European Journal of Applied Physiology

, Volume 113, Issue 6, pp 1477–1488 | Cite as

Determinants and reference values of short-term heart rate variability in children

  • Nathalie MichelsEmail author
  • Els Clays
  • Marc De Buyzere
  • Inge Huybrechts
  • Staffan Marild
  • Barbara Vanaelst
  • Stefaan De Henauw
  • Isabelle Sioen
Original Article


This paper provides age- and sex-specific reference values for short-term heart rate variability (HRV) data in children by time domain and frequency domain methods. Furthermore, HRV determinants will be determined. In 460 children (5–10 years), 5-minute HRV measurements in supine position were undertaken with Polar chest belts. The data were manually edited and processed with time and frequency domain methods. Age, time point, physical activity (accelerometry), physical fitness (cardiopulmonary fitness, upper and lower limb muscular fitness) and body composition (body mass index, fat%, fat and fat-free mass) were analysed as determinants using multiple regression analysis stratified by sex. Sex- and age-specific reference values were produced. Overall, girls had lower HRV. Age-related parasympathetic increases and sympathetic decreases were seen with sometimes age-related year-to-year wave-like changes in boys. The time point of recording had limited influence on HRV. Of the lifestyle related factors, fatness (only 7 % overweight) was not associated with HRV but fat-free mass, physical activity and in particular physical fitness (over and above activity) had a favourable association by increased parasympathetic activity. Future HRV studies in children should consider age, sex and physical fitness.


Heart rate variability Children Reference values Physical fitness Fast Fourier transform 



Body fat percentage


Children’s body composition and stress


Fast Fourier transform


Fat mass


Fat-free mass


Heart rate variability


High frequency


Intraclass correlation


Limits of agreement


Low frequency


Maximal oxygen uptake


Mean RRI


Moderate-to-vigorous activity


Normalized units


Parasympathetic activity


Percentage of consecutive normal RRI differing more than 50 ms


Root mean square of successive differences


RR intervals


Standard deviation of the normal RRI


Sympathetic activity



This work was done as part of the IDEFICS Study ( We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD). The information in this document reflects the author’s view and is provided as is. Nathalie Michels is financially supported by the research council of Ghent University (Bijzonder Onderzoeksfonds). Isabelle Sioen and Barbara Vanaelst are financially supported by the Research Foundation—Flanders. The results of the present study do not constitute endorsement by ACSM. The authors want to thank the ChiBS children and their parents for their voluntary participation.

Conflict of interest

The authors have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Nathalie Michels
    • 1
    Email author
  • Els Clays
    • 1
  • Marc De Buyzere
    • 2
  • Inge Huybrechts
    • 1
  • Staffan Marild
    • 3
  • Barbara Vanaelst
    • 1
    • 4
  • Stefaan De Henauw
    • 1
    • 5
  • Isabelle Sioen
    • 1
    • 4
  1. 1.Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
  2. 2.Department of CardiologyUniversity Hospital GhentGhentBelgium
  3. 3.Department of PaediatricsInstitution of Clinical Sciences Sahlgrenska Academy, Göteborg UniversityGöteborgSweden
  4. 4.Research Foundation FlandersBrusselsBelgium
  5. 5.Department of Health Sciences, VesaliusHogeschool GentGhentBelgium

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