Introduction: Previously, an intervention involving volitional slow breathing reduced trait food craving with protective effects on cardiac vagal activity (CVA). Breathing with a low inspiration-to-expiration (i/e) ratio also increases CVA. High CVA was separately associated with low unregulated eating and lesser impulsivity. Hence, the present study assessed breathing with a low i/e for effects on state food craving, hunger and satiety, state impulsivity, and heart rate variability (HRV) in healthy obese persons. Methods: Forty obese persons were randomized to two groups. The intervention group (mean age ± SD, 41.15 ± 12.63, M:F, 10:10) practiced metronome-regulated breathing with low i/e at 12 breaths per minute (expiration 72% of total breath duration) and attained expiration 55.8% of total breath duration, while the active control group (mean age ± SD, 44.45 ± 11.06, M:F, 13:07) sat motionless and directed their gaze and awareness to the stationary metronome without modifying their breath consciously. The HRV was recorded before, during, and after breathing intervention (or control) (standard limb lead I, acquisition at 2,000 Hz, with an LF filter = 0.5 Hz and HF filter = 50 Hz). Time-domain and frequency-domain HRV parameters were obtained with Kubios software. State food craving, and hunger and satiety were recorded before and after the intervention/control. Results: The intervention group decreased total state food craving scores and the sub-domains (i.e., desire to eat, positive reinforcement, lack of control and hunger), increased current satisfaction with food, decreased total state impulsivity (repeated measures ANOVA, p < 0.05 in all cases), increased HF-HRV and RMSSD (linear mixed model analyses with age and gender as fixed factors; p < 0.05 in all cases) during the intervention compared to the preceding baseline. The intervention group also showed an increase in positive mood and a decrease in aroused and negative mood states. Conclusion: Changes in state food craving and impulsivity could be related to an increase in HRV or to changes in subjective relaxation and positive mood or to both.

1.
Myers
CA
,
Martin
CK
,
Apolzan
JW
.
Food cravings and body weight: a conditioning response
.
Curr Opin Endocrinol Diabetes Obes
.
2018
;
25
(
5
):
298
302
.
2.
Chao
A
,
Grilo
CM
,
White
MA
,
Sinha
R
.
Food cravings, food intake, and weight status in a community-based sample
.
Eat Behav
.
2014
;
15
(
3
):
478
82
.
3.
Chao
AM
,
Jastreboff
AM
,
White
MA
,
Grilo
CM
,
Sinha
R
.
Stress, cortisol, and other appetite-related hormones: prospective prediction of 6-month changes in food cravings and weight
.
Obesity
.
2017
;
25
(
4
):
713
20
.
4.
Hoertel
HA
,
Will
MJ
,
Leidy
HJ
.
A randomized crossover, pilot study examining the effects of a normal protein vs. high protein breakfast on food cravings and reward signals in overweight/obese “breakfast skipping”, late-adolescent girls
.
Nutr J
.
2014
;
13
:
80
.
5.
Davis
C
,
Curtis
C
,
Levitan
RD
,
Carter
JC
,
Kaplan
AS
,
Kennedy
JL
.
Evidence that “food addiction” is a valid phenotype of obesity
.
Appetite
.
2011
;
57
(
3
):
711
7
.
6.
Meule
A
.
The psychology of food cravings: the role of food deprivation
.
Curr Nutr Rep
.
2020
;
9
(
3
):
251
7
.
7.
Innamorati
M
,
Imperatori
C
,
Harnic
D
,
Erbuto
D
,
Patitucci
E
,
Janiri
L
, et al
.
Emotion regulation and mentalization in people at risk for food addiction
.
Behav Med
.
2017
;
43
(
1
):
21
30
.
8.
Shriver
LH
,
Dollar
JM
,
Lawless
M
,
Calkins
SD
,
Keane
SP
,
Shanahan
L
, et al
.
Longitudinal associations between emotion regulation and adiposity in late adolescence: indirect effects through eating behaviors
.
Nutrients
.
2019
;
11
(
3
):
517
.
9.
Aldao
A
.
The future of emotion regulation research: capturing context
.
Perspect Psychol Sci
.
2013
;
8
(
2
):
155
72
.
10.
Thayer
JF
,
Ahs
F
,
Fredrikson
M
,
Sollers
JJ
3rd
,
Wager
TD
.
A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health
.
Neurosci Biobehav Rev
.
2012
;
36
(
2
):
747
56
.
11.
Thayer
JF
,
Sternberg
E
.
Beyond heart rate variability: vagal regulation of allostatic systems
.
Ann N Y Acad Sci
.
2006
;
1088
:
361
72
.
12.
Beauchaine
TP
,
Thayer
JF
.
Heart rate variability as a transdiagnostic biomarker of psychopathology
.
Int J Psychophysiol
.
2015
;
98
(
2 Pt 2
):
338
50
.
13.
Spitoni
GF
,
Ottaviani
C
,
Petta
AM
,
Zingaretti
P
,
Aragona
M
,
Sarnicola
A
, et al
.
Obesity is associated with lack of inhibitory control and impaired heart rate variability reactivity and recovery in response to food stimuli
.
Int J Psychophysiol
.
2017
;
116
:
77
84
.
14.
Smith
KE
,
Mason
TB
,
Schaefer
LM
,
Juarascio
A
,
Dvorak
R
,
Weinbach
N
, et al
.
Examining intra-individual variability in food-related inhibitory control and negative affect as predictors of binge eating using ecological momentary assessment
.
J Psychiatr Res
.
2020
;
120
:
137
43
.
15.
Ranzenhofer
LM
,
Engel
SG
,
Crosby
RD
,
Haigney
M
,
Anderson
M
,
McCaffery
JM
, et al
.
Real-time assessment of heart rate variability and loss of control eating in adolescent girls: a pilot study
.
Int J Eat Disord
.
2016
;
49
(
2
):
197
201
.
16.
van der Zwan
JE
,
de Vente
W
,
Huizink
AC
,
Bögels
SM
,
de Bruin
EI
.
Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: a randomized controlled trial
.
Appl Psychophysiol Biofeedback
.
2015
;
40
(
4
):
257
68
.
17.
Meule
A
,
Freund
R
,
Skirde
AK
,
Vögele
C
,
Kübler
A
.
Heart rate variability biofeedback reduces food cravings in high food cravers
.
Appl Psychophysiol Biofeedback
.
2012
;
37
(
4
):
241
51
.
18.
Meule
A
,
Kübler
A
.
A pilot study on the effects of slow paced breathing on current food craving
.
Appl Psychophysiol Biofeedback
.
2017
;
42
(
1
):
59
68
.
19.
Russo
MA
,
Santarelli
DM
,
O’Rourke
D
.
The physiological effects of slow breathing in the healthy human
.
Breathe
.
2017
;
13
(
4
):
298
309
.
20.
Bae
D
,
Matthews
JJL
,
Chen
JJ
,
Mah
L
.
Increased exhalation to inhalation ratio during breathing enhances high-frequency heart rate variability in healthy adults
.
Psychophysiology
.
2021
;
58
(
11
):
e13905
.
21.
Telles
S
,
Sharma
SK
,
Kumar
A
,
Gandharva
K
,
Balkrishna
A
.
Breath phase durations, affect, and attention: a pilot randomized crossover trial
.
Int J Yoga
.
2023
;
16
(
2
):
143
7
.
22.
Reents
J
,
Seidel
AK
,
Wiesner
CD
,
Pedersen
A
.
The effect of hunger and satiety on mood-related food craving
.
Front Psychol
.
2020
;
11
:
568908
.
23.
Misra
A
,
Chowbey
P
,
Makkar
BM
,
Vikram
NK
,
Wasir
JS
,
Chadha
D
, et al
.
Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management
.
J Assoc Physicians India
.
2009
;
57
:
163
70
.
24.
Faul
F
,
Erdfelder
E
,
Buchner
A
,
Lang
AG
.
Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses
.
Behav Res Methods
.
2009
;
41
(
4
):
1149
60
.
25.
Wood
AM
,
White
IR
,
Thompson
SG
.
Are missing outcome data adequately handled? A review of published randomized controlled trials in major medical journals
.
Clin Trials
.
2004
;
1
(
4
):
368
76
.
26.
Urbaniak
GC
,
Plous
S
.
Research Randomizer (Version 4.0)
[cited 2013 June 22]. Available from: https://www.randomizer.org/
27.
Ramakrishnan
AG
,
Adarsh
A
.
R-wave amplitude changes and atypical heart rate changes accompanying breath hold during low breathing rates
. In:
2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)
.
IEEE
;
2020
; p.
2667
70
.
28.
Cepeda-Benito
A
,
Gleaves
DH
,
Fernández
MC
,
Vila
J
,
Williams
TL
,
Reynoso
J
.
The development and validation of Spanish versions of the state and trait food cravings questionnaires
.
Behav Res Ther
.
2000
;
38
(
11
):
1125
38
.
29.
Cepeda-Benito
A
,
Gleaves
DH
,
Williams
TL
,
Erath
SA
.
The development and validation of the state and trait food-cravings questionnaires
.
Behav Ther
.
2000
;
31
(
1
):
151
73
.
30.
Flint
A
,
Raben
A
,
Blundell
JE
,
Astrup
A
.
Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies
.
Int J Obes Relat Metab Disord
.
2000
;
24
(
1
):
38
48
.
31.
Shaffer
F
,
Ginsberg
JP
.
An overview of heart rate variability metrics and norms
.
Front Public Health
.
2017
;
5
:
258
.
32.
Malik
M
.
Heart rate variability: standards of measurement, physiological interpretation, and clinical use: task force of the European society of cardiology and the north American society for pacing and electrophysiology
.
Ann Noninvasive Electrocardiol
.
1996
;
1
(
2
):
151
81
.
33.
Berntson
GG
,
Bigger
JT
Jr
,
Eckberg
DL
,
Grossman
P
,
Kaufmann
PG
,
Malik
M
, et al
.
Heart rate variability: origins, methods, and interpretive caveats
.
Psychophysiology
.
1997
;
34
(
6
):
623
48
.
34.
Hill
NE
,
Tyson
DF
.
Parental involvement in middle school: a meta-analytic assessment of the strategies that promote achievement
.
Dev Psychol
.
2009
;
45
(
3
):
740
63
.
35.
Bigger
JT
,
Camm
AJ
,
Kleiger
RE
,
Malliani
A
,
Moss
AJ
, et al
.
Heart rate variability: standards of measurement, physiological interpretation, and clinical use
.
Eur Heart J
.
1996
;
17
(
3
):
354
81
.
36.
Tarvainen
MP
,
Niskanen
JP
,
Lipponen
JA
,
Ranta-Aho
PO
,
Karjalainen
PA
.
Kubios HRV--heart rate variability analysis software
.
Comput Methods Programs Biomed
.
2014
;
113
(
1
):
210
20
.
37.
Kvadsheim
E
,
Sørensen
L
,
Fasmer
OB
,
Osnes
B
,
Haavik
J
,
Williams
DP
, et al
.
Vagally mediated heart rate variability, stress, and perceived social support: a focus on sex differences
.
Stress
.
2022
;
25
(
1
):
113
21
.
38.
BIOPAC
.
Product sheet MP ACQUISITION UNITS
. Available from: https://www.biopac.com/wp-content/uploads/MP36-MP45.pdf
39.
Gholamrezaei
A
,
Van Diest
I
,
Aziz
Q
,
Vlaeyen
JWS
,
Van Oudenhove
L
.
Psychophysiological responses to various slow, deep breathing techniques
.
Psychophysiology
.
2021
;
58
(
2
):
e13712
.
40.
Wingrove
J
,
Bond
AJ
.
Impulsivity: a state as well as trait variable. Does mood awareness explain low correlations between trait and behavioural measures of impulsivity
.
Pers Indiv Differ
.
1997
;
22
(
3
):
333
9
.
41.
Mayer
JD
,
Gaschke
YN
.
The experience and meta-experience of mood
.
J Pers Soc Psychol
.
1988
;
55
(
1
):
102
11
.
42.
Fung
BJ
,
Crone
DL
,
Bode
S
,
Murawski
C
.
Cardiac signals are independently associated with temporal discounting and time perception
.
Front Behav Neurosci
.
2017
;
11
:
1
.
43.
Arakaki
X
,
Arechavala
RJ
,
Choy
EH
,
Bautista
J
,
Bliss
B
,
Molloy
C
, et al
.
The connection between heart rate variability (HRV), neurological health, and cognition: a literature review
.
Front Neurosci
.
2023
;
17
:
1055445
.
44.
Van Diest
I
,
Verstappen
K
,
Aubert
AE
,
Widjaja
D
,
Vansteenwegen
D
,
Vlemincx
E
.
Inhalation/Exhalation ratio modulates the effect of slow breathing on heart rate variability and relaxation
.
Appl Psychophysiol Biofeedback
.
2014
;
39
(
3–4
):
171
80
.
45.
Macht
M
.
How emotions affect eating: a five-way model
.
Appetite
.
2008
;
50
(
1
):
1
11
.
46.
Cardi
V
,
Leppanen
J
,
Treasure
J
.
The effects of negative and positive mood induction on eating behaviour: a meta-analysis of laboratory studies in the healthy population and eating and weight disorders
.
Neurosci Biobehav Rev
.
2015
;
57
:
299
309
.
47.
Laborde
S
,
Allen
MS
,
Borges
U
,
Dosseville
F
,
Hosang
TJ
,
Iskra
M
, et al
.
Effects of voluntary slow breathing on heart rate and heart rate variability: a systematic review and a meta-analysis
.
Neurosci Biobehav Rev
.
2022
;
138
:
104711
.
48.
Noble
DJ
,
Hochman
S
.
Hypothesis: pulmonary afferent activity patterns during slow, deep breathing contribute to the neural induction of physiological relaxation
.
Front Physiol
.
2019
;
10
:
1176
.
49.
Sevoz-Couche
C
,
Laborde
S
.
Heart rate variability and slow-paced breathing: when coherence meets resonance
.
Neurosci Biobehav Rev
.
2022
;
135
:
104576
.
50.
Rodríguez-Ruiz
S
,
Ruiz-Padial
E
,
Vera
N
,
Fernández
C
,
Anllo-Vento
L
,
Vila
J
.
Effect of heart rate variability on defensive reaction and eating disorder symptomatology in chocolate cravers
.
J Psychophysiol
.
2009
;
23
(
3
):
95
103
.
51.
Godfrey
KM
,
Juarascio
A
,
Manasse
S
,
Minassian
A
,
Risbrough
V
,
Afari
N
.
Heart rate variability and emotion regulation among individuals with obesity and loss of control eating
.
Physiol Behav
.
2019
;
199
:
73
8
.
52.
Williams
DP
,
Cash
C
,
Rankin
C
,
Bernardi
A
,
Koenig
J
,
Thayer
JF
.
Resting heart rate variability predicts self-reported difficulties in emotion regulation: a focus on different facets of emotion regulation
.
Front Psychol
.
2015
;
6
:
261
.
53.
Nakano
T
,
Kuriyama
C
.
Transient heart rate acceleration in association with spontaneous eyeblinks
.
Int J Psychophysiol
.
2017
;
121
:
56
62
.
54.
Reents
J
,
Pedersen
A
.
Differences in food craving in individuals with obesity with and without binge eating disorder
.
Front Psychol
.
2021
;
12
:
660880
.
You do not currently have access to this content.