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Epidemiology and Population Health

Diurnal timing and volume of physical activity in relation to metabolic syndrome in US adults: a population-based cohort study

International Journal of Obesity (2025)Cite this article

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Abstract

Objective

To examine the independent and joint associations between physical activity (PA) timing and volume patterns in relation to metabolic syndrome (MetS).

Methods

Data from the NHANES 2011–2014 cycles, involving 5065 participants, were used. PA was measured using triaxial accelerometers. PA timing patterns were determined using the K-means clustering algorithm, and PA volumes were categorized based on tertiles (low, moderate, and high). Logistic regression models were used to assess the associations between PA patterns and MetS and its components. We also used restricted cubic spline curves to fit the PA to the MetS and its component non-linear associations.

Results

Three distinct PA timing patterns were identified using K-means clustering (morning, midday-afternoon, and late afternoon-evening). Independent analyses indicated that engaging in PA during the morning or midday-afternoon PA was with lower odds of MetS compared to late afternoon-evening. The adjusted odds ratios (95% confidence intervals) were 0.79 (0.63–0.99) and 0.78 (0.62–0.98), respectively. In joint analyses, compared with the late afternoon-evening/low PA pattern, the morning and midday-afternoon PA timing patterns were associated with lower odds of MetS when combined with moderate or high PA volume. In contrast, the late afternoon-evening PA pattern was significantly associated with lower odds of MetS only at high PA volumes. Additionally, a nonlinear association with MetS was identified in the morning PA pattern, whereas dose-dependent associations with MetS were observed in the midday-afternoon and late afternoon-evening PA patterns.

Conclusions

Our study shows that morning and midday-afternoon PA patterns are associated with lower odds of MetS compared to late afternoon-evening PA. Higher total PA volume is also linked with lower odds of MetS. Conversely, prolonged PA during the late evening or nighttime is associated with higher odds of poorer metabolic outcomes.

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Fig. 1: 24-h physical activity timing patterns.
Fig. 2: Joint association between patterns of PA patterns with MetS and its components.
Fig. 3: Sample weighted-adjusted multivariable non-linear associations of PA and MetS.

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Data availability

This study was conducted using publicly available data from the National Health and Nutrition Examination Survey (https://www.cdc.gov/nchs/nhanes/). The analysis code is available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. School of Physical Education, Shandong University, Jinan City, Shandong Province, China

    Qingxu Wu, Beibei Shi, Litao Du, Wei Jin, Jiping Chen, Xiangli Xue, Yang Pan, Xianliang Zhang & Qiang He

  2. School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China

    Si Chen

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Contributions

QW was responsible for conceptualization, data curation, formal analysis, visualization, and writing the original draft. BS, LD, WJ, and JC contributed to methodology development and supervision. XX, YP, SC, and XZ participated in conceptualization and methodology design. QH contributed to conceptualization, methodology development, and reviewing and editing the manuscript.

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Correspondence to Qiang He.

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The authors declare no competing interests.

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All methods were performed in accordance with the relevant guidelines and regulations. The study protocol for the US NHANES was approved by the US NHANES institutional review board and National Center for Health Statistics Research ethics review board (Protocol #2011-17). All participants provided written informed consent. Institutional review board approval was exempted for this study because of the publicly available and deidentified data.

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Wu, Q., Shi, B., Du, L. et al. Diurnal timing and volume of physical activity in relation to metabolic syndrome in US adults: a population-based cohort study. Int J Obes (2025). https://doi.org/10.1038/s41366-025-01893-4

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