“Weekend warrior” and regular physical activity patterns may both reduce cardiovascular and all-cause mortality

1. In this prospective cohort study of adults with diabetes, “weekend warrior” and regular physical activity patterns were associated with similarly reduced risk of all-cause and cardiovascular mortality.

2. Regular activity, but not “weekend warrior” activity, was also associated with significantly reduced risk of cancer mortality.

Evidence Rating Level: 2 (Good)

Study Rundown: Physical activity is known to be protective against mortality, and current guidelines recommend at least 150 minutes of moderate-to-vigorous physical activity (MVPA) a week distributed across at least 3 days. The “weekend warrior” approach, whereby the 150 minutes of physical activity is compressed into 1-2 weekly sessions, has been suggested to deliver similar benefits among the general population, although its comparative effects in people with diabetes remain unclear. This study aimed to assess how the “weekend warrior” approach, regularly active physical activity, and insufficient physical activity affect all-cause, cardiovascular, and cancer mortality compared with physical inactivity in adults with diabetes. All-cause mortality risk was reduced by more than one-fifth among “weekend warriors,” over fifteen percent lower among regularly active participants, and ten percent lower among insufficiently active participants. Cardiovascular mortality risk was reduced by one-third among “weekend warriors” and reduced by almost one-fifth among regularly active participants; insufficient activity was not associated with a significant reduction in cardiovascular mortality risk. Fewer differences were found for cancer mortality; only regular activity was associated with a fifteen percent reduction in cancer mortality risk. The generalizability of this study was limited by potential recall bias and exposure misclassification due to self-reported physical activity data; a lack of reporting on non-exercise activities such as work and travel; and an inability to capture changes in physical patterns over time. Nevertheless, this study suggested that “weekend warrior” patterns of activity confer similar mortality benefits to more frequent physical activity among adults with diabetes.

Click to read this study in AIM

Relevant Reading: Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns With All-Cause and Cause-Specific Mortality

In-Depth [prospective cohort]: This prospective cohort study aimed to examine the effect of “weekend warrior,” regular, and insufficient physical activity compared with physical inactivity in reducing all-cause, cardiovascular, and cancer mortality among adults with diabetes. Key outcomes were all-cause, cardiovascular, and cancer mortality. The study included 51,650 participants, with a median age of 59.8 years and an approximately even split between men and women. The “weekend warrior” group reported 240 minutes per week of MVPA, while the regularly active group reported 420 minutes per week of MVPA. During a median follow-up of 9.5 years (interquartile range, 5.0 to 14.8 years), 16,345 deaths were recorded, including 5620 from cardiovascular disease and 2883 from cancer. Compared with physically inactive participants (n = 26,501), multivariable-adjusted HRs for all-cause mortality were 0.90 (95% CI, 0.85 to 0.95) for insufficiently active participants (n = 9722), 0.79 (95% CI, 0.69 to 0.91) for “weekend warriors” (n = 1435), and 0.83 (95% CI, 0.78 to 0.87) for regularly active participants (n = 13,992). Compared with physically inactive participants, multivariable-adjusted HRs for cardiovascular mortality were 0.98 (95% CI, 0.89 to 1.07) for insufficiently active participants, 0.67 (95% CI, 0.52 to 0.86) for “weekend warriors,” and 0.81 (95% CI, 0.74 to 0.88) for regularly active participants. Compared with physically inactive participants, multivariable-adjusted HRs for cancer mortality were 0.88 (95% CI, 0.78 to 1.00) for insufficiently active participants, 0.99 (95% CI, 0.76 to 1.30) for “weekend warriors,” and 0.85 (95% CI, 0.75 to 0.96) for regularly active participants. After 20 years of follow-up, insufficiently active participants, “weekend warriors,” and regularly active participants had extended survival times of 4.4 months (95% CI, 2.2 to 6.7 months), 9.4 months (95% CI, 4.2 to 14.7 months), and 7.9 months (95% CI, 5.7 to 10.0 months), respectively, compared with inactive participants. Overall, these results suggested that both “weekend warriors” and regularly active participants had lower cardiovascular and all-cause mortality compared with inactive participants.

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