Exercise has been shown to be one of the most effective ways to reduce the risk of heart disease and stroke. Regular physical activity can improve cardiovascular health by lowering blood pressure, lowering cholesterol levels, and improving blood sugar control. It can also help with weight control and stress reduction, both of which are important factors in reducing the risk of heart disease and stroke. However, does the time of day you exercise affect its effectiveness in improving heart health?
The risk of heart disease and stroke is lower in those who engage in morning physical activity.
A new study published in the European Journal of Preventive Cardiology has found that morning physical activity is associated with the lowest risk of heart disease and stroke. The study, which included more than 85,000 people, found that this association held regardless of total daily activity level.
“It is well established that exercise is good for heart health, and our study now indicates that morning activity appears to be more beneficial,” said study author Ms Gali Albalak, from Leiden University Medical Center. , Netherlands. “The findings were particularly pronounced in women and applied to both early risers and night owls.”
The study used data from the UK Biobank to investigate the relationship between physical activity and the risk of heart disease and stroke in 86,657 adults. The participants, who did not have cardiovascular disease at the start of the study and were between the ages of 42 and 78 (average age 62), wore an activity tracker for one week. The study found that morning physical activity was associated with the lowest risk of heart disease and stroke, regardless of the total level of daily activity. Participants were followed for incident cardiovascular disease, defined as a hospital admission or death related to coronary artery disease or stroke.
During six to eight years of follow-up, 2,911 participants developed coronary artery disease and 796 had a stroke. When comparing peak activity times in a 24-hour period, being most active between 8 a.m. and 11 a.m. was linked to the lowest risks of heart disease and stroke.
In a second analysis, the researchers divided the participants into four groups based on the peak time of physical activity: 1) noon; 2) early in the morning (~8 am); 3) late in the morning (~10 am); and 4) late (~7 pm). The categories were selected according to the peak times of activity in the study population, rather than being predetermined before the study began. The associations between the peak time of activity and the incidence of cardiovascular disease were analyzed using noon as the reference group.
After adjusting for age and sex, participants who were most active in the early morning or late morning had an 11% and 16% lower risk of incident coronary artery disease, respectively, compared with the control group . Additionally, those who were most active in the late morning had a 17% lower risk of incident stroke compared to the control group.
The findings were consistent regardless of the total amount of daily activity and whether the participants described themselves as a morning or evening person. When the results were analyzed separately by sex, the researchers found that the results were particularly prominent in women but no longer significant in men. Women who were most active in the early morning or late morning had a 22% and 24% lower risk of incident coronary artery disease, respectively, compared with the control group. Additionally, women who were most active in the late morning had a 35% lower risk of incident stroke compared to the control group.
Ms Albalak said: “This was an observational study and therefore we cannot explain why the associations were stronger in women. Our findings add to the evidence for the health benefits of physical activity by suggesting that morning, and especially late morning, activity may be the most advantageous. It’s too early for formal advice prioritizing morning exercise, as this is a fairly new field of research. But we hope that one day we can refine the current recommendations simply by adding a line: ‘when exercising, it is recommended to do it in the morning’.”
Reference: “Setting your clock: associations between the timing of objective physical activity and cardiovascular disease risk in the general population” by Gali Albalak, Marjon Stijntjes, David van Bodegom, J Wouter Jukema, Douwe E Atsma, Diana van Heemst, and Raymond Noordam, November 14, 2022, European Journal of Preventive Cardiology.
DOI: 10.1093/eurjpc/zwac239
