'Weekend warriors' may gain same health benefits as people who spread out exercise

Weekend warriors – people who pack most of their physical activity into one or two days – may gain the same health-protective benefits as people who exercise throughout the week, as long as they get the recommended amount, new research finds.

The study found regardless of whether people concentrated their 150 minutes of moderate to vigorous physical activity over a short period of time or stretched it out over the week, the risk fell for more than 200 diseases over the next six years, with the strongest associations found among cardiometabolic conditions such as high blood pressure and diabetes.

The findings were published Thursday in the American Heart Association journal Circulation and presented at the German Cardiac Society's Heart Days conference in Hamburg.

"The bottom line is that it's really the total volume of physical activity, rather than the pattern, that matters," said Dr. Shaan Khurshid, the study's co-senior author and a cardiac electrophysiologist at Massachusetts General Hospital in Boston. "The important thing is that you get your recommended levels of physical activity. If one to two days a week works for you, you're still going to get that benefit."

Physical activity has been shown to reduce the risk of cardiovascular and other diseases. Federal physical activity guidelines recommend adults engage in at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity each week, or a combination of both.

There's little guidance, however, on how that activity should be spread throughout the week.

In the study, researchers investigated whether so-called weekend warriors, who get most of their physical activity over a one- or two-day period and are largely inactive the rest of the week, would get the same health benefits as people who spread their 150 minutes of exercise throughout the week.

Using data from the UK Biobank, a large database containing genetic and medical information on volunteers in the United Kingdom, researchers analyzed physical activity levels and disease prevalence for 89,573 people who were an average 62 years old. Physical activity was measured using wrist-based accelerometers that participants wore for one week. They also tracked the development of 678 diseases over a median 6.3 years of follow-up, including circulatory, digestive, skin, endocrine/metabolic, kidney, infectious, musculoskeletal and neurological diseases, along with cancers, mental health disorders and injuries.

Among participants who met the recommended weekly amount of physical activity, those who exercised throughout the week achieved a median of 418 minutes. Weekend warriors, however, were substantially more active in a shorter period, with a median of 288 minutes. Compared to people who did not meet the recommended amount of exercise per week, being a weekend warrior was associated with a reduced risk for 264 health conditions and being active throughout the week was associated with a lower risk for 205 conditions.

The strongest associations between physical activity and lower disease risk were found among cardiometabolic conditions, including a more than 20% lower risk for high blood pressure, more than 40% lower risk for diabetes and sleep apnea, and a roughly 50% lower risk for obesity. There were no significant differences in disease risk reduction between weekend warriors and weeklong exercisers when they were compared directly.

Dr. Leanna Ross, an assistant professor in medicine at Duke University School of Medicine in Durham, North Carolina, said the findings not only provide reassurance to people unable to exercise during the week but also show just how beneficial physical activity can be to overall health.

"Physical activity really can be like a wonder drug for our health and well-being," said Ross, who was not involved in the research.

"This study extends our knowledge about how physical activity affects health to an even broader range of diseases and conditions and shows that if your schedule and your lifestyle make it so you prefer to exercise one or two days a week, you're going to likely receive the same wide-ranging health benefits as you would if that activity were spread throughout the week," she said.

Ross said one weakness in the study is that the UK Biobank participants are predominantly white, so it's unclear whether the findings can be applied to other racial and ethnic groups.