| Summary: | This study examined the effectiveness of Tai-Chi and running exercises on cardiorespiratory fitness and biomarkers in sedentary middle-aged adults under 24 weeks of supervised training. Methods Thirty-six healthy middle-aged adults (55.6 ± 5.3 yr) were randomly assigned into Tai-Chi, running and control groups. During a 24-week training period, the Tai-Chi and running groups were asked to perform exercises for 60 min/day and 5 days/week, which were supervised by Tai-Chi and running instructors throughout. Resting heart rate, lean mass, blood pressure and blood lipids were measured, and cardiorespiratory fitness (VO<sub>2max</sub>, V<sub>max</sub> and Peak heart rate) was assessed at the baseline and the 12- and 24-week interventions. Results Compared to the no-exercise control group, both the Tai-Chi and running groups significantly decreased resting heart rate, diastolic blood pressure and cardiorespiratory fitness and increased lean mass across the training session (<i>p</i> < 0.05). Compared to the Tai-Chi group, the running group showed greater improvement in VO<sub>2max</sub> and V<sub>max</sub> (<i>p</i> < 0.05) and reduced triglyceride and low-density lipoprotein cholesterol (<i>p</i> < 0.05). Conclusion Both Tai-Chi and running exercise showed beneficial effects on cardiorespiratory fitness and enhanced health-related outcomes in middle-aged adults. Although Tai-Chi exercises were less effective in VO<sub>2max</sub> than running, Tai-Chi may be considered as a plausible alternative to running exercises that can be achieved in the indoor-based setting.
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