A study of electrocardiograms recorded during exercise tests on subjects in the fasting state and after the ingestion of a heavy meal

Effect of nutritional composition of meals on exercise tests in patients with ischaemic heart disease

“…It should be noted, however, that we measured the time to complete return of the ST segment to the pre-test pattern (not only to < 1 mm ST-depression) since we felt that it would be a more reliable ('harder') endpoint for estimating time to complete resolution of electrocardiographic ischaemia. Also, we did not notice any difference in the magnitude of ST-depression or of subjective chest pain postprandially (these parameters were not quantified in our study), in accord with other studies, which demonstrated that such postprandial changes are negligible [13,14] although others noted a greater STdepression after a high-fat than a low-fat meal [12].…”

Haemodynamic and electrocardiographic accompaniments of resting postprandial angina.

“…It is of interest that despite the rather low caloric intake and variable composition of the meals, the time of onset of ischaemia in our own studies in man was similar in all the patients studied, as well as in 30 other patients with postprandial angina in whom the study could not be performed. In this respect our findings confirm previous studies that indicated that neither the amount nor the content of the ingested food had significant bearing on the appearance of postprandial angina (Wayne and Graybiel, 1933;Klakeg et al, 1955). Though it has been claimed that, specifically, the ingestion of a large fatty meal is responsible for postprandial angina in some patients, it appears to occur significantly (3-5 hours) later, and it apparently coincides with the peak levels of the plasma triglycerides (Kuo and Joyner, 1955;Friedman et al, 1964).…”

“…There was also a tendency for the arterial blood pressure to decrease and for the heart rate to increase, and though these changes were not statistically significant, they were similar to the postprandial haemodynamic changes previously reported in normal subjects (Jones et al, 1965), noncardiac patients (Norryd et al, 1975) as well as in patients with coronary artery disease (Wayne and Graybiel, 1933;Klakeg et al, 1955;Goldstein et al, 1971). The moderate albeit inconsistent increases in heart rate and cardiac output may constitute part of an increased sympathomimetic activity associated with the ingestion of food as has been postulated by some investigators who noted the absence of such a response in catecholamine-depleted dogs (Fronek and Stahlgren, 1968).…”

Estimation of Free-Living Energy Expenditure by Heart Rate and Movement Sensing: A Doubly-Labelled Water Study

“…These investigators did, however, also use an extensive individual calibration protocol, utilising both 27-hour whole-body calorimetry and additional high-intensity exercises and were able to obtain a slightly higher PAEE precision (RMSE = 32 kJ·day -1 ·kg -1 , r = 0.8) after HR data had been cleaned and missing data imputed, a process which was shown to profoundly improve EE estimates. Finally, as heart rate also increases after eating [ 63 , 64 ], this may or may not be reflected in the estimate of energy expenditure, depending on whether heart rate was above the flex HR point or not; this is because all observations below flex HR would be translated as resting metabolic rate. About a third of observations were above flex HR in this study; if we assume the same 2:1 distribution of time in the postprandial phase following three meals per day and that meals would increase heart rate by an average of 10bpm [ 64 ] and stay elevated for two hours after each meal, the theoretical contribution to the PAEE estimates from this source would be in the order of 7 kJ·day -1 ·kg -1 .…”

“…Finally, as heart rate also increases after eating [ 63 , 64 ], this may or may not be reflected in the estimate of energy expenditure, depending on whether heart rate was above the flex HR point or not; this is because all observations below flex HR would be translated as resting metabolic rate. About a third of observations were above flex HR in this study; if we assume the same 2:1 distribution of time in the postprandial phase following three meals per day and that meals would increase heart rate by an average of 10bpm [ 64 ] and stay elevated for two hours after each meal, the theoretical contribution to the PAEE estimates from this source would be in the order of 7 kJ·day -1 ·kg -1 . This would constitute a positive bias of the PAEE estimates, which, if corrected, suggests that flex-HR model estimates of energy expenditure may be negatively biased; that said this underestimation was not significant for neither PAEE nor TEE in the present study when the data were re-analysed this way.…”