Assessing Heart Rate Variability Responses to Food Cues and Cognitive Stress: A Comparative Study of a Wearable Device and ECG

Variations in heart rate variability (HRV) have been linked to emotional distress, disordered eating and exposure to food stimuli, suggesting HRV as a potential biomarker for emotional dysregulation related to maladaptive eating. With advancements in wearable technology, continuous HRV monitoring is now feasible. This study explored HRV responses to visual food cues, food consumption, and cognitive stress in healthy individuals using both a wrist-worn wearable device and a 12-lead electrocardiography (ECG), the gold standard for HRV measurements. The motivation behind the study was to investigate the feasibility of detecting a binge eating episode prior to the event, as a first step to subsequently developing a just-in-time intervention. Unlike previous studies, no conclusive food-elicited HRV responses were found with the ECG. However, the ECG did capture a significant difference in HRV from baseline compared to the cognitive stress test. The wrist-worn devices signal quality was insufficient for a reliable comparison with the ECG. While wearable devices can continuously measure heart activity, this study highlights the susceptibility of their sensors to motion interference and indicates that signals should be interpreted with care.