Association of Timing of Moderate-to-Vigorous Physical Activity With Changes in Glycemic Control Over 4 Years in Adults With Type 2 Diabetes From the Look AHEAD Trial

Authors

Jingyi Qian
Qian Xiao
Michael P Walkup
Mace Coday
Melissa L Erickson
Jessica Unick
John M Jakicic
Kun Hu
Frank A J L Scheer
Roeland J W Middelbeek
Look AHEAD Research Group

Publication Date

7-1-2023

Journal

Diabetes Care

Abstract

OBJECTIVE: We aimed to determine the association of the time-of-day of bout-related moderate-to-vigorous physical activity (bMVPA) with changes in glycemic control across 4 years in adults with overweight/obesity and type 2 diabetes.

RESEARCH DESIGN AND METHODS: Among 2,416 participants (57% women; mean age, 59 years) with 7-day waist-worn accelerometry recording at year 1 or 4, we assigned bMVPA timing groups based on the participants' temporal distribution of bMVPA at year 1 and recategorized them at year 4. The time-varying exposure of bMVPA (≥10-min bout) timing was defined as ≥50% of bMVPA occurring during the same time period (morning, midday, afternoon, or evening),

RESULTS: HbA1c reduction at year 1 varied among bMVPA timing groups (P = 0.02), independent of weekly bMVPA volume and intensity. The afternoon group had the greatest HbA1c reduction versus inactive (-0.22% [95%CI -0.39%, -0.06%]), the magnitude of which was 30-50% larger than the other groups. The odds of discontinuation versus maintaining or initiating glucose-lowering medications at year 1 differed by bMVPA timing (P = 0.04). The afternoon group had the highest odds (odds ratio 2.13 [95% CI 1.29, 3.52]). For all the year-4 bMVPA timing groups, there were no significant changes in HbA1c between year 1 and 4.

CONCLUSIONS: bMVPA performed in the afternoon is associated with improvements in glycemic control in adults with diabetes, especially within the initial 12 months of an intervention. Experimental studies are needed to examine causality.

Keywords

Adult, Female, Humans, Male, Middle Aged, Diabetes Mellitus, Type 2, Exercise, Glycated Hemoglobin, Glycemic Control, Obesity

DOI

10.2337/dc22-2413

PMID

37226675

PMCID

PMC10300518

PubMedCentral® Posted Date

5-25-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes