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Aim <p>Physical exercise (PE) may be important for glucose metabolism. Therefore, this systematic review and meta-analysis aims to investigate the effect of PE performed in the morning versus afternoon or evening on glycemia parameters in human intervention studies.</p> Methods <p>MEDLINE and Embase.com were searched until February 2023 for intervention studies in the general adult population, examining the effect the timing of PE on glycemia parameters after one or multiple bouts of exercise. Results were meta-analysed using a random-effects models where appropriate or were described using qualitative synthesis.</p> Results <p>55,569 publications were screened for a series of reviews, of which 20 studies (680 participants) were included in this review. In studies including one bout of PE (<i>n</i> = 12), glucose levels measured directly after PE were 0.26 mmol/L (95%CI -0.18;0.70, I<sup>2</sup> = 81%, <i>n</i> = 3) higher after morning PE, compared to afternoon PE. Studies including repeated PE for 1–12 weeks (<i>n</i> = 8), showed that fasting glucose was 0.25mmol/L (95%CI 0.02;0.47, I<sup>2</sup> = 32%, <i>n</i> = 7) higher in morning PE, compared to afternoon/evening PE. Other outcomes (e.g. 24&#xa0;h mean glucose, HOMA-IR) could not be meta-analyzed and were assessed qualitatively, showing no associations or results in line with the results above. Only time in range (TIR) and hypoglycemic events tended to favor morning PE.</p> Conclusion <p>This review suggests that fasting glucose may be higher following morning PE, compared with afternoon or evening PE in long-term studies. Evidence on glucose directly after PE in acute studies and other glycemic outcomes remains limited and inconclusive. The included studies were generally small, heterogeneous in design and interventions, and often did not account for important factors such as nutritional intake and chronotype. Therefore, well-designed, adequately powered trials that account for lifestyle factors and assess clinically relevant outcomes are needed to clarify these associations.</p> Trial registration <p>This review is part of a larger search ‘The effect of altering timing of physical activity, sleep and energy intake on glycemia and Type 2 Diabetes risk in humans’, of which the protocol was registered in the PROSPERO database on November 27<sup>th</sup>, 2021 under number: CRD42021287828.</p>

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The effect of timing of physical exercise on glycemia: a systematic review and meta-analysis of human intervention studies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月29日

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  • Samantha B.J. Schipper,
  • Romy Slebe,
  • Linda J. Schoonmade,
  • Denis P. Blondin,
  • David J.T. Campbell,
  • André C. Carpentier,
  • Jean-Pierre P. Després,
  • Joris Hoeks,
  • Andries Kalsbeek,
  • Parminder Raina,
  • Patrick Schrauwen,
  • Mireille J. Serlie,
  • Dirk Jan Stenvers,
  • Chun-Xia Yi,
  • Renée de Mutsert,
  • Joline W.J. Beulens,
  • Femke Rutters

摘要

Aim

Physical exercise (PE) may be important for glucose metabolism. Therefore, this systematic review and meta-analysis aims to investigate the effect of PE performed in the morning versus afternoon or evening on glycemia parameters in human intervention studies.

Methods

MEDLINE and Embase.com were searched until February 2023 for intervention studies in the general adult population, examining the effect the timing of PE on glycemia parameters after one or multiple bouts of exercise. Results were meta-analysed using a random-effects models where appropriate or were described using qualitative synthesis.

Results

55,569 publications were screened for a series of reviews, of which 20 studies (680 participants) were included in this review. In studies including one bout of PE (n = 12), glucose levels measured directly after PE were 0.26 mmol/L (95%CI -0.18;0.70, I2 = 81%, n = 3) higher after morning PE, compared to afternoon PE. Studies including repeated PE for 1–12 weeks (n = 8), showed that fasting glucose was 0.25mmol/L (95%CI 0.02;0.47, I2 = 32%, n = 7) higher in morning PE, compared to afternoon/evening PE. Other outcomes (e.g. 24 h mean glucose, HOMA-IR) could not be meta-analyzed and were assessed qualitatively, showing no associations or results in line with the results above. Only time in range (TIR) and hypoglycemic events tended to favor morning PE.

Conclusion

This review suggests that fasting glucose may be higher following morning PE, compared with afternoon or evening PE in long-term studies. Evidence on glucose directly after PE in acute studies and other glycemic outcomes remains limited and inconclusive. The included studies were generally small, heterogeneous in design and interventions, and often did not account for important factors such as nutritional intake and chronotype. Therefore, well-designed, adequately powered trials that account for lifestyle factors and assess clinically relevant outcomes are needed to clarify these associations.

Trial registration

This review is part of a larger search ‘The effect of altering timing of physical activity, sleep and energy intake on glycemia and Type 2 Diabetes risk in humans’, of which the protocol was registered in the PROSPERO database on November 27th, 2021 under number: CRD42021287828.