In metabolically healthy obese individuals, increased BMI was significantly associated with reduced vagal tone as indicated by decreased high-frequency HRV (p < .05).
Is metabolically healthy obesity associated with changes in heart rate variability and neurocognitive performance compared to healthy controls?
Metabolically healthy obesity is associated with reduced vagal tone and lower BDNF levels, suggesting early autonomic and cognitive changes.
Background Studies suggest that obesity is linked to both autonomic nervous system dysfunction and cognitive impairment, but the specific quantitative associations are not well explored. Purpose This study was proposed to explore the quantification of different neurocognitive signatures and heart rate variability (HRV) parameters with increasing body weight among metabolically healthy obese participants for better analytical predictors. Methods The present research is a cross-sectional study, including a total of 101 ( n = 101) participants. Out of the total, 71 were metabolically healthy obese or overweight individuals (body mass index BMI = 23.0–30.0 kg/m 2 ; age 36–55 years; both genders) and 30 participants were enrolled as the control group. All the participants completed various neurological and psychological assessments, including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), serum levels of brain-derived neurotrophic factor (BDNF) and cardio-autonomic tone by HRV analysis. Results Significant changes were observed for neurocognitive performances and HRV indices for the metabolically healthy obese group compared with the control group. With the association heatmaps, BMI was found to be significantly negatively associated with the BDNF and high-frequency band (HF band, ms 2 ). In socio-demographic-adjusted models, the analysis showed a substantial decline ( p < .05) in the HF band, ms 2 with an increase in BMI, emphasising its significant effect on vagal tone among the obese group. Also, a noteworthy association between BDNF levels and the standard deviation of all normal-to-normal intervals (SDNN)-HRV indices have confirmed the robustness of the findings for obese participants when compared with the control group. Conclusion The findings of the present study support that HRV could be a valuable early non-invasive tool for future cognitive decline in a population with metabolically healthy obesity. Clinical Trial Registry The study was registered at Clinical Trial Registry of India (CTRI/2022/10/046935).
Bansal et al. (2026) studied this question. In metabolically healthy obese individuals, increased BMI was significantly associated with reduced vagal tone as indicated by decreased high-frequency HRV (p < .05).