‘Weekend warriors’, regular exercisers have a similar risk

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The amount of exercise one does in a week might have more benefits for heart health than its frequency. Manu Prats/Stocksy
  • Physical activity is beneficial for cardiovascular well-being; however, getting regular physical activity throughout the week may be difficult.
  • A​ recent study found that regular moderate to vigorous physical activity during the week has similar outcomes on cardiovascular health as moderate to vigorous physical exercise concentrated over one to two days — typically the weekend.
  • Both ‘weekend warriors’ and regular exercisers saw a decreased risk for heart attacks, atrial fibrillation (AFib), heart failure, and stroke, the findings showed.

Exercise has key benefits to health, including reducing the risk of cardiovascular disease and the risk of developing type two diabetes and metabolic syndrome. It may be difficult for some people to get regular physical activity throughout the week, leading to more intense physical activity on the weekends.

A​ new study comparing patterns of physical activity behavior, looking at people who concentrated their moderate to vigorous physical activity over one to two days with those who spread their physical activity over the week.

Researchers found that both styles of physical activity were associated with similarly decreased risk for heart attack, atrial fibrillation, heart failure, and stroke.

The study is published in JAMA.

Researchers of this current study noted that recommendations for physical activity include 150 minutes a week of moderate to vigorous physical activity.

They wanted to understand if the associated health benefits varied between two key groups:

  1. People who concentrate their moderate to vigorous physical activity over one to two days (weekend warriors)
  2. People who spread their moderate to vigorous physical activity more evenly throughout the week

To make an accurate comparison, researchers also included a group whose activity levels were less than 150 minutes a week. This group did not reach the threshold of recommended weekly exercise and was therefore considered inactive.

The study included almost 90,000 participants from the UK Biobank cohort study. Participants wore accelerometers on their wrists for one week to capture physical activity levels. Researchers classified participants as weekend warriors, regularly active, or inactive based on activity levels.

About 42% of the participants were in the weekend warrior group. 24% were in the regularly exercising group, and 33.7% were rated inactive. Researchers accounted for factors such as age, education level, and tobacco use in their data analysis.

Both weekend warrior activity and regular activity were associated with a lower risk for AFib (a type of abnormal heart rhythm), heart attack, heart failure, and stroke. The decreased risks were similar between both groups.

Study authorDr. Shaan Khurshid with the Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, explained to MedicalNewsToday that the findings show that “both a weekend warrior type activity pattern and a more even activity pattern were each associated with similar reductions in risk of heart attack, heart failure, atrial fibrillation, and stroke as compared to inactive individuals.”

“Our findings suggest that efforts to improve physical activity, even if concentrated within 1-2 days of the week, should be beneficial for cardiovascular risk. It appears that it is the total volume of activity, rather than the pattern, that matters most.”
—Dr. Shaan Khurshid

This study did have particular limitations.

First, the study included mostly white participants, all from the UK, which limits study generalization. Second, the data only looked at one week of activity, so it’s possible that participants deviated from their typical behavior or changed their behavior because they were being watched.

Researchers further note that the accuracy of classifying moderate to vigorous physical activity can vary based on the type of activity a person does. They used a classification system based on a broad range of activities, which could have impacted results.

Finally, data on covariates could have been misclassified because this data collection was several years before accelerometry data collection.

Dr. Gregory Katz, assistant professor in the Department of Medicine, the Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine, and cardiologist at NYU Langone Heart, who was not involved in the study, noted the following limitations of the study to MNT:

“The biggest thing is that the study is a bit limited in the conclusions you can draw because they weren’t following people for long periods of time in terms of tracking their exercise. They were only evaluating them over the course of 7 days with an accelerometer. So this is taking tens of thousands of people and following them for a week of exercise and then monitoring health outcomes for much longer than that. So there’s just a limit to how transferable this is to everybody else.”

Drrs. Ellinor and Khurshid further noted a few areas for continued research:

“We are planning to assess whether weekend warrior-type activity has similar benefits on other diseases across the spectrum of human conditions. Our results may also motivate future studies of physical activity interventions delivered in a concentrated fashion, which may be more practical and efficient.”

As demonstrated by this study, physical activity levels each week will vary among individuals, and the real challenge is finding a way to help fit physical activity into our lives. People who are told what physical activity levels and patterns are satisfactory can consult their doctor for appropriate physical activity recommendations.

the Centers for Disease Control and Prevention says finding activities you enjoy, exercising with a friend, and setting aside specific times for exercise could help increase activity levels.

Dr. John Bahadorani, a board certified interventional cardiologist at MemorialCare Heart & Vascular Institute at Saddleback Medical Center in Laguna Hills, California, who was also not involved in the study, further emphasized the critical benefits of exercise to MNT:

“Exercise is crucial for cardiovascular health as it positively impacts the heart and blood vessels. Regular physical activity strengthens the heart muscle, lowers blood pressure, reduces bad cholesterol (LDL), and increases good cholesterol (HDL). It also helps maintain a healthy weight, improves blood circulation, and enhances the body’s ability to use oxygen efficiently.”

“This study suggests that this activity may not have to occur daily throughout the week, but can occur concentrated over the course of 1-2 days as long as you are reaching the target of >150 minutes per week.”
—Dr. John Bahadorani

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