Why are yoga and tai chi (Traditional Chinese exercise) appropriate culturally sensitive exercises for Chinese patients with metabolic disorders, such as diabetes mellitus (DM) and dyslipidemia?

From the Guidelines

Yoga and tai chi are appropriate culturally sensitive exercises for Chinese patients with metabolic disorders, such as diabetes mellitus (DM) and dyslipidemia, because they align with traditional Chinese health philosophies while providing effective physical benefits. These practices are rooted in Eastern traditions that emphasize balance, energy flow, and mind-body connection, making them more culturally acceptable and familiar to Chinese patients. Tai chi specifically originates from Chinese martial arts and philosophical traditions, creating an immediate cultural resonance. Both exercises offer gentle, low-impact movements that are particularly beneficial for metabolic disorders as they improve insulin sensitivity, reduce stress hormones, enhance cardiovascular function, and promote weight management without requiring intense exertion. The meditative aspects of these practices also address the psychological components of metabolic health by reducing stress and improving sleep quality. For implementation, patients should begin with 20-30 minute sessions 2-3 times weekly under qualified instruction, gradually increasing to 4-5 sessions per week, as recommended by recent guidelines 1. These exercises complement conventional medical treatments for conditions like diabetes, hypertension, and obesity while respecting cultural values and health beliefs, potentially improving patient adherence to exercise recommendations. Some key benefits of these exercises include:

• Improving insulin sensitivity and reducing stress hormones
• Enhancing cardiovascular function and promoting weight management
• Addressing psychological components of metabolic health by reducing stress and improving sleep quality
• Being gentle and low-impact, making them suitable for patients with mobility issues or other limitations
• Aligning with traditional Chinese health philosophies, making them more culturally acceptable and familiar to Chinese patients. Recent studies have shown that yoga and tai chi can have significant impacts on A1C, flexibility, muscle strength, and balance, making them a valuable addition to conventional medical treatments for metabolic disorders 1. Overall, incorporating yoga and tai chi into treatment plans for Chinese patients with metabolic disorders can have a positive impact on their physical and mental health, while also respecting their cultural values and beliefs.

From the Research

Cultural Sensitivity of Yoga and Tai Chi for Chinese Patients

• Yoga and Tai Chi are considered culturally sensitive exercises for Chinese patients with metabolic disorders, such as diabetes mellitus (DM) and dyslipidemia, due to their origins and popularity in Chinese culture 2, 3.
• These exercises have been shown to be effective in reducing cardiovascular disease risk factors, improving psychosocial well-being, and managing metabolic syndrome, hypertension, and diabetes 2, 4, 5, 3.

Benefits of Tai Chi for Metabolic Disorders

• Tai Chi has been found to significantly lower blood pressure, fasting blood sugar, and glycated haemoglobin, and improve perceived mental health and exercise self-efficacy in adults with hypertension and metabolic disorders 2, 3.
• A meta-analysis of 57 studies found that Tai Chi exerted an improvement on systolic blood pressure, diastolic blood pressure, triglyceride, and fasting blood glucose concentrations among middle-aged and elderly individuals 3.
• Tai Chi has also been shown to have excellent evidence of benefit for preventing falls, osteoarthritis, Parkinson disease, and improving cognitive capacity in older adults, as well as good evidence of benefit for depression, cardiac and stroke rehabilitation, and dementia 6.

Recommendations for Exercise in Metabolic Disorder Management

• Regular exercise, including moderate- to high-intensity aerobic exercise, dynamic resistance exercise, and isometric exercises, is recommended for the management of metabolic syndrome, diabetes, and hypertension 4, 5.
• The general recommendations for exercise in disease management guidelines include a regimen of physical activity with moderate- to high-intensity exercise of 30-min bouts on multiple days, with a desired goal of a total of 150 min of exercise per week 4, 5.
• Tai Chi, as a gentle form of aerobic exercise, is recommended for a minimum duration of 16 weeks, with each session lasting 30-50 min and conducted 6-7 times per week, without any restrictions on the style employed 3.