Autonomic cardiac function, body composition and cardiorespiratory fitness changes in adolescents after a multidisciplinary obesity treatment program: a feasibility study
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This feasibility study aimed to analyze the effects of a multidisciplinary (e.g., psychological, nutritional and water-based exercise interventions) obesity treatment program on resting heart rate variability (rHRV) indices according to the degree of excess body mass (overweight vs obesity) in adolescents. Additionally, we tested the association between changes in rHRV indices with changes in body composition and cardiorespiratory fitness.
Twenty-five adolescents completed the study, 11 from the overweight group (OWG) and 14 from the obese group (OBG) classified according to body mass index. Anthropometric measures, autonomic cardiac function (measured by rate-to-rate interval analyses), lean mass and body fat, and cardiorespiratory fitness were assessed prior to and after the 16-week intervention period.
Both groups increased their parasympathetic indices (e.g., standard deviation 1) [OWG: Δ = 8.5 (1.7–15.3) ms; magnitude of change: “likely”; OBG: Δ = 11.4 (4.3–18.4) ms; “very likely”] and cardiorespiratory fitness [OWG: Δ = 2.0 (1.1–2.8) mL/kg/min; “likely”; OBG: Δ = 2.4 (1.5–3.3) mL/kg/min; “Almost certain”] with a slightly greater magnitude of change for the OBG. The OWG showed greater changes in body composition [e.g., body fat: Δ = −3.2 (–4.6 to −1.8) kg “Very likely”] when compared to the OBG [Δ = −2.8 (−4.4 to −1.3) kg “Possible”]. Inverse and large correlations were noted for changes in body fat markers (%) and changes in parasympathetic indices of rHRV (%) (i.e., rMSSD and SD1).
These results provide evidence that a multidisciplinary program improves parasympathetic indices, body composition, and cardiorespiratory fitness independent of the degree of excess body mass.
KeywordsPediatric obesity Intervention studies Parasympathetic indices Body composition Cardiorespiratory fitness
Body mass index
Resting heart rate
Obese adolescent group
Overweight adolescents group
Resting heart rate variability
Square root of the mean of the squares of successive R–R interval differences
Standard deviation 1 of instantaneous beat-to-beat R–R interval variability measured from Poincare plots
Maximal oxygen consumption
The authors thank the members of the Multiprofessional Nucleus of Obesity Treatment program for their contribution to data collection and intervention development; they also thank the Araucaria Foundation (Agreement 179/10, protocol 19213) and Capes (501100002322) for financial support.
Compliance with ethical standards
This study was funded by Araucaria Foundation (agreement 179/10, protocol 19213).
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the local Ethics Committee (protocol 463/2009). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study as well as their guardians.
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