Does body fat percentage predict post-exercise heart rate response in non-obese children and adolescents?

Tatjana Jezdimirovic 1 , 2 , Valdemar Stajer 1 , Sasa Semeredi 1 , Julio Calleja-Gonzalez 3  and Sergej M. Ostojic 1
  • 1 Faculty of Sport and Physical Education, Novi Sad, Serbia
  • 2 Faculty of Sport and Tourism, Sremska Kamenica, Serbia
  • 3 Faculty of Sport Sciences, Vitoria-Gasteiz, Spain
Tatjana Jezdimirovic
  • Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
  • Faculty of Sport and Tourism, Educons University, Sremska Kamenica, Serbia
  • Search for other articles:
  • degruyter.comGoogle Scholar
, Valdemar Stajer, Sasa Semeredi, Julio Calleja-Gonzalez
  • Faculty of Sport Sciences, University of the Basque Country, Vitoria-Gasteiz, Spain
  • Search for other articles:
  • degruyter.comGoogle Scholar
and Sergej M. Ostojic



A correlation between adiposity and post-exercise autonomic regulation has been established in overweight and obese children. However, little information exists about this link in non-obese youth. The main purpose of this cross-sectional study was to describe the relationship between body fat percentage (BFP) and heart rate recovery after exercise [post-exercise heart rate (PEHR)], a marker of autonomic regulation, in normal-weight children and adolescents.


We evaluated the body composition of 183 children and adolescents (age 15.0±2.3 years; 132 boys and 51 girls) who performed a maximal graded exercise test on a treadmill, with the heart rate monitored during and immediately after exercise.


A strong positive trend was observed in the association between BFP and PEHR (r=0.14; p=0.06). Hierarchical multiple regression revealed that our model explained 18.3% of the variance in PEHR (p=0.00), yet BFP accounted for only 0.9% of the variability in PEHR (p=0.16). The evaluation of the contribution of each independent variable revealed that only two variables made a unique statistically significant contribution to our model (p<0.01), with age contributing 38.7% to our model (p=0.00) while gender accounted for an additional 25.5% (p=0.01). Neither BFP (14.4%; p=0.16) nor cardiorespiratory endurance (5.0%, p=0.60) made a significant unique contribution to the model.


Body fatness seems to poorly predict PEHR in our sample of non-obese children and adolescents, while non-modifiable variables (age and gender) were demonstrated as strong predictors of heart rate recovery. The low amount of body fat reported in non-obese young participants was perhaps too small to cause disturbances in autonomic nervous system regulation.

  • 1.

    Ohuchi H, Suzuki H, Yasuda K, Arakaki Y, Echigo S, et al. Heart rate recovery after exercise and cardiac autonomic nervous activity in children. Pediatr Res 2000;47:329–35.

  • 2.

    Lin LY, Kuo HK, Lai LP, Lin JL, Tseng CD, et al. Inverse correlation between heart rate recovery and metabolic risks in healthy children and adolescents: insight from the National Health and Nutrition Examination Survey 1999–2002. Diabetes Care 2008;31:1015–20.

  • 3.

    Simhaee D, Corriveau N, Gurm R, Geiger Z, Kline-Rogers E, et al. Recovery heart rate: an indicator of cardiovascular risk among middle school children. Pediatr Cardiol 2013;34: 1431–7.

  • 4.

    Javorka K, Javorková J, Petrásková M, Tonhajzerová I, Buchanec J, et al. Heart rate variability and cardiovascular tests in young patients with diabetes mellitus type 1. J Pediatr Endocrinol Metab 1999;12:423–31.

  • 5.

    Kuo HK, Gore JM. Relation of heart rate recovery after exercise to insulin resistance and chronic inflammation in otherwise healthy adolescents and adults: results from the National Health and Nutrition Examination Survey (NHANES) 1999–2004. Clin Res Cardiol 2015;104:764–72.

  • 6.

    Ostojic SM. Post-exercise recovery: fundamental and interventional physiology. Front Physiol 2016;7:3.

  • 7.

    Rossi RC, Vanderlei LC, Gonçalves AC, Vanderlei FM, Bernardo AF, et al. Impact of obesity on autonomic modulation, heart rate and blood pressure in obese young people. Auton Neurosci 2015;193:138–41.

  • 8.

    Laguna M, Aznar S, Lara MT, Lucía A, Ruiz JR. Heart rate recovery is associated with obesity traits and related cardiometabolic risk factors in children and adolescents. Nutr Metab Cardiovasc Dis 2013;23:995–1001.

  • 9.

    Abu Hanifah R, Mohamed MN, Jaafar Z, Mohsein NA, Jalaludin MY, et al. The correlates of body composition with heart rate recovery after step test: an exploratory study of Malaysian adolescents. PLoS One 2013;8:e82893.

  • 10.

    Soares-Miranda L, Alves AJ, Vale S, Aires L, Santos R, et al. Central fat influences cardiac autonomic function in obese and overweight girls. Pediatr Cardiol 2011;32:924–8.

  • 11.

    Dangardt F, Volkmann R, Chen Y, Osika W, Marild S, et al. Reduced cardiac vagal activity in obese children and adolescents. Clin Physiol Funct Imaging 2011;31:108–13.

  • 12.

    Kaufman CL, Kaiser DR, Steinberger J, Kelly AS, Dengel DR. Relationships of cardiac autonomic function with metabolic abnormalities in childhood obesity. Obesity 2007;15:1164–71.

  • 13.

    Dipla K, Zafeiridis A, Koidou I, Geladas N, Vrabas IS. Altered hemodynamic regulation and reflex control during exercise and recovery in obese boys. Am J Physiol Heart Circ Physiol 2010;299:2090–6.

  • 14.

    Baum P, Petroff D, Classen J, Kiess W, Blüher S. Dysfunction of autonomic nervous system in childhood obesity: a cross-sectional study. PLoS One 2013;8:e54546.

  • 15.

    Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol 1988;60:709–23.

  • 16.

    McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM. Body fat reference curves for children. Int J Obes 2006;30:598–602.

  • 17.

    Ostojic SM, Stojanovic MD, Calleja-Gonzalez J. Ultra short-term heart rate recovery after maximal exercise: relations to aerobic power in sportsmen. Chin J Physiol 2011;54:105–10.

  • 18.

    da Silva DF, Bianchini JA, Antonini VD, Hermoso DA, Lopera CA, et al. Parasympathetic cardiac activity is associated with cardiorespiratory fitness in overweight and obese adolescents. Pediatr Cardiol 2014;35:684–90.

  • 19.

    Üner A, Doğan M, Epcacan Z, Epçaçan S. The effect of childhood obesity on cardiac functions. J Pediatr Endocrinol Metab 2014;27:261–71.

  • 20.

    Tonello L, Reichert FF, Oliveira-Silva I, Del Rosso S, Leicht AS, et al. Correlates of heart rate measures with incidental physical activity and cardiorespiratory fitness in overweight female workers. Front Physiol 2016;6:405.

  • 21.

    Imai K, Sato H, Hori M, Kusuoka H, Ozaki H, et al. Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 1994;24:1529–35.

  • 22.

    Hägglund H, Uusitalo A, Peltonen JE, Koponen AS, Aho J, et al. Cardiovascular autonomic nervous system function and aerobic capacity in type 1 diabetes. Front Physiol 2012;3:356.

  • 23.

    Porges SW, Furman SA. The early development of the autonomic nervous system provides a neural platform for social behavior: a polyvagal perspective. Infant Child Dev 2011;20:106–18.

  • 24.

    Liu CC, Kuo TB, Yang CC. Effects of estrogen on gender-related autonomic differences in humans. Am J Physiol Heart Circ Physiol 2003;285:H2188–93.

Purchase article
Get instant unlimited access to the article.
Log in
Already have access? Please log in.

Journal + Issues

The Journal of Pediatric Endocrinology and Metabolism (JPEM) is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups, and publishes the results of clinical investigations in pediatric endocrinology and basic research. JPEM publishes Review Articles, Original Research, Case Reports, Short Communications and Letters to the Editor.