Diabetes & Metabolism Journal

Original Article

Basic and Translational Research
Effect of 4 Weeks Resonance Frequency Breathing on Glucose Metabolism and Autonomic Tone in Healthy Adults: Benedict Herhaus, Andreas Peter, Julia Hummel, Thomas Kubiak, Martin Heni, Katja Petrowski; Diabetes Metab J. 2025;49(6):1219-1228. Published online April 3, 2025; DOI: https://doi.org/10.4093/dmj.2024.0647

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Background
The autonomic nervous system plays a crucial role in the brain’s communication with metabolically important peripheral organs, modulating insulin sensitivity and secretion. Increased sympathetic tone is a common feature in prediabetes and diabetes. The parasympathetic nervous system activity might be improvable through resonance frequency breathing (RFB) with heart rate variability biofeedback (HRV-BF) training.
Methods
We here investigated the effect of a 4-week mobile RFB-HRV-BF intervention on glucose metabolism and HRV of 30 healthy adults (17 females; mean age 25.77±3.64 years; mean body mass index 22.65±2.95 kg/m²). Before and after the intervention, glucose metabolism was assessed by 75 g oral glucose tolerance tests (with blood sampling every 30 minutes over 2 hours) and HRV was measured through electrocardiography.
Results
RFB-HRV-BF training did not influence glucose metabolism in healthy adults but reduced fasting as well as 2-hour-postload glucose in participants categorized as more insulin resistant before the intervention. In addition, RFB-HRV-BF training was associated with an increase in the time and frequency domain HRV parameters standard deviation of all NN-intervals, root mean square successive differences, HRV high-frequency and HRV low-frequency after 4 weeks of intervention.
Conclusion
Our findings introduce RFB-HRV-BF training as an effective tool to modulate the autonomic nervous system with a shift towards the parasympathetic tone. Along with the observed decrease in glycemia in those with lower insulin sensitivity, RFB-HRV-BF training emerges as a promising non-pharmacological approach to improve glucose metabolism which has to be further investigated in prediabetes and diabetes.

Citations

Citations to this article as recorded by

The autonomic nervous system in the regulation of glucose and lipid metabolism
Sabrina Wangler, Marc N. Jarczok, Matthew Ennis, Benedict Herhaus, Róbert Wagner, Ratika Sehgal, Martin Heni
Nature Reviews Endocrinology.2026;[Epub] CrossRef

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