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Tussana Jaruchart


Obesity is an excess of body fat, generally, caused by an energy imbalance between calories consumed and calories expended, which can lead to a cause of noncommunicable diseases, especially cardiovascular diseases (hypertension, heart disease, and stroke) diabetes, musculoskeletal disorders, some cancers, Alzheimer’s disease, and dementia. Individuals with obesity has a high risk of premature death when compared with underweight. There is evidence that increased waist hip ratio, as an indicator of visceral adiposity, was significantly associated with malfunction of autonomic activity in obesity. Notably, This is an imbalance of sympathetic and parasympathetic activity, in favor of an increase in sympathetic or a decrease in parasympathetic activity. This results in deteriorations in cardiovascular health of obesity. Heart rate variability (HRV) is a non-invasive tool for assessment and prediction of the future health. In clinical settings, heart rate variability can be used as a marker to reflect the cardiac modulation of the autonomic nervous system in patients with obesity. The analysis and assessment of HRV includes time-domain parameters and frequency-domain parameters analysis. Recently, there is evident indicating that obesity–related malfunction of autonomic activity can be improved by weight reduction, nutritional consumption, and regular exercise, leading loading to improve sympathetic and parasympathetic activity in obesity.


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Jaruchart, T. (2020). AUTONOMIC NERVOUS SYSTEM ACTIVITY AND HEART RATE VARIABILITY IN OBESITY. Journal of Sports Science and Health, 21(2), 177–194. Retrieved from
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Adam, M., Imboden, M., Schaffner, E., Boes, E., Kronenberg, F., Pons, M., et al. (2017). The adverse impact of obesity on heart rate variability is modified by a NFE2L2 gene variant: The SAPALDIA cohort. International Journal of Cardiology, 228, 341-346.

Ahmed, S., Ahmed, M.S., Mahmoud, W.S., Abdelbasset, W.K., Elnaggar, R.K. (2019). Effect of high intensity interval training on heart rate variability and aerobic capacity in obese adults with type 2 diabetes mellitus. Bioscience Research, 16(3), 2450-2458.

Anstey, K.J., Cherbuin, N., Budge, M., Young, J. (2011). Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obesity Reviews, 12, e426-437.

Anthony, K., Reed, L.J., Dunn, J.T., et al. (2006). Attenuation of insulin-evoked responses in brain networks controlling appetite and reward in insulin resistance: the cerebral basis for impaired control of food intake in metabolic syndrome?. Diabetes, 55, 2986-2892.

Bibiloni., M.D.M., Pons, A., and Tur, J. A. (2013). Prevalence of overweight and obesity in adolescents: a systematic review. International Scholarly Research Notices Obesity, 2013, 1-14.

Bruning, J.C., Gautam, D., Burks, D.J. et al. (2000). Role of brain insulin receptor in control of body weight and reproduction. Science, 289, 2122-2125.

Buch, A.N., Coote, J.H., Townened, J.N. (2002). Mortrality, cardiac vagal, control and physical training – What’s the link?. Experimental Physiology, 87, 423.435.

Chethan, H.A., Murthy, N., and Basavaraju, K. (2012). Comparative study of heart rate variability in normal and obese young adult males. International Journal of Biological & Medical Research, 3(2), 1621-1623.

Delaney, J.P.A., Leong, K.S., Watkins, A., and Brodie, D. (2002). The short-term effects of myofascial trigger point massage on cardiac autonomic tone in healthy subjects. Journal of Advanced Nursing, 37(4), 364-371.

Dietrich, D. F., Ackermann-Liebrich, U., Schindler, C., Barthelemy, J. C., Brandli, O., Gold, D. R., et al. (2008). Effect of physical activity on heart rate variability in normal weight, overweight and obese subjects: results from the SAPALDIA study. European Journal of Applied Physiology, 104(3), 557-565.

Dong, J. G. (2016). The role of heart rate variability in sports physiology. Experimental and Therapeutic Medicine, 11(5), 1531-1536.

Ferreira, L.F., Rodrigues, G.D., and da Silva Soares, P.P. (2017). Quantity of aerobic exercise training for the improvement of heart rate variability in older adults. International Journal of Cardiovascular Sciences, 30(2), 157-162.

Ghouse, S.M., Barwal, S.B., and Wattamwar, A.S. (2016). A review on obesity. Health Science Journal, 10(4), 1-5.

Grassi, G., Seravalle, G., Colombo, M. (1998). Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans. Circulation, 97, 2037-2042.

Guarino, D., Nannipieri, M., Iervasi, G., Taddei, S., and Bruno, R. M. (2017). The role of the autonomic nervous system in the pathophysiology of obesity. Frontiers in Physiology, 8, 1-16.

Husin, H.M., Schleger, F., Bauer, I., Fehlert, E., Fiefer-Schmidt, I., Weiss, M., et al. (2020).Maternal weight, weight gain and metabolism are associated with changes in fetal heart rate and variability. Obesity Biology and Integrated Physiology, 28, 114-121.

Jitnarin, N., Kosulwat, V., Rojroongwasinkul, N., Boonpraderm, A., Haddock, C., and Poston, W. (2011). Prevalence of overweight and obesity in Thai population: results of the national Thai food consumption survey. Eating and Weight Disorders, 16(4), e242-249.

Jordan, S.D., Konner, A.C., Bruning, J.C. (2010). Sensing the fuels: glucose and lipid signaling in the CNS controlling energy homeostasis. Cellular Molecular Life Sciences, 67, 3255-3273.

Kaila, B., and Raman, M. (2008). Obesity: Review of pathogenesis and management strategies. Canadian Journal of Gastroenterology, 22(1), 61-68.

Karmali, S. N., Sciusco, A., May, S. M., and Ackland, G. L. (2017). Heart rate variability in critical care medicine: a systematic review. Intensive Care Medicine Experimental, 5(33).

Kentish, S., Li, I.I., Philp, L.K., et al. (2012). Diet-induced adaptation of vagal afferent function. Journal of Physiology (London), 590, 209-221.

Manimmanakorn, N., Manimmanakorn, A., Vichiansiri, R., Saengsuwan, J., and Leelayuwat, N. (2018). Heart rate variability assessment and clinical uses. Journal of Thai Rehabilitation Medicine, 28(1), 32-36.

Martini, G., Riva, P., Rabbia, F., Molini, V., Ferrero, G.B., Cerutti, F., et al. (2001). Heart rate variability in childhood obesity. Clinical Autonomic Research, 11, 87-91. Miller, G.D. (2019). Appetite regulation: Hormones, peptides, and neurotransmitters and their role in obesity. American Journal of Lifestyle Medicine, 13(6), 586-601.

Mirescu, S.C., Ciocoiu, A.L., David, L., and Tarba, C. (2017). Heart rate variability: a practical review for the beginner. Studia Universitatis Babeş-Bolyai Biologia, 62(1), 87-100.

Mujeeb, N. (2018). A study to access impairment of autonomic nervous system in obesity. National Journal of Physiology, Pharmacy and Pharmacology, 8(4), 475-478.

Naznin, F., Toshinai, K., Waise, T.M.Z., et al. (2015). Diet-induced obesity causes eripheral and central ghrelin resistance by promoting inflammation. Journal of Endocrinology, 226, 81-92.

No-in, K. (2017). Overweight and obesity among Thai school-aged children and adolescents. Journal of The Royal Thai Army Nurses, 18, 1-8.

O’Brien, P.D., Hinder, L.M., Callaghan, B.C., Feldman, E.L. (2017). Neurological consequences of obesity. The Lancet Neurology, 16, 465-477.

Peschel, S.K., Feeling, N.R., Vogele, C., Kaess, M. Thayer, J.F. Koenig, J. (2016). A meta-analysis on resting state highfrequency heart rate variability in bulimia nervosa. European Eating Disorders Review, 24, 355-365.

Phoemsapthawee, J., Prasertsri, P., Leelayuwat, N. (2019). Heart rate variability responses to combined exercise training program: correlation with adiposity and cardiorespiratory fitness changes in obese young men. Journal of Exercise Rehabilitation, 15(1), 114-122.

Phongphibool, S. (2013). Prevention and Noncommunicable diseases therapy with exercise. Nonthaburi: Department of Health.

Rajalakshmi, R., Vageesh, V., Nataraj, S.M.,MuraliDhar, and Srinath, C.G. (2012). Heart rate variability in Indian obese young adults. Pakistan Journal of Physiology, 8(1), 39-44.

Rajendra Acharya, U., Paul Joseph, K., Kannathal, N., Lim, C. M., and Suri, J. S. (2006). Heart rate variability: a review. Medical & Biological Engineering & Computing, 44(12), 1031-1051.

Routledge, F.S., Campbell, T.S., McFetridge-Durdle, J., and Bacon, S.L. (2010). Improve in heart rate variability with exercise therapy. Canadian Journal of Cardiology, 26(6), 303-312.

Saechee, J., Wannasamai, K., Jaimanee, P., Pinkeaw, D., Chinda, K., Inthachai, T. (2019). Effects of general obesity on heart rate variability in Thai people with physical inactivity. Chulalongkorn Medical Journal, 63(3), 187-192.

Soares-Miranda, L., Sattelmair, J., Chaves, P., Duncan, G. E., Siscovick, D. S., Stein, P. K., and Mozaffarian, D. (2014). Physical activity and heart rate variability in older adults: the cardiovascular health study. Circulation, 129(21), 2100-2110.

Souza, N. M., Rossi, R.C., Vanderlei, F.M., Vitor, A.N.R., Bernardo, A.F.B., Gonçalves, A.C.C.R., Ferreira, L.L., and Vanderlei, L.C.M. (2012). Heart rate variability in obese children. Journal of Human Growth and Development, 22(3), 328-333.

Task Force of the European Society of Cardiology and the North America Society of Pacing and Electrophysiology (1996). Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation, 93, 1043-1065.

Triggiani, A.I., Valenzano, A., Trimigno, V., Palma, A.D., Moscatelli, F., Cibelli, G., et al. (2019). Heart rate variability reduction is related to high amount of visceral adiposity in healthy young women. PLoSONE, 14(9), 1-12.

Vinik, A.I., Master, R.E., Mitchell, B.D., Freeman, R. (2003). Diabetic autonomic neuropathy. Diabetes Care, 26, 1553-1579.

Vishrutha, K.V., and Lyall, P. (2019). A crosssectional study on effect of obesity on autonomic functions in a tertiary care center. National Journal of Physiology, Pharmacy and Pharmacology, 9(4), 349-352.

Waise, T.M.Z., Toshinai, K., Naznin, F., et al. (2015). One-day high fat diet induces inflammation in the nodose ganglion and hypothalamus of mice. Biochemical and Biophysical Research Communications, 464, 1157-1162.

Williams, K.W., and Elmquist, J.K. (2012). From neuroanatomy to behavior: central integration of peripheral signals regulating feeding behavior. Nature Neuroscience, 15, 1350-1355.

World Health Organization. (2018). Obesity and overweight. (Online). Retrieved April 24, 2019, from World Health Organization website:

Yadav, R.L., Yadav, P.K., Yadav, L.K., Agrawal, K., Sah, S.K., and Islam, M.N. (2017). Association between obesity and heart rate variability indices: intuition toward cardiac autonomic alteration–a risk of CVD. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 10, 57-64.

Young, H.A., and Benton, D. (2018). Heart-rate variability: a biomarker to study the influence of nutrition on physiological and psychological health?. Behavioural Pharmacology, 29(2&3), 140-151.

Young, H.A., Cousins, A.L., Watkins, H.T., Benton, D. (2017a). Is the link between expressed mood and heart rate variability explained by disinhibited eating and diet?. Biological Psychology, 123, 94-102.