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. 2024 May 1;47(5):890-897.
doi: 10.2337/dc23-2448.

Timing of Moderate to Vigorous Physical Activity, Mortality, Cardiovascular Disease, and Microvascular Disease in Adults With Obesity

Angelo Sabag  1   2 , Matthew N Ahmadi  1   2   3 , Monique E Francois  4 , Svetlana Postnova  1   5 , Peter A Cistulli  1   6 , Luigi Fontana  1   7   8 , Emmanuel Stamatakis  1   2   3
Affiliations

Timing of Moderate to Vigorous Physical Activity, Mortality, Cardiovascular Disease, and Microvascular Disease in Adults With Obesity

Angelo Sabag et al. Diabetes Care. .

Abstract

Objective: To assess the association between timing of aerobic moderate to vigorous physical activity (MVPA) and risk of cardiovascular disease (CVD), microvascular disease (MVD), and all-cause mortality in adults with obesity and a subset with obesity and type 2 diabetes (T2D).

Research design and methods: Participants included adults with obesity (BMI ≥30 kg/m2) and a subset of those with T2D from the UK Biobank accelerometry substudy. Aerobic MVPA was defined as bouts of MVPA lasting ≥3 continuous minutes. Participants were categorized into morning, afternoon, or evening MVPA based on when they undertook the majority of their aerobic MVPA. The reference group included participants with an average of less than one aerobic MVPA bout per day. Analyses were adjusted for established and potential confounders.

Results: The core sample included 29,836 adults with obesity, with a mean age of 62.2 (SD 7.7) years. Over a mean follow-up period of 7.9 (SD 0.8) years, 1,425 deaths, 3,980 CVD events, and 2,162 MVD events occurred. Compared with activity in the reference group, evening MVPA was associated with the lowest risk of mortality (hazard ratio [HR] 0.39; 95% CI 0.27, 0.55), whereas afternoon (HR 0.60; 95% CI 0.51, 0.71) and morning MVPA (HR 0.67; 95% CI 0.56, 0.79) demonstrated significant but weaker associations. Similar patterns were observed for CVD and MVD incidence, with evening MVPA associated with the lowest risk of CVD (HR 0.64; 95% CI 0.54, 0.75) and MVD (HR 0.76; 95% CI 0.63, 0.92). Findings were similar in the T2D subset (n = 2,995).

Conclusions: Aerobic MVPA bouts undertaken in the evening were associated with the lowest risk of mortality, CVD, and MVD. Timing of physical activity may play a role in the future of obesity and T2D management.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Association of aerobic MVPA bout (≥3 min) timing with all-cause mortality in adults with obesity. No aerobic bouts group represents participants who did not accumulate an average of one or more aerobic MVPA bout (≥3 min) per day over the week.
Figure 2
Figure 2
Association of aerobic MVPA bout (≥3 min) timing with the incidence of CVD in adults with obesity. No aerobic bouts group represents participants who did not accumulate an average of one or more aerobic MVPA bouts (≥3 min) per day over the week.
Figure 3
Figure 3
Association of aerobic MVPA bout (≥3 min) timing with the incidence of MVD in adults with obesity. No aerobic bouts group represents participants who did not accumulate an average of one or more aerobic MVPA bouts (≥3 min) per day over the week.
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References

    1. Ganz ML, Wintfeld N, Li Q, Alas V, Langer J, Hammer M. The association of body mass index with the risk of type 2 diabetes: a case-control study nested in an electronic health records system in the United States. Diabetol Metab Syndr 2014;6:50. - PMC - PubMed
    1. Powell-Wiley TM, Poirier P, Burke LE, et al. ; American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council . Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2021;143:e984–e1010 - PMC - PubMed
    1. Xu H, Cupples LA, Stokes A, Liu CT. Association of obesity with mortality over 24 years of weight history: findings from the Framingham Heart Study. JAMA Netw Open 2018;1:e184587. - PMC - PubMed
    1. Suren Garg S, Kushwaha K, Dubey R, Gupta J. Association between obesity, inflammation and insulin resistance: insights into signaling pathways and therapeutic interventions. Diabetes Res Clin Pract 2023;200:110691. - PubMed
    1. Fontana L, Eagon JC, Trujillo ME, Scherer PE, Klein S. Visceral fat adipokine secretion is associated with systemic inflammation in obese humans. Diabetes 2007;56:1010–1013 - PubMed

Grants and funding

This research was conducted using the UK Biobank resource under application 25813. This study was funded by an Australian National Health and Medical Research Council Investigator Grant (APP1194510) and the National Heart Foundation of Australia Postdoctoral Fellowship (APP107158).