{"doi":"10.2337/dc20-2178","title":"Association of Objectively Measured Timing of Physical Activity Bouts With Cardiovascular Health in Type 2 Diabetes","abstract":"OBJECTIVE Moderate- to vigorous-intensity physical activity (MVPA) improves cardiovascular health. Few studies have examined MVPA timing. We examined the associations of timing of bout-related MVPA with cardiorespiratory fitness and cardiovascular risk in adults with type 2 diabetes. RESEARCH DESIGN AND METHODS Baseline 7-day hip-worn accelerometry data from Look AHEAD participants (n = 2,153, 57% women) were analyzed to identify bout-related MVPA (≥3 METs/min for ≥10 min). Cardiorespiratory fitness was assessed by maximal graded exercise test. Participants were categorized into six groups on the basis of the time of day with the majority of bout-related MVPA (METs × min): ≥50% of bout-related MVPA during the same time window (morning, midday, afternoon, or evening), <50% of bout-related MVPA in any time category (mixed; the reference group), and ≤1 day with bout-related MVPA per week (inactive). RESULTS Cardiorespiratory fitness was highly associated with timing of bout-related MVPA (P = 0.0005), independent of weekly bout-related MVPA volume and intensity. Importantly, this association varied by sex (P = 0.02). In men, the midday group had the lowest fitness (β = −0.46 [95% CI −0.87, −0.06]), while the mixed group in women was the least fit. Framingham risk score (FRS) was associated with timing of bout-related MVPA (P = 0.02), which also differed by sex (P = 0.0007). The male morning group had the highest 4-year FRS (2.18% [0.70, 3.65]), but no association was observed in women. CONCLUSIONS Timing of bout-related MVPA is associated with cardiorespiratory fitness and cardiovascular risk in men with type 2 diabetes, independent of bout-related MVPA volume and intensity. Prospective studies are needed to determine the impacts of MVPA timing on cardiovascular health.","journal":"Diabetes Care","year":2021,"id":152711,"datarank":2.8186900359870615,"base_score":4.304065093204169,"endowment":4.304065093204169,"self_citation_contribution":0.6456097639806255,"citation_network_contribution":2.173080272006436,"self_endowment_contribution":0.6456097639806255,"citer_contribution":2.173080272006436,"corpus_percentile":null,"corpus_rank":null,"citation_count":73,"citer_count":62,"citers_with_citation_signal":48,"citers_with_endowment":48,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5716,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT00017953"],"figshare":["10.2337/figshare.13618967"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":649000,"name":"Michael P. Walkup","orcid":null,"position":1,"is_corresponding":false},{"id":396328,"name":"Shyh‐Huei Chen","orcid":null,"position":2,"is_corresponding":false},{"id":648156,"name":"Peter H. Brubaker","orcid":"0000-0003-0918-4056","position":3,"is_corresponding":false},{"id":428256,"name":"Dale S. Bond","orcid":"0000-0002-1976-1235","position":4,"is_corresponding":false},{"id":364878,"name":"Phyllis A. Richey","orcid":"0000-0002-0757-212X","position":5,"is_corresponding":false},{"id":235351,"name":"John M. Jakicic","orcid":"0000-0001-6800-9368","position":6,"is_corresponding":false},{"id":396849,"name":"Kun Hu","orcid":"0000-0003-0350-3132","position":7,"is_corresponding":false},{"id":249994,"name":"Frank A. J. L. Scheer","orcid":"0000-0002-2014-7582","position":8,"is_corresponding":false},{"id":49872,"name":"Roeland J.W. Middelbeek","orcid":"0000-0003-3862-8082","position":9,"is_corresponding":false},{"id":249991,"name":"Jingyi Qian","orcid":"0000-0002-8793-9330","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-18T23:43:34.972031Z","pmid":"33597215","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}