Eat, Then Exercise—or Exercise First? In Type 1 Diabetes, the Order May Matter

From diabetesincontrol.com

For people with type 1 diabetes, exercise is rarely as simple as choosing a workout and getting started. Food, insulin, glucose trends, and workout intensity can all change what happens next. New research on exercise timing in type 1 diabetes adds another piece to that puzzle. A randomized crossover trial found that glucose responses differed depending on whether exercise occurred in a post-absorptive state or after a meal, when insulin on board was higher. The results suggest that what happens before exercise may be nearly as important as the workout itself.

Why Exercise Timing in Type 1 Diabetes Matters

Exercise can produce very different glucose responses in people with type 1 diabetes. Moderate aerobic activity often lowers glucose because working muscles rapidly use glucose for energy. In contrast, intense intervals can sometimes produce a smaller decline or even a temporary rise as stress hormones increase glucose production.

However, exercise type is only part of the story. The amount of circulating insulin also matters. After a meal and mealtime insulin dose, insulin on board may remain substantial when exercise begins. As a result, muscle glucose uptake can combine with insulin action and create a sharper glucose decline.

This is why the timing of exercise can matter for people with type 1 diabetes. Two identical workouts may produce different glucose patterns depending on their relationship to food and insulin.

The American Diabetes Association notes that glucose responses can vary with starting glucose, exercise intensity, duration, and insulin adjustments. Diabetes in Control has also reviewed how different workouts affect glucose in type 1 diabetes.

What the Randomized Crossover Trial Found

The 2026 randomized crossover trial published in Diabetologia included 20 physically active adults with type 1 diabetes. Each participant completed four 25-minute cycling sessions. Researchers compared high-intensity interval exercise, or HIIE, with continuous moderate-intensity exercise under both post-absorptive and post-meal conditions.

Importantly, the exercise sessions were matched for mechanical load. The interval sessions alternated one-minute bouts at 100% of maximal aerobic power, while continuous exercise was performed at 50%.

Meal state clearly influenced the response. During exercise, capillary glucose fell less in the post-absorptive state than after a meal. Glucose also declined less during HIIE than during continuous moderate exercise. Moreover, the difference between interval and continuous exercise was strongest in the post-absorptive state.

The average glucose change was approximately -0.72 mmol/L during post-absorptive HIIE compared with -1.73 mmol/L during post-absorptive continuous exercise. After a meal, declines were larger at -2.33 mmol/L for HIIE and -2.61 mmol/L for continuous exercise.

Notably, the differences extended beyond the workout. During the following 24 hours, participants spent less time below 3.0 mmol/L after HIIE than after continuous exercise after researchers adjusted for carbohydrate intake and insulin doses. The study abstract is available through PubMed.

Insulin on Board and Exercise Intensity

Why did eating first make such a difference? Insulin on board is a likely contributor.

During the post-meal sessions, participants had higher circulating insulin. Exercise itself increases glucose uptake by working muscles. Therefore, adding significant insulin action can accelerate the movement of glucose out of the bloodstream.

High-intensity intervals create a different hormonal environment. Catecholamines and other counterregulatory hormones can stimulate the liver to release glucose. Consequently, intense exercise may partly offset the glucose-lowering effect seen during steady aerobic activity.

Still, these findings should not be interpreted as evidence that everyone with type 1 diabetes should exercise before eating or switch to HIIT. The study was small, involving only 20 physically active adults. Individual responses can also vary according to insulin delivery method, fitness, starting glucose, previous activity, carbohydrate intake, and automated insulin delivery settings.

For additional background, Diabetes in Control has discussed target glucose considerations around exercise, emphasizing that exercise type and intensity affect planning.

Applying Exercise Timing Research to Everyday Care

The practical message is personalization rather than finding one ideal time to exercise with type 1 diabetes. Clinicians may want to ask patients not only what exercise they perform, but also when they perform it relative to meals and bolus insulin.

CGM data can make these conversations more useful. For example, patients can compare glucose trends during similar workouts performed under different conditions. Recording meal timing, insulin doses, exercise intensity, and glucose direction may reveal repeatable patterns.

Additionally, patients should be aware that a stable glucose level during exercise does not eliminate the possibility of delayed hypoglycaemia. Increased insulin sensitivity can continue after activity, so post-exercise and overnight monitoring may remain important.

Current diabetes guidance emphasizes individualized carbohydrate and medication adjustments because glycaemic responses to physical activity can vary widely. Therefore, insulin changes should not be based on one study or a single workout.

People experiencing repeated exercise-related hypoglycaemia, unexplained hyperglycaemia, or difficulty adjusting insulin around workouts should discuss their patterns with their diabetes care team. Personalized medical guidance can also be found through Healthcare.pro.

Conclusion

For people with type 1 diabetes, when exercise happens can be just as important as the type of activity. Meal state, insulin on board, and workout intensity can interact to produce meaningfully different glucose responses.

In this randomized crossover trial, high-intensity interval exercise produced a smaller glucose decline than continuous moderate exercise, particularly when performed in the post-absorptive state. Meanwhile, exercising after a meal was associated with larger glucose declines across both exercise types.

These findings reinforce a practical lesson: the same workout does not always produce the same glucose response. Tracking exercise timing alongside insulin, meals, and CGM trends may help clinicians and patients develop safer and more predictable exercise strategies.

FAQs

Does exercising after a meal lower glucose more in type 1 diabetes?

In this study, glucose declined more during post-meal exercise than during exercise in the post-absorptive state. However, individual responses can vary considerably.

Is HIIT safer than moderate exercise for preventing hypoglycaemia?

The trial found smaller glucose declines and less time below 3.0 mmol/L after HIIE compared with continuous moderate exercise. However, that does not establish HIIT as universally safer for every person with type 1 diabetes.

Why does insulin on board matter during exercise?

Insulin promotes glucose uptake, while exercising muscles also consume more glucose. When substantial insulin remains active, these effects can combine and increase the likelihood of falling glucose.

Should people with type 1 diabetes exercise before eating?

Not necessarily. The best timing depends on insulin therapy, glucose trends, exercise type, fitness, and individual responses. Changes to insulin or exercise routines should be discussed with a diabetes care professional.

Can glucose fall hours after exercise?

Yes. Exercise can increase insulin sensitivity after a workout, so delayed and overnight hypoglycaemia may occur. CGM monitoring and an individualized management plan can help identify these patterns.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.

https://www.diabetesincontrol.com/exercise-timing-type-1-diabetes/ 

Forget the Gym? Why 2-Minute Exercise Snacks Could Improve Glucose Control

From diabetesincontrol.com

Finding time for a full workout can be difficult, but what if two minutes of movement still mattered? Emerging research on exercise snacking for diabetes suggests that brief bursts of activity spread throughout the day may reduce post-meal glucose excursions and limit some metabolic effects of prolonged sitting. Instead of treating exercise as one long daily event, patients can think of movement as small doses taken throughout the day. For clinicians, this approach may offer a practical way to help patients become more active without asking them to completely reorganize their schedules.

What Exercise Snacking Means for Diabetes Management

Exercise snacking describes short bouts of physical activity performed several times during the day. These bouts may last only two to five minutes, although protocols vary. For example, a patient might walk around the office, climb stairs, perform chair stands, or do simple resistance movements before sitting down again.

The concept matters because many adults spend hours sitting even when they complete a traditional workout. Prolonged sedentary time creates a different metabolic challenge than simply failing to exercise. Therefore, breaking up sitting may provide benefits beyond counting total workout minutes.

The American Diabetes Association’s Standards of Care advise people with diabetes to interrupt prolonged sitting at least every 30 minutes for glucose and other health benefits. Importantly, these activity breaks should complement rather than replace recommended aerobic and resistance exercise.

This distinction can make counselling patients about exercise snacking easier. Patients do not have to choose between structured exercise and short movement breaks. Instead, clinicians can encourage both approaches according to ability, glucose patterns, treatment, and lifestyle.

Why Brief Exercise Snacks May Reduce Glucose Spikes

After a meal, glucose enters the bloodstream as carbohydrates are digested. Meanwhile, working muscles need energy. Muscle contractions can increase glucose uptake, which helps explain why movement after eating may reduce glucose excursions.

Research supports this idea. In one randomized crossover study of adults with type 2 diabetes, participants interrupted sitting every 30 minutes with three minutes of light walking or simple resistance exercises. Both approaches significantly reduced postprandial glucose responses compared with uninterrupted sitting.

Other research has tested even shorter breaks. A study involving two-minute light walking breaks every 20 minutes found lower postprandial glucose exposure compared with uninterrupted sitting. Likewise, a systematic review and meta-analysis found that two-to-five-minute walking or simple resistance breaks performed about every 30 minutes can acutely reduce post-meal glucose and insulin responses in adults with obesity. However, researchers noted that longer-term trials are still needed.

Timing may also matter. Diabetes in Control has previously examined how post-meal exercise may affect postprandial glucose. In addition, clinicians can review the site’s discussion of physical activity recommendations for type 2 diabetes, including the benefits of breaking up sedentary time.

Practical Exercise Snacking Strategies for Diabetes

The appeal of exercise snacking is its simplicity. Rather than prescribing an elaborate routine, clinicians can connect movement with activities patients already perform. For example, someone working at a desk could take a two-to-three-minute walking break every 30 minutes. A patient working from home might perform chair stands or calf raises between meetings.

After meals, a short walk can be another practical option. Patients could walk through the office, around the house, or outside after lunch or dinner. Similarly, taking the stairs for a brief period can provide a more vigorous exercise snack for people who can safely tolerate it.

Simple resistance movements also offer alternatives when walking is inconvenient. Chair stands, calf raises, knee raises, and gentle body-weight movements require little equipment. Consequently, patients may be more likely to perform them consistently.

Clinicians should still individualize recommendations. People using insulin or insulin secretagogues may experience exercise-related hypoglycaemia, particularly when activity is added unexpectedly. Glucose monitoring, medication timing, meal timing, fitness level, and exercise intensity can all influence the response.

People with neuropathy, cardiovascular disease, retinopathy, balance limitations, or other diabetes complications may also need modified activities. Therefore, patients with questions about starting or changing an exercise routine should discuss their individual circumstances with a qualified healthcare professional.

Helping Patients Turn Movement Snacks Into a Habit

A successful exercise snacking plan for diabetes should be easy enough to repeat. Rather than telling a sedentary patient to “exercise more,” clinicians can attach a specific movement to an existing cue. For instance, every calendar reminder could trigger two minutes of walking, or every finished meal could prompt a brief activity break.

Technology may make this strategy even more useful. Smartwatches and phones can remind patients when they have been sitting too long. Additionally, continuous glucose monitoring can help some patients observe how different types and timing of movement affect their glucose patterns.

However, clinicians should avoid presenting exercise snacks as a replacement for established physical activity recommendations. The American Diabetes Association recommends regular moderate-to-vigorous aerobic activity for most adults with diabetes, along with other appropriate forms of exercise. Short movement breaks provide another tool, especially for reducing long periods of sedentary behaviour.

Most importantly, the strategy lowers the psychological barrier to getting started. Two minutes can feel achievable when 30 or 60 minutes does not. Over time, those small opportunities may help patients build a more active day.

Conclusion

Exercise does not always require a gym, workout clothes, or an uninterrupted hour. Evidence suggests that brief bouts of walking or simple resistance activity can reduce post-meal glucose responses when they regularly interrupt prolonged sitting. For diabetes care, exercise snacking offers a practical addition to traditional exercise counselling.

Still, the evidence is strongest for acute metabolic effects, while questions remain about long-term outcomes and the ideal duration, intensity, and frequency. Therefore, exercise snacks should complement established physical activity recommendations rather than replace them. For many patients, though, the message is refreshingly simple: when long workouts seem impossible, a few minutes of movement can still count.

Frequently Asked Questions

What is exercise snacking for diabetes?

Exercise snacking involves performing short bouts of physical activity throughout the day instead of relying only on longer workouts. Walking, stair climbing, chair stands, and simple resistance movements are common examples.

Can two minutes of exercise really lower blood glucose?

Research suggests that repeated two-to-five-minute activity breaks can reduce acute post-meal glucose responses compared with prolonged uninterrupted sitting. However, individual responses vary, and long-term benefits require further study.

How often should patients take an exercise snack?

Current diabetes guidance recommends regularly interrupting prolonged sitting. A brief walking or movement break about every 30 minutes can be a practical way to reduce sedentary time.

Does exercise snacking replace regular workouts?

No. Brief activity breaks should complement regular aerobic, resistance, balance, and other appropriate exercise rather than replace established physical activity recommendations.

Are exercise snacks safe for everyone with diabetes?

Not necessarily. Exercise can affect glucose differently depending on medications, insulin use, complications, fitness level, and activity intensity. Patients at risk for hypoglycaemia or those with diabetes-related complications should discuss appropriate activity with their healthcare professional.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.

https://www.diabetesincontrol.com/exercise-snacking-diabetes-glucose-control/ 

Type 2 Diabetes in the Office: 9 Ways to Add More Movement to Your Day

From everydayhealth.com

When you work a desk job, finding an opportunity to move more can feel challenging. But if you have type 2 diabetes, moving throughout your day helps your body keep blood sugar levels stable.

Even quick exercise breaks can keep glucose levels down. Moving your muscles uses sugar in your bloodstream and makes your natural insulin (a hormone that manages blood sugar) more sensitive to high sugar levels, says Kelly Bogowith, a physical therapist at OSF HealthCare in Alton, Illinois.

You don’t have to do a complicated routine to get the benefit of movement, says Theresa Marko, DPT, a doctor of physical therapy in private practice in New York City and a spokesperson for the American Physical Therapy Association. “Doing small and consistent movements and routines throughout the day can be more sustainable and have a real impact on diabetes management over time.”

iStock

You have lots of choices in adding more movement to your day at a desk. Here are some options you can try.

1. Walk a Few Laps Around Your Office

To start, take a walk around your office space. If possible, go outside and stroll around your building.

Your walks don’t have to last too long. In one small study, participants who took 3-minute walks every 30 minutes throughout the day lowered their blood sugar by 17.5 percent.

“[Another] study showed that if people went for a short walk after eating, their blood sugar levels rose and fell more gradually, and their insulin levels were more stable,” says Ashley Katzenback, DPT, a physical therapist in private practice in Plymouth, Massachusetts.

2. Take a 10-Minute Walk After Lunch

Walk for 10 minutes right after any meal or snack, says Katzenback. Blood sugar spikes after eating can boost your HbA1C levels, but getting active can lessen those effects.

“If you are unable to walk immediately after, another equally effective option is to walk for 30 minutes, 30 minutes after your meal,” says Katzenback.

3. Take the Scenic Route

As you walk to work from your car, or make a cup of coffee in the break room or visit the toilet, you can add length to each journey. “Park farther away from your building entrance or get off public transportation one stop early if feasible,” says Marko.

Marko also suggests getting off the elevator one floor early and taking the stairs the rest of the way. If you need to make copies or go to the bathroom, take an extra lap around the office before going back to your desk, says Marko.

4. March in Place at Your Desk

Marching in place or stepping up on a step are great exercise options for small spaces.

If you don’t want to attract attention by doing these at your desk, you can sneak away to a stairwell or even do them in a bathroom stall. On the other hand, you can lead the charge and invite your co-workers to join you in movement breaks.

5. Try Seated Soleus Push-Ups

Seated soleus push-ups (SPUs) sound complicated, but you can do them while you sit at your desk or in a meeting.

Here’s how to do one:

1. Sit in a chair and place both feet flat on the floor.
2. Raise your heel, keeping the ball of your foot down.
3. Relax and lower your heel.
4. Repeat.

One study review found that doing SPUs after a meal can lower your blood sugar by up to 52 percent.

“The results of the study are really quite remarkable because previously we suspected you needed to walk to stabilize post-meal blood sugar,” says Katzenback. “But this study concluded that simple interventions that can be performed while seated are more than enough to do the trick.”

Katzenback recommends doing three minutes of SPUs every 30 minutes throughout the day. 

6. Do Push-Ups Against a Break Room Wall

Standing wall push-ups can be another good way to move at work, says Bogowith.

Here’s how to do these exercises.

1. Stand facing a wall (a few feet away).
2. Place your hands against the wall at about chest level.
3. Lean forward, bending your elbows.
4. Pause and hold when your head gets close to the wall, keeping your body straight.
5. Push away from the wall until your arms are straight again.
6. Repeat as many times as you can.

You can make this exercise easier, if needed, by moving your feet closer to the wall. Or make it more challenging by leaning against a countertop instead of the wall.

7. Use Mini-Squats in Tight Spaces

Mini-squats work well to strengthen your legs in a small office space, says Bogowith. These modified squats strengthen your core and support the sugar-managing benefits of movement.

To do a mini-squat, follow these steps:

1. Stand up straight with your feet apart (about shoulder-width).
2. Bend your knees and move your hips back slightly as if you are about to sit. A mini-squat doesn’t lower your body as far as a traditional squat.
3. Hold this almost-sitting position while keeping your back straight and tightening your core and thigh muscles.
4. Rise back up into a standing position.
5. Repeat 10 to 15 times.

Make sure to keep your knees from pushing out over your toes to avoid injury.

8. Stand Up, Sit Down, Repeat

The simple act of sitting and standing uses muscles. “Stand up and sit down 5 to 10 times every time you go to use the restroom,” says Marko.

For best results, get in and out of your chair without using your arms.

9. Do Leg Kicks While You Wait

While waiting for coffee to brew, water to boil, or food to cook in the break room, do 20 standing side leg kicks or back leg kicks, says Marko.

Here’s how to do a standing side leg kick.

1. Stand straight, starting with your feet together.
2. Place your hands on your hips or use one hand to hold onto a counter or chair.
3. Lift one leg out to the side as far as you can and hold it there for a few seconds. Your hips should stay in place during this movement.
4. Lower your leg slowly.
5. Repeat 8 to 12 times
6. Switch to the other leg and repeat steps 1 to 5.

Standing back leg kicks follow the same steps, except you lift each leg behind you, instead of to the side.

If you want more ideas for simple exercises to do at the office, ask your healthcare provider for suggestions or a referral to a physical therapist.

The Takeaway

• An office job can make it hard to stay active when you have diabetes, but adding movement to your day can help you manage your blood sugar levels.
• To move more at work, do mini-squats at your desk, try leg kicks while your coffee brews, march in place while your lunch heats, and take walks around your office or building, especially after you eat.
• If you want more personalized exercise tips, ask your provider for their suggestions or a referral to physical therapy.

https://www.everydayhealth.com/type-2-diabetes/ways-to-add-more-movement-to-your-day/

 

Exercise and Diabetes: Benefits, Risks, and What Patients Should Know

From news.cuanschutz.edu

Researcher offers insights on the related advantages, barriers and risks

Roughly one in eight Americans has type 2 diabetes – totalling over 40 million individuals, with an additional two million Americans with type 1 diabetes. In addition to the lifestyle and health impacts, the condition carries a heavy financial burden of a 2.5 times higher cost of living compared to someone without diabetes.

One step can vastly improve – and even prevent – negative diabetes outcomes and costs: exercise.

Salwa Zahalka, MD, assistant professor of endocrinology, metabolism and diabetes at the CU Anschutz School of Medicine and her colleagues recently contributed to a review that examined the role of exercise in diabetes.

In the following Q&A, Zahalka details how exercise reduces the chances of getting type 2 diabetes and helps patients with both type 1 and type 2 diabetes with their overall health. She also talks about the barriers to exercise and any risks to be aware of when starting a routine.

Can exercise prevent type 2 diabetes?

Exercise is a great tool for preventing type 2 diabetes. Studies have shown that even small changes in peoples’ physical activity levels can lead to decreased rates of type 2 diabetes, so every movement matters.

In a study of the Diabetes Prevention Program – a Center for Disease Control and Prevention lifestyle change program that enrols people who are at high risk of developing diabetes – participants who achieved 150 minutes of moderate intensity activity per week had a 44% reduction in diabetes development.

What is one main obstacle to exercise for both patients with type 1 and type 2 diabetes? How can those obstacles be overcome?

One major obstacle to exercise can be exercise-induced hypoglycaemia, or low blood sugar. This is a common challenge for people with type 1 diabetes and for people with type 2 diabetes who are on certain glucose-lowering medications such as insulin. Different exercises can affect blood sugars differently, and these effects are not only experienced for the duration of the activity or what we call the “bout” of exercise, but also for up to 48 hours afterward in what we call the “post-bout” period.

One area of interest in exercise and diabetes research is to evaluate whether the specific order of performing exercises – such as resistance exercise followed by aerobic exercise – can help decrease low blood sugars. It is important that people living with diabetes discuss their exercise regimens with their diabetes providers as we have many individualized strategies to help prevent these low blood sugars and support each person’s exercise journey.

What are the benefits?

Many benefits are associated with regular exercise for people living with diabetes or who are at risk for diabetes. Some of these benefits are a reduction in blood pressure, an improvement in insulin sensitivity and glucose levels, prevention and minimization of weight gain, improvement in cholesterol levels and a reduction in rates of death from cardiovascular disease. This last benefit is particularly important because people with diabetes have a higher risk of bad outcomes from cardiovascular disease. We know that if we help people to improve their cardiorespiratory fitness (ability to exercise) we can decrease mortality.  

Are there any dangers around exercise for those with diabetes?

Consistent exercise is associated with a reduction in cardiovascular risk. However, sudden exercise can be a cardiovascular stressor and, in susceptible individuals, may be associated with cardiovascular events. If someone with diabetes is just starting out on their exercise journey, it may be a safer and more effective strategy to start with being consistent with a low-intensity exercise and work up to higher intensity rather than being more sporadic with a high-intensity exercise.

Additionally, people with diabetes can have decreased sensation and blood flow to their feet, which puts them at higher risk for trauma to their feet from weight-bearing exercises. These are both important reasons for people with diabetes to discuss exercise programs with their providers so that they can assess their individual risks and help safely support their exercise.

What types of exercise – and their frequency – have been shown to be beneficial?

Both aerobic (running, jogging, brisk walking, swimming, cycling) and resistance (weights, resistance bands, body weight exercises) exercise regimens have been shown to help prevent type 2 diabetes and improve outcomes in people with diabetes.

An optimal modality and frequency of exercise have not been established, but the American Diabetes Association recommends that most adults with type 1 or type 2 diabetes engage in at least 150 minutes of moderate-to-vigorous-intensity aerobic activity and two to three sessions of resistance exercise per week.

The intensity of an aerobic activity can be defined by the amount of oxygen used by the body during that activity. One metabolic equivalent (MET) is the amount of oxygen (O2) used while at rest/sitting still, which is 3.5 millilitres O2 per kilogram of body weight per minute. Physical activities that burn 3.0 to 5.9 METs are considered moderate intensity, and those that burn 6.0 METs or more are considered vigorous intensity.

Brisk walking usually falls into the moderate-intensity MET category and running falls into the vigorous category.

What are “non-responders” and how can they still use exercise to help their health?

The term “non-responders” is used to describe people who do not get certain anticipated benefits of exercise, such as improved glucose or blood pressure. However, the good news is that even if a specific benefit isn’t achieved from exercise therapy, other benefits are often attained. For example, if someone’s blood sugars are unchanged by exercise, they may gain increased cardiorespiratory fitness. Sometimes, the lack of “response” may also be due to the type of exercise (aerobic vs. resistance) or the timing of exercise, and that is why to achieve someone’s desired benefits from exercise an individualized approach is key.  

What is GLUT4 and how does it translate into exercise being a positive step for diabetes?

GLUT4, a glucose transporter that insulin stimulates to bring glucose inside the cell, is also stimulated by muscle contraction during exercise without insulin. This increases transport of glucose into muscle cells and is one way that exercise can acutely decrease blood sugar levels even when someone has insulin resistance or does not produce insulin. 

What is some ongoing clinical research underway on campus on this topic?

My colleagues Drs. Jane Reusch and Judy Regensteiner are conducting an NIH study to understand how exercise training improves cardiac and skeletal muscle function in adults with and without type 2 diabetes. They are currently seeking volunteers who are not exercising and not on certain types of diabetes medications, such as SGLT2 inhibitors or GLP-1 receptor agonists. In this study, people can learn a lot about the function of their heart, skeletal muscle and blood vessels and receive an individualized exercise program.  

https://news.cuanschutz.edu/news-stories/how-does-exercise-help-with-diabetes

Obesity and diabetes: Early morning exercise may help lower risk

From medicalnewstoday.com

• Previous studies show that having poor cardiometabolic health can potentially increase a person’s risk for heart disease and type 2 diabetes.
• Past research has also demonstrated that making healthy lifestyle choices, such as being physically active, may help lower a person’s risk for cardiometabolic disease.
• A new study found that while physical activity may help lower a person’s cardiometabolic risk, the time of day they exercise may also play an important role.

Previous studies show that having poor cardiometabolic health can potentially increase a person’s risk for heart disease.

Known as cardiometabolic disease, this condition includes several health issues that are known to raise a person’s risk for cardiovascular disease, including type 2 diabetes, obesityTrusted Source, high blood pressure, chronic kidney disease, and non-alcoholic fatty liver disease.

Past research demonstrates that making healthy lifestyle choices, such as eating a nutritious diet, not smoking, getting enough sleep, and being physically active may help lower a person’s risk for cardiometabolic disease.

“Cardiometabolic diseases remain the leading cause of morbidity and mortality worldwide,” Prashant Rao, MBBS, MRCP(UK), FACC, sports cardiologist and physician-scientist in the Division of Cardiovascular Medicine in Beth Israel Deaconess Medical Center at Harvard Medical School, told Medical News Today.

“Even small improvements in risk at a population level can translate into substantial reductions in disease burden. Identifying modifiable behaviours, especially ones that are simple and scalable, remains a major public health priority,” he said.

Rao is the senior author of a new study to be presented at the American College of Cardiology’s Annual Scientific Session (ACC.26) that found that while physical activity may help lower a person’s cardiometabolic risk, what time of day they exercise may also play an important role.

The results of the study are yet to be published in a peer-reviewed journal.

How exercise time of day impacts cardiometabolic health

For this study, researchers analysed health data from almost 14,500 participants of the All of Us study. Data included heart rate data from participants’ Fitbits, and exercise was assessed every 15 minutes throughout the day.

Scientists then looked for links between the times of day participants exercised and cardiometabolic risk factors, such as high blood pressure, obesity, and type 2 diabetes.

“There is growing recognition that biology is not static across the day,” Rao said. “Many important metabolic and cardiovascular processes follow circadian rhythms. Despite this, exercise recommendations have largely ignored timing. We wanted to test whether timing represents an independent and clinically relevant dimension of exercise behaviour in real-world populations.”

Researchers also evaluated participants’ rates of cardiovascular issues, such as coronary artery disease and atrial fibrillation.

Could the time of day people exercise affect their risk of obesity or diabetes? Design by MNT; Photography by lzf/Getty Images

Morning exercise lowers coronary artery disease risk by 31%

At the study’s conclusion, Rao and his team found that participants who exercised in the morning, when compared to those who exercised in the evening, were:

• 35% less likely to have obesity
• 31% lower chance of developing coronary artery disease
• 30% lower risk for type 2 diabetes
• 21% less likely to have hyperlipidemia
• 18% lower chance of developing high blood pressure

This shows that when people exercise may be just as important as how much they exercise. The study also found that exercise performed between 7:00 a.m. and 8:00 a.m. was specifically associated with the lowest odds of coronary artery disease.

“Importantly, these associations were independent of total physical activity, indicating that timing is not simply a proxy for ‘more exercise,’ but may reflect an additional behavioural or biological signal,” Rao said.

“Exercise timing may represent a previously underappreciated dimension of exercise and cardiometabolic health. While any exercise is beneficial, morning exercise may confer additional advantages.”
— Prashant Rao, MBBS, MRCP(UK), FACC

“The next step is to move from association to causation,” Rao added. “I think these findings should motivate a large randomized trial of exercise timing. Ultimately, the goal is to determine whether we can optimize exercise prescriptions not just by dose, but by timing.”

Exercise is one of the most powerful medications for heart health

MNT spoke with Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study.

“This study found that exercising in the morning was associated with lower levels of cardiometabolic risk factors such as coronary artery disease, high blood pressure, high cholesterol, diabetes, and obesity,” Chen commented. “This is an interesting finding that should stimulate more research into specific timing of exercise for the greatest health benefit.”

“Cardiovascular disease continues to be the leading cause of deathTrusted Source in the United States,” he continued. “We need to continue to work on lowering cardiometabolic risk factors in order to decrease the burden of this disease on our society. Future research can include randomized controlled trials that better ascertain the role of exercise timing on health outcomes.”

MNT also spoke with Brett A. Sealove, MD, FACC, FAHA, RPVI, CPE, chair of cardiology at Hackensack Meridian Jersey Shore University Medical Center, and associate professor and vice chair of cardiology at the Hackensack Meridian School of Medicine in New Jersey, who said he sees the consequences of cardiometabolic disease every day: heart attacks, heart failure, strokes, and amputations.

“We’ve known for decades that exercise is one of the most powerful medicines,” Sealove explained. “It should not be overstated that exercise is one of our biggest problems in the U.S., as it is one of the best solutions for cardiac health and longevity, anytime, anywhere.”

“However, this study takes that knowledge a step further by helping those who want to optimize their risk reduction, especially if the timing of exercise matters,” he added.

Why might morning exercisers have lower cardiometabolic risk?

MNT also asked Sealove why exercising in the morning could help lower cardiometabolic risk more effectively than exercising in the evening.

“First, consider the role of circadian rhythms,” Sealove said. “Our bodies are controlled by internal biological clocks that regulate nearly every metabolic process, including cortisol secretion, insulin sensitivity, glucose uptake, and fat oxidation.”

“In the early morning, cortisol levels naturally increase, preparing the body for activity. Insulin sensitivity, especially in skeletal muscle, also tends to be higher in the morning. Aligning exercise with these circadian signals may improve metabolic responses in ways that evening workouts cannot,” he explained.

“Second, morning exercise, often performed in a fasted or semi-fasted state, may promote greater fat oxidation,” he continued. “When the body’s carbohydrate stores are lower after an overnight fast, it more readily breaks down fat for fuel during exercise. This increase in fat utilization could, over time, lead to better lipid profiles and reduced visceral fat, lowering cardiometabolic risk.”

“Third, there is a practical behavioural aspect. Morning exercisers tend to be more consistent because there are fewer competing demands early in the day. Consistency is crucial in exercise medicine. Along with adherence over months and years, it contributes to the long-term reduction in disease risk observed in this study.”
— Brett A. Sealove, MD, FACC, FAHA, RPVI, CPE

https://www.medicalnewstoday.com/articles/7-am-morning-exercise-sweet-spot-lowering-cardiometabolic-risk#How-exercise-time-of-day-impacts-cardiometabolic-health