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ORIGINAL ARTICLE

VLCD-Induced Weight Loss Improves Heart Rate Variability in Moderately Obese Japanese

Yuko Akehi^*,, Hironobu Yoshimatsu, Mamoru Kurokawa, Toshiie Sakata^,1, Hiroshi Eto, Sukenobu Ito and Junko Ono^*

^* Laboratory Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan;
Department of Internal Medicine I, School of Medicine, Oita Medical University, Oita, Japan;
Yufuin Kouseinenkin Hospital, Oita, Japan

To evaluate the effects of weight reduction on the autonomic nervous system in obese patients, we investigated heart rate variability (HRV) based on 24-hr ambulatory electrocardiogram (ECG) recordings before and after weight reduction. To aim for weight reduction, 16 obese patients were treated with the very-low-calorie conventional Japanese diet (VLCD-CJ) therapy combined with behavior therapy. Percent weight reduction was 17.8% ± 1.5% (means ± SEM), but mean blood pressure did not change significantly after VLCD-CJ therapy. The mean normal R-R interval (mNN) of the 24-hr ECG and all other five time-domain indices increased after weight reduction. Spectral analysis revealed that weight reduction increased the high frequency (HF) component, but decreased the ratio of low to high (LF/HF) components. Rate of change in mNN or HF correlated positively with reduction rate of body mass index, but not that in LF/HF. Analysis of daily fluctuations in each HRV parameter showed that significant improvement after weight loss occurred mainly during the nocturnal period, but an HF component was improved throughout the day and night periods. These findings indicate that functional impairment of the autonomic nervous system in obese subjects, particularly in the nocturnal period, is improved by effective weight reduction after VLCD-CJ therapy.

Key Words: heart rate variability • obesity • weight reduction • conventional Japanese VLCD therapy • spectral analysis • parasympathetic dominance