Chaining weekly physical activity over 1 or 2 days always gives advantages

So-called weekend warriors—those who get a week of recommended physical activity on Saturday and Sunday—are at significantly lower risk of developing a host of diseases and conditions, including hypertension, diabetes and obesity, compared to inactive people. , a new study showed.

These results, the investigators say, show once again that it is the total volume of exercise, rather than the pattern of physical activity, that is most important in reducing the risk of incident disease.

“When I counsel patients, I tell them that it is important to do physical activity and reach guideline-recommended levels, but the rest is up to you,” lead researcher Shaan Khurshid, MD, MPH (Massachusetts General Hospital, Boston, MA). ), told TCTMD. “Whatever way you do it, do it in a way that will most likely be consistent over time. If you do this, you seem to benefit.

The American Heart Association and the World Heart Organization recommend at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous activity each week. The groups don’t mention the best way to spread this activity over 7 days, but the UK National Health Service suggests spreading it evenly throughout the week.

The “weekend warrior” model, however, is increasingly common and potentially more practical, given people’s busy lifestyles, Khurshid said. In 2023, his group showed that people concentrating their recommended weekly physical activity on 1 or 2 days drifted as much cardiovascular benefit such as those who exercised more consistently throughout the week. In this study, weekend warriors and regularly active people had similarly low risks of atrial fibrillation, MI, heart failure, and stroke as inactive people over more than 6 years of follow-up .

Other reports have supported the weekend warrior approach, with one recent meta-analysis showing that this trend leads to similar reductions in cardiovascular and all-cause mortality as regular physical activity.

More than 200 diseases

The new study, published recently in Trafficremoved the lens to examine the risks and/or benefits of physical activity focused on 678 incident diseases/conditions using a phenome-wide association approach that is analogous to what is commonly done in genome-wide association studies.

“You take an exposure, which in this case is physical activity, and you do serial association testing across a large number of diseases,” Khurshid explained. The risk models were adjusted for several baseline variables, such as age, sex, and socioeconomic status, among others, that could affect the relationship between physical activity and disease outcome, and they have also been corrected to account for multiplicity.

A total of 89,573 UK Biobank study participants with accelerometer data were stratified into three groups based on activity levels and patterns: those who performed more than 150 minutes or more of moderate to vigorous per week, with at least half of the exercise performed over 1 or 2 days; the regularly active (≥ 150 minutes/week) and the inactive.

A third of people were inactive, 42.2% were weekend warriors, and 24.0% were regularly active throughout the week. Those who were regularly active exercised at moderate to vigorous intensity for a median of 418 minutes per week, followed by weekend warriors at 288 minutes and inactive people at 72 minutes.

Patterns of regular, concentrated physical activity were largely associated with reduced risk of disease. The weekend warrior pattern was significantly associated with 267 of all diseases tested, of which disease risk was lower for all but three. With regular physical activity, there were 209 significant disease associations, of which there was a lower risk for 205; these links largely concerned circulatory, metabolic and digestive conditions. The few diseases with higher risks were mainly muscle, ligament and fascia disorders.

The 5-year risks of hypertension, diabetes, obesity, and sleep apnea were similar for regular physical activity and weekend warrior models, and both groups had significantly higher risks. weaker than inactive people. For both weekend warriors and regularly active people, risks were lower among those who exercised more (i.e., categorized by quartile of moderate to vigorous physical activity).