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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},
}