Physical activity confers similar benefits when spread out or concentrated in fewer days

“Weekend warriors” who completed the recommended amount of weekly physical activity in fewer days experienced similar health benefits as those who were regularly active throughout the week, according to researchers.

“For people with fewer opportunities for daily or regular physical activity during their work week, these findings are important,” Mauricio Dos Santos, MSc, of the department of preventive medicine at Escola Paulista de Medicina, Universidade Federal de São Paulo in Brazil, and colleagues wrote in JAMA Internal Medicine.

WHO’s 2020 guidelines for physical activity recommend that adults perform 150 minutes or more of moderate to vigorous physical activity or 75 minutes of vigorous activity per week, according to dos Santos and colleagues. Although researchers have long known that physical activity confers health benefits, it was unclear if the benefits differ based on how the activity is spread throughout the week.

Dos Santos and colleagues conducted a large, prospective cohort study to learn whether there is a difference in mortality risk between “weekend warriors” — who they defined as people who perform the recommended levels of weekly physical activity in one to two sessions — and those who are regularly active — performing three or more sessions during the week. They also compared outcomes among people who were physically active vs. inactive.

The study included 350,978 adults in the United States who participated in the U.S. National Health Interview Survey. The participants were followed for a median of 10.4 years. During this time, the researchers identified 21,898 deaths, including 4,130 from CVD and 6,034 from cancer.

Compared with physically inactive participants, the researchers found that the risk for all-cause mortality was lower among weekend warriors (HR = 0.92; 95% CI, 0.83-1.02) and regularly active participants (HR = 0.85; 95% CI, 0.83-0.88).

Given the same amount of moderate to vigorous physical activity, the risk for all-cause mortality among weekend warriors was similar to that of regularly active participants (HR = 1.08; 95% CI, 0.97-1.2), as was the risk for CVD mortality (HR = 1.14; 95% CI, 0.85-1.53) and cancer mortality (HR = 1.07; 95% CI, 0.87-1.31).

When studying demographics, the researchers noted that regularly active participants tended to be younger and were more likely to be leaner men with a higher education level and income who were never or former smokers and current drinkers and had better self-rated health and lower comorbidity scores. Median physical activity for regularly active participants was about 420 minutes per week. Weekend warriors, however, were more likely to be Hispanic men with overweight or obesity who currently smoke and have lower education and income levels. The median physical activity for this group was 240 minutes per week. The study did not specify how physical activity within one’s occupation may contribute to the findings.

Overall, the findings “reinforce the importance of reaching the recommended levels of physical activity for health” and could potentially be useful for public health policies and interventions or for clinical and individual counseling, according to the researchers.

“Observational epidemiologic evidence suggests that there may be some health benefits associated with weekend warrior physical activity pattern, supporting its inclusion in prevailing physical activity guidelines. This is good news considering that the weekend warrior physical activity pattern may be a more convenient option for many people striving to achieve the recommended levels of physical activity,” they wrote. “Clinicians and practitioners involved in public health interventions may advise that the same amount of physical activity, whether it is spread over more days or concentrated in fewer days during a week, may provide similar health benefits.”