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@ARTICLE{Stein:298227,
      author       = {M. J. Stein and A. Weber and F. Bamberg and H. Baurecht and
                      K. Berger and P. Bohmann and H. Brenner$^*$ and J.
                      Brummer$^*$ and M. Dörr and B. Fischer and S. Gastell and
                      K.-H. Greiser$^*$ and V. Harth and A. Hebestreit and J.-K.
                      Heise and F. Herbolsheimer$^*$ and T. Ittermann and A. Karch
                      and T. Keil and A. Kluttig and L. Krist and K. B. Michels
                      and R. Mikolajczyk and M. Nauck and K. Nimptsch and N. Obi
                      and T. Pischon and O. Pivovarova-Ramich and T. Schikowski
                      and B. Schmidt and M. B. Schulze and K. Steindorf$^*$ and S.
                      Zylla and M. F. Leitzmann},
      title        = {{D}iurnal timing of physical activity in relation to
                      obesity and diabetes in the {G}erman {N}ational {C}ohort
                      ({NAKO}).},
      journal      = {International journal of obesity},
      volume       = {49},
      issn         = {0307-0565},
      address      = {Avenel, NJ},
      publisher    = {Nature Publ. Group},
      reportid     = {DKFZ-2025-00234},
      pages        = {921–930},
      year         = {2025},
      note         = {49, pages 921–930 (2025)},
      abstract     = {Physical activity supports weight regulation and metabolic
                      health, but its timing in relation to obesity and diabetes
                      remains unclear. We aimed to assess the diurnal timing of
                      physical activity and its association with obesity and
                      diabetes.We cross-sectionally analyzed hip-worn
                      accelerometry data from 61,116 participants aged 20-75 in
                      the German National Cohort between 2015 and 2019. We divided
                      physical activity into sex- and age-standardized quartiles
                      of total morning (06:00-11:59), afternoon (12:00-17:59),
                      evening (18:00-23:59), and nighttime (00:00-06:00) physical
                      activity. Using multivariable logistic regression, we
                      estimated associations of physical activity timing with
                      obesity (BMI ≥ 30.0 kg/m2) and diabetes (self-reported or
                      HbA1c ≥ $6.5\%).$ We accounted for sex, age, study region,
                      education, employment, risky alcohol use, smoking, night
                      shift work, and sleep duration.High afternoon (top vs.
                      bottom quartile, OR: 0.36, $95\%$ CI: 0.33-0.38) and evening
                      physical activity (OR: 0.45, $95\%$ CI: 0.42-0.48) showed
                      lower obesity odds than high morning activity (OR: 0.71,
                      $95\%$ CI: 0.66-0.76), whereas nighttime activity increased
                      obesity odds (OR: 1.58, $95\%$ CI: 1.48-1.68). Associations
                      were similar for diabetes, with the lowest odds for
                      afternoon (OR: 0.47, $95\%$ CI: 0.42-0.53), followed by
                      evening (OR: 0.56, $95\%$ CI: 0.50-0.62) and morning
                      activity (OR: 0.80, $95\%$ CI: 0.71-0.89), and higher odds
                      for nighttime activity (OR: 1.43, $95\%$ CI: 1.29-1.58).
                      Findings were not modified by employment status, night shift
                      work, and sleep duration.Our cross-sectional findings
                      require longitudinal corroboration but suggest afternoon and
                      evening activity provide greater metabolic health benefits
                      than morning activity, while nighttime activity is
                      discouraged.},
      cin          = {C070 / C110 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C110-20160331 /
                      I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39856244},
      doi          = {10.1038/s41366-025-01721-9},
      url          = {https://inrepo02.dkfz.de/record/298227},
}