150 minutes of moderate-to-vigorous physical activity per week may reduce cardiovascular risk in overweight or obese adults

1. In adults with overweight or obesity, performing at least 150 minutes of moderate-to-vigorous physical activity per week reduces cardiovascular risk, whether activity is concentrated in 1–2 days or distributed throughout the week.

2. Flexible activity patterns may offer a pragmatic strategy to improve adherence while preserving cardiovascular benefit in high-risk populations.

Evidence Rating Level: 2 (Good) 

Cardiovascular disease (CVD) remains the leading global cause of mortality, with overweight and obesity substantially increasing risk. While current guidelines recommend at least 150 minutes per week of moderate-to-vigorous physical activity (MVPA), they emphasize distributing activity across multiple days. Whether concentrating activity within 1–2 days (“weekend warrior” pattern) confers similar benefit in adults with overweight or obesity remains uncertain. This prospective cohort study analyzed 49,368 overweight or obese UK Biobank participants (mean age 63.5 years; 51.4% women) with accelerometer-measured activity and no baseline CVD. Participants were categorized as inactive (<150 minutes/week MVPA), regularly active (≥150 minutes/week distributed over ≥3 days), or concentrated activity (≥150 minutes/week with ≥50% performed on 1–2 days). Median follow-up was 7.9 years. The primary outcome was incident fatal or nonfatal CVD (myocardial infarction, atrial fibrillation, heart failure, stroke). In fully adjusted Cox models, both concentrated and regularly active patterns were associated with similar reductions in composite CVD risk compared with inactivity (HR 0.79 [0.74–0.85] and 0.76 [0.70–0.83], respectively). Protective associations were observed across individual CVD subtypes and were consistent across subgroups and sensitivity analyses. These findings suggest that accumulating guideline-recommended MVPA—even if concentrated within 1–2 days—is associated with substantial cardiovascular benefit in adults with overweight or obesity.

Click here to read this study in BMC Medicine

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