近年，臺灣成人肥胖盛行率未減反增，減肥需求不斷的提高，消費者對於減重品質及效果的期待也越來越嚴格。雖然國內外有很多的學者在減重方式方面已經做了很多的研究，但是如何幫助消費者選擇有效且可持續性的減重方式，這方面研究還是缺少。為了進一步幫助消費者選擇適合個人的減重方式，本研究在瞭解了當前減重方式和減重現況以及消費者的需求後，整理出減重失敗和重複減重導致愈減愈胖的原因，並應用一種快速有效的工具“心律變異數(Heart Rate Variance, HRV)”分析，搭配消費者的問題，可協助選擇適合個人的減重方式並提供改善對策，以提高減重成效。
為了確實了解，應用HRV來選擇減重方式的減重成效，本研究進行減重分組，研究對象共60人，依照HRV指數與身體量測值分成3組，A組進行飲食控制、B組進行飲食控制並輔助營養素、C組進行飲食控制並輔助營養素及調制中頻電療等3種不同減重課程12週。依據統計分析的結果得知，肥胖與HRV活性改变有關，肥胖者有高的交感神經活性和副交感神經活性低下，肥胖者所有心跳間期的標準偏差(Standard Deviation of Normal to Normal, SDNN)較低而低頻與高頻比值(LF/HF)較高，減重後體重、體脂肪、HRV均有明顯改善。綜論，科學量測的HRV可以區分不同類型特質的人，並作為個人化減重方法選擇的依據，可避免人為主觀喜好與經驗誤判，使得減重品質及成效能達到改善與精進。

The prevalence of adult obesity in Taiwan does not decrease in recent years, and the demand for weight loss continuously raises. Consumers' expectations for weight loss quality and effectiveness have become stricter. Although a lot of research on weight loss methods and help consumers select effective and continuous weight loss, personalized methods are still lacking. To further help consumers and select the proper weight loss method for individuals, the current study evaluates the current situation of weight loss methods and the needs of consumers for weight loss failure or repeated weight loss which leads to gain more fat. A fast and effective tool of Heart Rate Variance (HRV) combined with consumer problems could help to classify obesity individuals for the personalized weight loss method.
To understand the effects of weight loss method via HRV activity classification. Sixty volunteers participated in the study. According to HRV index and body measurements, the participants are divided into three groups for different weight loss courses, which are diet control, diet control with nutrients, diet control with nutrients and modulated intermediate frequency electrotherapy in three months. The statistical analysis results demonstrated obesity was associated with changes in HRV activity. Obese participants had high sympathetic nerve activity and low parasympathetic activity. Furthermore, obese participants had lower SDNN and higher LF/LF. Individuals’ weigh, body fat percentage, and HRV are significantly improved after weight reduction. In summary, the scientific measurement of HRV can distinguish between different types of traits, and as the basis for personal weight loss method selection, can avoid people's subjective preferences and experience misjudgment, so that weight loss quality and effectiveness can be improved and refined.

目錄
摘要 i
ABSTRACT ii
誌謝 iv
目錄 v
圖目錄 viii
表目錄 ix
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的與範圍 2
1.3 研究架構與流程 3
第二章 文獻回顧 6
2.1 肥胖問題 6
2.1.1肥胖成因 7
2.1.2肥胖指標 7
2.1.3減重需求 10
2.1.4減重方式 12
2.1.5 減重失敗的原因與對策 18
2.2 自律神經檢測 21
2.2.1 HRV檢測原理 21
2.2.2臨床價值 28
2.3 HRV運用 31
2.3.1 HRV運用健康狀況影響 31
2.3.2 HRV運用於減重 35
第三章 研究方法 39
3.1研究架構 39
3.2研究設計 40
3.2.1減重課程 40
3.2.2研究對象 42
3.2.3收案條件 42
3.2.5實驗分組 42
3.3研究工具 44
3.4研究步驟 47
3.5資料處理與分析 49
第四章 研究結果 50
4.1 減重者基本資料分布情形及同質性分析 50
4.1.1減重者性別分布與差異情形 50
4.1.2減重者年齡及身高分布與差異情形 51
4.2 三組實驗對象在身體測量與 HRV 變項之差異情形 53
4.2.1 身體測量與HRV變項之差異分析-減重前 53
4.2.2 身體測量與HRV變項之差異分析-減重後 55
4.2.3 身體測量與HRV變項之差異分析-減重改變量 57
4.3 分別探討各組在減重介入後身體測量與 HRV改變量之情形 59
4.4 介入前後符合正常值的比率是否有差異 63
第五章　討論與建議 68
5.1 減重者基本資料之分析 68
5.2 減重前，三組實驗對象的身體組成與 HRV之差異 71
5.3 不同減重課程介入後的減重成效 73
5.3.1 A組減重課程(飲食與營養素調整) 73
5.3.2 B組減重課程(飲食與中頻波物療) 75
5.3.3 C組減重課程(飲食與+營養素+中頻波物療) 77
5.3.4 小結 78
第六章 結論與未來方向 80
6-1結論 80
6-2未來方向與建議 81
中文參考文獻 82
英文參考文獻 86
附錄一 參與者研究說明與同意書 98
附錄二 基本資料調查表 99
附錄三 8Z11核准證書及仿單 104
附錄四 名片型心率變異紀錄儀衛署醫器輸字第004896號 105
附錄五 經皮神經電刺激器製造許可證 106


 

中文參考文獻
王信淵、謝佳容、李光武 (2015)。各類減重方式成效之探討。海峽兩岸體育研究學報，9(2)，101-111。
王群光 (2010)。自律神經失調HRV檢測及治療衛教手冊。2010 年 9 月 9 日，取自：http://hrvtw.blogspot.com/2010/09/hrv13.html
李甘 (2016)。基於營養學臨床飲食控制對患者減重作用分析。東方食療與保健，9，100-100。
李明遠 (2015)。使用穿戴式裝置分析心律變異及偵測心律不整之應用程式。國立中央大學資訊工程學系碩士論文，桃園縣。取自：https://hdl.handle.net/11296/2u4cs5
吳俊輝(2013)。理想的體重控制計畫。2013年(無日期)，取自：https://ws.kinmen.gov.tw/download.ashx?u=lzawms9vcgxvywqvmze2l3jlbgzpbguvmtazodcvmtkynjexl%2beqhuads%2beahomrlomhjeaop%2bwituioioevqyjlrapliioplmrvyw%3d%3d&n=55cg5ooz55qe6auu6yen5o6n5yi26kii55wrkowto%2bwiiikuzg9j
林世德 (2000)。我國中頻電流療法的發展。華理療雜誌，4，251-251。
林良士 (2004)。中頻與低頻經皮神經電刺激系統之研製。國立成功大學電機工程學系碩博士班碩士論文，台南市。取自:https://hdl.handle.net/11296/758554
林素惠 (2005)。減肥藥物的消費者行為之研究。亞洲大學國際企業學系碩士班碩士論文，台中市。取自:https://hdl.handle.net/11296/p4ehn5
柯文清(2015)。減重手術。2015年(無日期)，取自：http://www.mmh.org.tw/taitam/gen_su/edu_obesity.asp
洪淑怡 (2009)。依據各種膳食營養素攝取建議及國人食物選擇型態，設計多元化之飲食指南。國立臺灣大學微生物與生化學研究所碩士論文，台北市。 取自https://hdl.handle.net/11296/24f7ha
胡玉萍、古博文、魏大森 (2015)。不同肥胖度之員工參加職場體重管理計劃之成效－以某健康促進醫院為例。彰化師大體育學報，14，95-104。
夏建勳 (2016)。心血管疾病的檢查利器。2016 年 11 月 4 日，取自：https://www.cch.org.tw/cchhec/knowledge_detail.aspx?oid=117
張育彰、吳佩芬、丁彥伶、郭姿均 (2007)。壓力大到快生病嗎？常春月刊，294，39-42
翁清松、胡威志、莊朝欽、許善華 (2004)。四種不同頻率的電刺激於人體穴位之經絡及肌電現象之研究。中原學報，32(3)，373-381。
翁根本、何慈育、歐善福、林竹川、謝凱生 (2009)。心律變動性分析。臺灣醫界，52(6)，290-293。
張尹凡、盧豐華、吳至行、張秦松、吳坤陵、張智仁 (2001)。成年民眾體重認知與減重行為之研究。台灣家庭醫學雜誌，11，180-189。
許善華 (2004)。調制中頻電刺激器之研製及應用於疼痛治療之評估。中原大學醫學工程研究所碩士論文，桃園縣。取自:https://hdl.handle.net/11296/6382qf
郭博昭、楊靜修 (2004)。陰陽虛實之偵測方法及其裝置。中華民國發明專利第198840 號。
陳玉玲、黃瑞華、陳玉楚、李鴻森、謝芳傑、湯豐誠 (2008) 。職場減重班之飲食日誌成效評估。中華職業醫學雜誌，15(3)，219 - 226。
陳帥 (2017)。判斷是不是肥胖的4大指標，體質指數(BMI)是最落後的！。2017 年 7 月 17 日，取自：https://kknews.cc/health/npk5xx3.html。
陳高揚、郭正典、駱惠銘 (2000)。心率變異度：原理與應用。中華民國急救加護醫學會雜誌，11(2)，47-58。
陳志豪、莊海華、陳昭源 (2017)。醫療從業人員中央型肥胖盛行率及其健康風險探討。中華職業醫學雜誌，24(2)，115-120。
陳淑如、蔡月霞、羅映琪、蔡宜珊、鄭綺 (2005)。心率變異度的簡介及護理上的應用。新臺北護理期刊，7(1)，1-11。
曾啟權 (2004)。針刺對肥胖症婦女減重與心率變異性關係之研究。中國醫藥大學中西醫結合研究所碩士論文，台中市。 取自：https://hdl.handle.net/11296/ec9td5
黃伯超、游素玲、林月美、朱志良 (1992)。我國成年人性別、年齡別、身高別體重及過重與肥胖界定之探討。中華民國營養學會雜誌，17，157-172。
黃淑華、洪兆嘉、謝美倫、李雅惠、趙櫻花 (2014)。社區肥胖控制介入計畫的成效探討。健康與建築雜誌，1(3)，77 - 84。
黃寶珠 (2004)。中頻電療腹部治療肥胖症225例。中國臨床康復，8(24)，5073- 5077。
楊定一、楊元寧 (2014)。靜坐的科學、醫學與心靈之旅：21世紀最實用的身心轉化指南。臺北市：天下生活。
楊景琪 (2014)。青少年肥胖行為與健康認知對身體體位影響之分析研究。國立臺東大學教育學系教學科技碩士班碩士論文，台東縣。取自：https://hdl.handle.net/11296/66k3np
楊靜修 (2016)。心率變異研究:從健康養生到疾病診療。新北市：合記圖書出版社。
詹美玲 (2017)。不同比例負能量平衡監控介入對年輕肥胖女性體適能及心臟血液動力學的影響。國立臺灣師範大學體育學系博士論文，台北市。取自：https://hdl.handle.net/11296/ted3bk
詹遠華 (1994)。電療學。臺北市：大學出版社。
復御企業 (2012)。自律神經檢測儀。2012 年 3 月 26 日，取自：https://fuyu.com.tw/ContentList.asp?MainCatNo=109&SubCatNo=10901&SubAdvCatId=1090101&ContentId=1358
歐姆龍 (2018)。體重體脂計HBF-371。2018 年 9 月 6 日。取自：https://www.omronhealthcare.com.tw/product/ins.php?index_prm_id=0&index_id=22
廖文炫、張梅蘭、蔡美文、王淑芬 (2001)。物理因子治療學-電磁療學。臺北市：合記圖書出版社。
慶名醫療器材有限公司 (2009)。中頻電刺激器。2009 年(無日期)。取自：http://www.cmmd.com.tw/about.asp
潘文涵 (2004)。肥胖定義與肥胖流行病學。台灣肥胖醫學會，肥胖臨床診斷與治療(1-15)。台北。
蔚百彥譯 (2018)。心電圖快速解讀(第一版)。台北：合記圖書出版社。
呂惠珠 (2003)。肥胖影響因素之結構方程模式分析。國立台北護理學院中西醫結合護理研究所碩士論文，台北市。取自https://hdl.handle.net/11296/da2wsr
衛生福利部國民健康署 (2018)。每日飲食指南手冊。台北：國健署。
衛生福利部國民健康署 (2018)。105年健康促進統計年報。2018 年 8 月 2 日。取自：https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=268&pid=8967
謝懿安(2019)。沒時間運動，可以取代嗎？。2019年2月13日。取自：https://www.commonhealth.com.tw/article/article.action?nid=78982
 
英文參考文獻
Adachi, T., Sert-Kuniyoshi, F. H., Calvin, A. D., Singh, P., Romero-Corral, A., van der Walt, C., . . . Somers, V. K. (2011). Effect of weight gain on cardiac autonomic control during wakefulness and sleep. Hypertension, 57(4), 723-730. doi: 10.1161/HYPERTENSIONAHA.110.163147
Agelink, M. W., Boz, C., Ullrich, H., & Andrich, J. (2002). Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Psychiatry Res, 113(1-2), 139-149.
Akselrod, S., Gordon, D., Ubel, F. A., Shannon, D. C., Berger, A. C., & Cohen, R. J. (1981). Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science, 213(4504), 220-222. doi: 10.1126/science.6166045
Altuncu, M. E., Baspinar, O., & Keskin, M. (2012). The use of short-term analysis of heart rate variability to assess autonomic function in obese children and its relationship with metabolic syndrome. Cardiol J, 19(5), 501-506.
Amano, M., Kanda, T., Ue, H., & Moritani, T. (2001). Exercise training and autonomic nervous system activity in obese individuals. Med Sci Sports Exerc, 33(8), 1287-1291.
Backhaus, J., Junghanns, K., & Hohagen, F. (2004). Sleep disturbances are correlated with decreased morning awakening salivary cortisol. Psychoneuroendocrinology, 29(9), 1184-1191. doi: 10.1016/j.psyneuen.2004.01.010
Batacan, R. B., Jr., Duncan, M. J., Dalbo, V. J., Tucker, P. S., & Fenning, A. S. (2017). Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. Br J Sports Med, 51(6), 494-503. doi: 10.1136/bjsports-2015-095841
Bleich, S., Cutler, D., Murray, C., & Adams, A. (2008). Why is the developed world obese? Annu Rev Public Health, 29, 273-295. doi: 10.1146/annurev.publhealth.29.020907.090954
Chaloupka, J., Hlubik, P., Opltova, L., & Mala, H. (1998). [Changes in autonomic nervous system activity in obese individuals during weight reduction]. Sb Lek, 99(3), 251-254.
Chandola, T., Britton, A., Brunner, E., Hemingway, H., Malik, M., Kumari, M., . . . Marmot, M. (2008). Work stress and coronary heart disease: what are the mechanisms? Eur Heart J, 29(5), 640-648. doi: 10.1093/eurheartj/ehm584
Chang, S. S., Wen, C. P., Tsai, M. K., Lawlor, D. A., Yang, Y. C., & Gunnell, D. (2012). Adiposity, its related biologic risk factors, and suicide: a cohort study of 542,088 taiwanese adults. Am J Epidemiol, 175(8), 804-815. doi: 10.1093/aje/kwr386
Chen, M. L., Chiang, C. H., Huang, C. S., & Chen, J. S. (1974). A study on the nutritional status and physical growth on Chinese children and young adults. Taiwan Yi Xue Hui Za Zhi, 73(7), 374-386.
Chen, W. L., & Kuo, C. D. (2007). Characteristics of heart rate variability can predict impending septic shock in emergency department patients with sepsis. Acad Emerg Med, 14(5), 392-397. doi: 10.1197/j.aem.2006.12.015
Chien, L. W., Lin, M. H., Chung, H. Y., & Liu, C. F. (2011). Transcutaneous electrical stimulation of acupoints changes body composition and heart rate variability in postmenopausal women with obesity. Evid Based Complement Alternat Med, 2011, 862121. doi: 10.1093/ecam/nep145
Chien, L. Y., Liou, Y. M., & Chen, J. J. (2004). Association between indices of obesity and fasting hyperglycemia in Taiwan. Int J Obes Relat Metab Disord, 28(5), 690-696. doi: 10.1038/sj.ijo.0802619
Davy, K. P., DeSouza, C. A., Jones, P. P., & Seals, D. R. (1998). Elevated heart rate variability in physically active young and older adult women. Clin Sci (Lond), 94(6), 579-584.
De Luca, M., Angrisani, L., Himpens, J., Busetto, L., Scopinaro, N., Weiner, R., . . . Shikora, S. (2016). Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg, 26(8), 1659-1696. doi: 10.1007/s11695-016-2271-4
Dekker, J. M., Crow, R. S., Folsom, A. R., Hannan, P. J., Liao, D., Swenne, C. A., & Schouten, E. G. (2000). Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. Circulation, 102(11), 1239-1244. doi: 10.1161/01.cir.102.11.1239
Deurenberg-Yap, M., Schmidt, G., van Staveren, W. A., & Deurenberg, P. (2000). The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore. Int J Obes Relat Metab Disord, 24(8), 1011-1017.
Deurenberg, P., Yap, M., & van Staveren, W. A. (1998). Body mass index and percent body fat: a meta analysis among different ethnic groups. Int J Obes Relat Metab Disord, 22(12), 1164-1171.
Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., Smith, B. K., & American College of Sports, M. (2009). American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc, 41(2), 459-471. doi: 10.1249/MSS.0b013e3181949333
Duncan, G. E., Perri, M. G., Theriaque, D. W., Hutson, A. D., Eckel, R. H., & Stacpoole, P. W. (2003). Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care, 26(3), 557-562. doi: 10.2337/diacare.26.3.557
Ekblom, B., Kilbom, A., & Soltysiak, J. (1973). Physical training, bradycardia, and autonomic nervous system. Scand J Clin Lab Invest, 32(3), 251-256.
Epstein, L. H., Coleman, K. J., & Myers, M. D. (1996). Exercise in treating obesity in children and adolescents. Med Sci Sports Exerc, 28(4), 428-435.
Ewing, D. J., Martyn, C. N., Young, R. J., & Clarke, B. F. (1985). The value of cardiovascular autonomic function tests: 10 years experience in diabetes. Diabetes Care, 8(5), 491-498. doi: 10.2337/diacare.8.5.491
Facchini, M., Malfatto, G., Sala, L., Silvestri, G., Fontana, P., Lafortuna, C., & Sartorio, A. (2003). Changes of autonomic cardiac profile after a 3-week integrated body weight reduction program in severely obese patients. J Endocrinol Invest, 26(2), 138-142. doi: 10.1007/BF03345142
Figueroa, A., Baynard, T., Fernhall, B., Carhart, R., & Kanaley, J. A. (2007). Endurance training improves post-exercise cardiac autonomic modulation in obese women with and without type 2 diabetes. Eur J Appl Physiol, 100(4), 437-444. doi: 10.1007/s00421-007-0446-3
Franz, R., Maturana, M. A., Magalhaes, J. A., Moraes, R. S., & Spritzer, P. M. (2013). Central adiposity and decreased heart rate variability in postmenopause: a cross-sectional study. Climacteric, 16(5), 576-583. doi: 10.3109/13697137.2012.745123
Goats, G. C. (1990). Interferential current therapy. Br J Sports Med, 24(2), 87-92. doi: 10.1136/bjsm.24.2.87
Goulopoulou, S., Baynard, T., Franklin, R. M., Fernhall, B., Carhart, R., Jr., Weinstock, R., & Kanaley, J. A. (2010). Exercise training improves cardiovascular autonomic modulation in response to glucose ingestion in obese adults with and without type 2 diabetes mellitus. Metabolism, 59(6), 901-910. doi: 10.1016/j.metabol.2009.10.011
Hankinson, A. L., Daviglus, M. L., Bouchard, C., Carnethon, M., Lewis, C. E., Schreiner, P. J., . . . Sidney, S. (2010). Maintaining a high physical activity level over 20 years and weight gain. JAMA, 304(23), 2603-2610. doi: 10.1001/jama.2010.1843
Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., . . . Bauman, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc, 39(8), 1423-1434. doi: 10.1249/mss.0b013e3180616b27
Hilton, M. F., Bates, R. A., Godfrey, K. R., Chappell, M. J., & Cayton, R. M. (1999). Evaluation of frequency and time-frequency spectral analysis of heart rate variability as a diagnostic marker of the sleep apnoea syndrome. Med Biol Eng Comput, 37(6), 760-769.
Hon, E. H., & Lee, S. T. (1963). Electronic Evaluation of the Fetal Heart Rate. Viii. Patterns Preceding Fetal Death, Further Observations. Am J Obstet Gynecol, 87, 814-826.
Hwang, L. C., Bai, C. H., & Chen, C. J. (2006). Prevalence of obesity and metabolic syndrome in Taiwan. J Formos Med Assoc, 105(8), 626-635. doi: 10.1016/S0929-6646(09)60161-3
Ismail, I., Keating, S. E., Baker, M. K., & Johnson, N. A. (2012). A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Obes Rev, 13(1), 68-91. doi: 10.1111/j.1467-789X.2011.00931.x
Ito, H., Ohshima, A., Tsuzuki, M., Ohto, N., Yanagawa, M., Maruyama, T., . . . Nishioka, K. (2001). Effects of increased physical activity and mild calorie restriction on heart rate variability in obese women. Jpn Heart J, 42(4), 459-469.
Jahangir, E., De Schutter, A., & Lavie, C. J. (2014). Low weight and overweightness in older adults: risk and clinical management. Prog Cardiovasc Dis, 57(2), 127-133. doi: 10.1016/j.pcad.2014.01.001
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., . . . Obesity, S. (2014). 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol, 63(25 Pt B), 2985-3023. doi: 10.1016/j.jacc.2013.11.004
Kaiser, K. A., Brown, A. W., Bohan Brown, M. M., Shikany, J. M., Mattes, R. D., & Allison, D. B. (2014). Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis. Am J Clin Nutr, 100(2), 567-576. doi: 10.3945/ajcn.114.090548
Keating, S. E., Johnson, N. A., Mielke, G. I., & Coombes, J. S. (2017). A systematic review and meta-analysis of interval training versus moderate-intensity continuous training on body adiposity. Obes Rev, 18(8), 943-964. doi: 10.1111/obr.12536
Kuo, T. B., Lin, T., Yang, C. C., Li, C. L., Chen, C. F., & Chou, P. (1999). Effect of aging on gender differences in neural control of heart rate. Am J Physiol, 277(6), H2233-2239. doi: 10.1152/ajpheart.1999.277.6.H2233
Lau, D. C., Douketis, J. D., Morrison, K. M., Hramiak, I. M., Sharma, A. M., Ur, E., & Obesity Canada Clinical Practice Guidelines Expert, P. (2007). 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ, 176(8), S1-13. doi: 10.1503/cmaj.061409
Lemon, S. C., Schneider, K. L., Wang, M. L., Liu, Q., Magner, R., Estabrook, B., . . . Pbert, L. (2014). Weight loss motivations: a latent class analysis approach. Am J Health Behav, 38(4), 605-613. doi: 10.5993/AJHB.38.4.14
Liao, D., Carnethon, M., Evans, G. W., Cascio, W. E., & Heiss, G. (2002). Lower heart rate variability is associated with the development of coronary heart disease in individuals with diabetes: the atherosclerosis risk in communities (ARIC) study. Diabetes, 51(12), 3524-3531. doi: 10.2337/diabetes.51.12.3524
Lin, A., Jabbari, S., Worden, F. P., Bradford, C. R., Chepeha, D. B., Teknos, T. N., . . . Eisbruch, A. (2005). Metabolic abnormalities associated with weight loss during chemoirradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys, 63(5), 1413-1418. doi: 10.1016/j.ijrobp.2005.05.012
Lu, C. W., Yang, K. C., Chang, H. H., Lee, L. T., Chen, C. Y., & Huang, K. C. (2013). Sarcopenic obesity is closely associated with metabolic syndrome. Obes Res Clin Pract, 7(4), e301-307. doi: 10.1016/j.orcp.2012.02.003
Lu, W. C., Tzeng, N. S., Kao, Y. C., Yeh, C. B., Kuo, T. B., Chang, C. C., & Chang, H. A. (2016). Correlation between health-related quality of life in the physical domain and heart rate variability in asymptomatic adults. Health Qual Life Outcomes, 14(1), 149. doi: 10.1186/s12955-016-0555-y
Ma, W. Y., Yang, C. Y., Shih, S. R., Hsieh, H. J., Hung, C. S., Chiu, F. C., . . . Li, H. Y. (2013). Measurement of Waist Circumference: midabdominal or iliac crest? Diabetes Care, 36(6), 1660-1666. doi: 10.2337/dc12-1452
Malik, V. S., Schulze, M. B., & Hu, F. B. (2006). Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr, 84(2), 274-288. doi: 10.1093/ajcn/84.1.274
Matsumoto, T., Miyawaki, C., Ue, H., Yuasa, T., Miyatsuji, A., & Moritani, T. (2000). Effects of capsaicin-containing yellow curry sauce on sympathetic nervous system activity and diet-induced thermogenesis in lean and obese young women. J Nutr Sci Vitaminol (Tokyo), 46(6), 309-315.
Mattes, R. (2014). Energy intake and obesity: ingestive frequency outweighs portion size. Physiol Behav, 134, 110-118. doi: 10.1016/j.physbeh.2013.11.012
McTiernan, A., Sorensen, B., Irwin, M. L., Morgan, A., Yasui, Y., Rudolph, R. E., . . . Potter, J. D. (2007). Exercise effect on weight and body fat in men and women. Obesity (Silver Spring), 15(6), 1496-1512. doi: 10.1038/oby.2007.178
Metra, M., Nodari, S., Parrinello, G., Giubbini, R., Manca, C., & Dei Cas, L. (2003). Marked improvement in left ventricular ejection fraction during long-term beta-blockade in patients with chronic heart failure: clinical correlates and prognostic significance. Am Heart J, 145(2), 292-299. doi: 10.1067/mhj.2003.105
Mozaffarian, D. (2016). Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review. Circulation, 133(2), 187-225. doi: 10.1161/CIRCULATIONAHA.115.018585
Pan, W. H., & Yeh, W. T. (2008). How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr, 17(3), 370-374.
Pate, R. R. (1995). Physical activity and health: dose-response issues. Res Q Exerc Sport, 66(4), 313-317. doi: 10.1080/02701367.1995.10607917
Penicaud, L., Cousin, B., Leloup, C., Atef, N., Casteilla, L., & Ktorza, A. (1996). Changes in autonomic nervous system activity and consecutive hyperinsulinaemia: respective roles in the development of obesity in rodents. Diabetes Metab, 22(1), 15-24.
Poirier, P., Hernandez, T. L., Weil, K. M., Shepard, T. J., & Eckel, R. H. (2003). Impact of diet-induced weight loss on the cardiac autonomic nervous system in severe obesity. Obes Res, 11(9), 1040-1047. doi: 10.1038/oby.2003.143
Pomeranz, B., Macaulay, R. J., Caudill, M. A., Kutz, I., Adam, D., Gordon, D., . . . et al. (1985). Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol, 248(1 Pt 2), H151-153. doi: 10.1152/ajpheart.1985.248.1.H151
Quilliot, D., Zannad, F., & Ziegler, O. (2005). Impaired response of cardiac autonomic nervous system to glucose load in severe obesity. Metabolism, 54(7), 966-974. doi: 10.1016/j.metabol.2005.03.002
Raynor, H. A., & Champagne, C. M. (2016). Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults. J Acad Nutr Diet, 116(1), 129-147. doi: 10.1016/j.jand.2015.10.031
Reis, J. P., Macera, C. A., Araneta, M. R., Lindsay, S. P., Marshall, S. J., & Wingard, D. L. (2009). Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity (Silver Spring), 17(6), 1232-1239. doi: 10.1038/oby.2008.664
Rissanen, P., Franssila-Kallunki, A., & Rissanen, A. (2001). Cardiac parasympathetic activity is increased by weight loss in healthy obese women. Obes Res, 9(10), 637-643. doi: 10.1038/oby.2001.84
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., . . . Williamson, D. A. (2009). Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med, 360(9), 859-873. doi: 10.1056/NEJMoa0804748
Schwartz, P. J., & Vanoli, E. (1981). Cardiac arrhythmias elicited by interaction between acute myocardial ischemia and sympathetic hyperactivity: a new experimental model for the study of antiarrhythmic drugs. J Cardiovasc Pharmacol, 3(6), 1251-1259.
Sessa, F., Anna, V., Messina, G., Cibelli, G., Monda, V., Marsala, G., . . . Salerno, M. (2018). Heart rate variability as predictive factor for sudden cardiac death. Aging (Albany NY), 10(2), 166-177. doi: 10.18632/aging.101386
Shaw, K., Gennat, H., O'Rourke, P., & Del Mar, C. (2006). Exercise for overweight or obesity. Cochrane Database Syst Rev(4), CD003817. doi: 10.1002/14651858.CD003817.pub3
Sjostrom, L., Narbro, K., Sjostrom, C. D., Karason, K., Larsson, B., Wedel, H., . . . Swedish Obese Subjects, S. (2007). Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med, 357(8), 741-752. doi: 10.1056/NEJMoa066254
Stice, E., Presnell, K., Shaw, H., & Rohde, P. (2005). Psychological and behavioral risk factors for obesity onset in adolescent girls: a prospective study. J Consult Clin Psychol, 73(2), 195-202. doi: 10.1037/0022-006X.73.2.195
Sztajzel, J., Golay, A., Makoundou, V., Lehmann, T. N., Barthassat, V., Sievert, K., . . . Bobbioni-Harsch, E. (2009). Impact of body fat mass extent on cardiac autonomic alterations in women. Eur J Clin Invest, 39(8), 649-656. doi: 10.1111/j.1365-2362.2009.02158.x
Tentolouris, N., Tsigos, C., Perea, D., Koukou, E., Kyriaki, D., Kitsou, E., . . . Katsilambros, N. (2003). Differential effects of high-fat and high-carbohydrate isoenergetic meals on cardiac autonomic nervous system activity in lean and obese women. Metabolism, 52(11), 1426-1432.
Todd Miller, M., Lavie, C. J., & White, C. J. (2008). Impact of obesity on the pathogenesis and prognosis of coronary heart disease. J Cardiometab Syndr, 3(3), 162-167. doi: 10.1111/j.1559-4572.2008.00004.x
Tseng, C. H., Chong, C. K., Chan, T. T., Bai, C. H., You, S. L., Chiou, H. Y., . . . Chen, C. J. (2010). Optimal anthropometric factor cutoffs for hyperglycemia, hypertension and dyslipidemia for the Taiwanese population. Atherosclerosis, 210(2), 585-589. doi: 10.1016/j.atherosclerosis.2009.12.015
Tsuji, H., Larson, M. G., Venditti, F. J., Jr., Manders, E. S., Evans, J. C., Feldman, C. L., & Levy, D. (1996). Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation, 94(11), 2850-2855. doi: 10.1161/01.cir.94.11.2850
Ueno, L. M., Hamada, T., & Moritani, T. (2002). Cardiac autonomic nervous activities and cardiorespiratory fitness in older men. J Gerontol A Biol Sci Med Sci, 57(9), M605-610. doi: 10.1093/gerona/57.9.m605
Verwaerde, P., Galinier, M., Fourcade, J., Massabuau, P., Galitzky, J., Senard, J. M., . . . Montastruc, J. L. (1997). [Autonomic nervous system abnormalities in the initial phase of insulin resistance syndrome. Value of the study of variability of cardiac rate and blood pressure on a model of nutritional obesity]. Arch Mal Coeur Vaiss, 90(8), 1151-1154.
Wolf, M. M., Varigos, G. A., Hunt, D., & Sloman, J. G. (1978). Sinus arrhythmia in acute myocardial infarction. Med J Aust, 2(2), 52-53.
Yadav, R. L., Yadav, P. K., Yadav, L. K., Agrawal, K., Sah, S. K., & Islam, M. N. (2017). Association between obesity and heart rate variability indices: an intuition toward cardiac autonomic alteration - a risk of CVD. Diabetes Metab Syndr Obes, 10, 57-64. doi: 10.2147/DMSO.S123935
Yusuf, S., Hawken, S., Ounpuu, S., Bautista, L., Franzosi, M. G., Commerford, P., . . . Investigators, I. S. (2005). Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet, 366(9497), 1640-1649. doi: 10.1016/S0140-6736(05)67663-5
Zahorska-Markiewicz, B., Obuchowicz, E., Waluga, M., Tkacz, E., & Herman, Z. S. (2001). Neuropeptide Y in obese women during treatment with adrenergic modulation drugs. Med Sci Monit, 7(3), 403-408.
Zoppini, G., Cacciatori, V., Gemma, M. L., Moghetti, P., Targher, G., Zamboni, C., . . . Muggeo, M. (2007). Effect of moderate aerobic exercise on sympatho-vagal balance in Type 2 diabetic patients. Diabet Med, 24(4), 370-376. doi: 10.1111/j.1464-5491.2007.02076.x