Accelerometer-Derived “Weekend Warrior” Physical Activity and Incident Cardiovascular Disease

Abstract

ImportanceGuidelines recommend 150 minutes or more of moderate to vigorous physical activity (MVPA) per week for overall health benefit, but the relative effects of concentrated vs more evenly distributed activity are unclear.ObjectiveTo examine associations between an accelerometer-derived “weekend warrior” pattern (ie, most MVPA achieved over 1-2 days) vs MVPA spread more evenly with risk of incident cardiovascular events.Design, Setting, and ParticipantsRetrospective analysis of UK Biobank cohort study participants providing a full week of accelerometer-based physical activity data between June 8, 2013, and December 30, 2015.ExposuresThree MVPA patterns were compared: active weekend warrior (active WW, ≥150 minutes with ≥50% of total MVPA achieved in 1-2 days), active regular (≥150 minutes and not meeting active WW status), and inactive (<150 minutes). The same patterns were assessed using the sample median threshold of 230.4 minutes or more of MVPA per week.Main Outcomes and MeasuresAssociations between activity pattern and incident atrial fibrillation, myocardial infarction, heart failure, and stroke were assessed using Cox proportional hazards regression, adjusted for age, sex, racial and ethnic background, tobacco use, alcohol intake, Townsend Deprivation Index, employment status, self-reported health, and diet quality.ResultsA total of 89 573 individuals (mean [SD] age, 62 [7.8] years; 56% women) who underwent accelerometry were included. When stratified at the threshold of 150 minutes or more of MVPA per week, a total of 37 872 were in the active WW group (42.2%), 21 473 were in the active regular group (24.0%), and 30 228 were in the inactive group (33.7%). In multivariable-adjusted models, both activity patterns were associated with similarly lower risks of incident atrial fibrillation (active WW: hazard ratio [HR], 0.78 [95% CI, 0.74-0.83]; active regular: 0.81 [95% CI, 0.74-0.88; inactive: HR, 1.00 [95% CI, 0.94-1.07]), myocardial infarction (active WW: 0.73 [95% CI, 0.67-0.80]; active regular: 0.65 [95% CI, 0.57-0.74]; and inactive: 1.00 [95% CI, 0.91-1.10]), heart failure (active WW: 0.62 [95% CI, 0.56-0.68]; active regular: 0.64 [95% CI, 0.56-0.73]; and inactive: 1.00 [95% CI, 0.92-1.09]), and stroke (active WW: 0.79 [95% CI, 0.71-0.88]; active regular: 0.83 [95% CI, 0.72-0.97]; and inactive: 1.00 [95% CI, 0.90-1.11]). Findings were consistent at the median threshold of 230.4 minutes or more of MVPA per week, although associations with stroke were no longer significant (active WW: 0.89 [95% CI, 0.79-1.02]; active regular: 0.87 [95% CI, 0.74-1.02]; and inactive: 1.00 [95% CI, 0.90-1.11]).Conclusions and RelevancePhysical activity concentrated within 1 to 2 days was associated with similarly lower risk of cardiovascular outcomes to more evenly distributed activity.

Physical Activity for Health—Every Minute Counts

“…In this issue of JAMA, Khurshid et al 9 examined the associations between an accelerometer-derived "weekend warrior" pattern in which 150 minutes or more of MVPA with 50% or more of total MVPA was achieved in 1 to 2 days per week vs 150 minutes or more of MVPA but not meeting the weekend warrior definition, with risk of incident atrial fibrillation, myocardial infarction, heart failure, and stroke among 89 573 participants in the UK Biobank. Compared with inactive adults, those with either pattern of physical activity accumulation showed similar, significantly reduced risk of all cardiovascular disease outcomes.…”

“…Compared with inactive adults, those with either pattern of physical activity accumulation showed similar, significantly reduced risk of all cardiovascular disease outcomes. 9 These results highlight the flexibility with which physical activity can be accumulated to achieve health benefits, which should further enhance opportunities for engagement for large segments of the population.…”

Associations of between‐ and within‐day patterns of physical activity accumulation with arterial stiffness and indices of microvascular health—Evidence from The Maastricht study

“…They found that compared to those who were inactive, participants who were insufficiently active, regularly active or “weekend warriors” all had a more favorable vascular health, with no difference between the regularly active or the “weekend warriors.” When looking at downstream cardiovascular events in the UK Biobank study, Kurshid et al 7 . similarly found that those who completed ≥150 min/week through being “active regularly” or “weekend warriors” both had lower risk of cardiovascular events compared to those who were inactive 7 . However, grouping people based on combinations of duration, intensity and frequency of PA makes it difficult to isolate the effect of PA pattern from overall PA volume, of which we know is beneficially associated with vascular health.…”

Kommentar zu „Auch ‚Weekend Warriors‘ reduzieren ihr kardiovaskuläres Risiko“

“…Nun wurde erstmals in einer sehr großen Untersuchung mit objektiver Messung der Aktivität mittels eines Akzelerometers ein ähnlich großer Gesundheitseffekt bezüglich einer großen Bandbreite kardiovaskulärer Endpunkte, einschließlich der Mortalität, gezeigt. Es machte keinen Unterschied, ob die Sporteinheiten über die Woche verteilt oder konzentriert auf das Wochenende stattfanden [4].…”