The aim of this systematic review and meta-analysis is to evaluate existing randomized clinical trials (RCTs) regarding the overall effect of tai chi exercise on lipid profiles. 

Electronic databases (MEDLINE and Cumulative Index to Nursing and Allied Health Literature) were searched. The authors included only English peer reviewed published RCTs that used a tai chi intervention and high-density lipoprotein cholesterol (HDL-C) as the primary outcome along with low-density lipoprotein cholesterol (LDL-C) and/or total cholesterol (TC) as secondary outcomes. 

The authors identified 37 potentially eligible studies. Only eight RCTs were eligible for their qualitative review, and seven studies were eligible for meta-analysis. The included studies were rated as having a low risk of bias. Despite the overall low risk of bias, all studies failed to blind participants to group assignment and were generally unclear about whether they were selectively reporting data. A fixed effect model (I2 = 38.16%) demonstrated a small positive effect of tai chi on HDL-C (Cohen d = 0.12; standard error [SE] = 0.067; p = 0.037). A random effect model demonstrated a medium effect and small effect for LDL-C (Cohen d = 0.47; SE = 0.347; p = 0.089) and TC (Cohen d = 0.34; SE = 0.225; p = 0.066), respectively. 

Tai chi may potentially be beneficial on lipid profiles across different age groups and populations. Although there were conflicting results regarding the effect of tai chi on lipid profiles, the majority of studies had at least a small positive effect indicating a potential positive effect of tai chi on HDL-C, LDL-C, and/or TC. Therefore, further research is needed to confirm the small positive effect of tai chi on lipid profiles found in this review.