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The Ideal Timing for Exercise in Adults with Obesity: An Evening Walk Might Be the Key to Better Health

Written by Andrew Le, MD

UpdatedMay 29, 2024

A recent study published in Diabetes Care has found that the timing of physical activity could play an influential role in managing health outcomes for adults with obesity, including those with type 2 diabetes (T2D). This large-scale study, conducted by researchers including Angelo Sabag, Matthew N. Ahmadi, and Emmanuel Stamatakis, provides striking evidence that moderate to vigorous physical activity (MVPA) undertaken in the evening may lead to a lower risk of mortality, cardiovascular disease (CVD), and microvascular disease (MVD).

The comprehensive analysis drew upon data from 29,836 overweight participants from the UK Biobank, a subset of whom (2,995) were living with T2D. Participants were categorised into groups based on their preferred timing for physical activity bouts lasting more than three minutes—either in the morning, afternoon, or evening—with a reference group that did not partake in MVPA bouts.

Over a follow-up period averaging just under eight years, the study found that, compared with the reference group, those who engaged in evening MVPA exhibited the lowest risk for all-cause mortality (a hazard ratio [HR] of 0.39), CVD (HR of 0.64), and MVD events such as nephropathy, neuropathy, or retinopathy (HR of 0.76). While morning and afternoon MVPA were also associated with significant benefits, they were less pronounced when compared to evening activity.

Interestingly, for participants with T2D, the benefits of evening exercise were even more distinct, with the lowest mortality risk (HR of 0.24), CVD risk (HR of 0.54), and MVD risk (HR of 0.52) found among this group. This suggests that the timing of exercise may be particularly crucial for those managing diabetes.

The study supports the idea that not only is regular physical activity vital for health, but the time of day when it's performed might be important for optimizing health outcomes in individuals with obesity. This adds a novel consideration for health professionals managing obesity and T2D.

While the study relied on the UK Biobank's large, diverse participant base and extended follow-up duration to provide these robust findings, the limitations inherent in an observational study, such as potential residual confounding, were acknowledged. Still, the utilization of negative control outcomes in the analysis suggests that the observed associations were likely not due to bias or confounding, but may indeed reflect a true relationship between MVPA timing and health outcomes.

In conclusion, this significant research indicates that evening MVPA is consistently associated with reduced risks of mortality, cardiovascular disease, and microvascular complications in adults with obesity. These findings pave the way for future clinical studies to investigate MVPA timing as a potential factor in lifestyle interventions aiming to manage cardiometabolic diseases more effectively.

The study emphasizes the prospect that particularly for those with obesity or T2D, an evening walk or workout could hold greater benefits for long-term health.

For more details about the study and its findings, you can access the full-text article via the Diabetes Care journal at this link.

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Sabag, A., Ahmadi, M. N., Francois, M. E., Postnova, S., Cistulli, P. A., Fontana, L., & Stamatakis, E. (2024). Timing of moderate to vigorous physical activity, mortality, cardiovascular disease, and microvascular disease in adults with obesity. Diabetes Care, 47(5), 1-8.