Aligning the timing of exercise with chronotype ('morning' or 'evening' type) may yield greater cardiometabolic benefit. In this 12-week randomised trial (Lahore, Pakistan; 150 sedentary adults aged 40-60 with at least one cardiovascular risk factor), chronotype was determined by questionnaire and confirmed with 48-hour core body-temperature monitoring. Participants trained supervised (5×/week, 40 min moderate intensity) either at their preferred time (chronotype-aligned, CAE) or at their non-preferred time (CME). The CAE group improved significantly more in systolic blood pressure (-10.8 vs -5.5 mmHg), diastolic blood pressure, heart-rate variability (RMSSD), peak VO2, LDL, fasting glucose and sleep quality (PSQI). Matching exercise to individual chronotype could thus be a low-cost, personalised way to improve cardiovascular health.
To investigate whether aligning exercise timing with chronotype enhances cardiometabolic and sleep-related benefits in sedentary adults with cardiovascular risk factors.
In this 12-week randomised controlled trial conducted in Lahore, Pakistan (January-June 2025), 150 sedentary adults (aged 40-60) with at least one cardiovascular risk factor were recruited and categorised as morning-type or evening-type using the Morningness-Eveningness Questionnaire and validated by 48 hour core body temperature monitoring. Participants were randomised into a chronotype-aligned exercise (CAE) group exercising at their preferred time, or a chronotype-misaligned exercise (CME) group exercising at their non-preferred time. Moderate-intensity aerobic training (5 sessions/week, 40 min/session) was supervised. Primary outcomes included systolic and diastolic blood pressure (BP) and heart rate variability (RMSSD); secondary outcomes included peak oxygen consumption (VO₂ peak), low density lipoprotein (LDL), fasting glucose and sleep quality (PSQI), assessed pre- and post-intervention.
Of 150 randomised participants, 134 completed the study (CAE: n=64; CME: n=70). CAE led to significantly greater improvements in systolic BP (-10.8 vs -5.5 mm Hg, p=0.002), diastolic BP, RMSSD, VO₂ peak, LDL, fasting glucose and PSQI scores compared with CME. Repeated measures analysis of variance (ANOVA) revealed significant group×time interactions across all outcomes (eg, systolic BP: η²=0.095, p=0.005). The reduction in systolic BP in the CAE group was substantial and significantly greater than in the CME group.
Aligning exercise timing with individual chronotype significantly enhances cardiometabolic and sleep-related outcomes in at-risk adults. Chronotype-based exercise prescriptions may offer a cost-effective, personalised approach to improving cardiovascular health.
