In an ever-busy world, many people have difficulty fitting in any form of self-care let alone regular exercise. The ever-growing group of people who find time to exercise only during weekends are now commonly dubbed “weekend warriors.” Health professionals tend to discourage the weekend warrior lifestyle (i.e., concentrating a week’s-worth of physical activity into 1-2 days) and instead encourage patients to spread out physical activity for optimal cardiovascular benefit. However, a new research study published in the Journal of the American Medical Association (JAMA), suggests that prioritizing the volume of activity over the timing of workouts each week is more important when considering cardiovascular disease risk.1 The American Heart Association (AHA), World Heart Organization (WHO), and UK National Health Service recommend at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous activity each week to reduce cardiovascular disease incidence and mortality.2 The 2023 JAMA study shows that completing the recommended amount of physical activity in 1-2 days is equally as effective at preventing cardiovascular disease as completing the same amount of activity over a period greater than 1-2 days.1 In this month’s Movement Memo, our fitness team explores the methodology and results of this new study as well as its practical value in formulating physical fitness regimens.
In this study, the research team analyzed physical activity levels and incidence of cardiovascular disease of 89,573 participants as part of a prospective UK Biobank study. Data were collected from wrist-accelerometers (devices that measure motion and vibration), and activities (walking, jogging, stationary cycling, and elliptical) were characterized as either moderate or vigorous. Participants were classified into three groups of activity patterns: 1) “active weekend warriors,” who completed >50% of 150 minutes in 1-2 days; 2) “active regulars,” who completed 150 minutes in >2 days; and 3) “inactives,” who completed <150 minutes total. The main outcome studied was heart disease risk, which was determined by measuring incidence of atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), or stroke. To control for other variables, the model was adjusted for age, sex, racial/ethnic background, tobacco/alcohol use, material deprivation, education, employment, self-reported health status, and diet quality.
In contradiction to traditional fitness recommendations, the results of this study support the weekend warrior’s effectiveness in lowering risk of cardiovascular disease. Both active groups, the “active weekend warrior” group and the “active regular” group, were associated with significantly lower rates of AF, MI, HF, and stroke over the 6.3 year follow-up period.1 When compared to the “inactive” group, “active weekend warriors” had a 22%, 27%, 28%, and 21% lower incidence of AF, MI, HF, and stroke, respectively.1 These surprising findings suggest that the weekend warrior lifestyle and regular activity lifestyle are similarly effective in decreasing cardiovascular disease risk, supporting the notion that completing the recommended amount of activity is protective regardless of when it gets done.
Despite these outcomes, limitations of the study may affect its validity. First, activity was measured for a 1-week period only, which does not account for deviations in exercise behavior that may have occurred in the years prior to follow-up. Additionally, the optimal thresholds for moderate to vigorous physical activity using wrist-based accelerometers are unclear, especially when accounting for the different classifications of exercise (walking, jogging, cycling, elliptical use, etc.). Lastly, 97% of the participants were Caucasian, which decreases the generalizability of these results to the overall population despite attempts to control for other variables.
The findings of this study provide doctors and fitness professionals with evidence to support a potential alternative fitness plan, the weekend warrior lifestyle, for individuals who struggle to get in workouts during the week. However, considering the limitations of the study and the potential risk for musculoskeletal injury from irregular physical activity, the SHIFT fitness team continues to recommend regular cardiovascular exercise throughout the week. Nevertheless, when it comes to reducing the risk of cardiovascular disease the most important factor is completing recommended minutes of aerobic activity, even if that means waiting until the weekend.
If you have questions about how to incorporate exercise into your schedule and with your unique fitness goals in mind, then please reach out to our fitness team!
In Real Health,
Scott Robin, PT, DPT
- Khurshid S, Al-Alusi MA, Churchill TW, Guseh JS, Ellinor PT. Accelerometer-Derived “Weekend Warrior” Physical Activity and Incident Cardiovascular Disease. JAMA. 2023;330(3):247–252. doi:10.1001/jama.2023.10875
- Piercy KL, Troiano RP. Physical Activity Guidelines for Americans From the US Department of Health and Human Services. Circ.: Cardiovasc. Qual. Outcomes. 2018;11(11): e005263. doi:10.1161/CIRCOUTCOMES.118.005263