Key points Does participation in moderate to vigorous physical activity, with most of the activity concentrated on 1 or 2 days of the week (i.e., a "weekend warrior" pattern ), confer cardiovascular benefits similar to physical activity ? more evenly distributed physics? Findings In an analysis of 89,573 people who provided one week of accelerometer-based physical activity data, a weekend warrior physical activity pattern was associated with similarly lower risks of incident atrial fibrillation, myocardial infarction, heart failure, and stroke compared to a more even distribution of physical activity. Meaning Increasing activity, even when concentrated on 1 or 2 days a week, can be effective in improving cardiovascular risk profiles. |
Physical activity is considered health-promoting and is consistently associated with lower risks of death and cardiovascular disease. Guidelines from the World Health Organization and the American Heart Association recommend 150 minutes or more of moderate to vigorous physical activity (MVPA) per week, without specifying an optimal pattern of MVPA. The UK National Health Service recommends that MVPA be distributed "evenly over 4 or 5 days a week or every day" . However, it is unclear whether MVPA concentrated on 1 or 2 days per week ( "weekend warrior" pattern ) confers similar benefits compared to more evenly distributed activity. Previous studies were limited by self-reported activity, modest sample sizes, and a limited set of outcomes (e.g., mortality).
Here, associations between physical activity patterns, defined using wrist accelerometers, and incident cardiovascular events were assessed among nearly 90,000 participants from the UK Biobank prospective cohort study.
Summary
Guidelines recommend 150 minutes or more of moderate to vigorous physical activity (MVPA) per week for overall health benefit, but the relative effects of concentrated versus more evenly distributed activity are unclear.
Aim
To examine the associations between an accelerometer-derived “weekend warrior” pattern (i.e., most MVPA achieved in 1 or 2 days) versus a more even distribution of MVPA with the risk of cardiovascular events. incidents.
Design, environment and participants
Retrospective analysis of UK Biobank cohort study participants who provided a full week of accelerometer-based physical activity data between June 8, 2013 and December 30, 2015.
Exhibitions
Three patterns of moderate to vigorous physical activity (MVPA) were compared : weekend warrior active (WW active, ≥150 minutes with ≥50% of total MVPA achieved in 1-2 days), regular active (≥150 minutes and without reaching the active WW state) and inactive (< 150 minutes). The same patterns were evaluated using the sample median threshold of 230.4 minutes or more of MVPA per week.
Main results and measures
Associations between activity pattern and incident atrial fibrillation, myocardial infarction, heart failure, and stroke were assessed using Cox proportional hazards regression, adjusted for age, sex, racial and ethnic origin, and tobacco use. , alcohol consumption, Townsend Deprivation Index, employment status, self-reported health and diet quality.
Results
A total of 89,573 individuals (mean [SD] age, 62 [7.8] years; 56% female) who underwent accelerometry were included . When stratified on the threshold of 150 minutes or more of MVPA per week, a total of 37,872 were in the WW active group (42.2%), 21,473 were in the regular active group (24.0%), and 30,228 They were in the inactive group (33.7%).
In multivariable-adjusted models, both activity patterns were associated with equally lower risks of incident AF (active WW: hazard ratio [HR], 0.78 [95% CI, 0.74-0.83]; regular active: 0.81 [95% CI, 0.74-0.88; inactive: HR, 1.00 [95% CI, 0.94-1.07]), myocardial infarction (WW active: 0 .73 [95% CI, 0.67-0.80]; regular active: 0.65 [95% CI, 0.57-0.74]; and inactive: 1.00 [95% CI, 0.91 -1.10]), heart failure (active WW: 0.62 [95% CI, 0.56-0.68]; active regular: 0.64 [95% CI, 0.56-0.73]; and inactive: 1.00 [95% CI, 0.92-1.09]) and stroke (active WW: 0.79 [95% CI, 0.71-0.88]; fair active: 0.83 [95% CI, 0.72-0.97] and inactive: 1.00 [95% CI, 0.90-1.11]).
Findings were consistent at the mean threshold of 230.4 minutes or more of MVPA per week, although associations with stroke were no longer significant (active WW: 0.89 [95% CI, 0.79-1.02 ]; regular active: 0.87 [95% CI, 0.74 -1.02] and inactive: 1.00 [95% CI, 0.90-1.11]).
Figure : Distribution of moderate-to-vigorous physical activity (MVPA) on the main 2 days versus the remaining 5 days among active people using a guideline-based activity threshold of 150 minutes or more of MVPA per week.
Distribution of daily MVPA on the 2 most active days of the week (blue), versus the remaining 5 days (yellow), is shown among individuals with activity above the guideline-based threshold (i.e., ≥150 minutes of MVPA during the week, 1-3 n = 59345). A, Individuals who meet criteria for weekend warrior activity (i.e., ≥50% of total MVPA achieved in 1 or 2 days) are shown. B, Active people who do not meet the criteria for weekend warrior (regular) activity are shown. A total of 431 individuals in the weekend warrior group (1.1%) with a value of zero for the remaining 5 days were attributed 1 minute of MVPA to accommodate the logarithmic x-axis scale.
Discussion
The results of this study have implications for efforts that leverage physical activity to reduce cardiovascular morbidity.
First, when quantified using accelerometry , a weekend warrior pattern appears common . Across multiple activity thresholds, more than half of active people accumulated most of their MVPA within 1 to 2 days.
Second, variable activity patterns, over just 5 years, were found to have similar associations with lower risk of AF, MI, HF, and stroke. These observations extend previous work reporting improved cardiovascular outcomes with increased moderate and vigorous activity as well as reports suggesting that concentrated physical activity is associated with similar reductions in mortality as more regular activity. Specifically, these findings suggest that participation in physical activity, regardless of pattern , can optimize risk across a broad spectrum of cardiovascular diseases.
Third, efforts to increase physical activity for cardiovascular health can be effective even when such efforts are concentrated on 1 or 2 days per week. Because weekend warrior patterns may be more feasible for certain schedules, targeted interventions delivered over shorter time frames may be more accessible. Despite concerns that weekend warrior activity may be associated with musculoskeletal injuries , a similarly lower risk of musculoskeletal conditions was observed with both activity patterns. Future research is warranted to better define the potential negative effects of concentrated activity.
Conclusions In nearly 90,000 people who provided wrist-based activity quantification, physical activity concentrated over 1 to 2 days was associated with a similarly lower risk of cardiovascular outcomes than more regular activity. Future prospective studies are warranted to evaluate whether interventions to increase physical activity, even when focused on one or two days per week, improve cardiovascular outcomes. Final message Concentrated physical activity within 1 to 2 days was associated with a similarly lower risk of cardiovascular outcomes than more evenly distributed activity. |
