Qiuyu Feng1, Gali Albalak, Ko Willems van Dijk, Jeroen H.P.M. van der Velde, Milena Schönke, Heming Wang, Martin K Rutter, Qian Xiao, Raymond Noordam, Diana van Heemst

  1. Leiden University Medical Center, Leiden, the Netherlands

Abstract

Introduction: There is increasing evidence from experimental and epidemiological studies for a role of the timing of physical activity, independent of the total amount of physical activity, in disease pathogenesis. Here, we studied the association between timing of physical activity – chronoactivity – and the risk of type 2 diabetes (T2D).

Methods: We included UK Biobank participants with accelerometry data (N=89,439; mean age: 61.7 [SD:7.9] years, 57% women). Cox-proportional hazard modeling examined the associations between hourly physical activity (expressed as the ratio to the overall mean and standardized) and T2D risk, adjusted for potential confounders including demographics and lifestyle factors. In addition, to identify subgroups of participants with similar daily chronoactivity patterns, we performed k-means clustering on the hourly physical activity data. All analyses were adjusted for body mass index (BMI) as a potential mediator.

Results: Over a median follow-up duration of 7.8 (interquartile range: 7.2-8.3) years, 2240 participants developed T2D. Higher physical activity levels during the late morning (8:00–10:59) and afternoon (15:00– 15:59, 17:00– 17:59) were associated with a 5%-10% lower T2D risk; while higher physical activity levels during the late evening, night and early morning (21:00–6:59) were associated with 5%-16% higher risk. Four clusters of daily chronoactivity patterns were identified: midday pattern, early morning peak, late morning peak, evening peak. Compared with participants exhibiting a midday pattern, those with a late morning peak had a lower T2D risk (HR: 0.88, 95%CI: 0.79, 0.98). Results from both analyses attenuated to some extent after additional adjustment for BMI.

Conclusion: Being more active in the morning and afternoon was associated with a lower T2D risk, while being more active in the late evening/night was associated with a higher risk, possibly mediated by BMI. These results warrant future research on the potential of chronoactivity as a novel strategy for T2D prevention.