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Why Exercise Timing Is Important for Better Diabetes Control – And Best Workout Time

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What time of day is best for exercise? A new study compares morning, afternoon, and evening workouts to help you choose.

New research published in the journal Diabetologia reveals that compared to a more evenly distributed amount of physical activity throughout the day, doing so in the afternoon or evening is associated with reduced insulin resistance (and thus better blood sugar control).

According to the findings of a study conducted by Dr. Jeroen van der Velde and his colleagues at the Department of Clinical Epidemiology at the Leiden University Medical Center in Leiden, the Netherlands, engaging in physical activity in the morning provided no benefits.

The global obesity pandemic is partly caused by a lack of physical exercise and prolonged sitting. This kind of behavior is linked to a higher risk of metabolic diseases like type 2 diabetes (T2D), while earlier research found that short breaks from being sedentary were linked to a better cardiometabolic profile.

Experiment studies show that frequent breaks from sitting for long periods of time with standing or light physical activity led to lower levels of triacylglycerol and less glucose in the blood, which shows a better blood sugar profile.

Having a high fasting blood triacylglycerol level is strongly associated with insulin resistance, which in turn may be linked to higher fat concentrations in the liver.

Exercise has been associated with decreased liver fat and increased insulin sensitivity, according to earlier studies. The authors hypothesized that regular breaks from sedentary behavior would reduce liver fat, resulting in lower insulin resistance and, eventually, the prevention of T2D.

In addition to the duration of sedentary times, it has been suggested that the timing of physical activity throughout the day may play a role in metabolic health. Daylight-dependent alterations in exercise capacity and related metabolic risk markers have been found in in-vitro studies and animal research, but few similar studies have been conducted in humans, and the results are conflicting. The team wanted to know how physical exercise and sedentary breaks affected liver fat and insulin resistance in middle-aged people.

Researchers analyzed information gathered from the population-based prospective cohort study, Netherlands Epidemiology of Obesity (NEO), which aimed to better understand the factors that contribute to the emergence of obesity-related disorders.

Between 2008 and 2012, men and women living in the greater Leiden area who were 45 to 65 years old and had a self-reported body mass index (BMI) of 27kg/m2 or higher were asked to take part in the study.

Invitations were also extended to all residents aged 45 to 65 from one municipality in the region to serve as a reference population with a BMI representative of the general Dutch population, resulting in a study population of 6,671 people.

Participants were subjected to a physical examination, during which blood samples were taken to test fasting and postprandial (after meal) blood glucose and insulin levels, as well as demographic, lifestyle, and clinical information through a questionnaire.

They were also checked to see if they were healthy enough for an MRI scan. About 35% of those who were healthy enough for the scan were chosen at random to have their liver fat content measured using this method.

For the purpose of tracking their activity levels and heart rates, another 955 volunteers were randomly selected to wear a combined accelerometer and heart rate monitor for four days and nights.

The team was able to calculate the physical activity energy expenditure (PAEE, expressed in kJ/kg/day), which in turn allowed them to calculate the amount of time spent at various activity intensities. These were measured as metabolic equivalents of task (MET), which is a PAEE ratio between activity and rest (and a standard method for measuring physical activity).

Sedentary time (not including sleep) was defined as being less than ≤1.5 MET. A break in sedentary time was shown by a period of activity with accelerations of more than >0.75 m/s2 (as such accelerations have been established by previous research as an accurate indicator of breaking up sedentary time). Light physical activity (LPA) was defined as intensity of more than 1.5 MET up to 3 MET, with still higher intensities being classified as MVPA.

The day was separated into three segments: morning (06:00-12:00), afternoon (12:00-18:00), and evening (18:00-24:00), with the proportion of total daily MVPA occurring during each segment revealing the most active time of day. If the amount of MVPA in each block was different from the other blocks by less than 5%, it was considered that the activity was spread out evenly during the day.

This study is based on an analysis of the results from the 775 participants for whom we had full data sets. The group’s average age was 56 years old, and their average BMI was 26.2 kg/m2. There were 42% men and 58% women in the group.

The Findings: Exercising during the afternoon or evening could help control blood sugar

After taking into account things like age, gender, race, and total body fat, the researchers found that a higher total PAEE and, in particular, a higher MVPA were linked to both less liver fat and less insulin resistance. Researchers also found a link between insulin resistance and when MVPA was done during the day.

Even when the total amount of MVPA was taken into account, doing MVPA in the afternoon or evening was linked to lower insulin resistance by 18% and 25%, respectively, compared to doing MVPA evenly throughout the day. There was no big difference in insulin resistance between activities done in the morning and those done evenly throughout the day.

There was no link between the amount of time spent sitting or the number of breaks from sitting and the amount of fat in the liver or insulin resistance. 

The authors write: “It could be that in our study the intensity of the activity during the breaks was too light to cause metabolic responses. 

Most daily activities are of light intensity and because we did not observe an association between LPA and insulin resistance, this may also explain the lack of an association between breaks and insulin resistance.”

Timing of physical activity is an area of human biology that hasn’t been studied very much, and it’s still not clear how the possible benefits of timing of physical activity work. Previous research has demonstrated that the time of day that high-intensity exercise was conducted affected the metabolic responses. Furthermore, the metabolic activity of skeletal muscle cells peaks in the late afternoon, which suggests that being most active during this time may have a greater metabolic impact than exercise earlier in the day.

The researchers came to the conclusion that “in addition to the total amount of daily MVPA, timing of MVPA during the day was associated with reduced insulin resistance: performing most MVPA in the afternoon or evening was associated with up to 25% reduced insulin resistance compared with an even distribution of MVPA during the day. 

“These results suggest that timing of physical activity throughout the day is relevant for the beneficial effects of physical activity on inulin sensitivity. Further studies should assess whether timing of physical activity is indeed important for the occurrence of type 2 diabetes.”

Source: 10.1007/s00125-022-05813-3

Image Credit: Getty

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