Abstract
The autonomic control of the heart is abnormal in obese subjects due to a prevalence of sympathetic over parasympathetic limb of the autonomic balance. We evaluated the effects of a short-term (3 weeks) integrated body weight reduction program (consisting of energy restricted diet and high-intensity exercise training) on heart rate variability (HRV) in severely obese, normotensive patients. The HRV was evaluated both in the time and frequency domain over a 18-hour Holter recording period obtained before and at the end of the third week. Three-week body weight reduction program reduced BMI (from 41.4±4.6 to 39.5±4.3 kg/m2, −4.6%, p<0.0001) and heart rate (from 77.8±8.6 to 73.6±8.7 b/min, p=0.0003). Significant changes in the autonomic profile were observed both in the time and frequency domain (SD of RR interval, SDRR: +16.1%; mean squared successive difference: (MSSD) +16.7%; percentage of RR intervals differing more than 50 msec from the preceding one, pNN50: +31.8%; low frequency oscillation, LF: +17.1%; high frequency oscillation, HF: ±18.2%). In conclusion, this study demonstrates that a short-term, integrated body weight reduction program is able to favorably modify the autonomic profile in a population of normotensive, severely obese subjects. The reduction of heart rate and the increase in parasympathetic activity may consistently contribute to a reduction of the risk of cardiovascular morbidity and of sudden cardiac death, still high in this patients’ group.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Karason K., Molgaard H., Wilkstrand J., Sjostrom L. Heart rate variability in obesity and the effect of weight loss. Am. J. Cardiol. 1999, 83: 1242–1247.
Amano M., Kanda T., Ue H., Moritani T. Exercise training and autonomic nervous system activity in obese individuals. Med. Sci. Sports Exerc. 2000, 33: 287–1291.
Emdin M., Gastaldelli A., Muscelli E., et al. Hyperinsulinemia and autonomic nervous system dysfunction in obesity. Effects of weight loss. Circulation 2001, 103: 513–519.
Rossi M., Marti G., Ricordi L. et al. Cardiac autonomic dysfunction in obese subjects. Clin. Sci. 1989, 76: 567–572.
Grassi G., Seravalle G., Cattaneo B.M. et al. Sympathetic activation in obese normo-tensive subjects. Hypertension 1995, 25 (part 1): 560–563.
Grassi G., Seravalle G., Colombo M. et al. Body weight reduction, sympathetic nerve traffic and arterial baroreflex in obese normotensive humans. Circulation 1998, 97: 2037–2042.
Malfatto G., Facchini M., Sala L., Branzi G., Bragato R., Leonetti G. Short and long term effects of exercise training on the tonic autonomic modulation of heart rate variability after myocardial infarction. Eur. Heart J. 1996, 17: 532–538.
Levy W.C., Cerqueira M.D., Harp G.D. et al. Effects of endurance exercise training on heart rate variability at rest in healty young and older men. Am. J. Cardiol. 1998, 82: 1236–1241.
Malfatto G., Branzi G., Riva B., Sala L., Leonetti G., Facchini M. Recovery of cardiac autonomic responsiveness with low-intensity physical training in patients with chronic heart failure. Eur. J. Heart Fail. 2002, 4: 159–166.
ACSM’s resource manual for guidelines for exercise testing and prescription. 6th edition, Baltimore, Lippincot, Williams & Wilkins, 2000.
Deurenberg P. International consensus conference on impedance in body composition. Age Nutr. 1994, 5: 142–145.
Peterson H.R., Rothschild M., Weinberg C.R., Fell R.D., Mc Leish K.R., Pfeifer M.A. Body fat and the activity of the autonomic nervous system. N. Engl. J. Med. 1988, 318: 1077–1083.
Aronne L.J., Mackintosh R., Rosembaum M., Liebel R.L., Hirsch J. Cardiac autonomic nervous system activity in obese and never-obese young men. Obes. Res. 1997, 5: 354–359.
Petretta M., Bonaduce D., De Filippo E. et al. Assessment of cardiac autonomic control by heart period variability in patients with early-onset familial obesity. Eur. J. Clin. Invest. 1995, 25: 826–832.
Hirsch J., Leibel R.L., Mackintosh R., Aguirre A. Heart rate variability as a measure of autonomic function during weight change in humans. Am. J. Physiol. 1991, 261: R1418–R1423.
Van Vliet B.N., Hall J.E., Mizelle H.L., Montani J.P., Smith M.J. Reduced parasympathetic control of heart rate in obese dogs. Am. J. Physiol. 1995, 269: H629–H637.
Truett A.A., Borne A.T., Poincot M.A., West D.B. Autonomic control of blood pressure and heart rate in obese hypertensive dogs. Am. J. Physiol. 1996, 270: R541–R549.
Smith M.L., Hudson D.L., Graitzer H.M., Raven P.B. Exercise training bradycardia: the role of autonomic balance. Med. Sci. Sport Exerc. 1989, 21: 40–44.
Aronne L.J., Mackintosh R., Rosenbaum M., Liebel R.L., Hirsch J. Autonomic nervous system activity in weight gain and weight loss. Am. J. Physiol. 1995, 269: R222–R225.
Kansanen M., Vanninen E., Tuunainen A. et al. The effect of very low-calorie diet-induced weight loss on the severity of obstructive sleep apnoea and autonomic nervous function in obese patients with obstructive sleep apnoea syndrome. Clin. Physiol. 1998, 18: 377–385.
O’Leary D.S., Seamans D.P. Effect of exercise on autonomic mechanisms of baroreflex control of heart rate. J. Appl. Physiol. 1993, 75: 2251–2257.
Dornfeld L.P., Maxwell M.H., Waks A.V., Schroth P., Tuck M.L. Obesity and hypertension: long-term effects of weight reduction on blood pressure. J. Obes. Relat. Metab. Disord. 1985, 9: 381–389.
Peronnet F., Cleroux J., Perrault H., Cosineau D., de Champlain J., Nadeau R. Plasma norepinephrine response to exercise before and after training in humans. J. Appl. Physiol. 1981, 51: 812–815.
Domh G.L., Pennington S.N., Baraket H. Effect of physical training on adenyl cyclase and phosphodiesterase in skeletal muscle, heart and liver. Biochem. Med. 1976, 16: 138–142.
Werle E.O., Strobel G., Weicker H. Decrease in rat cardiac beta 1 and beta 2 adrenoreceptors by training and endurance exercise. Life Sci. 1990, 46: 9–17.
La Rovere M.T., Mortara A., Sandrone G., Lombardi F. Autonomic nervous system adaptation to short-term exercise training. Chest 1992, 101: 299S–303S.
Sartorio A., Lafortuna C.L., Vangeli V., Tavani A., Bosetti C., La Vecchia C. Short-term changes of cardiovascular risk factors after a non-pharmacological body weight reduction program. Eur. J. Clin. Nutr. 2001, 55: 865–869.
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article is available at http://dx.doi.org/10.1007/BF03345151.
Rights and permissions
About this article
Cite this article
Facchini, M., Malfatto, G., Sala, L. et al. Changes of autonomic cardiac profile after a 3-week integrated body weight reduction program in severely obese patients. J Endocrinol Invest 26, 138–142 (2003). https://doi.org/10.1007/BF03345142
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03345142