Mattos Samanta, Rabello da Cunha Michelle, Barreto Silva Maria Inês, Serfaty Fabiano, Tarvainen Mika P, Klein Márcia Regina Simas Torres, Neves Mario Fritsch
Department of Clinical Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Applied Nutrition, Nutrition Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Applied Nutrition, Nutrition School, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
Clin Nutr. 2022 Nov;41(11):2577-2586. doi: 10.1016/j.clnu.2022.09.009. Epub 2022 Sep 21.
BACKGROUND & AIMS: The effects of calorie restriction and physical activity on autonomic regulation and cardiac vagal control in overweight and obese individuals remain inconsistent. Thus, this systematic review aimed to evaluate the weight loss effects through lifestyle changes on heart rate variability (HRV) markers in overweight and obese subjects.
A systematic search for studies published up to November 2021 was conducted in MEDLINE, Embase, EBSCO host and VHL REGIONAL/LILACS. The main outcomes were changes in HRV indices from pre- and post-nutritional intervention and exercise in overweight and obese individuals. This review was registered in PROSPERO: CRD42021274467.
The literature search retrieved 959 articles, of which 12 were included in this review. The intervention in nine studies was diet only, in two studies was diet and exercise, and in one study diet was compared to diet and exercise. The weight loss was greater than 10% in four studies and between 5 and 10% in three studies. Most of the studies revealed that weight loss through lifestyle changes seems to promote beneficial effects on HRV, restoring sympathovagal balance by increasing parasympathetic activity and reducing sympathetic activation.
This systematic review exhibited the beneficial effects of weight loss through lifestyle changes on cardiac autonomic control in overweight and obese individuals. Future investigations need standardization of HRV indices for better interpretation of autonomic function in different clinical situations.
热量限制和体育活动对超重和肥胖个体自主神经调节及心脏迷走神经控制的影响仍不一致。因此,本系统评价旨在评估超重和肥胖受试者通过生活方式改变减重对心率变异性(HRV)指标的影响。
在MEDLINE、Embase、EBSCO主机和VHL REGIONAL/LILACS中对截至2021年11月发表的研究进行系统检索。主要结局是超重和肥胖个体营养干预和运动前后HRV指标的变化。本评价已在PROSPERO注册:CRD42021274467。
文献检索共获得959篇文章,其中12篇纳入本评价。9项研究的干预措施仅为饮食,2项研究为饮食加运动,1项研究将饮食与饮食加运动进行了比较。4项研究中的体重减轻超过10%,3项研究中的体重减轻在5%至10%之间。大多数研究表明,通过生活方式改变减重似乎对HRV有有益影响,通过增加副交感神经活动和减少交感神经激活来恢复交感迷走平衡。
本系统评价显示超重和肥胖个体通过生活方式改变减重对心脏自主神经控制有有益影响。未来的研究需要对HRV指标进行标准化,以便在不同临床情况下更好地解释自主神经功能。