Exercising only on weekends yields similar CV benefits as with exercising entire week: JAMA

In an analysis of 89 573 individuals providing a week of accelerometer-based physical activity data, a weekend warrior pattern of physical activity was linked with similarly lower risks of incident atrial fibrillation, heart failure, myocardial infarction, and stroke compared with more evenly distributed physical activity.

According to cardiologist Patrick Ellinor, the total volume of physical activity is more important than the pattern of activity.

Physical activity is reported to be beneficial for health and is associated with reduced risks of cardiovascular disease and death. American Heart Association (AHA) and World Health Organization (WHO) guidelines recommend 150 minutes or more of MVPA (moderate to vigorous physical activity) per week, without mentioning an optimal MVPA pattern.

The UK National Health Service recommends that MVPA can be spread "evenly over 4-5 days per week, or every day." However, there is no clarity on whether MVPA concentrated within 1 to 2 days per week (“weekend warrior” pattern) provides similar health benefits versus more evenly distributed activity.

To fill this knowledge gap, Shaan Khurshid, Cardiovascular Research Center, Massachusetts General Hospital, Boston, and colleagues aimed to examine associations between an accelerometer-derived “weekend warrior” pattern versus MVPA spread more evenly with risk of incident CV events.

The research included about 90 000 participants in the UK Biobank prospective cohort study. A comparison was made between three MVPA patterns: active weekend warrior (active WW, ≥150 minutes with ≥50% of total MVPA achieved in 1-2 days), inactive (<150 minutes), and active regular (≥150 minutes and not meeting active WW status). The same patterns were evaluated using the sample median threshold of 230.4 minutes or more of MVPA per week.

Cox proportional hazards regression was used to assess the associations between activity patterns and incident atrial fibrillation, heart failure, myocardial infarction, and stroke after adjustments for sex, age, racial and ethnic background, alcohol intake, tobacco use, employment status, Townsend Deprivation Index, diet quality, and self-reported health.

The study included a total of 89 573 individuals (mean age, 62 years; 56% women) who underwent accelerometry.

The authors reported the following findings:

• When stratified at the threshold of 150 minutes or more of MVPA per week, 42.2% were in the active WW group, 24.0% were in the active regular group, and 33.7% were in the inactive group.
• In multivariable-adjusted models, both activity patterns were associated with similarly lower risks of incident atrial fibrillation (active WW: hazard ratio [HR], 0.78; active regular: 0.81; inactive: HR, 1.00), myocardial infarction (active WW: 0.73; active regular: 0.65; and inactive: 1.00), heart failure (active WW: 0.62; active regular: 0.64; and inactive: 1.00), and stroke (active WW: 0.79; active regular: 0.83; and inactive: 1.00).
• Findings were consistent at the median threshold of 230.4 minutes or more of MVPA per week, although associations with stroke were no longer significant (active WW: 0.89; active regular: 0.87; and inactive: 1.00).

"Within nearly 90 000 individuals providing wrist-based activity quantification, physical activity concentrated within 1 to 2 days was tied to a similarly reduced risk of CV outcomes to more regular activity," the researchers wrote.

"There is a need for future prospective studies to assess whether interventions to boost physical activity, even when concentrated within a day or 2 each week, improve cardiovascular outcomes," they concluded.

Reference:

Khurshid S, Al-Alusi MA, Churchill TW, Guseh JS, Ellinor PT. Accelerometer-Derived “Weekend Warrior” Physical Activity and Incident Cardiovascular Disease. JAMA. 2023;330(3):247–252. doi:10.1001/jama.2023.10875