Twenty-four-hour movement patterns relate with cardiometabolic health in adults with obesity

Aim Low moderate-to-vigorous physical activity (MVPA), high sedentary behavior (SB), and inadequate sleep are individually associated with type 2 diabetes (T2D) risk. However, the aggregate impact of these movement patterns remains unclear. Purpose Assess whether being aligned with 24-h movement guidelines of MVPA, SB, and sleep relates to cardiometabolic health, and compare this with the American Heart Association’s Life’s Essential 8. Methods In a cross-sectional study, adults with obesity [ n = 56 (39 F); 55.6 ± 1.1 y; 34.5 ± 0.7 kg/m 2 ] with low 24-h movement z -scores [“aligned”; n = 28 (21 F)] were compared to those with high z -scores [“misaligned” n = 28 (18 F)]. MVPA and SB (accelerometer) and sleep (Pittsburgh Sleep Quality Index) were assessed to calculate z scores. LE8 scores were calculated according to AHA guidelines. A 120-min hyperinsulinemic-euglycemic clamp (40 mU/m 2 /min, 90 mg/dl) with indirect calorimetry was used to determine metabolic insulin sensitivity [glucose infusion rate (GIR)] and substrate oxidation. Pulse wave velocity and augmentation index (AIx75) were assessed at 0 and 120 min of the clamp to assess arterial stiffness. Fitness ( V O 2max ) and body fat (DXA) were also assessed. Results Despite no differences in age, body fat, or V O 2max , the misaligned group had higher fasting DBP, MAP, and AIx75 ( P < 0.05), lower GIR ( P = 0.07), and lower FFA suppression ( P = 0.01). While both the z -score and LE8 related to blood pressure, only the z -score correlated with AIx75 and FFA suppression. Conclusion Aligning with 24-h movement patterns related to better cardiometabolic health in people with obesity. Clinical trials registration NCT03355469.