title: Effect of a weight reduction program on baseline and stress-induced heart rate variability in children with obesity.
abstract: OBJECTIVE
  Autonomic dysregulation is a well-established feature in adults with obesity but not in children. Since this dysregulation could contribute to weight dynamics, this study aimed to compare autonomic regulation in children with obesity and normal-weight peers and to track autonomic status during weight reduction.
  
  
  METHODS
  Sixty children with obesity and 27 age- and sex-matched normal-weight healthy participants were included. Heart rate variability (HRV) was assessed at baseline and during a mental stress test and a subsequent recovery period. Children with obesity were investigated both upon admission and discharge.
  
  
  RESULTS
  Upon admission, no significant differences in HRV parameters were found for normal-weight participants and those with obesity. Inpatient treatment led to significant changes in HRV with increase in general variability (standard deviation of the normal-to-normal interval (SDNN), P < 0.001) as well as of parasympathetic regulation (root mean square successive difference (RMSSD) and high frequency power (logHF), P < 0.01). Children with obesity had sympathetic activation similar to normal-weight controls during mental stress with subsequent return to baseline values, and weight loss did not affect this profile.
  
  
  CONCLUSIONS
  A weight reduction program induced a change in autonomic activity in children with obesity toward parasympathetic dominance but had no influence on autonomic nervous system reactivity during stress conditions.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.|SymbioGruppe GmbH, Herborn, Germany.
authors.forename: Nazar
authors.initials: N
authors.lastname: Mazurak
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Helene
authors.initials: H
authors.lastname: Sauer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Weimer
authors.affiliation: Fachkliniken Wangen I.A., Children Rehabilitation Hospital for Respiratory Diseases, Allergies and Psychosomatics, Wangen I.A., Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Dammann
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.affiliation: Department of Psychology, Clemson University, Clemson, South Carolina, USA.
authors.forename: Björn
authors.initials: B
authors.lastname: Horing
authors.affiliation: Department of Psychology, Clemson University, Clemson, South Carolina, USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Muth
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Teufel
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Enck
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Mack
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005858:Germany; D006339:Heart Rate; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome; D061217:Weight Reduction Programs