Cardiometabolic health and the timing of habitual exercise in the All of Us Research Program
Patel, P.; Riegal, C.; Kalyanasundaram, A.; Singh, M.; Raveendra, K.; Mi, M. Y.; Tahir, U. A.; Robbins, J. M.; Tiwari, G.; Peters, N. S.; Sofer, T.; Kramer, D. B.; Gerszten, R. E.; Rao, P.
Show abstract
While the cardiometabolic benefits of exercise volume and intensity are well established, the clinical significance of exercise timing remains poorly understood, largely due to the limitations of short-term accelerometry. We leveraged minute-level heart rate data from 14,489 participants from the All of Us Research Program to define habitual exercise timing over a one-year period. Compared to daytime exercise, habitual morning exercise was associated with lower odds of coronary artery disease (OR 0.69; CI 0.55-0.87), hypertension (OR 0.82; CI 0.72-0.94), type 2 diabetes (OR 0.70; CI 0.58-0.85), hyperlipidemia (OR 0.79; CI 0.69-0.90), and obesity (OR 0.65; CI 0.55-0.77). These associations were independent of total physical activity volume and remained consistent across hour-of-day analyses, with the lowest risk nadir occurring between 07:00-08:00 for coronary artery disease. These findings suggest that exercise timing may represent a distinct, underappreciated dimension of exercise behavior linked to cardiometabolic health.
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