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

Author:

Sabag Angelo12ORCID,Ahmadi Matthew N.123ORCID,Francois Monique E.4ORCID,Postnova Svetlana15,Cistulli Peter A.16ORCID,Fontana Luigi178ORCID,Stamatakis Emmanuel123ORCID

Affiliation:

1. 1Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia

2. 2Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia

3. 3Mackenzie Wearables Research Hub @ Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia

4. 4School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia

5. 5School of Physics, The University of Sydney, Sydney, New South Wales, Australia

6. 6Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia

7. 7Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia

8. 8Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia

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.

Publisher

American Diabetes Association

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