The Natural “Yin-Yang” Transformation inside the Body

From Dr. Ma

The Natural “Yin-Yang” Transformation inside the Body

by Dr. Li-Jun Ma

Obesity is increasing worldwide, with 66% of adults in the US overweight, and 33% obese (1). The prevalence of childhood obesity in the United States has also increased substantially. Approximately 17 percent (or 12.5 million) of children and adolescents from 2 to19 years of age are obese. Obesity is an important risk factor for development of diabetes, hypertension, kidney disease, cardiovascular disease, and even cancer. Body weight is a big deal to us. Some people spend a lot of money on  diet pills. However, it is not just body weight or “fat” that matters.  “What is inside the fat” matters the most.

In 2003, scientists reported that in response to obesity, macrophages, the key cell component in the immune system, migrated and accumulated in the fat. These fat tissue infiltrated macrophages play an important role in adipose tissue inflammation and systemic insulin resistance (when your body responds poorly to insulin signaling, and therefore, the organs like skeletal muscles and liver can not use glucose to generate energy, therefore, your blood glucose levels rise up). Thus, obesity is not only a metabolic disease, it is also recognized as a state of low-grade inflammation.

Scientists recently discovered that there are, in general, two populations of macrophages: one is “bad” (yin), and the other one is “good” (yang). Those macrophages that migrate into the fat from the blood in response to the obesity state or the high-fat diet are “bad” (or pro-inflammatory) macrophages. However, those macrophages, which reside inside the fat when we are lean, are “good” (or anti-inflammatory) macrophages. These good macrophages generate anti-inflammatory molecules, including interleukin 10, and act to counteract the effects induced by bad macrophages. Interestingly, at certain conditions, some of the bad macrophages can be transformed and changed to good macrophages (2).  Therefore, it is not just the amount of fat that influences one’s health, it is what’s inside the fat, the balance of a pro-inflammatory versus an anti-inflammatory state (or the balance of Yin versus Yang), determines the local or systemic impacts by obesity.

The macrophages transforming from one state to another state during obesity is just one example of how natural Yin and Yang inside the body works, how the existing inner healing power in the body plays its protective role. I have been working in the fields of healthcare and medical research for over 25 years. In our long-term battle with many diseases including kidney diseases, cancers, diabetes and obesity, scientists have been developing medicines that can inhibit or reduce the fibrosis and/or inflammation, in order to slow down the progression of the underlying diseases. In the last decade, especially the last few years, it is very inspiring and exciting to witness that scientists are starting to uncover the robust intrinsic regenerative capacity of the human body.  New terms such as “reparative macrophages”, “myocyte death and renewal”, “coordinated signaling pathways”…. appeared frequently in scientific articles and news papers. This indicates that many “secret” inner healing molecules, cells or pathways, which already exist in the body, are being increasingly recognized and identified by scientists, researchers and clinicians. This new development in medical researche reinforces the critical importance of the “Yin-Yang” theory of balance which was developed in China thousands of years ago. According to the principals of Chinese medicine, when we treat a disease, we should not only try to eliminate or suppress the “xie” (or Yin), but also need to enhance or cultivate the “Zheng” (or Yang), and induce the transformation occurring through the inner healing system.

However, the process through which damaged cells are renewed and macrophages are transformed in the body are still largely unknown. Regular exercise reduces the risk of chronic metabolic and cardiovascular diseases. Very interestingly, recent research data reveals that regular exercise training inhibits inflammation in the fat via both suppressing the bad macrophage infiltration and also helping and facilitating bad macrophage “transformation” into good, anti-inflammatory macrophages in obese state (3). Postulated mechanisms of how regular exercise exerts its anti-inflammatory effects via both a reduction in fat mass (with a subsequent decreased release of adipokines) and the induction of an anti-inflammatory environment have been elegantly reviewed in Nature Review Immunology recently (4).

Tai Chi and Qigong have been shown to be beneficial in the treatment of many chronic conditions, including type 2 diabetes (5, 6). It will be intriguing to examine the effects of Tai Chi and/or Qigong on these two different macrophage functions in obesity, diabetes or other chronic diseases, to uncover the secrets of the inner “Yin-Yang” system in our body modulated by Tai Chi and Qigong, the ancient pathway to health transformation and the process of healing.


(1) Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR & Flegal KM: Prevalence of

overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA 291:

2847-2850, 2004.

(2) Lumeng CN, Bodzin JL, Saltiel AR. Obesity induces a phenotypic switch in adipose tissue macrophage polarization. J Clin Invest 117(1):175-184, 2007

(3) Kawanishi N, Yano H, Yokogawa Y, Suzuki K. Exercise training inhibits inflammation in adipose tissue via both suppression of macrophage infiltration and acceleration of phenotypic switching from M1 to M2 macrophages in high-fat-diet-induced obese mice. Exerc Immunol Rev:16:105-18, 2010
(4) Michael Gleeson, Nicolette C. Bishop, David J. Stensel, Martin R. Lindley, Sarabjit S. Mastana & Myra A. Nimmo. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immuno 11: 607, 2011

(5) Yeh SH, Chuang H, Lin LW, Hsiao CY, Wang PW, Liu RT, Yang KD. Regular Tai Chi Chuan exercise improves T cell helper function of patients with type 2 diabetes mellitus with an increase in T-bet transcription factor and IL-12 production. Br J Sports Med 43(11):845-850, 2009

(6) Chen KW, Liu T, Zhang H, Lin Z. An analytical review of the Chinese literature on Qigong therapy for diabetes mellitus.  Am J Chin Med 37(3):439-547, 2009

[Li-Jun Ma, M.D. was a nephrologist in China before coming to America in 1995. Dr. Ma is a Research Associate Professor in the Department of Pathology, Microbiology and Immunology at Vanderbilt University Medical Center. Dr. Ma’s researches are focused on studying the profibrotic and proinflammatory mechanisms of renal fibrosis and kidney complications caused by diabetes and obesity. In 1971, Li-Jun Ma started studying Tai Chi Chuan at the age of seven with Master XiFang Chen (who was from Chen village) in Luohe, Henan province of China. In 1999, Dr. Ma won one gold medal and one silver medal for his competition performance of 24-form Tai Chi Chuan and 32-form Tai Chi Sword in Chicago Wushu Tournament. Since 1999, Dr. Ma has been actively teaching and promoting Tai Chi in the Nashville area (including The Nashville Chinese School, YMCA, MTSU, and at Fannie Mae Dees Park). From 2009 to present, due to his medical background and extensive Tai Chi experience, he is selected as an instructor for teaching “Therapeutic Tai Chi” classes at Vanderbilt Center for Integrative Health (VCIH). The overall goals of the Tai Chi classes Dr. Ma is teaching at VCIH are these: (1) Teach people to learn this ancient Chinese approach to achieve mind and body relaxation and to reduce stress. (2) Instruct patients who have chronic medical conditions how to use Tai Chi and Qigong, mind-body exercise tools of complementary and alternative medicine, to facilitate the healing process of their chronic illnesses and diseases. The class schedule can be found in the website of VCIH at Vanderbilt (]


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