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.

中文翻译：

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肥胖成人中度至剧烈体力活动的时机、死亡率、心血管疾病和微血管疾病

目的 评估成人肥胖症以及肥胖合并 2 型糖尿病亚群的有氧中度至剧烈体力活动 (MVPA) 时机与心血管疾病 (CVD)、微血管疾病 (MVD) 和全因死亡率之间的关联（T2D）。研究设计和方法 参与者包括肥胖成人（BMI ≥30 kg/m2）和来自英国生物银行加速测量子研究的 T2D 患者子集。有氧 MVPA 定义为持续 ≥3 分钟的 MVPA 发作。根据参与者进行大部分有氧 MVPA 的时间，将其分为上午、下午或晚上 MVPA。参考组包括平均每天少于 1 次有氧 MVPA 比赛的参与者。针对已确定的和潜在的混杂因素对分析进行了调整。结果 核心样本包括 29,836 名肥胖成年人，平均年龄为 62.2 (SD 7.7) 岁。在平均 7.9 (SD 0.8) 年的随访期内，发生了 1,425 例死亡、3,980 例 CVD 事件和 2,162 例 MVD 事件。与参考组的活动相比，晚上 MVPA 与最低的死亡风险相关（风险比 [HR] 0.39；95% CI 0.27，0.55），而下午（HR 0.60；95% CI 0.51，0.71）和早晨 MVPA （HR 0.67；95% CI 0.56，0.79）显示出显着但较弱的关联。 CVD 和 MVD 发生率也观察到类似的模式，夜间 MVPA 与 CVD（HR 0.64；95% CI 0.54，0.75）和 ​​MVD（HR 0.76；95% CI 0.63，0.92）风险最低相关。 T2D 子集 (n = 2,995) 中的结果相似。结论 晚上进行有氧 MVPA 训练与死亡率、CVD 和 MVD 风险最低相关。体力活动的时机可能在未来的肥胖和 T2D 管理中发挥重要作用。