscle control, body functionality, flexibility, and balance, as well as reducing physical limitations, chronic pain, stress, and more5. Taichi is a popular mind-body exercise all around the word. It is a form of traditional Chinese martial arts known for its slow, dynamic balance, flowing movements and deep breathing techniques, has been identified as a potential beneficial exercise for improving health outcomes6. Previous studies have warranted that Taichi has a positive effect on individuals’ physical health. For example, some researchers confirmed that Taichi exercise (TE) can benefit individuals’ body composition7 and pulmonary function8. Moreover, A latest study revealed that even a short Taichi qigong exercise can significantly improve college students’ physical and mental health9. However, less is known about its effects on the population of university students with obesity. Consequently, there is an implementation gap between the Taichi research and the sample of USO.

Lean body mass (LBM) is an important indicator for assessing body composition. It mainly consists of muscle, bone, and connective tissue10. The loss of LBM will lead to various health problems such as reducing basal metabolic rate, handgrip force, knee-extensor strength, increasing body fat as well as cardio-metabolic diseases11–13.Waist circumference (WC) is a vital symbol for clinical practice14it can be used to predict obesity15mortality16cardiovascular morbidity17 and so on. maximum oxygen uptake VO2max. It is the “gold standard” to measure aerobic capacity and is a vital part in various health-related fields18. Obviously, lean body mass, waist circumference, as well as VO2max, are vital factors in indicating university students’ health status.

The present study aims to explore the impact of a structured Taichi exercise (TE) program on these three critical health parameters in University Students with Obesity (USO). By targeting LBM, WC, and VO2max, this research seeks to provide evidence on the role of Taichi as a viable and effective exercise intervention for enhancing physical health in this specific population.

According to the aims of this study, there are two objectives: Firstly, to identify the effectiveness of TE on LBM, WC, and VO2max among USO. Secondly, to compare the difference between TE and the control group (normal exercise) on LBM, WC, and VO2max for USO. Consistent with the objectives, three research questions are raised: (1) what is the effectiveness of TE on USO’ LBM, WC, and VO2max? (2) what is the effectiveness of the control group on USO’ LBM, WC, and VO2max? (3) what is the difference between TE and the control group on OUS’ LBM, WC, and VO2max?

As previous mentioned, various studies have warranted that Taichi has significant positive on individuals’ physical and mental health9,19–23. General physical activity recommendations without specific intensity, duration, and frequency often fail to yield substantial improvements in these areas, particularly in populations prone to obesity and sedentary behaviors.

Given above statement, three hypotheses are put forwarded by the researcher: (1) Taichi exercise group has a significant improvement in USO’s LBM, WC, and VO2max. (2) the control group has no significant improvement in USO’s LBM, WC, and VO2max. (3) Taichi exercise group has a better effect than the control group.

Materials and methods

Research design

The aim of this study was to identify the effectiveness of TE on USO’s LBM, WC, and VO2max. Thus, the researcher chose a nonequivalent research design for it. A control group was indispensable in this trial in order to compare the difference between TE and normal exercise.

Stretching exercises are generally considered low-impact, accessible, and do not require extensive physical exertion or specialized equipment, making them suitable for a wide range of individuals, including those who are suffering from obesity or not accustomed to regular physical activity. Thus, it was chosen as the normal exercise in this experiment. Therefore, there was two independent variables: TE and the control group (stretching exercise). The dependent variables consist of LBM, WC, and VO2max. 46 eligible participants were enrolled in this experiment and were distributed into either the Taichi group or control group according to the convenient sampling methods. All students took part in the pretest to record the baseline of LBM, WC, and VO2max. Then 12 weeks of Taichi exercise was conducted among all participants. A posttest would be given to all students at the end of the intervention. The specific procedure is shown in Fig. 1, the following chart.

Fig. 1.

Fig. 1

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The procedure of experiment.

Location and participants

This study was conducted at a public university in southern China. Participants were university students with obesity, regardless of their level of physical activity. The sample was voluntarily recruited from among undergraduate students at the university. Before the study commenced, a rigorous screening process was conducted based on the following inclusion and exclusion criteria:

Inclusion criteria: (1) BMI of 28 or above; (2) Enrolled as an active undergraduate student; (3) No prior experience in learning or practicing Tai Chi. Exclusion criteria: (1) Frequent absenteeism; (2) Serious physical or mental health conditions.

Sample size and sampling

Based on MAZLAN’s study, there were at least 21 participants for the treatment group and control group, after estimating the dropout rate of 10%. Therefore, 23 subjects for each group were need24. Therefore, 46 eligible students enrolled in this trial. According to the total sample size, we set the effect size at 0.5 and the significance level (α) at 0.05. Using G*Power, the calculated statistical power is 0.9, indicating that this study has a high statistical power.

This study used convenient sampling method, students in faculty of social science were defined as TE group while students from faculty of medicine were chosen as control group.

Protocol for Taichi exercise and stretching exercise

Regarding the frequency, intensity, duration, and volume, both Taichi and stretching exercises are performed at a low to moderate intensity. The training program was designed to last for 12 weeks, with sessions held three times per week, each lasting 60 min for both practices. The Taichi exercise session included a 5 min warm-up 50 min for Taichi Bafawubu, and 5 min for cool down. The Tai Chi Bafawubu (in mandarin meaning 8 methods and 5 step-forwards) is the latest Tai Chi style which launched the Administration Bureau of Sport China25It integrates eight essential forms called Peng (warding off), Lv (rolling back), Ji (pressing), An (pushing), Cai (plucking), Lie (laying), Zhou (elbowing), Kao (leaning sideways), and five steps called Jin (advancing), Tui (retreating), Gu (shifting left), Pan (shifting right), and Ding (central equilibrium), which are the core patterns of Tai Chi19.

The stretching exercise session covered a 5 min warm-up, 45 min stretching, and 5 min cool down. The 10 BEST STRETCHES FOR BEGINNERS were chosen by the researcher. Those includes: Standing Calf Stretch, Standing or Seated Inner Thigh Stretch, Standing or Seated Hamstrings Stretch, Quad Stretch, Kneeling or Standing Hip Flexor Stretch, Standing Lat Stretch, Standing Chest Stretch, Standing or Seated Traps Stretch, Standing scapulae stretch, Thoracic Spine Stretch26.

The specific protocol for Taichi exercise and stretching exercise is available from the corresponding author, Dr Wang Feng (wangfeng@fsskj.upsi.edu.my).

Measurement of LBM, WC, VO2max

The instrument for lean body mass was the body composition analyzer, which was based on Bioelectrical Impedance Analysis (BIA)27. The WC was measured by a tape which passed round the body and positioned mid-way between the iliac crest and costal margin of the lower rib28. For VO2max, researchers assessed it via the VO2max formula: VO2 max = 15 x (HRmax/HRrest)29. Although it might not be as precise as other methods, it was the easiest and safest measurement for obesity cohorts.

Statistic data

SPSS version 18 was utilized to analyses all of the data in this study. The data results would be recorded as means ± SD. The data descriptive was implemented for demographic information, and a paired T test was taken to assess the difference between pretest and posttest for the Taichi exercise group and the control group. Moreover, one-way MANOVA was taken to compare the difference between the Taichi exercise group and control group on LBM, WC, as well as VO2max. The significant level was defined as 0.05, and the extremely significant was set at 0.001.

Results

Demographics of participants

As is clearly shown in Fig. 1, for the Taichi exercise group, 2 students dropped out for time conflicts. And 1 student left in the stretching exercise group due to suffering a leg fracture. Therefore, 21 students in the Taichi group and 22 students in the control group were taken for analysis.

The specific demographic information is shown in Table 1. In the Taichi exercise group, 81% of the students were male and 19% were female. The mean and standard deviation for age, height, weight, and BMI was 18.48 ± 0.68, 169.2 ± 8.2, 93.1 ± 14.4, and 32.5 ± 3.7 respectively. In the control group, 86.40% of the students were male and 13.60% were female. The mean and standard deviation for age, height, weight, and BMI was 18.27 ± 0.77, 174.6 ± 5.9, 93 ± 8.2, as well as 30.5 ± 1.86 respectively.

Table 1.

Demographic of participants (n = 43).

Gender Age Height Weight BMI
Male Female

Taichi Group

n = 21

 81% 19% 18.48 ± 0.68 169.2 ± 8.2 93.1 ± 14.4 32.5 ± 3.7

Control Group

n = 22

 86.40% 13.60% 18.27 ± 0.77 174.6 ± 5.9 93 ± 8.2 30.5 ± 1.86
Note: Percentage for Gender; Mean ± Std. Deviation for Age, Height, Weight, and BMI
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Effects of Taichi exercise on LBM, WC, and VO2max

As shown in Table 2; Fig. 2-A and -B, and Fig. 2-C, according to the paired T test, we can find that the mean of WC decreased from 105.6 ± 12.68 cm to 102.2 ± 12.17 cm, reducing it by 3.38 cm (P = 0.004, 95% CI, d = − 0.274). The mean of lean body mass increased from 58.6 ± 9.75 kg to 59.4 ± 10.06 kg, increasing it by 0.87 kg (P = 0.030, 95% CI, d = 0.081). The mean of VO2max had a slight change which shifted from 37.0 ± 5.63mL/kg/min to 38.7 ± 4.78mL/kg/min, which increased by 1.7 mL/kg/min (P = 0.284, 95% CI, d = 0.326).

Table 2.

Effects of Taichi exercise on LBM, WC and VO2max (n = 21).

Pretest (M ± SD) Posttest (M ± SD) Difference (Mean) Sig
WC 105.6 ± 12.68 102.2 ± 12.17 −3.38 0.004*
VO2max 37.0 ± 5.63 38.7 ± 4.78 1.7 0.284
LBM 58.6 ± 9.75 59.4 ± 10.06 0.87 0.030*
Note: M = Mean; SD = Std. Deviation. Statistic Significant level defined as 0.05
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Fig. 2.

Fig. 2

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The Results of TE and CG.

Effects of stretching exercise (control group) on LBM, WC, and VO2max

As is shown in Table 3; Fig. 2-D and -E, and Fig. 2-F, based on the paired T test, we can find that the mean of WC decreased from 101.6 ± 7.2 cm to 96.9 ± 12.27 cm, which was reduced by 4.68 cm (P = 0.007, 95% CI, d = − 0.467). Both VO2max and LBM just had marginal changes. The mean of VO2max had a slight change which raised from 40.1 ± 4.20mL/kg/min to 41.1 ± 4.62mL/kg/min, with an increase of 0.12 mL/kg/min (P = 0.991, 95% CI, d = 0.227). The mean of LBM rose from 61.1 ± 8.31 kg to 61.5 ± 7.60 kg, which increased by 0.40 kg (P = 0.547, 95% CI, d = 0.050).

Table 3.

Effects of stretching exercise on LBM, WC and VO2max (n = 22).

Pretest (M ± SD) Posttest (M ± SD) Difference (Mean) Sig
WC 101.6 ± 7.2 96.9 ± 12.27 −4.68 0.007*
VO2max 40.1 ± 4.20 41.1 ± 4.62 0.12 0.991
LBM 61.1 ± 8.31 61.5 ± 7.60 0.40 0.547
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The difference between the TE group and control group on LBM, WC, and VO2max

In order to compare the difference between the Taichi exercise group and the stretching exercise group. The researcher took a one-way MANOVA for it. The Multivariate Tests are shown in Table 4. We can find that the value of Wilks’ Lambda was 0.827, P > 0.05. Specifically, F (3, 39) = 2.721, P = 0.057; Wilk’s Λ = 0.827, partial η2 = 0.173. It highlighted that there was no statistically significant difference in WC, VO2max, as well as LBM based on OUS’ exercise group. In other words, there was no statistical difference in the Taichi exercise group and the control group (stretching exercise). However, there was still some difference between the Taichi exercise group and the control group. According to Tables 2 and 3, although both the Taichi exercise group and the control group (stretching exercise) had a significant effect on OUS’ waist circumference, the control group showed a better effect (reduced 4.68 cm) than the Taichi exercise group (reduced 3.38 cm). Besides, the Taichi exercise group had a significant effect on OUS’ lean body mass (increased 0.87 kg, P = 0.030), while the control group did not (just increased 0.40 kg, P = 0.547).

Table 4.

One way MANOVA for Taichi and control Group.

Effect Value F Hypothesis
df		 Error df Sig. Partial
Eta Squared
Group Pillai’s Trace 0.173 2.721 3.000 39.000 0.057 0.173
Wilks’ Lambda 0.827 2.721 3.000 39.000 0.057 0.173
Hotelling’s Trace 0.209 2.721 3.000 39.000 0.057 0.173
Roy’s Largest Root 0.209 2.721 3.000 39.000 0.057 0.173
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To summarize, although there was no statistical difference between the Taichi exercise group and the control group on WC, VO2max, and LBM for university students with obesity, Taichi exercise could improve both WC and LBM, while the control group only had effects on WC.

Discussion

This study had two primary objectives: (1) to evaluate the effectiveness of Tai Chi exercise (TE) on lean body mass (LBM), waist circumference (WC), and maximal oxygen uptake (VO2max) in university students with obesity (USO); and (2) to compare the effects of TE with those of the control group (engaging in normal exercise) on these variables. The main findings indicate that the TE group exhibited a significant positive effect on WC and LBM but had no measurable impact on VO2max. In contrast, the control group showed a significant reduction in WC but no significant changes in LBM or VO2max. Furthermore, while the TE group demonstrated superior outcomes—reducing WC and increasing LBM—compared to the control group, which only showed a reduction in WC, the difference between the two groups was not statistically significant. Based on these results, Hypotheses 1 and 2 are rejected: (1) TE did not lead to a statistically significant improvement in USO’s VO2max; and (2) the control group did show a significant improvement in WC. However, Hypothesis 3, which posits that TE has a greater effect than the control group, is supported.

As findings in previous research that Taichi exercise can dramatically reduce practitioners’ waist circumference30,31. This study also showed that Taichi exercise was effective for university students with obesity to reduce waist circumference. However, while the mean of the Taichi exercise group reduced 3.38 cm in WC, the mean of the control group (stretching exercise) dropped 4.68 cm. This outcome indicated that compared with Taichi exercise, stretching exercise showed a better result in losing waist circumference. Although some studies have found that stretching exercises can effectively reduce waist circumference32there is no comparison of the effectiveness of WC between Taichi exercise and stretching exercise. Moreover, the reason why stretching exercise performed better outcomes than Taichi is still uncertain. One potential assumption is that stretching exercise has more extensive movements on the waist than Taichi exercise. Specifically, stretching exercise is always practiced by lying down on the cushion so that the individual can release whole limbs to stretch the waist and abdomen; all movements of Taichi exercise are conducted by standing, which limits the extensive stretch of the waist. But it needs further study to confirm.

According to previous research, Taichi exercise can increase practitioners’ lean body mass7. Some potential reasons may contribute to it. Firstly, Taichi exercise can maintain insulin levels and make changes in cytokine levels, which are critical to lean body mass33. Secondly, Taichi exercise can stimulate the lower body’s strength and increase its low muscular mass which helps to preserve lean body mass34. Moreover, Taichi is a kind of aerobic exercise. Consistent with currently study, the combined aerobic and resistance training can significantly improve practitioners’ fat free mass35. This study further confirms that Taichi exercise had an obvious effect on lean body mass (averagely added 0.87 kg, P = 0.030), while stretching exercise did not (increased 0.40 kg, P = 0.547). It indicates that Taichi exercise is more effective than stretching exercise in preserving lean body mass.

Neither Taichi exercise (increased 1.70mL/kg/min, P = 0.284) nor stretching exercise (increased 0.12mL/kg/min, P = 0.991) had an effect on USO’s VO2max. This highlighted that Taichi and stretching exercise couldn’t improve VO2max for university students with obesity. According to previous research, high-intensity interval training (HIIT) has a significantly positive effect on VO2max while low and moderate exercise do not36–38. Both Taichi exercise and stretching exercise are low to moderate intensity exercise39,40which is too slight to stimulate lung function. Therefore, Taichi and stretching exercise had no influence on VO2max for university students with obesity.

The major value of this study is to bridge the implementation gap between Taichi exercise and the population sample. It is the first and original research that implements Taichi among the cohorts of university students with obesity. Moreover, this study tries to compare the difference between Taichi and normal exercise. Besides, the researcher and his team attempt to explain the reasons for the outcomes in the study.

This study has four main limitations. First, VO2max was estimated using a predictive formula rather than measured directly with advanced instruments. Compared to more precise methods, this approach may introduce measurement inaccuracies. Second, external variables were not controlled. Participants’ dietary habits and physical activity outside the training sessions were not monitored, potentially influencing the study’s outcomes. Third, the study lacked a detailed data collection timeline. Measurements were taken only before and after the intervention, capturing overall changes but not the progression of lean body mass (LBM), waist circumference (WC), and VO2max over time, thereby missing important patterns of change. Lastly, the study focused exclusively on a student cohort, which may limit the generalizability of the findings to other populations, such as adolescents and older adults.

In light of these limitations, three key recommendations are proposed for future research. First, more precise measurement instruments should be employed to enhance the accuracy of VO2max assessments, and additional variables should be considered to improve the comprehensiveness of the analysis. Second, implementing standardized meal plans or dietary guidelines could help control for the influence of nutrition on body composition, thereby minimizing the impact of uncontrolled variables. Third, incorporating intermediate measurements (e.g., at 4- and 8-weeks post-intervention) would allow researchers to track changes in LBM, WC, and VO2max throughout the study period. This would provide insight into when the training regimen begins to take effect and whether these effects are sustained over time. Furthermore, future studies should include diverse age groups and genders to determine whether Tai Chi exercise produces similar effects across different demographic populations.

Conclusion

Based on the results, this study demonstrates that Taichi exercise is more effective than stretching exercises in improving the physical health of university students with obesity. Specifically, Taichi exercise enhances lean body mass and reduces waist circumference, whereas stretching exercises only contribute to waist circumference reduction. Although Taichi exercise does not significantly impact VO2max, it remains a valuable physical activity for promoting overall health in this population. Future research should incorporate intermediate measurements and utilize more precise instruments to enhance the accuracy and depth of analysis.

Acknowledgements

We would like to thank all the students and staff who participated in and supported this study.

Abbreviations

TE

Taichi Exercise

USO

University Students with Obesity

LBM

Lean Body Mass

WC

Waist Circumference

VO2max

Maximal Oxygen Consumption

Author contributions

Yali Xu and Feng Wang make same contribution to this study. Yali Xu and Feng Wang make contribution investigation, analysis, and primary manuscript writing.Yali Xu and Feng Wang make contribution to supervising, revise, analysis program administration, and conception. Lei Yang contribute to prepare figure, table, and exercise guiding.Qiao Wei make contribution to ethical approval, training instruction.Annisa, Hutkemri, and Syed contribute to proofreading, validity, and so on.

Funding

This study has no funding support.

Data availability

The original data is available from the corresponding author (Dr Wang, Email: wangfeng@fsskj.upsi.edu.my) upon request.

Declarations

Competing interests

The authors declare no competing interests.

Ethical concerns

This study had received an ethical approval letter from the Ethical Panels of the Academic Committee, Anqing Normal University. All participants have signed the consent form to participate in this experiment.

Footnotes

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

These authors contributed equally: Yali Xu and Feng Wang.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The original data is available from the corresponding author (Dr Wang, Email: wangfeng@fsskj.upsi.edu.my) upon request.

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