Dual Cohort Insights Into Accelerometer‐Derived Weekend Warrior Physical Activity and Its Impact on Mortality

Background Although guidelines on physical activity recommend at least 150 minutes of moderate‐to‐vigorous exercise weekly for optimal health outcomes, the distinction between concentrated and evenly distributed activity patterns remains unclear. We explored the relationships between accelerometer‐measured weekend warrior and evenly spread moderate‐to‐vigorous physical activity (MVPA) and the risks of all‐cause, cardiovascular disease, and cancer mortality. Methods Accelerometer‐based physical activity data from the UK Biobank (Cohort 1 [June 8, 2013–December 30, 2015]: 89 488 individuals) and the US National Health and Nutrition Examination Survey (Cohort 2 [2003–2006]: 6198 individuals) were included in this study. Accelerometer‐derived MVPA was categorized as inactive, weekend warrior, or regularly active. Activity patterns were further evaluated using population‐specific MVPA thresholds at the 25th, 50th, and 75th percentiles. All‐cause, cardiovascular disease, and cancer mortalities were ascertained from death certificates. Results Over median follow‐up periods of 6.9 and 6.0 years, we recorded 3759 and 1404 deaths in Cohorts 1 and 2, respectively. Compared with inactivity, both activity patterns, at ≥150 minutes of MVPA per week, were correlated with similarly lower risks of all‐cause, cardiovascular disease, and cancer mortality at any threshold in both cohorts. These findings were consistent at the 25th percentile threshold and higher for MVPA per week. Conclusions Physical activity concentrated within 1 to 2 days is associated with reduced risks of all‐cause, cardiovascular, and cancer mortality, with benefits comparable with those of activity spread more evenly throughout the week.