1. In this analysis of questionnaire data from surveillance studies in England and Scotland, the pattern of physical activity consisting of one to two sessions per week (termed “Weekend Warriors”) was associated with reduced all-cause mortality.
2. Both weekend warrior and more regularly active participants demonstrated similar reductions in cardiovascular mortality. The former had a trend towards decreased cancer mortality, while the latter had significantly lower cancer mortality as compared with inactive participants.
Evidence Rating Level: 2 (Good)
Study Rundown: A sedentary lifestyle remains an important modifiable risk factor for many life-limiting conditions. The World Health Organization (WHO) suggests minimum activity levels of 150 min/week of moderate exercise or 75 min/week of vigorous-intensity activity. Frequency of physical activity (spread over the course of the week versus in one or two sessions) within that one-week time has not been assessed. The current study used data from the Scottish Health Survey (SHS), and Health Survey of England (HSE) to assess differences in mortality between those who were sedentary, insufficiently active (one or two activity sessions but not meeting the WHO recommended activity time), weekend warriors (meeting WHO recommended activity time in one or two sessions), or regularly active.
Compared to those who were sedentary, insufficiently active, weekend warriors, and regularly active participants all demonstrated reduced all-cause and cardiovascular mortality. Weekend warriors also had a trend towards reduced cancer-specific mortality. The strengths of the study included the large sample size and attempted control for several confounding variables. The main limitations of the study included the reliance on questionnaire data, no determination for the reason for inactivity (unwell people may be less active), and no data on differences in injury patterns between the different activity strategies.
Relevant Reading: The “Weekend Warrior” and Risk of Mortality
In-Depth [retrospective cohort]: This study used data from the HSE and SHS household surveillance studies from 1994 to 2008. Participants were included if they were 40 years or older and excluded if they died within 2 years of the start of study. Data on smoking habit, illness, occupation, ethnicity, BMI, dyslipidemia, and blood pressure was obtained and used for adjusted analysis. Mortality data was collected from the Nation Health Service Registry using standard codes for primary cause of death.
A total of 63 591 participants were included in the study with 62.8% classified as inactive (no moderate/vigorous activity reported), 22.4% were insufficiently active (less than 150 min/week moderate or 75 min/week vigorous activity), 3.7% were weekend warriors (sufficient exercise obtained in 1-2 sessions per week), and 11.1% were regularly active (3 or more sessions per week). Compared to those who were inactive, there was lower all-cause mortality for those who were insufficiently active (aHR 0.69; 95%CI 0.65-0.74), weekend warriors (aHR 0.70; 95%CI 0.60-0.82), and regularly active (0.65; 95%CI 0.58-0.73) participants. Results for cardiovascular mortality were similar with an adjusted HR of 0.63 (95%CI 0.55-0.72) for insufficiently active, 0.60 (95%CI 0.45-0.82) for weekend warriors, and 0.59 (95%CI 0.48-0.73) for regularly active participants. While regularly active participants had lower risk of cancer-related death (aHR 0.79; 95%CI 0.66-0.94), there was only a non-significant trend towards lower cancer mortality in weekend warriors (0.82; 95%CI 0.63-1.06).
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