https://doi.org/10.1007/s00392-024-02526-y
1Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland; 2Broad Institute of MIT and Harvard Cardiovascular Disease Initiative Cambridge, USA; 3Massachusetts General Hospital Cardiology Division Boston, USA; 4Broad Institute of MIT and Harvard Data Sciences Platform Cambridge, USA
Background:
Achievement of guideline-recommended levels of physical activity (PA)—150 minutes or more of moderate-to-vigorous physical activity (MVPA) per week—is associated with lower risk of adverse cardiovascular events and represents an important public health priority. Although PA commonly follows a “weekend warrior” pattern, in which most MVPA is concentrated in 1-2 days rather than spread more evenly across the week (regular), the effects of PA pattern across a range of incident diseases, including cardiometabolic conditions, is unknown.
Methods:
We tested associations between PA pattern and incidence of 678 conditions in 89,573 UK Biobank participants (age 62±8 years; 56% women) who wore an accelerometer for one week. We tested the association of weekend warrior activity with clinical outcomes using various definitions. All models were adjusted for multiple baseline clinical factors and p-value thresholds were corrected for multiplicity.
Results:
When compared to inactive (<150 minutes MVPA/week), both weekend warrior (267 total associations, 264 [99%] with lower disease risk, hazard ratio [HR] range 0.35-0.89) and regular activity (209 associations, 205 [98%] with lower disease risk, HR range 0.41-0.88) were broadly associated with lower risk of incident disease. The strongest associations were observed for cardiometabolic conditions such as incident hypertension (weekend warrior: HR 0.77, 95% CI 0.73-0.80, p=1.2×10-27; regular: HR 0.72, 95% CI 0.68-0.77, p=4.5×10-28), type 2 diabetes (weekend warrior: HR 0.55, 95% CI 0.50-0.61, p=1.2×10-28; regular: HR 0.49, 95% CI 0.43-0.56, p=2.6×10-26), obesity (weekend warrior: HR 0.55, 95% CI 0.50-0.60, p=2.4×10-43, regular: HR 0.44, 95% CI 0.40-0.50, p=9.6×10-47) and sleep apnea (weekend warrior: HR 0.57, 95% CI 0.48-0.69, p=1.6×10-9; regular: HR 0.49, 95% CI 0.39-0.62, p=7.4×10-10). When compared directly, there were no conditions for which the effects of weekend warrior versus regular activity differed. Observations were similar when activity was defined using the sample median threshold (≳230.4 minutes of MVPA/week) or different thresholds for activity distribution.
Conclusion:
Achievement of measured PA volumes consistent with guideline recommendations is associated with lower risk for over 200 diseases, with prominent effects on cardiometabolic conditions. Associations were similar regardless of whether PA followed a weekend warrior versus regular pattern. Future studies are warranted to assess the potential value of concentrated physical activity interventions to improve public health.