Busy with work and other obligations, some people concentrate their moderate-to-vigorous exercise in one or two days of the week or weekend. A study led by investigators at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system, has found that this "weekend warrior" pattern of exercise is associated with lower risk of developing 264 future diseases and was just as effective at decreasing risk as more evenly distributed exercise activity. Results are published in Circulation.
"Physical activity is known to affect risk of many diseases," said co-senior author Shaan Khurshid, MD, MPH, a faculty member in the Demoulas Center for Cardiac Arrhythmias at Massachusetts General Hospital. "Here, we show the potential benefits of weekend warrior activity for risk not only of cardiovascular diseases, as we've shown in the past, but also future diseases spanning the whole spectrum, ranging from conditions like chronic kidney disease to mood disorders and beyond."
Guidelines recommend at least 150 minutes of moderate-to-vigorous physical activity per week for overall health. Among people who meet these recommendations, however, do those who exercise 20–30 minutes most days of the week experience benefits over those who go 5 or 6 days between longer exercise sessions?
Khurshid, along with co-senior author Patrick Ellinor, MD, PhD, the acting chief of Cardiology and the co-director of the Corrigan Minehan Heart Center at Massachusetts General Hospital, and their colleagues analyzed information on 89,573 individuals in the prospective UK Biobank study who wore wrist accelerometers that recorded their total physical activity and time spent at different exercise intensities over one week. Participants' physical activity patterns were categorized as weekend warrior, regular, or inactive, using the guideline-based threshold of 150 minutes per week of moderate-to-vigorous physical activity.
The team then looked for associations between physical activity patterns and incidence of 678 conditions across 16 types of diseases, including mental health, digestive, neurological, and other categories.
The investigators' analyses revealed that weekend warrior and regular physical activity patterns were each associated with substantially lower risks of over 200 diseases compared with inactivity. Associations were strongest for cardiometabolic conditions such as hypertension (23% and 28% lower risks over a median of 6 years with weekend warrior and regular exercise, respectively) and diabetes (43% and 46% lower risks, respectively). However, associations also spanned all disease categories tested.
"Our findings were consistent across many different definitions of weekend warrior activity, as well as other thresholds used to categorize people as active," said Khurshid.
The results suggest that physical activity is broadly beneficial for lowering the risk of future diseases, especially cardiometabolic conditions. "Because there appears to be similar benefits for weekend warrior versus regular activity, it may be the total volume of activity, rather than the pattern, that matters most," said Khurshid. "Future interventions testing the effectiveness of concentrated activity to improve public health are warranted, and patients should be encouraged to engage in guideline-adherent physical activity using any pattern that may work best for them."
Authorship: Shinwan Kany, MD, MSc; Mostafa A. Al-Alusi, MD; Joel T. Rämö, MD, PhD; James P. Pirruccello, MD; Timothy W. Churchill, MD; Steven A. Lubitz, MD, MPH; Mahnaz Maddah, PhD; J. Sawalla Guseh, MD; Patrick T. Ellinor, MD, PhD; and Shaan Khurshid, MD, MPH.
Disclosures: Ellinor receives sponsored research support from Bayer AG, IBM Research, Bristol Myers Squibb, Pfizer, and Novo Nordisk; he has also served on advisory boards or consulted for MyoKardia and Bayer AG. Lubitz is an employee of Novartis as of July 2022 and received sponsored research support from Bristol Myers Squibb, Pfizer, Boehringer Ingelheim, Fitbit, Medtronic, Premier, and IBM, and has consulted for Bristol Myers Squibb, Pfizer, Blackstone Life Sciences, and Invitae.
Funding: This work was supported by funding from the National Institutes of Health (K08HL159346, K23HL159262-01A1, 1RO1HL092577, 1R01HL157635, 5R01HL139731, 18SFRN34230127, 961045, R01HL157635, T32HL007208, K23HL169839-01., the Walter Benjamin Fellowship from the Deutsche Forschungsgemeinschaft (521832260), the Sigrid Jusélius Foundation, the American Heart Association (19AMFDP34990046, 18SFRN34230127, 961045, 18SFRN34250007, 2023CDA1050571), the president and fellows of Harvard College (5KL2TR002542-04), the European Union (MAESTRIA 965286).
Paper cited: Kany S et al. "Associations of 'Weekend Warrior' Physical Activity With Incident Disease and Cardiometabolic Health." Circulation DOI: 10.1161/CIRCULATIONAHA.124.068669
