To the Editor: We were pleased to see an acknowledgement of our findings [1] and the comment regarding the fasting state as a factor that mediates clinical outcomes [2]. We wholeheartedly agree that fasting needs to be accounted for in future observational and biological investigations. We raise a few concerns: first, we did not explicitly consider fasting time as a factor in our analyses [1]; however, the strength of associations increased when considering dietary behaviour. Second, the range of the time groups was large (06:00–12:00 hours, 12:00–18:00 hours and 18:00–24:00 hours). Third, we lacked information about the participants' mealtimes. This absence of specific temporal details and the large ranges make it challenging to assert that the morning group engaged in more fasted-state exercise, while the afternoon and evening groups were more likely to exercise after meals. Nonetheless, we remain enthusiastic about the potential of our findings, and we eagerly wait for experiments to derive biological explanations of our observations that incorporate fasting.
References
Tian C, Bürki C, Westerman KE, Patel CJ (2023) Association between timing and consistency of physical activity and type 2 diabetes: a cohort study on participants of the UK Biobank. Diabetologia 66:2275–2282. https://doi.org/10.1007/s00125-023-06001-7
Chacko E (2024) Morning exercise as fasted-state activity. Diabetologia. https://doi.org/10.1007/s00125-023-06080-6
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Tian, C., Patel, C.J. Morning exercise as fasted-state activity. Reply to Chacko E [letter]. Diabetologia 67, 757 (2024). https://doi.org/10.1007/s00125-024-06091-x
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DOI: https://doi.org/10.1007/s00125-024-06091-x