Factors Associated With Obesity in Adult Women: Respiratory Exchange Ratio, Heart Rate Variation and Body Image

August 10, 2020 updated by: National Taiwan University Hospital
The prevalence of obesity all over the world has increased year by year, and how to effectively prevent and treat obesity has become an important health care issue. Many adjustable and nonadjustable causes of obesity have been proposed, such as unbalanced eating habits, lack of physical activity, psychological factors, and genes. The practice guidelines recommended lifestyle modification interventions which include diet control combined with regular exercise as the core treatment for obesity, but the effects on different ethnic groups are not ideal. In order to provide more choices for future weight loss intervention, it would be important to find out more risk factors for obesity. Previous studies have shown that lower sympathetic activity assessed by heart rate variability was related to obesity; obese men have higher respiratory exchange rates which might indicate they are more likely to use carbohydrates as a source of energy, and therefore, fat cannot be effectively consumed and led to an accumulation in the body. Furthermore, previous studies showed that Asians are less satisfied with their body image than other races, and women are more dissatisfied than men. Poor body image will lead to a series of effects, such as changes in eating habits, hormonal changes, depression, etc., eventually forming a vicious circle of obesity. However, most aforementioned Asians in these studies are immigrants living in overseas areas such as the Americas, and cannot fully represent the ethnic groups in Asia. Therefore, the purpose of this study are (1) to investigate the physiological and psychological factors influence obesity in adult women, including respiratory exchange rate, heart rate variability, and body image, and (2) to examine the correlations among these risk factors and different degree of obesity.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Methods: This is a cross-sectional design study. Subjects were recruited from Taipei city. Inclusion criteria are women aged between 20 and 50 years old and have willing to participate to this study. Subjects will be excluded as follows: (1) taking medications that affect weight or hormones; (2) fluctuation of weight exceeds 2 kg within 3 months before the enrolled in study; (3) any condition that causes the subject fail to complete the test paper, such as: cognitive problems; (4) diagnosed with mental illness; (5) pregnancy or menopause. The assessments include: obesity-related indicators (height, weight, waist and hip circumference, percentage of body fat), respiratory exchange ratio, heart rate variability, body image (multi-directional self-body relationship questionnaire (MBSRQ), figure rating scale (FRS)), physical activity (Seven-days Physical Activity Recall, 7-d PAR), eating behavior (Three-Factor Eating Questionnaire, revised 18-item, TFEQ-18), and depression (Mongomery-Asberg Depression Rating Scale, MADRS). Statistical analysis will be performed by using SPSS version 18 (SPSS Inc, Chicago: SPSS Inc.), and significant level would be set at 0.05. Analysis of variance (ANOVA) will be used to examine the differences of all measured variables among different degrees of obesity groups. In addition, we will use multiple linear regression analysis to examine whether overweight and obesity are significantly related to respiratory exchange rate, heart rate variability and body image.

Study Type

Observational

Enrollment (Actual)

121

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
    • Zhongzheng
      • Taipei, Zhongzheng, Taiwan, 100
        • National Taiwan University, College of Medicine, Department of Physical Therapy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 50 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Sampling Method

Probability Sample

Study Population

Asian, mainly living in Taiwan

Description

Inclusion Criteria:

  • 20-50 years old, premenopausal

Exclusion Criteria:

  • Taking medications that affect weight or hormones
  • Fluctuation of weight exceeds 2 kg within 3 months before the enrolled in study
  • Any condition that causes the subject fail to complete the test paper, such as: cognitive problems
  • Diagnosed with mental illness
  • Pregnancy or menopause

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Case-Control
  • Time Perspectives: Cross-Sectional

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Non-overweight/obese & normal weight
Body mass index (BMI) < 24.0 kg/m^2
Device: Respiratory exchange ratio
Ask participants to supine on bed, using a ventilator hood cover upon their head. Measure respiratory exchange ratio for 15 minutes.
Device: Heart rate variability
Ask participants to supine on bed for 10 minutes, connect electrodes on their right wrist. Measure heart rate variability for 5 minutes.
Device: Body composition
Ask participants to supine on bed for 10 minutes, connect electrodes on their right wrist and right foot. Measure body composition.
Behavioral: Eating behavior
Fill in questionnaire (Three-Factor Eating Questionnaire, revised 18-item, TFEQ-18).
Behavioral: Physical activity recall
Fill in questionnaire (Seven-days Physical Activity Recall, 7-d PAR).
Behavioral: Depression
Fill in questionnaire (Mongomery-Asberg Depression Rating Scale, MADRS).
Behavioral: Body image
Fill in questionnaire (multi-directional self-body relationship questionnaire (MBSRQ), figure rating scale (FRS)).
Overweight and obese
Body mass index (BMI) >= 24.0 kg/m^2
Device: Respiratory exchange ratio
Ask participants to supine on bed, using a ventilator hood cover upon their head. Measure respiratory exchange ratio for 15 minutes.
Device: Heart rate variability
Ask participants to supine on bed for 10 minutes, connect electrodes on their right wrist. Measure heart rate variability for 5 minutes.
Device: Body composition
Ask participants to supine on bed for 10 minutes, connect electrodes on their right wrist and right foot. Measure body composition.
Behavioral: Eating behavior
Fill in questionnaire (Three-Factor Eating Questionnaire, revised 18-item, TFEQ-18).
Behavioral: Physical activity recall
Fill in questionnaire (Seven-days Physical Activity Recall, 7-d PAR).
Behavioral: Depression
Fill in questionnaire (Mongomery-Asberg Depression Rating Scale, MADRS).
Behavioral: Body image
Fill in questionnaire (multi-directional self-body relationship questionnaire (MBSRQ), figure rating scale (FRS)).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Respiratory exchange ratio (RER)
Time Frame: After filling in all questionnaires, lasting 15 minutes.

Ask participants to supine on bed, using a ventilator hood cover upon their head. Measure respiratory exchange ratio for 15 minutes.

Device used: Vmax® Encore Metabolic Cart, Carefusion Corporation, Yorba Linda, California (CA).

Normal range: 0.7-1.0, greater value indicates more carbohydrates oxidation, while smaller value indicates more fat oxidation.
After filling in all questionnaires, lasting 15 minutes.
Heart rate variability (HRV)
Time Frame: After measuring respiratory exchange ratio, lasting 15 minutes.

Ask participants to supine on bed for 10 minutes, connect electrodes on their right wrist. Measure heart rate variability for 5 minutes. Device used: SS1C, Enjoy Research Inc., Taiwan.

High frequency (HF): greater value indicates active parasympathetic activity. Low frequency-high frequency ratio (LF/HF): greater value indicates active sympathetic activity.
After measuring respiratory exchange ratio, lasting 15 minutes.
Body image
Time Frame: After filling in basic data questionnaire, lasting 10 minutes.
Fill in questionnaire (multi-directional self-body relationship questionnaire (MBSRQ)). There are 69 questions, each question scores 1-5 points. Sum up all points, greater value indicates better body image.
After filling in basic data questionnaire, lasting 10 minutes.
Body image (evaluative component)
Time Frame: After filling in multi-directional self-body relationship questionnaire (MBSRQ), lasting 5 minutes.
Figure rating scale (FRS) is used. Nine figures of women (from lean to obese) is provided, participants are asked to choose which figure fits her present and ideal appearance the most. Scoring 1-9 points, greater value indicates poorer body image.
After filling in multi-directional self-body relationship questionnaire (MBSRQ), lasting 5 minutes.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Body fat percentage
Time Frame: After measuring heart rate variability, lasting 5 minutes.
Ask participants to supine on bed for 10 minutes, connect electrodes on their right wrist and right foot. Measure body fat percentage. Device used: Maltron BioScan 920-2. Greater value indicates higher body fat percentage.
After measuring heart rate variability, lasting 5 minutes.
Physical activity
Time Frame: After filling in body image questionnaire, lasting 5 minutes.
Fill in questionnaire (Seven-days Physical Activity Recall, 7-d PAR). Participants are asked to recall average time spent in a week on sleeping and activities of different intensities (Unit: metabolic equivalent of tasks (METs)). Sleeping, mild activity, moderate activity, vigorous activity, very vigorous activity are calculated as 1, 1.5, 4, 6, 10 METs respectively. Sum up all METs, divided by 7, we can obtain average daily energy expenditure. Greater value indicates more physical activity done.
After filling in body image questionnaire, lasting 5 minutes.
Eating behavior
Time Frame: After filling in physical activity questionnaire, lasting 5 minutes.
Fill in questionnaire (Three-Factor Eating Questionnaire, revised 18-item, TFEQ-18). This questionnaire includes 18 questions, scoring 1-4 points, except question 18 (1-8 points). Sum up all points, greater value indicates better eating behavior.
After filling in physical activity questionnaire, lasting 5 minutes.
Depression
Time Frame: After filling in eating behavior questionnaire, lasting 5 minutes.
Fill in questionnaire (Mongomery-Asberg Depression Rating Scale, MADRS). This questionnaire includes 10 questions, scoring 0-6 points. Sum up all points, greater value indicates more depressed.
After filling in eating behavior questionnaire, lasting 5 minutes.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2019

Primary Completion (Actual)

October 26, 2019

Study Completion (Actual)

January 14, 2020

Study Registration Dates

First Submitted

April 15, 2019

First Submitted That Met QC Criteria

July 22, 2019

First Posted (Actual)

July 23, 2019

Study Record Updates

Last Update Posted (Actual)

August 12, 2020

Last Update Submitted That Met QC Criteria

August 10, 2020

Last Verified

November 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 201901140RINA

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

IPD Plan Description

We will respect the participants' willingness.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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