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Health tele-Coaching by automated HRV (heart rate variability)
Transmission, nutritional and activity feedback
Description of implemented mobile Health service and report on work in progress for long term evaluation
Gerhard Lingg1,2,4, Wilhelm Mosgöller3,4, Ralf Arne Wittling5, P.C. Endler4
1IMI

Health AG, 2 IQCURE, 3Medical University of Vienna, 4The Interuniversity College for Health and Development
5 Center

for Cognitive Neuroscience, University of Trier

Discussion
PROJECT- OBJECTIVES & AIMS
We plan a clinical study to achieve the following goals:
- test the IMI-Health Care System (HCS) with HRV-Diagnosis (heart rate variability)
under “field conditions” to integrate the European customer perspective.
- Find the relationship between HRV parameters and nutritional state.
- Describe benefits of IMI-HCS for healthy and diseased clients, define group specific
details.
Mobile health (mHealth) is a promising strategy in the field of public health. Mobile devices transmit
diagnostic parameters from the patient to a medical centre, in return the participant receives
individualized health relevant information. Mobile applications (e.g. phones) collect health data,
deliver them to professionals (practitioners, researchers, etc.). The system allows for real-time
monitoring of vital signs from a remote patient, in return individualized health related information is
provided.
mHealth empowers larger population segments (including developing countries) to participate in
quality healthcare. By the end of 2011 millions of patients worldwide used a home monitoring service
with integrated connectivity to a central service. The demand is still rapidly growing.
Because nutrition and activity have a major impact on health and fitness IMI has developed a
nutrition and fitness monitoring system that - based on scientific evidence, - and by implementing
modern information technologies can coach individuals on a day to day basis. The IMI health
coaching system uses a modified mobile phone to document the Heart Rate Variability (HRV) of
healthy persons and patients, transmits the recordings to a central server, which analyses the actual
metabolic / catabolic profile, and in return provides individualized dietary coaching and tips for
physical activity for this day, aiming to improve physical fitness, obesity, diabetes, etc. .

HRV AND METABOLISM

Many so called civilisation deceases are associated with catabolic metabolic lapses. Essentially the lack of
physical activity, unphysiologic (chronic) stress, high carbohydrate intake, etc. are catabolic events, associated
with impairment of the heart-circulation-system, and degenerative deceases. Stress increases the susceptibility
of infections. It is to explain, where the deficit concerning the blockades of the basic system is situated and
where conditions of energy lack can be found, which disturb the metabolic regulation.
Only therapeutic balance of the deficit creates an optimal solid metabolic condition in an undisturbed
information transfer in the basic system of the organism. Accessible by HRV Metabolic correlation results
derived food recommendation.
Thus it is detectable, that regulation deceases in typical form can be recovered in nearly all occasions of
chronification.
The IMI mobile health system provide a concise program for the participants
On a day to day basis the will:
measure fitness and provide immediate feedback to participating persons, including activity coaching. measure
metabolic (anabolic or catabolic) body condition and provide immediately corresponding nutritional advice.
On the short-term this will empower participating persons to:
• feel self responsible for their health and fitness.
• to get to know a healthier life style, and
• train lifestyle and nutritional habits at their own individual pace.
• benefit from the increase of fitness and health.
The IMI health coach system is easily integrated into the participants daily routine.
The participants are required to:
• accept to receive and operate a business mobile phone which is adapted to measure and analyse
the heart rate variability as diagnostic tool to determine fitness and metabolic status.
• transmit the diagnostic parameters to a server which records the individuals health benefit, and in
return receive nutrition and activity related advice.
• if desired, obtain additional activity and nutritional coaching from the server user area.
After successful short term studies, we plan to recruit and observe about 200 participants for one
year to observe how the system is accepted under “everyday life” condition:
• the individuals health and fitness benefit from participation
• the potential of the health coaching system for the public health
• indicators of participants compliance to the system
• indications where the system should be modified in order to increase acceptability, efficacy, and
compliance.
The expected societal long term perspectives are
• educational effects, raise people’s awareness for the importance of nutrition to their health and
fitness.
• improvement of the average health status in the society
• reduce expenses for chronic (nutrition and non-activity related) diseases

POSSIBLE RESULTS
• Confirm the relationsship between HRV measurements and nutritional status.
• Based on the feedback from study participants: improve the IMI-HRV diagnostic and HCS.
• Obtain statistically comprehensible description of benefits from the IMI HRV diagnostic and
coaching system in healthy population.
• Details about the feasibility to use HRV diagnostics for monitoring the success of health coaching.
• Describe compliance under controlled conditions as bases for further strategic planning on the
further development of the HRV diagnostic and coaching system.

CITED LITERATURE
Soares-Miranda L, Alves AJ, Vale S, Aires L, Santos R, Oliveira J, Mota J: Central fat influences cardiac autonomic function in obese and overweight girls. Pediatr
Cardiol 2011, 32(7):924-928.
Sjoberg N, Brinkworth GD, Wycherley TP, Noakes M, Saint DA: Moderate weight loss improves heart rate variability in overweight and obese adults with type 2
diabetes. J Appl Physiol 2011, 110(4):1060-1064.
Poliakova N, Despres JP, Res 1998, 8(5):251-257.
Matsumoto T, Miyawaki T, Ue H, Kanda T, Zenji C, Bergeron J, Almeras N, Tremblay A, Poirier P: Influence of obesity indices, metabolic parameters and age on
cardiac autonomic function in abdominally obese men. Metabolism 2012.
Rutter MK, McComb JM, Brady S, Marshall SM: Autonomic neuropathy in asymptomatic subjects with non-insulin-dependent diabetes mellitus and
microalbuminuria. Clin Auton Moritani T: Autonomic responsiveness to acute cold exposure in obese and non-obese young women. Int J Obes Relat Metab
Disord 1999, 23(8):793-800.
N, Tsigos C, Perea D, Koukou E, Kyriaki D, Kitsou E, Daskas S, Daifotis Z, Makrilakis K, Raptis SA et al: Differential effects of high-fat and high-carbohydrate
isoenergetic meals on cardiac autonomic nervous system activity in lean and obese women. Metabolism 2003, 52(11):1426-1432.
Bergfors M, Barnekow-Bergkvist M, Kalezic N, Lyskov E, Eriksson JW: Short-term effects of repetitive arm work and dynamic exercise on glucose metabolism
and insulin sensitivity. Acta Physiol Scand 2005, 183(4):345-356.
Nagai N, Sakane N, Moritani T: Metabolic responses to high-fat or low-fat meals and association with sympathetic nervous system activity in healthy young men.
J Nutr Sci Vitaminol (Tokyo) 2005, 51(5):355-360.
Kimura T, Matsumoto T, Akiyoshi M, Owa Y, Miyasaka N, Aso T, Moritani T: Body fat and blood lipids in postmenopausal women are related to resting
autonomic nervous system activity. Eur J Appl Physiol 2006, 97(5):542-547.
Buchheit M, Platat C, Oujaa M, Simon C: Habitual physical activity, physical fitness and heart rate variability in preadolescents. Int J Sports Med 2007, 28(3):204210.
Kaufman CL, Kaiser DR, Steinberger J, Kelly AS, Dengel DR: Relationships of cardiac autonomic function with metabolic abnormalities in childhood obesity.
Obesity (Silver Spring) 2007, 15(5):1164-1171.
Kanaley JA, Goulopoulou S, Franklin RM, Baynard T, Holmstrup ME, Carhart R, Jr., Weinstock RS, Fernhall B: Plasticity of heart rate signalling and complexity
with exercise training in obese individuals with and without type 2 diabetes. Int J Obes (Lond) 2009, 33(10):1198-1206.
AE, Bertuzzi RC, Pires FO, Fronchetti L, Gevaerd MS, De-Oliveira FR: A low carbohydrate diet affects autonomic modulation during heavy but not moderate
exercise. Eur J Appl Physiol 2010, 108(6):1133-1140.
Millis RM, Austin RE, Hatcher MD, Bond V, Faruque MU, Goring KL, Hickey BM, DeMeersman RE: Association of body fat percentage and heart rate variability
measures of sympathovagal balance. Life Sci 2010, 86(5-6):153-157.
Pistorio E, Luca M, Luca A, Messina V, Calandra C: Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating
disorders. Lipids Health Dis 2011, 10:192
Schole, J. und W. Lutz (1988): Regulationskrankheiten – Versuch einer fächerübergreifenden Analyse. ISBN: 3-43297-1419.
Spranger, H.: Mind-Body. Separatum zu Spranger, H. & EU-team: Regulationsbiologische Grundlagen. Modul inter-uni.net. ISBN: 3-9502-326-0-8.
National Center for Complementary and Alternative Medicine. Zugriff12.01.2006 http://nccam.nih.gov/health/mindbody.htm
Dobos, G.J., A. Paul (2007): Was ist Mind-Body Medicine. Komplement. Integrat. Med. 48; Heft 9: 19-24.
Heine, H.(2007): Lehrbuch der biologischen Medizin. Grundregulation und Matrix. Hippokrates. ISBN: 3-8304-5335-3.

DDr. Gerhard Lingg PhD, http://www.imi-health.com, http://www.iqcure.at/ college @ inter-uni.net
Wilhelm Mosgöller, A.o. Univ. Prof. Dr., wilhelm.mosgoeller@meduniwien.ac.at, college @ inter-uni.net
Ralf Arne Wittling, Dipl.-Ing. Dr., arne-wittling@znf-gmbh.com
Peter Christian Endler, Prof. DDr., college @ inter-uni.net

RESEARCH POSTER PRESENTATION DESIGN © 2012

www.PosterPresentations.com

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Poster presentation Royal Society Of Medicine London

  • 1. Health tele-Coaching by automated HRV (heart rate variability) Transmission, nutritional and activity feedback Description of implemented mobile Health service and report on work in progress for long term evaluation Gerhard Lingg1,2,4, Wilhelm Mosgöller3,4, Ralf Arne Wittling5, P.C. Endler4 1IMI Health AG, 2 IQCURE, 3Medical University of Vienna, 4The Interuniversity College for Health and Development 5 Center for Cognitive Neuroscience, University of Trier Discussion PROJECT- OBJECTIVES & AIMS We plan a clinical study to achieve the following goals: - test the IMI-Health Care System (HCS) with HRV-Diagnosis (heart rate variability) under “field conditions” to integrate the European customer perspective. - Find the relationship between HRV parameters and nutritional state. - Describe benefits of IMI-HCS for healthy and diseased clients, define group specific details. Mobile health (mHealth) is a promising strategy in the field of public health. Mobile devices transmit diagnostic parameters from the patient to a medical centre, in return the participant receives individualized health relevant information. Mobile applications (e.g. phones) collect health data, deliver them to professionals (practitioners, researchers, etc.). The system allows for real-time monitoring of vital signs from a remote patient, in return individualized health related information is provided. mHealth empowers larger population segments (including developing countries) to participate in quality healthcare. By the end of 2011 millions of patients worldwide used a home monitoring service with integrated connectivity to a central service. The demand is still rapidly growing. Because nutrition and activity have a major impact on health and fitness IMI has developed a nutrition and fitness monitoring system that - based on scientific evidence, - and by implementing modern information technologies can coach individuals on a day to day basis. The IMI health coaching system uses a modified mobile phone to document the Heart Rate Variability (HRV) of healthy persons and patients, transmits the recordings to a central server, which analyses the actual metabolic / catabolic profile, and in return provides individualized dietary coaching and tips for physical activity for this day, aiming to improve physical fitness, obesity, diabetes, etc. . HRV AND METABOLISM Many so called civilisation deceases are associated with catabolic metabolic lapses. Essentially the lack of physical activity, unphysiologic (chronic) stress, high carbohydrate intake, etc. are catabolic events, associated with impairment of the heart-circulation-system, and degenerative deceases. Stress increases the susceptibility of infections. It is to explain, where the deficit concerning the blockades of the basic system is situated and where conditions of energy lack can be found, which disturb the metabolic regulation. Only therapeutic balance of the deficit creates an optimal solid metabolic condition in an undisturbed information transfer in the basic system of the organism. Accessible by HRV Metabolic correlation results derived food recommendation. Thus it is detectable, that regulation deceases in typical form can be recovered in nearly all occasions of chronification. The IMI mobile health system provide a concise program for the participants On a day to day basis the will: measure fitness and provide immediate feedback to participating persons, including activity coaching. measure metabolic (anabolic or catabolic) body condition and provide immediately corresponding nutritional advice. On the short-term this will empower participating persons to: • feel self responsible for their health and fitness. • to get to know a healthier life style, and • train lifestyle and nutritional habits at their own individual pace. • benefit from the increase of fitness and health. The IMI health coach system is easily integrated into the participants daily routine. The participants are required to: • accept to receive and operate a business mobile phone which is adapted to measure and analyse the heart rate variability as diagnostic tool to determine fitness and metabolic status. • transmit the diagnostic parameters to a server which records the individuals health benefit, and in return receive nutrition and activity related advice. • if desired, obtain additional activity and nutritional coaching from the server user area. After successful short term studies, we plan to recruit and observe about 200 participants for one year to observe how the system is accepted under “everyday life” condition: • the individuals health and fitness benefit from participation • the potential of the health coaching system for the public health • indicators of participants compliance to the system • indications where the system should be modified in order to increase acceptability, efficacy, and compliance. The expected societal long term perspectives are • educational effects, raise people’s awareness for the importance of nutrition to their health and fitness. • improvement of the average health status in the society • reduce expenses for chronic (nutrition and non-activity related) diseases POSSIBLE RESULTS • Confirm the relationsship between HRV measurements and nutritional status. • Based on the feedback from study participants: improve the IMI-HRV diagnostic and HCS. • Obtain statistically comprehensible description of benefits from the IMI HRV diagnostic and coaching system in healthy population. • Details about the feasibility to use HRV diagnostics for monitoring the success of health coaching. • Describe compliance under controlled conditions as bases for further strategic planning on the further development of the HRV diagnostic and coaching system. CITED LITERATURE Soares-Miranda L, Alves AJ, Vale S, Aires L, Santos R, Oliveira J, Mota J: Central fat influences cardiac autonomic function in obese and overweight girls. Pediatr Cardiol 2011, 32(7):924-928. Sjoberg N, Brinkworth GD, Wycherley TP, Noakes M, Saint DA: Moderate weight loss improves heart rate variability in overweight and obese adults with type 2 diabetes. J Appl Physiol 2011, 110(4):1060-1064. Poliakova N, Despres JP, Res 1998, 8(5):251-257. Matsumoto T, Miyawaki T, Ue H, Kanda T, Zenji C, Bergeron J, Almeras N, Tremblay A, Poirier P: Influence of obesity indices, metabolic parameters and age on cardiac autonomic function in abdominally obese men. Metabolism 2012. Rutter MK, McComb JM, Brady S, Marshall SM: Autonomic neuropathy in asymptomatic subjects with non-insulin-dependent diabetes mellitus and microalbuminuria. Clin Auton Moritani T: Autonomic responsiveness to acute cold exposure in obese and non-obese young women. Int J Obes Relat Metab Disord 1999, 23(8):793-800. N, Tsigos C, Perea D, Koukou E, Kyriaki D, Kitsou E, Daskas S, Daifotis Z, Makrilakis K, Raptis SA et al: Differential effects of high-fat and high-carbohydrate isoenergetic meals on cardiac autonomic nervous system activity in lean and obese women. Metabolism 2003, 52(11):1426-1432. Bergfors M, Barnekow-Bergkvist M, Kalezic N, Lyskov E, Eriksson JW: Short-term effects of repetitive arm work and dynamic exercise on glucose metabolism and insulin sensitivity. Acta Physiol Scand 2005, 183(4):345-356. Nagai N, Sakane N, Moritani T: Metabolic responses to high-fat or low-fat meals and association with sympathetic nervous system activity in healthy young men. J Nutr Sci Vitaminol (Tokyo) 2005, 51(5):355-360. Kimura T, Matsumoto T, Akiyoshi M, Owa Y, Miyasaka N, Aso T, Moritani T: Body fat and blood lipids in postmenopausal women are related to resting autonomic nervous system activity. Eur J Appl Physiol 2006, 97(5):542-547. Buchheit M, Platat C, Oujaa M, Simon C: Habitual physical activity, physical fitness and heart rate variability in preadolescents. Int J Sports Med 2007, 28(3):204210. Kaufman CL, Kaiser DR, Steinberger J, Kelly AS, Dengel DR: Relationships of cardiac autonomic function with metabolic abnormalities in childhood obesity. Obesity (Silver Spring) 2007, 15(5):1164-1171. Kanaley JA, Goulopoulou S, Franklin RM, Baynard T, Holmstrup ME, Carhart R, Jr., Weinstock RS, Fernhall B: Plasticity of heart rate signalling and complexity with exercise training in obese individuals with and without type 2 diabetes. Int J Obes (Lond) 2009, 33(10):1198-1206. AE, Bertuzzi RC, Pires FO, Fronchetti L, Gevaerd MS, De-Oliveira FR: A low carbohydrate diet affects autonomic modulation during heavy but not moderate exercise. Eur J Appl Physiol 2010, 108(6):1133-1140. Millis RM, Austin RE, Hatcher MD, Bond V, Faruque MU, Goring KL, Hickey BM, DeMeersman RE: Association of body fat percentage and heart rate variability measures of sympathovagal balance. Life Sci 2010, 86(5-6):153-157. Pistorio E, Luca M, Luca A, Messina V, Calandra C: Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders. Lipids Health Dis 2011, 10:192 Schole, J. und W. Lutz (1988): Regulationskrankheiten – Versuch einer fächerübergreifenden Analyse. ISBN: 3-43297-1419. Spranger, H.: Mind-Body. Separatum zu Spranger, H. & EU-team: Regulationsbiologische Grundlagen. Modul inter-uni.net. ISBN: 3-9502-326-0-8. National Center for Complementary and Alternative Medicine. Zugriff12.01.2006 http://nccam.nih.gov/health/mindbody.htm Dobos, G.J., A. Paul (2007): Was ist Mind-Body Medicine. Komplement. Integrat. Med. 48; Heft 9: 19-24. Heine, H.(2007): Lehrbuch der biologischen Medizin. Grundregulation und Matrix. Hippokrates. ISBN: 3-8304-5335-3. DDr. Gerhard Lingg PhD, http://www.imi-health.com, http://www.iqcure.at/ college @ inter-uni.net Wilhelm Mosgöller, A.o. Univ. Prof. Dr., wilhelm.mosgoeller@meduniwien.ac.at, college @ inter-uni.net Ralf Arne Wittling, Dipl.-Ing. Dr., arne-wittling@znf-gmbh.com Peter Christian Endler, Prof. DDr., college @ inter-uni.net RESEARCH POSTER PRESENTATION DESIGN © 2012 www.PosterPresentations.com