Weekend Warrior Activity Patterns Associated with Lower Cardiovascular Disease Risk

Patrick T. Eleanor, MD

Credit: Massachusetts General Hospital

A “weekend warrior” physical activity pattern, where the most moderate-to-vigorous activity was accomplished in 1-2 days, was similarly associated with reduced risk of: cardiovascular disease outcomes Activities are evenly distributed, according to new research.¹

An analysis of nearly 90,000 individuals who provided accelerometer-based physical activity data for a week suggested that the weekend warrior habit, as evenly distributed, was associated with similarly lower risks of developing atrial fibrillation, myocardial infarction, heart failure, and stroke.

“These observations extend previous studies that report improved cardiovascular outcomes with increased moderate and vigorous activity, and are also suggestive of reports suggesting that intense physical activity is associated with similar reductions in mortality as more regular activity,” wrote the investigative team led by Patrick T. Eleanor, M.D., Ph.D., of the Cardiac Arrhythmia Service and Cardiovascular Research Center at Massachusetts General Hospital. “In particular, these findings suggest that engaging in physical activity, regardless of pattern, may optimize risk for a wide range of cardiovascular diseases.”

Current guidelines from the World Health Organization and the American Heart Association recommend at least 150 minutes of moderate-to-vigorous physical activity per week, but do not specify an optimal exercise pattern.² Previous studies of weekend warrior locomotion patterns have been limited by self-reported activity, modest sample sizes, and limited result sets. Here, a retrospective analysis of the UK Biobank Cohort Study involved his 103,695 participants who provided their week’s worth of accelerometer-based physical activity data from June 2013 to December 2015.

Using guideline-based thresholds, the researchers compared three patterns of moderate-to-vigorous physical activity. Active Weekend Warrior (Active WW, >150 minutes, ≥50% of total moderate to physical activity achieved in 1-2 days), Vigorous Regular Exercise (≥150 minutes, does not meet Active Weekend Warrior status), and Inactive (<150 minutes). The researchers then assessed the same pattern using a sample median threshold of 230.4 minutes or more of moderate-to-vigorous physical activity per week.

As the primary endpoint, Ellinor et al. assessed the association between activity patterns and the incidence of atrial fibrillation, myocardial infarction, heart failure, and stroke using a Cox proportional hazards model adjusted for age, sex, racial and ethnic background, tobacco use, Townsend deprivation index, alcohol consumption, education, employment status, self-reported health status, and diet quality.

The analysis included a total of 89,573 individuals (mean age 62 years, 56% female) who underwent activity measurement between June 2013 and December 2015. A total of 37,872 participants were in the weekend active group (42.2%), 21,473 in the active regular group (24.0%), and 30,228 in the inactive group (33.7%) when stratified by the guideline-based threshold of ≥150 minutes of moderate-to-vigorous physical activity.

In a multivariate-adjusted analysis, both activity patterns were similarly associated with a reduced risk of developing atrial fibrillation (activity WW:hazard ratio). [HR]0.78 [95% CI, 0.74 – 0.83]Active Regular: HR, 0.81 [95% CI, 0.74 – 0.88]; Inactive, HR, 1.00 [95% CI, 0.94 – 1.07), myocardial infarction (active WW, 0.73 [95% CI, 0.67 – 0.80]; active regular, HR, 0.65 [95% CI, 0.57 – 0.74]; Inactive, HR, 1.00 [95% CI, 0.91 – 1.10]), heart failure (active WW, HR, 0.62 [95% CI, 0.56 – 0.68]; active regular, HR, 0.64 [95% CI, 0.56 – 0.73; inactive, HR, 1.00 [95% CI, 0.92 – 1.09]), and stroke (activity WW, HR, 0.79 [95% CI, 0.71 – 0.88; active regular, HR, 0.83 [95% CI, 0.72 – 0.97]inactive, HR, 1.00[95%CI090-111)[95%CI090-111)[95%CI、090-111)。[95%CI090-111)

This finding was consistent at a median threshold of moderate-to-vigorous physical activity ≥230.4 minutes per week, but the association with stroke was no longer significant (Active WW, HR, 0.89; Active, Regular, HR, 0.87; Inactive, HR, 1.00).

The researchers noted that a weekend warrior pattern may be more feasible on certain schedules, so targeted interventions in shorter time frames may be more accessible to some patients. Independent of the musculoskeletal injury concerns from weekend warrior activity, the analysis observed similarly low risk for both activity patterns.

“Future studies are warranted to more precisely define the potential adverse effects of concentrated activity,” the researchers wrote.

References

1. Khurshid S, Al-Arsi MA, Churchill TW, Guse JS, Eleanor PT. Incidence of accelerometer-derived ‘weekend warrior’ physical activity and cardiovascular disease. jam. 2023;330(3):247–252. Doi: 10.1001/jama.2023.10875
2. Arnett DK, Blumenthal RS, Albert MA, Other 2019 ACC/AHA Guidelines for Primary Prevention of Cardiovascular Disease: Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. Doi: 10.1161/CIR.0000000000000678