Physical activity in the morning associated with reduced CVD risk
Setting your clock: associations between timing of objective physical activity and cardiovascular disease risk in the general population
Introduction and methods
Background
Physical activity plays an important role in healthy aging. Sufficient physical activity lowers the risk of CV mortality and improves quality of life [1,2]. Large population-based studies have shown an inverse association between increased physical activity and CVD risk [3-8]. However, little is known about the association between timing of physical activity (chronoactivity) and CVD risk in the general population.
Aim of the study
The aim of this study was to examine the association between timing of physical activity and multiple CVD outcomes in the general UK population.
Methods
The researchers used data from the UK Biobank, a large prospective cohort study among 502,490 participants aged 40-69 years from the general UK population. The present study included 86,657 individuals (mean age: 61.6 years; 58% female) whose daily physical activity data had been collected using a triaxial accelerometer over a measurement period of 7 consecutive days. Participants were clustered according to their pattern of physical activity, using 24-hour means: (a) average pattern of physical activity, i.e., midday physical activity (cluster 1); (b) peak physical activity in the early morning (cluster 2); (c) peak physical activity in the late morning (cluster 3); and (d) peak physical activity in the evening (cluster 4).
Outcomes
The researchers were interested in multiple CVD outcomes: CAD, stroke (ischemic and hemorrhagic stroke) and ischemic stroke alone. Additional subgroup analyses were performed based on sex, total physical activity and self-reported chronotype. The follow-up duration was 6 years.
Main results
- A relatively high level of physical activity during the nightly hours (12:00 p.m.-6:00 a.m.) was associated with a higher risk of CAD, stroke and ischemic stroke alone, while a relatively high level of morning physical activity (8:00-11:00 a.m.) was associated with lower risks.
- Participants with peak physical activity in the early morning (cluster 2; HR: 0.89; 95%CI: 0.80-0.99) or late morning (cluster 3; HR: 0.84; 95%CI: 0.77-0.92) had a reduced CAD risk, compared with participants with an average pattern of physical activity (cluster 1).
- Participants with peak physical activity in the late morning (cluster 3; HR: 0.83; 95%CI: 0.70-0.98) also had a reduced risk of stroke, compared with participants with an average pattern of physical activity (cluster 1).
- Women in cluster 2 (HR: 0.73; 95%CI: 0.61-0.87) had a reduced CAD risk, but this did not apply to men in the same cluster (HR: 0.99; 95%CI: 0.87-1.13; P-interaction=0.001); in cluster 3 (P-interaction=0.18) and cluster 4 (P-interaction=0.16), the CAD risk was similar between men and women.
- There was no effect modification by total physical activity and self-reported chronotype (P interaction>0.05).
Conclusion
This prospective cohort study of 86,657 participants aged 40-69 years from the general UK population shows that morning physical activity is associated with a reduced CVD risk, irrespective of total physical activity, and with a pronounced effect in women.
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