Exercise in morning or afternoon better than evening for lowering type 2 diabetes risk
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Key takeaways:
- Adults who performed physical activity in the morning or afternoon lowered their risk for developing type 2 diabetes.
- Frequency of exercise from day to day was not associated with type 2 diabetes risk.
Physical activity during the morning and afternoon, but not during the evening, is associated with a lower risk for developing type 2 diabetes, according to findings published in Diabetologia.
“It is possible for the relationship between total physical activity and prospective risk for type 2 diabetes to differ by the time of day of physical activity,” Chirag J. Patel, PhD, assistant professor in the department of biomedical informatics at Harvard Medical School, told Healio. “We also found that, among these participants, there was a lack of correlation between routine and lowering of diabetes risk.”
Patel and colleagues obtained data from 93,095 UK Biobank participants who did not have a history of type 2 diabetes. Adults were given an accelerometer to be worn on the dominant wrist for a continuous 7-day period from 2013 to 2015. Metabolic equivalent of task (MET) was used to measure the amount of energy participants expended. A MET hour was defined as the total energy expenditure over 1 hour. Physical activity was assessed during the morning from 6 a.m. to noon, during the afternoon from noon to 6 p.m. and during the evening from 6 p.m. to midnight. Incident type 2 diabetes diagnoses were obtained from hospital records until February 2021 in England and Scotland and until February 2018 in Wales. Mean follow-up was 6.64 years.
After adjusting for covariates, each MET hour of physical activity performed in the morning (adjusted HR = 0.9; 95% CI, 0.86-0.93; P < .001) or in the afternoon (aHR = 0.91; 95% CI, 0.87-0.95; P < .001) lowered one’s risk for developing type 2 diabetes. Evening physical activity was not linked to a reduced risk for diabetes.
When adults were divided into quintiles based on physical activity level, those who were in the second or third quintiles for physical activity in the morning had a lower risk for type 2 diabetes than those in the lowest quintile who performed little or no physical activity. Adults in the highest quintile for physical activity in the morning had a 38% lower risk for type 2 diabetes compared with those in the lowest quintile. Participants in the highest quintile for afternoon physical activity reduced their risk for type 2 diabetes by 27%, and those in the highest quintile for evening physical activity had a 24% lower risk for type 2 diabetes compared with adults in the lowest quintile.
Adults who performed moderate to vigorous or vigorous physical activity reduced their risk for type 2 diabetes, but the risk reduction during each period was dependent on sociodemographics and lifestyle factors.
In a fully adjusted substation analyses, replacing 1 MET hour of evening physical activity with 1 MET hour in the morning was associated with a 6% lower risk for type 2 diabetes (P = .0345). No change in risk was observed when an evening MET hour of physical activity was replaced by an afternoon MET hour. Additionally, there was no change in type 2 diabetes risk per standard deviation of daily MET hour of physical activity.
“We found the lack of frequency of exercise was not related to type 2 diabetes,” Patel said. “Specifically, if one exercises plenty on one day vs. exercising less over multiple days makes no difference in participants of this cohort.”
Patel said more studies are needed to investigate how lifestyle factors may affect associations between physical activity and type 2 diabetes risk.
“All of our findings were influenced by dietary behavior and sleep behavior,” Patel said. “These findings need to be interrogated in a randomized setting or experimental setting to establish causality, as many factors, such as dietary and sleep behavior, can influence findings.”
For more information:
Chirag J. Patel, PhD, can be reached at chirag_patel@hms.harvard.edu.
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