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Leisure time physical activity patterns yield mortality benefits
Individuals who perform “weekend warrior” or insufficient, but regular physical activity each week had lower all-cause, CVD and cancer mortality; therefore, participating in such activity has the potential to reduce mortality risk, according to findings published in JAMA Internal Medicine.
“Leisure time physical activity is associated with reduced risks for mortality from all causes, cardiovascular disease (CVD), and cancer,” Gary O’Donovan, PhD, from Loughborough University in England, and colleagues wrote. “The WHO recommends that individuals aged 18 to 64 years should perform at least 150 min/wk of moderate-intensity aerobic activity, at least 75 min/wk of vigorous-intensity aerobic activity, or equivalent combinations. More research is needed to determine how frequency, intensity, and duration of activity might best be combined to achieve health benefits.”
O’Donovan and colleagues evaluated whether “weekend warrior” physical activity patterns — defined as performing all exercise in one or two sessions per week — and all cause CVD and cancer mortality risk are associated. They performed a pooled analysis of population-based surveys (Health Survey for England and Scottish Health Survey) with prospective linkage to mortality records, collected data between 1994 and 2014 and analyzed the data in 2016.
A total of 63,591 adult respondents aged 40 years or older (45.9% male; mean age, 58.6 years) were included in the analysis. Respondents reported their leisure time physical activity pattern as inactive (no moderate- or vigorous-intensity activities), insufficiently active (<150 min/wk in moderate-intensity and <75 min/wk in vigorous-intensity activities), weekend warrior (150 min/wk in moderate-intensity or 75 min/wk in vigorous-intensity activities from one or two sessions) or regularly active (150 min/wk in moderate-intensity or 75 min/wk in vigorous-intensity activities from 3 sessions). Participants who reported insufficient activity were also categorized by number of sessions of physical activity per week.
Survey data indicated that over 561,159 person-years of follow-up, 8,802 deaths occurred from all causes, 2,780 from CVD and 2,526 from cancer. Each physical activity pattern’s hazard ratio (HR) for all-cause, CVD and cancer were compared with inactive participants. The all-cause mortality HR was 0.66 (95% CI, 0.62-0.72) for insufficiently active participants who reportedly engaged in one to two sessions per week, 0.7 (95% CI, 0.60-0.82) for weekend warrior participants and 0.65 (95% CI, 0.58-0.73) in regularly active participants. The CVD mortality HR was 0.6 (95%CI, 0.52-0.69) for insufficiently active participants who reported one or two sessions per week, 0.6 (95% CI, 0.45-0.82) for weekend warrior participants and 0.59 (95% CI, 0.48-0.73) for regularly active participants. Cancer mortality HR was 0.83 (95% CI, 0.73-0.94) for insufficiently active participants who engaged in one or two sessions per week, 0.82 (95% CI, 0.63-1.06) for weekend warrior participants and 0.79 (95% CI, 0.66-0.94) for regularly active participants.
Insufficiently active respondents who engaged in three or more sessions per week had higher HRs; in addition, CVD (HR = 0.79; 95% CI, 0.6-1.01) and cancer (HR = 0.99; 95% CI, 0.79-1.24) mortality associations were reduced.
“This large, statistically powerful study suggests that different leisure time physical activity patterns are associated with reduced risks for all-cause, CVD, and cancer mortality,” O’Donovan and colleagues concluded. “The weekend warrior and other physical activity patterns characterized by one or two sessions per week of moderate or vigorous-intensity physical activity may be sufficient to reduce risks for all-cause, CVD, and cancer mortality regardless of adherence to prevailing physical activity guidelines.”
In a related editorial, Hannah Arem, PhD, and Loretta DiPietro, PhD, both of the Milken Institute School of Public Health at George Washington University, wrote that these findings point to the possibility of individuals to wait for the weekend to exercise, but they emphasize that more mortality benefit was seen with more frequent activity.
“Individuals may have to consider other health outcomes (eg, mental health, diabetes, etc.) and individual constraints (eg, time, access, etc.) in deciding which activity patterns work best for them,” they concluded. “We hope that future studies will continue to explore these questions to better inform national and international guidelines.” – by Alaina Tedesco
Additional reading:
Physical activity beneficial for CV health, but excessive exercise may confer harm
Disclosure: O’Donovan and colleagues report receiving support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care–East Midlands. Please see full study for complete list of disclosures. Arem and DiPietro do not report relevant financial disclosures.