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Updated: Jun 12, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Adiposity and cardiac autonomic function in children with a family history of obesity
Marie-Béatrice Saade1,2,3, Samuel Holden4, Lisa Kakinami4,5
1Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
Insights
Greater adiposity in children is linked to reduced heart rate variability (HRV), indicating poorer autonomic function. Waist-to-height ratio may be a more sensitive indicator of these changes than BMI.
Area of Science:
- Pediatric cardiology
- Autonomic nervous system function
- Childhood obesity research
Background:
- Limited data exists on the relationship between adiposity and heart rate variability (HRV) in prepubertal children.
- Understanding this link is crucial for early identification of cardiovascular risk factors.
Purpose of the Study:
- To investigate associations between various adiposity indices and HRV in children aged 8-10 years.
- To determine if these associations are independent of lifestyle behaviors.
- To explore potential sex-based differences in the adiposity-HRV relationship.
Main Methods:
- Utilized data from 469 children in the QUALITY cohort.
- Assessed adiposity using waist-to-height ratio, BMI, DEXA-defined fat mass, and android/gynoid ratio.
- Measured HRV via 3-hour daytime Holter recordings, analyzing frequency and spectral domains. Models were adjusted for covariates.
Main Results:
- Increased adiposity correlated with reduced parasympathetic activity and increased sympathetic dominance.
- Waist-to-height ratio and android/gynoid ratio showed significant associations with altered HRV.
- Obesity and higher fat mass were linked to decreased HRV indices (RMSSD, pNN50) and increased LF/HF ratio. Overweight status did not show significant associations.
Conclusions:
- Specific adiposity markers, particularly waist-to-height ratio, are associated with altered heart rate variability in children.
- Waist-to-height ratio may be a more relevant and pragmatic indicator of HRV changes than BMI or percent body fat in this age group.
Purpose:
Data on associations between adiposity and heart rate variability (HRV) in prepubertal children are limited. We examined the associations between adiposity indices and HRV, independent of lifestyle behaviors, comparing multiple indicators of adiposity, and explored differences between boys and girls.
Methods:
Data stem from 469 participants of the QUALITY cohort (630 children aged 8-10 years with a parental history of obesity). Adiposity indices included waist-to-height ratio, body mass index (BMI) percentiles and categories (overweight, obesity), dual-energy x-ray absorptiometry (DEXA) defined fat mass percentage and android/gynoid ratio. HRV indices in the frequency and the spectral domain were derived from a daytime 3-h Holter recording. Multivariable linear regression models were adjusted for age, sex, Tanner stage, physical activity, screen time, and fitness. Interactions between sex and adiposity were tested.
Results:
Greater adiposity was associated with decreased parasympathetic modulation and increased sympathetic dominance. Waist-to-height ratio was associated with lower parasympathetic activity: root mean square of the successive differences (RMSSD) [B = -23.32, 95% confidence interval (CI) -42.42, -4.22], pNN50 (B = -16.93, 95% CI - 28.58, - 5.27), LF/HF ratio (B = 1.83, 95% CI 0.97-2.70). Patterns of association were similar for android/gynoid ratio. Overweight was not associated with altered HRV. Obesity was negatively associated with RMSSD and pNN50 and positively with LF/HF ratio. Greater fat mass percentage was associated with lower RMSSD, pNN50, and HF, and increased LF/HF ratio. There were no differences between boys and girls.
Conclusions:
Specific markers of adiposity relate to altered HRV in childhood, with waist-to-height ratio being potentially a more relevant marker of HRV than BMI and more pragmatic than percent body fat.
Trial Registration:
NCT03356262, 11 November 2017.
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