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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Physical activity, body mass index and heart rate variability-based stress and recovery in 16 275 Finnish employees: a cross-sectional study

Authors: Tiina Föhr, Julia Pietilä, Elina Helander, Tero Myllymäki, Harri Lindholm, Heikki Rusko, Urho M. Kujala

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Physical inactivity, overweight, and work-related stress are major concerns today. Psychological stress causes physiological responses such as reduced heart rate variability (HRV), owing to attenuated parasympathetic and/or increased sympathetic activity in cardiac autonomic control. This study’s purpose was to investigate the relationships between physical activity (PA), body mass index (BMI), and HRV-based stress and recovery on workdays, among Finnish employees.

Methods

The participants in this cross-sectional study were 16 275 individuals (6863 men and 9412 women; age 18–65 years; BMI 18.5–40.0 kg/m2). Assessments of stress, recovery and PA were based on HRV data from beat-to-beat R-R interval recording (mainly over 3 days). The validated HRV-derived variables took into account the dynamics and individuality of HRV. Stress percentage (the proportion of stress reactions, workday and working hours), and stress balance (ratio between recovery and stress reactions, sleep) describe the amount of physiological stress and recovery, respectively. Variables describing the intensity (i.e. magnitude of recognized reactions) of physiological stress and recovery were stress index (workday) and recovery index (sleep), respectively. Moderate to vigorous PA was measured and participants divided into the following groups, based on calculated weekly PA: inactive (0 min), low (0 < 150 min), medium (150–300 min), and high (>300 min). BMI was calculated from self-reported weight and height. Linear models were employed in the main analyses.

Results

High PA was associated with lower stress percentages (during workdays and working hours) and stress balance. Higher BMI was associated with higher stress index, and lower stress balance and recovery index. These results were similar for men and women (P < 0.001 for all).

Conclusion

Independent of age and sex, high PA was associated with a lower amount of stress on workdays. Additionally, lower BMI was associated with better recovery during sleep, expressed by a greater amount and magnitude of recovery reactions, which suggests that PA in the long term resulting in improved fitness has a positive effect on recovery, even though high PA may disturb recovery during the following night. Obviously, several factors outside of the study could also affect HRV-based stress.
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Literature
1.
go back to reference Haskell WL, Blair SN, Hill JO. Physical activity: health outcomes and importance for public health policy. Prev Med. 2009;49(4):280–2.CrossRefPubMed Haskell WL, Blair SN, Hill JO. Physical activity: health outcomes and importance for public health policy. Prev Med. 2009;49(4):280–2.CrossRefPubMed
2.
go back to reference Kujala UM. Evidence on the effects of exercise therapy in the treatment of chronic disease. Br J Sports Med. 2009;43(8):550–5.CrossRefPubMed Kujala UM. Evidence on the effects of exercise therapy in the treatment of chronic disease. Br J Sports Med. 2009;43(8):550–5.CrossRefPubMed
5.
go back to reference Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013;128(8):873–934.CrossRefPubMed Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013;128(8):873–934.CrossRefPubMed
6.
go back to reference Jonsdottir IH, Rödjer L, Hadzibajramovic E, Börjesson M, Ahlborg G. A prospective study of leisure-time physical activity and mental health in Swedish health care workers and social insurance officers. Prev Med. 2010;51(5):373–7.CrossRefPubMed Jonsdottir IH, Rödjer L, Hadzibajramovic E, Börjesson M, Ahlborg G. A prospective study of leisure-time physical activity and mental health in Swedish health care workers and social insurance officers. Prev Med. 2010;51(5):373–7.CrossRefPubMed
8.
go back to reference Vartanian LR, Shaprow JG. Effects of weight stigma on exercise motivation and behavior: a preliminary investigation among college-aged females. J Health Psychol. 2008;13(1):131–8.CrossRefPubMed Vartanian LR, Shaprow JG. Effects of weight stigma on exercise motivation and behavior: a preliminary investigation among college-aged females. J Health Psychol. 2008;13(1):131–8.CrossRefPubMed
9.
go back to reference Shook RP, Blair SN, Duperly J, Hand GA, Matsudo SM, Slavin JL. What is causing the worldwide rise in body weight? US Endocrinol. 2014;10:44–52.CrossRef Shook RP, Blair SN, Duperly J, Hand GA, Matsudo SM, Slavin JL. What is causing the worldwide rise in body weight? US Endocrinol. 2014;10:44–52.CrossRef
10.
go back to reference Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L, et al. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. The Lancet. 2012;380(9852):1491–7.CrossRef Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L, et al. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. The Lancet. 2012;380(9852):1491–7.CrossRef
11.
go back to reference 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(6):431–42.CrossRefPubMed 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(6):431–42.CrossRefPubMed
12.
go back to reference 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(4):577–83.CrossRefPubMed 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(4):577–83.CrossRefPubMed
13.
go back to reference Sonnentag S, Jelden S. Job stressors and the pursuit of sport activities: a day-level perspective. J Occup Health Psychol. 2009;14(2):165–81.CrossRefPubMed Sonnentag S, Jelden S. Job stressors and the pursuit of sport activities: a day-level perspective. J Occup Health Psychol. 2009;14(2):165–81.CrossRefPubMed
14.
go back to reference Kouvonen A, Vahtera J, Oksanen T, Pentti J, Väänänen AK, Heponiemi T, et al. Chronic workplace stress and insufficient physical activity: a cohort study. Occup Environ Med. 2013;70(1):3–8.CrossRefPubMed Kouvonen A, Vahtera J, Oksanen T, Pentti J, Väänänen AK, Heponiemi T, et al. Chronic workplace stress and insufficient physical activity: a cohort study. Occup Environ Med. 2013;70(1):3–8.CrossRefPubMed
15.
go back to reference Asztalos M, Huybrechts I, Temme E, Van Oyen H, Vandevijvere S. Association of physical activity, waist circumference and body mass index with subjective health among Belgian adults. Eur J Public Health. 2013;24(2):205–9.CrossRefPubMed Asztalos M, Huybrechts I, Temme E, Van Oyen H, Vandevijvere S. Association of physical activity, waist circumference and body mass index with subjective health among Belgian adults. Eur J Public Health. 2013;24(2):205–9.CrossRefPubMed
16.
go back to reference Nyberg ST, Heikkilä K, Fransson EI, Alfredsson L, De Bacquer D, Bjorner JB, et al. Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. J Intern Med. 2012;272:65–73.CrossRefPubMed Nyberg ST, Heikkilä K, Fransson EI, Alfredsson L, De Bacquer D, Bjorner JB, et al. Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. J Intern Med. 2012;272:65–73.CrossRefPubMed
17.
go back to reference Proper KI, Koppes LLJ, van Zwieten MHJ, Bemelmans WJE. The prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers. Int Arch Occup Environ Health. 2012;85(5):537–45.CrossRefPubMed Proper KI, Koppes LLJ, van Zwieten MHJ, Bemelmans WJE. The prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers. Int Arch Occup Environ Health. 2012;85(5):537–45.CrossRefPubMed
18.
go back to reference Wardle J, Chida Y, Gibson EL, Whitaker KL, Steptoe A. Stress and Adiposity: A Meta‐Analysis of Longitudinal Studies. Obesity. 2011;19(4):771–8.CrossRefPubMed Wardle J, Chida Y, Gibson EL, Whitaker KL, Steptoe A. Stress and Adiposity: A Meta‐Analysis of Longitudinal Studies. Obesity. 2011;19(4):771–8.CrossRefPubMed
19.
20.
go back to reference Overgaard D, Gyntelberg F, Heitmann B. Psychological workload and body weight: is there an association? A review of the literature. Occup Med. 2004;54(1):35–41.CrossRef Overgaard D, Gyntelberg F, Heitmann B. Psychological workload and body weight: is there an association? A review of the literature. Occup Med. 2004;54(1):35–41.CrossRef
21.
go back to reference Armon G, Shirom A, Berliner S, Shapira I, Melamed S. A prospective study of the association between obesity and burnout among apparently healthy men and women. J Occup Health Psychol. 2008;13(1):43–57.CrossRefPubMed Armon G, Shirom A, Berliner S, Shapira I, Melamed S. A prospective study of the association between obesity and burnout among apparently healthy men and women. J Occup Health Psychol. 2008;13(1):43–57.CrossRefPubMed
22.
go back to reference Solovieva S, Lallukka T, Virtanen M, Viikari-Juntura E. Psychosocial factors at work, long work hours, and obesity: a systematic review. Scand J Work Environ Health. 2013;39(3):241–58.CrossRefPubMed Solovieva S, Lallukka T, Virtanen M, Viikari-Juntura E. Psychosocial factors at work, long work hours, and obesity: a systematic review. Scand J Work Environ Health. 2013;39(3):241–58.CrossRefPubMed
23.
go back to reference Montano N, Porta A, Cogliati C, Costantino G, Tobaldini E, Casali KR, et al. Heart rate variability explored in the frequency domain: a tool to investigate the link between heart and behavior. Neurosci Biobehav Rev. 2009;33(2):71–80.CrossRefPubMed Montano N, Porta A, Cogliati C, Costantino G, Tobaldini E, Casali KR, et al. Heart rate variability explored in the frequency domain: a tool to investigate the link between heart and behavior. Neurosci Biobehav Rev. 2009;33(2):71–80.CrossRefPubMed
24.
go back to reference 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. Eur Heart J. 1996;93(5):1043–65. 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. Eur Heart J. 1996;93(5):1043–65.
25.
go back to reference Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991;84(2):482–92.CrossRefPubMed Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991;84(2):482–92.CrossRefPubMed
26.
go back to reference Acharya UR, Joseph KP, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput. 2006;44(12):1031–51.CrossRef Acharya UR, Joseph KP, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput. 2006;44(12):1031–51.CrossRef
27.
go back to reference Jarczok MN, Kleber ME, Koenig J, Loerbroks A, Herr RM, Hoffmann K, et al. Investigating the associations of self-rated health: heart rate variability is more strongly associated than inflammatory and other frequently used biomarkers in a cross sectional occupational sample. PloS one. 2015;10(2):e0117196. doi:10.1371/journal.pone.0117196.CrossRefPubMedPubMedCentral Jarczok MN, Kleber ME, Koenig J, Loerbroks A, Herr RM, Hoffmann K, et al. Investigating the associations of self-rated health: heart rate variability is more strongly associated than inflammatory and other frequently used biomarkers in a cross sectional occupational sample. PloS one. 2015;10(2):e0117196. doi:10.​1371/​journal.​pone.​0117196.CrossRefPubMedPubMedCentral
29.
go back to reference Rennie KL, Hemingway H, Kumari M, Brunner E, Malik M, Marmot M. 2003. Effects of moderate and vigorous physical activity on heart rate variability in a British study of civil servants. Am J Epidemiol. 2003;158(2):135–43.CrossRefPubMed Rennie KL, Hemingway H, Kumari M, Brunner E, Malik M, Marmot M. 2003. Effects of moderate and vigorous physical activity on heart rate variability in a British study of civil servants. Am J Epidemiol. 2003;158(2):135–43.CrossRefPubMed
30.
go back to reference Soares-Miranda L, Sattelmair J, Chaves P, Duncan G, Siscovick DS, Stein PK, et al. Physical activity and heart rate variability in older adults: the Cardiovascular Health Study. Circulation. 2014;129(21):2100–10.CrossRefPubMedPubMedCentral Soares-Miranda L, Sattelmair J, Chaves P, Duncan G, Siscovick DS, Stein PK, et al. Physical activity and heart rate variability in older adults: the Cardiovascular Health Study. Circulation. 2014;129(21):2100–10.CrossRefPubMedPubMedCentral
35.
go back to reference Martinmäki K, Rusko H, Kooistra L, Kettunen J, Saalasti S. Intraindividual validation of heart rate variability indexes to measure vagal effects on hearts. Am J Physiol Heart Circ Physiol. 2006;290(2):640–7.CrossRef Martinmäki K, Rusko H, Kooistra L, Kettunen J, Saalasti S. Intraindividual validation of heart rate variability indexes to measure vagal effects on hearts. Am J Physiol Heart Circ Physiol. 2006;290(2):640–7.CrossRef
38.
go back to reference Ross RM, Jackson AS. Exercise concepts, calculations, and computer applications. Carmel: Benchmark Press; 1990. Ross RM, Jackson AS. Exercise concepts, calculations, and computer applications. Carmel: Benchmark Press; 1990.
39.
go back to reference Jones NL. Clinical exercise testing. 3rd ed. Philadelphia: W.B. Saunders; 1988. Jones NL. Clinical exercise testing. 3rd ed. Philadelphia: W.B. Saunders; 1988.
40.
go back to reference Jackson AS, Blair SN, Mahar MT, Wier LT, Ross RM, Stuteville JE. Prediction of functional aerobic capacity without exercise testing. Med Sci Sports Exerc. 1990;22(6):863–70.CrossRefPubMed Jackson AS, Blair SN, Mahar MT, Wier LT, Ross RM, Stuteville JE. Prediction of functional aerobic capacity without exercise testing. Med Sci Sports Exerc. 1990;22(6):863–70.CrossRefPubMed
41.
go back to reference Osborne JW. Improving your data transformations: Applying the Box-Cox transformation. Practical Assessment, Research & Evaluation. 2010;15(12):1–9. Osborne JW. Improving your data transformations: Applying the Box-Cox transformation. Practical Assessment, Research & Evaluation. 2010;15(12):1–9.
42.
go back to reference Birdee GS, Byrne DW, McGown PW, Rothman RL, Rolando LA, Holmes MC, et al. Relationship between physical inactivity and health characteristics among participants in an employee-wellness program. J Occup Environ Med. 2013;55(5):514–9.CrossRefPubMedPubMedCentral Birdee GS, Byrne DW, McGown PW, Rothman RL, Rolando LA, Holmes MC, et al. Relationship between physical inactivity and health characteristics among participants in an employee-wellness program. J Occup Environ Med. 2013;55(5):514–9.CrossRefPubMedPubMedCentral
43.
go back to reference Teisala T, Mutikainen S, Tolvanen A, Rottensteiner M, Leskinen T, Kaprio J, et al. Associations of physical activity, fitness, and body composition with heart rate variability-based indicators of stress and recovery on workdays: a cross-sectional study. J Occup Med Toxicol. 2014;34:26–40. doi:10.1186/1745-6673-9-16. Teisala T, Mutikainen S, Tolvanen A, Rottensteiner M, Leskinen T, Kaprio J, et al. Associations of physical activity, fitness, and body composition with heart rate variability-based indicators of stress and recovery on workdays: a cross-sectional study. J Occup Med Toxicol. 2014;34:26–40. doi:10.​1186/​1745-6673-9-16.
44.
go back to reference Zahorska-Markiewicz B, Kuagowska E, Kucio C, Klin M. Heart rate variability in obesity. Int J Obes Relat Metab Disord. 1993;17(1):21–3.PubMed Zahorska-Markiewicz B, Kuagowska E, Kucio C, Klin M. Heart rate variability in obesity. Int J Obes Relat Metab Disord. 1993;17(1):21–3.PubMed
45.
go back to reference Rissanen P, Franssila‐Kallunki A, Rissanen A. Cardiac parasympathetic activity is increased by weight loss in healthy obese women. Obes Res. 2001;9(10):637–43.CrossRefPubMed Rissanen P, Franssila‐Kallunki A, Rissanen A. Cardiac parasympathetic activity is increased by weight loss in healthy obese women. Obes Res. 2001;9(10):637–43.CrossRefPubMed
46.
go back to reference Lallukka T, Sarlio-Lähteenkorva S, Kaila-Kangas L, Pitkäniemi J, Luukkonen R, Leino-Arjas P. Working conditions and weight gain: a 28-year follow-up study of industrial employees. Eur J Epidemiol. 2008;23(4):303–10.CrossRefPubMed Lallukka T, Sarlio-Lähteenkorva S, Kaila-Kangas L, Pitkäniemi J, Luukkonen R, Leino-Arjas P. Working conditions and weight gain: a 28-year follow-up study of industrial employees. Eur J Epidemiol. 2008;23(4):303–10.CrossRefPubMed
48.
go back to reference Myllymäki T, Kyröläinen H, Savolainen K, Hokka L, Jakonen R, Juuti T, et al. Effects of vigorous late‐night exercise on sleep quality and cardiac autonomic activity. J Sleep Res. 2011;20:146–53.CrossRefPubMed Myllymäki T, Kyröläinen H, Savolainen K, Hokka L, Jakonen R, Juuti T, et al. Effects of vigorous late‐night exercise on sleep quality and cardiac autonomic activity. J Sleep Res. 2011;20:146–53.CrossRefPubMed
49.
go back to reference Kang D, Kim Y, Kim J, Hwang Y, Cho B, Hong T, et al. Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers. Ann Occup Environ Med. 2015;27(1):1–11.CrossRef Kang D, Kim Y, Kim J, Hwang Y, Cho B, Hong T, et al. Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers. Ann Occup Environ Med. 2015;27(1):1–11.CrossRef
50.
go back to reference Kaikkonen P, Rusko H, Martinmäki K. Post‐exercise heart rate variability of endurance athletes after different high‐intensity exercise interventions. Scand J Med Sci Sports. 2008;18(4):511–9.CrossRefPubMed Kaikkonen P, Rusko H, Martinmäki K. Post‐exercise heart rate variability of endurance athletes after different high‐intensity exercise interventions. Scand J Med Sci Sports. 2008;18(4):511–9.CrossRefPubMed
51.
go back to reference Seiler S, Haugen O, Kuffel E. Autonomic recovery after exercise in trained athletes: intensity and duration effects. Med Sci Sports Exerc. 2007;39(8):1366–73.CrossRefPubMed Seiler S, Haugen O, Kuffel E. Autonomic recovery after exercise in trained athletes: intensity and duration effects. Med Sci Sports Exerc. 2007;39(8):1366–73.CrossRefPubMed
52.
go back to reference Hynynen E, Vesterinen V, Nummela A, Rusko H. Effects of moderate and heavy endurance exercise on nocturnal HRV. Int J Sports Med. 2010;31:428–32.CrossRefPubMed Hynynen E, Vesterinen V, Nummela A, Rusko H. Effects of moderate and heavy endurance exercise on nocturnal HRV. Int J Sports Med. 2010;31:428–32.CrossRefPubMed
54.
go back to reference Smolander J, Ajoviita M, Juuti T, Nummela A, Rusko H. Estimating oxygen consumption from heart rate and heart rate variability without individual calibration. Clin Physiol Funct Imaging. 2011;31(4):266–71.CrossRefPubMed Smolander J, Ajoviita M, Juuti T, Nummela A, Rusko H. Estimating oxygen consumption from heart rate and heart rate variability without individual calibration. Clin Physiol Funct Imaging. 2011;31(4):266–71.CrossRefPubMed
56.
go back to reference Kang M, Bassett DR, Barreira TV, Tudor-Locke C, Ainsworth B, Reis JP, et al. How many days are enough? A study of 365 days of pedometer monitoring. Res Q Exerc Sport. 2009;80(3):445–53.CrossRefPubMed Kang M, Bassett DR, Barreira TV, Tudor-Locke C, Ainsworth B, Reis JP, et al. How many days are enough? A study of 365 days of pedometer monitoring. Res Q Exerc Sport. 2009;80(3):445–53.CrossRefPubMed
57.
go back to reference Tudor-Locke C, Burkett L, Reis J, Ainsworth B, Macera C, Wilson D. How many days of pedometer monitoring predict weekly physical activity in adults? Prev Med. 2005;40(3):293–8.CrossRefPubMed Tudor-Locke C, Burkett L, Reis J, Ainsworth B, Macera C, Wilson D. How many days of pedometer monitoring predict weekly physical activity in adults? Prev Med. 2005;40(3):293–8.CrossRefPubMed
58.
go back to reference Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008. doi:10.1186/1479-5868-5-56.PubMedPubMedCentral Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008. doi:10.​1186/​1479-5868-5-56.PubMedPubMedCentral
59.
go back to reference Van Amelsvoort L, Schouten E, Maan A, Swenne C, Kok F. Occupational determinants of heart rate variability. Int Arch Occup Environ Health. 2000;73(4):255–62.CrossRefPubMed Van Amelsvoort L, Schouten E, Maan A, Swenne C, Kok F. Occupational determinants of heart rate variability. Int Arch Occup Environ Health. 2000;73(4):255–62.CrossRefPubMed
60.
go back to reference Sammito S, Thielmann B, Seibt R, Klussmann A, Weippert M, Böckelmann I. Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational science. ASU Int. 2015. doi:10.17147/ASUI.2015-06-09-03. Sammito S, Thielmann B, Seibt R, Klussmann A, Weippert M, Böckelmann I. Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational science. ASU Int. 2015. doi:10.​17147/​ASUI.​2015-06-09-03.
63.
go back to reference Uusitalo A, Mets T, Martinmäki K, Mauno S, Kinnunen U, Rusko H. Heart rate variability related to effort at work. Appl Ergon. 2011;42(6):830–8.CrossRefPubMed Uusitalo A, Mets T, Martinmäki K, Mauno S, Kinnunen U, Rusko H. Heart rate variability related to effort at work. Appl Ergon. 2011;42(6):830–8.CrossRefPubMed
64.
go back to reference Föhr T, Tolvanen A, Myllymaki T, Jarvela-Reijonen E, Rantala S, Korpela R, et al. Subjective stress, objective heart rate variability-based stress, and recovery on workdays among overweight and psychologically distressed individuals: a cross-sectional study. J Occup Med Toxicol. 2015;10:39. doi:10.1186/s12995-015-0081-6.CrossRefPubMedPubMedCentral Föhr T, Tolvanen A, Myllymaki T, Jarvela-Reijonen E, Rantala S, Korpela R, et al. Subjective stress, objective heart rate variability-based stress, and recovery on workdays among overweight and psychologically distressed individuals: a cross-sectional study. J Occup Med Toxicol. 2015;10:39. doi:10.​1186/​s12995-015-0081-6.CrossRefPubMedPubMedCentral
65.
go back to reference Föhr T, Tolvanen A, Myllymäki T, Järvela-Reijonen E, Peuhkuri K, Rantala S et al. Physical activity, heart rate variability-based stress and recovery, and subjective stress during a 9-month study period. Scand J Med Sci Sports. Advance online publication. doi: 10.1111/sms12683 Föhr T, Tolvanen A, Myllymäki T, Järvela-Reijonen E, Peuhkuri K, Rantala S et al. Physical activity, heart rate variability-based stress and recovery, and subjective stress during a 9-month study period. Scand J Med Sci Sports. Advance online publication. doi: 10.​1111/​sms12683
67.
go back to reference Gorber SC, Tremblay M, Moher D, Gorber B. A comparison of direct vs. self‐report measures for assessing height, weight and body mass index: a systematic review. Obesity Reviews. 2007;8(4):307–26.CrossRefPubMed Gorber SC, Tremblay M, Moher D, Gorber B. A comparison of direct vs. self‐report measures for assessing height, weight and body mass index: a systematic review. Obesity Reviews. 2007;8(4):307–26.CrossRefPubMed
Metadata
Title
Physical activity, body mass index and heart rate variability-based stress and recovery in 16 275 Finnish employees: a cross-sectional study
Authors
Tiina Föhr
Julia Pietilä
Elina Helander
Tero Myllymäki
Harri Lindholm
Heikki Rusko
Urho M. Kujala
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3391-4

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