Time-of-day moderate-to-vigorous physical activity and all-cause mortality in individuals with type 2 diabetes

Tongyu Ma (Corresponding Author), Yaojie Xie, Thomas Bennett, Chong-Do Lee

Research output: Journal article publicationJournal articleAcademic researchpeer-review


There is no clear evidence for the best time of day for physical activity in benefitting health among individuals with type 2 diabetes. This study was aimed to examine whether there is an optimal time of day for physical activity to increase longevity. In this cohort study of 904 patients with type 2 diabetes, we fitted a Cox model with restricted cubic spline to examine the association of moderate-to-vigorous physical activity (MVPA) and time of day with all-cause mortality. Compositional data analysis was used to examine the association of time spent in sedentary behaviour (SB), light-intensity physical activity (LIPA), morning MVPA, and evening MVPA with all-cause mortality. MVPA was inversely associated with all-cause mortality in a curvilinear manner (P-value for nonlinearity<0.0001). The interaction between MVPA and time of day was not significant (P-value for interaction=0.11). Substituting evening MVPA with morning MVPA was not associated with appreciable changes in all-cause mortality. There is no evidence that the time of day moderates the association of MVPA with all-cause mortality. Patients with higher levels of MVPA had lower mortality regardless of the timing of MVPA. Patients with type 2 diabetes should engage in regular physical activity whenever possible.

Original languageEnglish
Pages (from-to)614-620
Number of pages7
JournalJournal of Sports Sciences
Issue number6
Publication statusPublished - Mar 2022


  • Physical activity
  • compositional data analysis
  • mortality
  • restricted cubic splines
  • timing

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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