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Clinical Studies and Practice

Impacts of obesity and stress on neuromuscular fatigue development and associated heart rate variability

Abstract

Objectives:

Obesity and stress are independently associated with decrements in neuromuscular functions. The present study examined the interplay of obesity and stress on neuromuscular fatigue and associated heart rate variability (HRV).

Methods:

Forty-eight non-obese (18.5<body mass index (BMI)<25 kg m−2) and obese (30BMI) adults performed repetitive handgrip exertions at 30% of their maximum strength until exhaustion in the absence and presence of a mental arithmetic stressor. Dependent measures included gold standard fatigue indicators (endurance time and rate of strength loss), perceived effort and mental demand, heart rate and temporal (RMSSD: root mean square of successive differences between N–N intervals) and spectral (LF/HF: ratio of low to high frequency) indices of HRV.

Results:

Stress negatively affected endurance time (P<0.0001) and rate of strength loss (P=0.029). In addition, significant obesity × stress interactions were found on endurance time (P=0.0073), rate of strength loss (P=0.027) and perceived effort (P=0.026), indicating that stress increased fatigability, particularly in the obese group. Both obesity (P=0.001) and stress (P=0.033) independently lowered RMSSD. Finally, stress increased LF/HF ratio (P=0.028) and the interaction of stress and obesity (P=0.008) indicated that this was augmented in the obese group.

Discussion:

The present study provides the first evidence that stress-related neuromuscular fatigue development is accelerated in obese individuals. In addition, the stress condition resulted in poorer HRV indices, which is indicative of autonomic dysfunction, particularly in the obese group. These findings indicate that workers are more susceptible to fatigue in high-stress work environments, particularly those with higher BMI, which can increase the risk of musculoskeletal injuries as well as cardiovascular diseases in this population.

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References

  1. Flegal KM, Carroll MD, Ogden CL, Curtin LR . Prevalence and trends in obesity among US adults, 1999-2008. Jama 2010; 303: 235–241.

    CAS  Article  Google Scholar 

  2. Finkelstein EA, Burgess SM, Hale BC . The costs of obesity in the workplace. J Occup Env Med 2010; 52: 971.

    Article  Google Scholar 

  3. Sartorio A, Proietti M, Marinone P, Agosti F, Adorni F, Lafortuna C . Influence of gender, age and BMI on lower limb muscular power output in a large population of obese men and women. Int J obes 2004; 28: 91–98.

    CAS  Article  Google Scholar 

  4. Houston DK, Ding J, Nicklas BJ, Harris TB, Lee JS, Nevitt MC et al. Overweight and Obesity Over the Adult Life Course and Incident Mobility Limitation in Older Adults. The Health, Aging and Body Composition Study. Am J Epidemiol 2009; 169: 927–936.

    Article  Google Scholar 

  5. Mehta RK, Cavuoto LA . The effects of obesity, age, and relative workload levels on handgrip endurance. Appl Ergon; e-pub ahead of print 31 July 2014; doi:10.1016/j.apergo.2014.07.007.

    Article  Google Scholar 

  6. Hilton TN, Tuttle LJ, Bohnert KL, Mueller MJ, Sinacore DR . Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function. Physical Therapy 2008; 88: 1336–1344.

    Article  Google Scholar 

  7. Maffiuletti NA, Jubeau M, Munzinger U, Bizzini M, Agosti F, De Col A et al. Differences in quadriceps muscle strength and fatigue between lean and obese subjects. Eur J Appl Physiol 2007; 101: 51–59.

    Article  Google Scholar 

  8. Østbye T, Dement JM, Krause KM . Obesity and workers' compensation: results from the Duke Health and Safety Surveillance System. Arch Intern Med 2007; 167: 766–773.

    Article  Google Scholar 

  9. Kern PA, Simsolo RB, Fournier M . Effect of weight loss on muscle fiber type, fiber size, capillarity, and succinate dehydrogenase activity in humans 1. J Clin Endocrinol Metab 1999; 84: 4185–4190.

    CAS  PubMed  Google Scholar 

  10. Tanner CJ, Barakat HA, Dohm GL, Pories WJ, MacDonald KG, Cunningham PRG et al. Muscle fiber type is associated with obesity and weight loss. Am J Physiol EndocrinolMetab 2002; 282: E1191–E1196.

    CAS  Article  Google Scholar 

  11. Mehta RK, Shortz A . Obesity-related differences in neural correlates of force control. Eur J Appl Physiol 2014; 114: 197–204.

    Article  Google Scholar 

  12. Schulte PA, Wagner GR, Ostry A, Blanciforti LA, Cutlip RG, Krajnak KM et al. Work, obesity, and occupational safety and health. Am J Public Health 2007; 97: 428–436.

    Article  Google Scholar 

  13. Nishitani N, Sakakibara H . Relationship of obesity to job stress and eating behavior in male Japanese workers. Int J Obesity 2006; 30: 528–533.

    CAS  Article  Google Scholar 

  14. Weber A, Fussler C, O'Hanlon JF, Gierer R, Grandjean E . Psychophysiological effects of repetitive tasks. Ergonomics 1980; 23: 1033–1046.

    CAS  Article  Google Scholar 

  15. Kivimäki M, Head J, Ferrie J, Shipley M, Brunner E, Vahtera J et al. Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study. Int J Obesity 2006; 30: 982–987.

    Article  Google Scholar 

  16. Mehta RK, Agnew MJ . Effects of concurrent physical and mental demands for a short duration static task. Int J Ind Ergon 2011; 41: 488–493.

    Article  Google Scholar 

  17. Mehta RK, Agnew MJ . Exertion-dependent effects of physical and mental workload on physiological outcomes and task performance. IIE Trans Occup 2012; 1: 3–15.

    Google Scholar 

  18. Mehta RK, Nussbaum MA, Agnew MJ . Muscle- and task-dependent responses to concurrent physical and mental workload during intermittent static work. Ergonomics 2012; 59: 1166–1179.

    Article  Google Scholar 

  19. Mehta RK, Agnew MJ . Influence of mental workload on muscle endurance, fatigue, and recovery during intermittent static work. Eur J Appl Physiol 2012; 112: 2891–2902.

    Article  Google Scholar 

  20. Marcora SM, Staiano W, Manning V . Mental fatigue impairs physical performance in humans. J Appl Physiol 2009; 106: 857–864.

    Article  Google Scholar 

  21. Melin B, Lundberg U . A biopsychosocial approach to work-stress and musculoskeletal disorders. J Psychophysiol 1997; 11: 238–247.

    Google Scholar 

  22. Kuper H, Singh-Manoux A, Siegrist J, Marmot M . When reciprocity fails: effort–reward imbalance in relation to coronary heart disease and health functioning within the Whitehall II study. Occup Environ Med 2002; 59: 777–784.

    CAS  Article  Google Scholar 

  23. Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J . Work stress in the etiology of coronary heart disease—a meta-analysis. Scand J Work Environ Health 2006; 32: 431–442.

    Article  Google Scholar 

  24. Stanek KM, Grieve SM, Brickman AM, Korgaonkar MS, Paul RH, Cohen RA et al. Obesity Is Associated With Reduced White Matter Integrity in Otherwise Healthy Adults*. Obesity 2011; 19: 500–504.

    Article  Google Scholar 

  25. Gentier I, D’Hondt E, Shultz S, Deforche B, Augustijn M, Hoorne S et al. Fine and gross motor skills differ between healthy-weight and obese children. Res Dev Disab 2013; 34: 4043–4051.

    Article  Google Scholar 

  26. Wolf PA, Beiser A, Elias MF, Au R, Vasan RS, Seshadri S . Relation of obesity to cognitive function: importance of central obesity and synergistic influence of concomitant hypertension. The Framingham Heart Study. Curr Alzheimer Res 2007; 4: 111–116.

    CAS  Article  Google Scholar 

  27. Lallukka T, Laaksonen M, Martikainen P, Sarlio-Lähteenkorva S, Lahelma E . Psychosocial working conditions and weight gain among employees. Int J obesity 2005; 29: 909–915.

    CAS  Article  Google Scholar 

  28. Kouvonen A, Kivimäki M, Cox SJ, Cox T, Vahtera J . Relationship between work stress and body mass index among 45,810 female and male employees. Psychosom Med 2005; 67: 577–583.

    Article  Google Scholar 

  29. Logue J, Murray HM, Welsh P, Shepherd J, Packard C, Macfarlane P et al. Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation. Heart 2011; 97: 564–568.

    Article  Google Scholar 

  30. Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Eng J Med 2011; 365: 1876–1885.

    CAS  Article  Google Scholar 

  31. Karason K, Mølgaard H, Wikstrand J, Sjöström L . Heart rate variability in obesity and the effect of weight loss. Am J Cardiol 1999; 83: 1242–1247.

    CAS  Article  Google Scholar 

  32. Steptoe A, Kivimäki M . Stress and cardiovascular disease. Nat Rev Cardiol 2012; 9: 360–370.

    CAS  Article  Google Scholar 

  33. Windham BG, Fumagalli S, Ble A, Sollers JJ, Thayer JF, Najjar SS et al. The relationship between heart rate variability and adiposity differs for central and overall adiposity. Journal of obesity 2012; 2012: 149516.

    Article  Google Scholar 

  34. Chandola T, Britton A, Brunner E, Hemingway H, Malik M, Kumari M et al. Work stress and coronary heart disease: what are the mechanisms? Eur Heart J 2008; 29: 640–648.

    Article  Google Scholar 

  35. (NIH) NIoH, National Heart L, and Blood Institute (NHLBI), (NAASO) NAAftSoO. The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Rockville, MD: National Institutes of Health, 2000.

  36. Fleishman EA . Toward a Taxonomy of Human Performance. Am Psychol 1975; 30: 1127–1149.

    Article  Google Scholar 

  37. Peterson L, Peterson MJ . Short-term retention of individual verbal items. J Exp Psychol 1959; 58: 193–198.

    CAS  Article  Google Scholar 

  38. Schleifer LM, Spalding TW, Kerick SE, Cram JR, Ley R, Hatfield BD . Mental stress and trapezius muscle activation under psychomotor challenge: A focus on EMG gaps during computer work. Psychophysiology 2008; 45: 356–365.

    Article  Google Scholar 

  39. Allen M, Crowell M . Patterns of autonomic response during laboratory stressors. Psychophysiology 1989; 26: 603–614.

    CAS  Article  Google Scholar 

  40. Vøllestad NK . Measurement of human muscle fatigue. J Neurosci Methods 1997; 74: 219–227.

    Article  Google Scholar 

  41. Borg G . Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 1990; 16: 55.

    Article  Google Scholar 

  42. Hart SG, Staveland LE . Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research. Adv Psychology 1988; 52: 139–183.

    Article  Google Scholar 

  43. Taylor JL, Gandevia SC . A comparison of central aspects of fatigue in submaximal and maximal voluntary contractions. J Appl Physiol 2008; 104: 542–550.

    Article  Google Scholar 

  44. Malik M, Bigger J, Camm A, Kleiger R, Malliani A, Moss A et al. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 1996; 93: 1043.

    Article  Google Scholar 

  45. Hulens M, Vansant G, Lysens R, Claessens AL, Muls E . Assessment of isokinetic muscle strength in women who are obese. J Orthop Sport Phys Ther 2002; 32: 347.

    Article  Google Scholar 

  46. Lafortuna C, Agosti F, Marinone P, Marazzi N, Sartorio A . The relationship between body composition and muscle power output in men and women with obesity. J Endocrinol Invest 2004; 27: 854.

    CAS  Article  Google Scholar 

  47. Eksioglu M . Endurance time of grip-force as a function of grip-span, posture and anthropometric variables. Int J Ind Ergon 2011; 41: 401–409.

    Article  Google Scholar 

  48. Cavuoto L, Nussbaum M . Obesity-related differences in muscular capacity during sustained isometric exertions. Appl Ergon 2013; 44: 254–260.

    Article  Google Scholar 

  49. Hjortskov N, Rissen D, Blangsted AK, Fallentin N, Lundberg U, Søgaard K . The effect of mental stress on heart rate variability and blood pressure during computer work. Eur J Appl Physiol 2004; 92: 84–89.

    Article  Google Scholar 

  50. Lundberg Forsman M, Zachau G, Ekloèf M, Palmerud G, Melin B et al. Effects of experimentally induced mental and physical stress on motor unit recruitment in the trapezius muscle. Work Stress 2002; 16: 166–178.

    Article  Google Scholar 

  51. Marras WS, Davis KG, Heaney CA, Maronitis AB, Allread WG . The Influence of psychosocial stress, gender, and personality on mechanical loading of the lumbar spine. Spine 2000; 25: 3045–3054.

    CAS  Article  Google Scholar 

  52. Mehta RK, Parasuraman R . The effect of mental fatigue on the development of physical fatigue: a neuroergonomic approach. Human Factors 2014; 56: 645–656.

    Article  Google Scholar 

  53. Mandrick K, Derosiere G, Dray G, Coulon D, Micallef J-P, Perrey S . Prefrontal cortex activity during motor tasks with additional mental load requiring attentional demand: a near-infrared spectroscopy study. Neurosci Res 2013; 76: 156–162.

    Article  Google Scholar 

  54. Thayer JF, Yamamoto SS, Brosschot JF . The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2010; 141: 122–131.

    Article  Google Scholar 

  55. Martini G, Riva P, Rabbia F, Molini V, Ferrero GB, Cerutti F et al. Heart rate variability in childhood obesity. Clin Auton Res 2001; 11: 87–91.

    CAS  Article  Google Scholar 

  56. Villareal DT, Banks M, Siener C, Sinacore DR, Klein S . Physical frailty and body composition in obese elderly men and women. Obesity Res 2004; 12: 913–920.

    Article  Google Scholar 

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Acknowledgements

Funding for this project was provided by Grant No. 5T42OH008421 from the National Institute for Occupational and Environmental Health (NIOSH)/Centers for Disease Control and Prevention to the Southwest Center for Occupational and Environmental Health (SWCOEH), a NIOSH Education and Research Center.

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Mehta, R. Impacts of obesity and stress on neuromuscular fatigue development and associated heart rate variability. Int J Obes 39, 208–213 (2015). https://doi.org/10.1038/ijo.2014.127

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