Being Physically Active in the Evening May Prolong Your Life

By Gabe Mirkin, M.D.

Moving about in the evening is associated with lower risk for heart disease and death in obese adults, compared to being physically active in the morning or afternoon (Diabetes Care, May 2024;47(5):890-897). Evening activity was associated with lower incidence of eye, kidney or nerve damage in those who were also diabetic in addition to being obese. The study included 29,836 obese adults, average age 62, including 2995 who also suffered from diabetes.

The researchers used wrist accelerometers to determine levels of physical activity, and followed the participants for 7.9 years. They compared pulse rates in the morning (6 AM to 12 PM), afternoon (12 PM to 6 PM), and evening (6 PM to 12 AM), and defined active time as when more than 50 percent of the total moderate to vigorous activity occurred. Those who had very little or no pulse accelerations were considered inactive.

Not only were the death rates lowest in people who were active in the evening, but diabetics who were active in the evening had a lower death rate than non-diabetics who were inactive. Being physically active in the evening has been previously reported to be associated with reduced risk for diabetes and premature death (Diabetologia, 2023;66:461–471 and 2021;64:2061–2076).

How Obesity Shortens Lives

Obesity is a major risk factor for the development of type 2 diabetes (Diabetol Metab Syndr 2014;6:50), heart attacks (Circulation 2021;143:e984–e1010) and premature death (JAMA Netw Open 2018;1:e184587), primarily because obesity is associated with high blood sugar levels that can damage every cell in your body (Diabetes Res Clin Pract 2023;200:110691).

Being obese markedly increases risk for having excess fat in your liver. More than 80 million North Americans suffer from a fatty liver and many do not know that they have it because most people with a fatty liver have normal liver function blood tests in the early stages of the disease. Storing fat in your belly is a stronger risk factor for diabetes than just being overweight, and is arguably the most common cause of Type II diabetes in North America today (BMC Public Health, November 18, 2019).

Most cases of Type II diabetes are caused by inability to respond to insulin because of excess fat in the liver (J Clin Invest, May 19, 2020). More than 50 percent of people with excess fat in their liver are already diabetic or pre-diabetic (J of Family Med and Prim Care, Dec, 2022;11(12):7640-7643), and 11-20 percent of people with excess fat in their liver will suffer from liver failure within 10–15 years (Clin Gastroenterol Hepatol, 2015;13:643–540).

Signs of a Fatty Liver

You are at very high risk for a fatty liver if:

• You have a big belly and small buttocks. Men are at increased risk for having a fatty liver and being diabetic if their waist circumference is greater than 38.7 inches, and women if it is greater than 36 inches. Measuring a person’s waist circumference is a simple and efficient way to see if people who are not overweight are still at increased risk for diabetes (Arch Med Sci Civil Dis, July 22, 2019;4:e64–e71).

• You can pinch more than 2.5 inches of skin and fat next to your belly button.

• A sonogram demonstrates a fatty liver.

• Your blood sugar one hour after eating a meal is greater than 145 mg/dL. You are probably already diabetic, even if your fasting blood sugar is normal (under 100 mg/dL).

Being physically active after eating causes contracting muscles to pull sugar from the bloodstream, which helps to prevent high rises in blood sugar. Eating within an hour after exercising also prevents a high rise in blood sugar. Your muscles can extract sugar from the bloodstream maximally without needing insulin for about an hour after you finish exercising, but this ability is then gradually lost over about 17 hours or until you contract your muscles again (J Appl Physiol, 2005;8750-7587).

My Recommendations

Keep moving around. Just moving about and any exercise program can help to prolong your life by:
• strengthening your heart muscle,
• increasing the ability of the heart to pump increased amounts of oxygen through the body,
• reducing belly fat, and
• increasing the diversity of bacteria in your colon to help prevent inflammation.

Being physically active at any time helps to prevent and treat diabetes and obesity (Prim Care Diabetes, 2021;15:340–346; Med Sci Sports Exerc 2022;54:353–368), but being physically active in the evening may be the most important time to move your muscles to help control blood sugar levels (Diabetologia, 2020;63:462–472). You can also help control blood sugar levels by being active in the evening. Examples include washing clothes, cleaning dishes, straightening up your house or going out for a walk.

Gabe Mirkin, M.D., is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/. Click to read Gabe’s full bio.