title: Impacts of obesity and stress on neuromuscular fatigue development and associated heart rate variability.
abstract: OBJECTIVE
  Obesity and stress are independently associated with decrements in neuromuscular functions. The present study examined the interplay of obesity and stress on neuromuscular fatigue and associated heart rate variability (HRV).
  
  
  METHODS
  Forty-eight non-obese (18.5<body mass index (BMI)<25 kg  m(-2)) and obese (30⩽BMI) adults performed repetitive handgrip exertions at 30% of their maximum strength until exhaustion in the absence and presence of a mental arithmetic stressor. Dependent measures included gold standard fatigue indicators (endurance time and rate of strength loss), perceived effort and mental demand, heart rate and temporal (RMSSD: root mean square of successive differences between N-N intervals) and spectral (LF/HF: ratio of low to high frequency) indices of HRV.
  
  
  RESULTS
  Stress negatively affected endurance time (P<0.0001) and rate of strength loss (P=0.029). In addition, significant obesity × stress interactions were found on endurance time (P=0.0073), rate of strength loss (P=0.027) and perceived effort (P=0.026), indicating that stress increased fatigability, particularly in the obese group. Both obesity (P=0.001) and stress (P=0.033) independently lowered RMSSD. Finally, stress increased LF/HF ratio (P=0.028) and the interaction of stress and obesity (P=0.008) indicated that this was augmented in the obese group.
  
  
  CONCLUSIONS
  The present study provides the first evidence that stress-related neuromuscular fatigue development is accelerated in obese individuals. In addition, the stress condition resulted in poorer HRV indices, which is indicative of autonomic dysfunction, particularly in the obese group. These findings indicate that workers are more susceptible to fatigue in high-stress work environments, particularly those with higher BMI, which can increase the risk of musculoskeletal injuries as well as cardiovascular diseases in this population.
authors.affiliation: Department of Environmental and Occupational Health, Texas A&M University, College Station, TX, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Mehta
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001794:Blood Pressure; D004734:Energy Metabolism; D005260:Female; D018737:Hand Strength; D006339:Heart Rate; D006801:Humans; D008297:Male; D018763:Muscle Fatigue; D053580:Muscle Strength; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D010807:Physical Endurance; D012307:Risk Factors