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Tai Chi for High Cholesterol

Medical Report: Hypercholesteremia and Tai Chi

Author: Eric L. Zielinski 


 Although the reasons explaining why are hotly debated, the general consensus in the medical community is that elevated levels of cholesterol (hypercholesteremia) is a primary risk factor for heart disease. One camp claims that that cholesterol is the main instigator in arterial occlusion much like septic sludge clogging up a drain pipe; whereas the other group supports the theory that cholesterol damages the inner walls of blood vessels and causes a dangerous inflammatory cascade that will lead to plaque build-up and atherosclerosis. In either case, the global health care system has waged war against cholesterol for decades now and, in spite of the billions of dollars spent on costly drug and surgical interventions every year, cardiovascular disease remains the number cause of death worldwide. It is, therefore, exciting to learn that research supports natural, non-invasive approaches like Tai Chi may help.




Cholesterol is a steroid alcohol, a waxy lipid-soluble substance found only in animal tissues. Since less than half of the required cholesterol in the body is made by the liver and intestines the remaining amount needs to be eaten. In fact, cholesterol is so absolutely vital for human life that if we do not consume enough of it in our diet (about 6 to 8 eggs yolks worth per day), the liver will be stressed to make up the difference. Ultimately, this may cause liver damage and can lead to significant health issues. The significance of cholesterol is seen by its necessary contribution to the following:


  • Brain synapses – made almost entirely of cholesterol.
  • Bile – cholesterol being a key component.
  • Cell membranes – in which cholesterol is a primary component.
  • Sex hormones – cholesterol being the precursor to every one; namely, progesterone, estrogen and testosterone.
  • Vitamin D – synthesized from cholesterol by sunlight acting on the skin. 


It is believed that if dietary intake of fats and high cholesterol foods exceed the immediate fuel needs of the liver, the excess is converted to low density lipoproteins (LDL) – commonly referred to as “bad cholesterol” 


Not so simple in its formation, high density lipoproteins (HDL) are created by a number of mechanisms. Not much is known of HDL’\s, but it is believed that they possess a very unique quality. In a process known as “reverse cholesterol transport,” they are purported to remove cholesterol crystals from cholesterol-saturated cells and return them to the liver for further processing into bile acids and other particles. Thus, the title commonly given to HDL’s, “Good Cholesterol.”


Medical Research and Management


Due to their oxidated, free-radical nature, excess LDL presented in the blood are readily attacked by macrophages (scavenger cells) near arterial endothelial cells. Because macrophages are not subject to down-regulation, the continued presence of oxidatively modified LDL causes them to get absorbed into the cell membrane, resulting in injury (lesion formation). Becoming engorged with lipids, macrophages form foam cells, which accumulate in the subendothelial space and develop the first signs of atherosclerotic plaque (i.e. fatty streak). This is believed to induce an inflammatory response, triggering atherosclerosis.


Therefore, medical management centers on reducing LDLs and increasing high density lipoproteins HDLs through a variety of methods.


Some physicians will approach lifestyle behaviors before prescribing drug therapies for mild to moderate cases. Examples of this include diet, exercise, smoking cessation and stress-relief techniques. Others are more prone to prescribe drugs immediately, which all depends on personal preference. 


Typically, the first medicine prescribed to treat hypercholesterolemia are statins. These inhibit HMG-CoA reductase, a crucial enzyme needed for cholesterol production, thus lowering LDL and triglyceride production in the liver. Statins are also known for raising HDLs, though, to a lesser degree. There is strong inference that they have a role in decreasing inflammation leading to atheromatous plaques. The side effects can be serious: muscle and liver toxicity; kidney failure; peripheral neuropathy; reduction of Coenzyme Q10. 


The IMS Institute For Healthcare Informatics stated in their most recent report, “The Use of Medicines in the United States: Review of 2010,” that spending on lipid regulators increased by $160 million in 2010. More than 255 million prescriptions were issued for these drugs in 2010, making them the most commonly prescribed medication in the U.S.


According to WebMD, B-complex vitamin, nicotinic acid (niacin), has been used for decades to lower LDLs and triglycerides and raise HDLs. Also known for increasing cholesterol size, niacin prevents bad cholesterols from migrating into arterial walls and oxidizing though, recent research suggests that niacin is not associated with lowered risk of CVD. Side effects include: flushing; itching; tingling; headache. Examples include Nicolar and Niaspan.


Research showing Tai Chi’s ability to help decrease hypercholesteremia


In 2011, University of Miami, School of Medicine conducted a review of literature to determine the widespread effects Tai Chi has on the body. In addition to outlining the various benefits related to psychological disorder, pain syndromes and immune conditions like diabetes and HIV, researchers discovered that “cardiovascular changes following Tai Chi include decreased heart rate and blood pressure, increased vagal activity and decreased cholesterol.” As seen above, cholesterol plays a global role in the body. Subsequently, properly managing it is best achieved by taking a holistic approach to health and wellness. Mind-body interventions like Tai Chi, for instance, have a profound effect on every component of the body and contributes greatly to heart health and balanced cholesterol levels. 


  • Measuring the effects Tai Chi has on cardiovascular risk factors in post-menopausal women, Chungnam National University, Daejeon, Korea researchers took 60 women and randomly selected 29 to participate in a six-month Tai Chi program and compared them to 31 volunteers who did not. According to the 2009 paper published in the Journal of Korean Academy of Nursing, “After 6 months of Tai Chi exercise, total cholesterol (213 to 185), LDL-cholesterol (135 to 128), and their 10 year cardiovascular disease risk (2.62 to 2.27) had improved significantly for the Tai Chi participants compared to the control group.” In addition, hypercholesteremia risk factors were also reduced as “total scores for quality of life along with the sub-dimensions of health perception and mental functioning were also significantly higher in the Tai Chi participants.”
  • In 2010, the Journal of Alternative and Complementary Medicine published work from Chung Shan Medical University researchers who tested the effects Tai Chi has on biochemical profiles and oxidative stress indicators in obese patients with type 2 diabetes.  Upon engaging in a 12 week Tai Chi program in which volunteers participated in one hour sessions three times per week, it was discovered that those participating in Tai Chi experienced significant regulation in their lipid profiles in comparison to a control group that participated in conventional exercise. For example, the Tai Chi’s group’s triglyceride levels were 171 in comparison to 214 from the control group and their HDL’s raised to 45 in comparison to 38.  In addition, C-reactive protein also decreased, which highlights Tai Chi’s ability to lower total body inflammation; a primary cause of hypercholesteremia. 
  • The American Journal of Geriatric Psychiatry printed a study in 2012 that reports the results of UCLA researchers evaluating the effects Tai Chi has on markers of inflammation in older adults.  Of the total of 83 healthy older adults, aged 59 to 86 years who participated, some were randomly selected to be part of a 16-week group Tai Chi program and others selected to be part of a control arm in which they experienced group health education. The primary data collected was circulating levels of interleukin 6 (IL-6) – an immune response heavily involved in the natural inflammatory process that indicates risk for heart disease. Secondary outcome measures evaluated were similar types of inflammatory markers: C-reactive protein, soluble IL-1 receptor antagonist, soluble IL-6 receptor, soluble intercellular adhesion molecule, and IL-18. In addition, severity of depression symptoms, sleep quality, and physical activity was also assessed over the treatment trial. The results were astonishing and highlight Tai Chi’s ability to help regulate the entire body and not just in regards to CVD. Not only was it reported that the Tai Chi group had greater drops in IL-6 than the control group, those with the highest IL-6 at the beginning of the study (and thereby were most at risk of a heart attack) experienced the greatest decline. In addition, the volunteers also experienced decreased depression symptoms that the researchers linked to the drop in IL-6. In summary, the researchers concluded, “[Tai Chi] can be considered a useful behavioral intervention to reduce circulating levels of IL-6 in older adults who show elevated levels of this inflammatory marker and are at risk for inflammation-related morbidity.”
  • Also in 2012, The Journal of Nutrition, Health and Aging reported on a study in which researchers from the National Autonomous University of Mexico was able to prove that Tai Chi reduced oxidative stress in a Mexican elderly population. Of the 55 people who were recruited for the study, 32 were randomly chosen to participate in 50-minute daily Tai Chi session and 23 were chosen as a control group. Before and after six months of intervention the following outcome measure were evaluated: thiobarbituric acid reactive substances (TBARS), total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase (GPx). According to the researchers, “It was found that the experimental group exhibited a statistically significant decrease in glucose levels, total cholesterol, low-density lipoprotein cholesterol (LDLC), and systolic blood pressure, as well as an increase in SOD and GPx activity and TAS compared with the control group.”
  • In 2013, The Journal of Nursing reviewed the effects Tai Chi has on blood pressure, blood sugar and blood lipid control for patients with chronic diseases. By reviewing six electronic databases for related articles published between 1990 and 2011, Chang Gung University of Science and Technlogy researchers were able to collect from seven studies in which 947 people participated in clinical trials. They concluded that risk factors leading to CVD were minimized by Tai Chi by stating, ”Systematic review results indicate that Tai Chi interventions have a significant and positive effect on blood pressure and lipid levels.” 




As the research supporting Tai Chi’s ability to normalize blood lipids grows, it is vital for physicians to balance more aggressive treatments with alternative solutions. One day it is our hope that Tai Chi will become an integral component to the regular management of cardiovascular disease. It is cost-effective, proven to be completely safe and has an astounding effect on overall health and wellness.


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