Weekend Warriors vs More Frequent Exercise Sessions: Do Both Benefit Survival?

It is unclear whether the weekly recommended amount of moderate to vigorous physical activity (MVPA) has the same benefits for mortality risk when activity sessions are spread throughout the week (Regular Exercisers RE) vs concentrated in fewer days (Weekend Warriors) WW.

Objective of Study:  To examine the association of weekend warrior WW and other patterns of leisure-time physical activity like RE with all-cause and cause-specific mortality.

Participants  This large nationwide prospective cohort study included 350 978 adults who self-reported physical activity to the US National Health Interview Survey from 1997 to 2013. Participant data were linked to the National Death Index through December 31, 2015.

Exposures  Participants were grouped by self-reported activity level: physically inactive (<150 minutes per week of MVPA) or physically active (≥150 min/wk of moderate or ≥75 min/wk of vigorous activity).

The physically active group was further classified by pattern: weekend warrior WW (1-2 sessions/wk) or regularly exercisers RE (≥3 session/wk); and then, by frequency, duration/session, and intensity of activity.

Outcomes and Measures  All-cause, cardiovascular disease (CVD), and cancer mortality. Statistical analyses were performed in April 2022.

Results  A total of 350 978 participants including 51% women were followed for a median of 10.4 years (3.6 million person-years). There were 21 898 deaths documented, including 4130 from CVD and 6034 from cancer.

Compared with physically inactive participants, hazard ratios (HR) for all-cause mortality were 0.92 (reduced 8%) for weekend warriors WW and 0.85 (reduced 15%) for regularly exercising RE participants.

Given the same amount of total MVPA, weekend warrior WW participants had similar all-cause and cause-specific mortality rates as regularly exercising RE participants.

Weekend warriors WW had the same risk of all-causes of death, cardiovascular death, and cancer deaths as the regular exercises RE as long as they met the weekly goals of either 150 minutes or 75 minutes of exercise.

Conclusions:

The findings of this large prospective cohort study suggest that individuals who engage in active patterns of physical activity, whether weekend warrior or regularly active, experience lower all-cause and cause-specific mortality rates than inactive individuals.

Individuals who engage in the recommended levels of physical activity may experience the same benefit whether the sessions are performed throughout the week or concentrated into fewer days.