Abstract
Few attempts have been made to incorporate multiple aspects of physical activity (PA) to classify patterns linked with health. Temporal PA patterns integrating time and activity counts were created to determine their association with health status. Accelerometry data from the National Health and Nutrition Examination Survey 2003–2006 was used to pattern PA counts and time of activity from 1999 adults with one weekday of activity. Dynamic time warping and kernel k-means clustering partitioned 4 participant clusters representing temporal PA patterns. Multivariate regression models determined associations between clusters and health status indicators and obesity, type 2 diabetes, and metabolic syndrome. Cluster 1 with a temporal PA pattern of the lowest activity counts reaching 4.8e4 cph from 6:00–23:00 was associated with higher body mass index (BMI) (β = 2.5 ± 0.6 kg/m2, 95% CI: 1.0, 4.1), higher waist circumference (WC) (β = 6.4 ± 1.3 cm, 95% CI: 2.8, 10.0), and higher odds of obesity (OR: 2.4; 95% CI: 1.3, 4.4) compared with Cluster 3 with activity counts reaching 9.6e4–1.2e5 cph between 16:00–21:00. Cluster 1 was also associated with higher BMI (β = 1.5 ± 0.5 kg/m2, 95% CI: 0.1, 2.8) and WC (β = 3.6 ± 1.3 cm, 95% CI: 0.1, 7.0) compared to Cluster 4 with activity counts reaching 9.6e4 cph between 8:00–11:00. A Temporal PA pattern with the lowest PA counts had significantly higher mean BMI and WC compared to temporal PA patterns of higher activity counts performed early (8:00–11:00) or late (16:00–21:00) throughout the day. Temporal PA patterns appear to meaningfully link to health status.
Highlights
Obesity is a global health problem with about 13% of the world’s adult population considered obese in 2016 [1]
One study reported higher odds of obesity in women who were less active in the morning hours compared to the evening [15], while another randomized clinical trial revealed significant lowering of body mass index (BMI) after 6 weeks of aerobic exercise was performed in the morning vs. evening in a group of women with overweight [16]
Consent was obtained from all participants and National Health and Nutrition Examination Survey (NHANES) protocols and content were approved by the National Center for Health Statistics (NCHS) Research Ethics Review Board [20]
Summary
Obesity is a global health problem with about 13% of the world’s adult population considered obese in 2016 [1]. Prevalence estimates of obesity in the United States (U.S.) increased between 2003–2004 and 2013–2014, reaching 42.4% among adults in 2017–2018 [2]. Obesity is both an outcome and a contributor to chronic disease development including type 2 diabetes and metabolic syndrome [3,4]. Most previous PA research has focused on the association between intensity (i.e., moderate to vigorous) or counts of PA and health outcomes [11,12,13,14] Beyond these two aspects of activity, the timing of activity may be relevant to health. Temporal PA patterns integrating time and activity counts were created to determine their association with health
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