Associations Between the Timing of 24 H Physical Activity and Diabetes Mellitus: Results From a Nationally Representative Sample of the US Population

Authors

Qian Xiao
Qiuyu Feng
Martin K Rutter
Gali Albalak
Heming Wang
Raymond Noordam

Language

English

Publication Date

5-1-2025

Journal

Diabetologia

DOI

10.1007/s00125-025-06368-9

PMID

39982484

PMCID

PMC12021934

PubMedCentral® Posted Date

2-21-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Aims/hypothesis: Growing evidence suggests that timing may be an important aspect of physical activity that influences cardiometabolic health. However, the current literature is inconclusive regarding the time of day that physical activity offers the greatest metabolic advantages. We investigated associations between hourly physical activity levels and diabetes mellitus and glycaemic biomarkers in a cross-sectional and nationally representative sample of US adults.

Methods: We studied 7074 adults (mean age 48 years; 52% women) from the National Health and Nutrition Examination Survey (2011-2014). Physical activity was measured by actigraphy. A monitor-independent movement summary (MIMS) unit was used to derive the total activity level (divided into quintiles) for hourly windows that were defined relative to sleep timing and according to clock time. The primary outcome was prevalent diabetes, and secondary outcomes included fasting glucose, fasting insulin, HOMA-IR and 2 h OGTT results.

Results: Physical activity levels in late morning and late afternoon were associated with lower adjusted odds of diabetes. Specifically, in late morning (8:01-9:00 h after the sleep midpoint), the highest quintile of activity was associated with a 35% decrease (OR 0.65; 95% CI 0.44, 0.96) in the odds of diabetes when compared with the lowest quintile, while in late afternoon (11:01-17:00 h after the sleep midpoint), the highest quintiles were associated with 56% and 36% lower odds (OR 0.44; 95% CI 0.29, 0.69 and OR 0.64; 95% CI 0.43, 0.95). Higher night-time activity was associated with higher odds of diabetes. Similar patterns of results were observed with OGTT data and across subgroups of age, gender, race/ethnicity, chronotype and sleep duration.

Conclusions/interpretation: Our findings suggest that the timing of physical activity may modulate its metabolic effects.

Keywords

Humans, Female, Male, Middle Aged, Exercise, Cross-Sectional Studies, United States, Adult, Diabetes Mellitus, Blood Glucose, Nutrition Surveys, Sleep, Aged, Time Factors, Insulin, Actigraphy, Chronotype, Diabetes, Physical activity, Timing, Type 2 diabetes

Published Open-Access

yes

Recommended Citation

Xiao, Qian; Feng, Qiuyu; Rutter, Martin K; et al., "Associations Between the Timing of 24 H Physical Activity and Diabetes Mellitus: Results From a Nationally Representative Sample of the US Population" (2025). Faculty, Staff and Student Publications. 1110.
https://digitalcommons.library.tmc.edu/uthsph_docs/1110