SynthesisEuropean eating disorders review : the journal of the Eating Disorders Association2026
Heart Rate Variability in Anorexia Nervosa: A Systematic Review and Meta-Analysis on the Moderating Role of Measurement Duration and Clinical Stage.
Synthesis in European eating disorders review : the journal of the Eating Disorders Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Heart Rate Variability in Anorexia Nervosa: A Systematic Review and Meta-Analysis on the Moderating Role of Measurement Duration and Clinical Stage.European eating disorders review : the journal of the Eating Disorders Association · 2026Pooled it
- The Relationship Between Heart Rate Variability and Interoception in Anorexia Nervosa Spectrum Disorders.The International journal of eating disorders · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo evaluate heart rate variability (HRV) as a biomarker of autonomic dysfunction in anorexia nervosa (AN), examining differences across clinical stages and the influence of HRV recording duration.
methodQuantitative studies comparing HRV parameters between individuals with AN and healthy controls were identified through a systematic search of six databases following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were conducted, with HRV recording duration (5-min vs. 24-h recordings) examined as a moderator. Meta-regression by clinical stage was not feasible due to an insufficient number of studies. Risk of bias was assessed using the Joanna Briggs Institute tool, and certainty of evidence was rated with GRADE.
resultsNineteen studies were included, with 16 contributing to the meta-analysis (805 participants). Acute AN was associated with significantly lower heart rate (SMD = -1.807; 95% CI: [-3.36, -0.26]; p = 0.022) and reduced LF/HF ratio (SMD = -0.74; 95% CI: [-1.179, -0.301]; p < 0.001). These results indicate parasympathetic predominance. Time-domain indices (SDNN and RMSSD) tended to be higher in AN but were not statistically significant and were supported by low-certainty evidence. Meta-regression analyses revealed that short-term (5-min) HRV recordings yielded significant differences for SDNN (SMD = 0.539; p = 0.008) and HF (SMD = 0.679; p = 0.037).
conclusionsOverall, HRV reflects autonomic alterations in AN, particularly in the acute phase characterised by parasympathetic predominance. HRV does not consistently normalise during recovery. These findings are strongly moderated by recording duration. Short-term recordings show more consistent effects.
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