The diurnal pattern of moderate-to-vigorous physical activity and obesity: a cross-sectional analysis

Objective: Moderate-to-vigorous physical activity (MVPA) is obesity-protective. However, the optimal time of the day to engage in MVPA for weight management is controversial. This study is designed to investigate the influence of the diurnal pattern of MVPA on the association between MVPA and obesity. Methods: A total of 5285 participants in the 2003 to 2006 National Health and Nutrition Examination Survey (NHANES) were cross-sectionally analyzed. The diurnal pattern of objectively measured MVPA was classified into three clusters by K-means clustering analysis: morning (n = 642); midday (n = 2456); and evening (n = 2187). The associations of MVPA level and the diurnal pattern with obesity were tested. Results: A strong linear association between MVPA and obesity was found in the morning group, whereas a weaker curvilinear association between MVPA and obesity was observed in the midday and evening groups, respectively. Among those who met the physical activity guidelines, the adjusted means for BMI were 25.9 (95% CI: 25.2–26.6), 27.6 (95% CI: 27.1–28.1), and 27.2 (95% CI: 26.8–27.7) kg/m² in the morning, midday, and evening groups, respectively, and for waist circumference were 91.5 (95% CI: 89.4–93.6), 95.8 (95% CI: 94.7–96.9), and 95.0 (95% CI: 93.9–96.1) cm, respectively. Conclusions: The diurnal pattern of MVPA influences the association between MVPA and obesity. The promising role of morning MVPA for weight management warrants further investigation.