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Association of "Weekend Warrior" Physical Activity with visceral and pericardial adipose tissue

https://doi.org/10.1007/s00392-025-02625-4

Shinwan Kany (Hamburg)1, M. Al-Alusi (Boston)2, J. Ramo (Cambridge)3, J. Pirruccello (Cambridge)3, E. Ajufo (Cambridge)3, T. Churchill (Cambridge)3, S. Lubitz (Boston)2, M. Maddah (Cambridge)3, J. S. Guseh (Boston)2, P. Ellinor (Boston)2, S. Khurshid (Boston)2

1Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland; 2Massachusetts General Hospital Boston, USA; 3Broad Institute of MIT and Harvard Cambridge, USA

 

Background: Attaining guideline-recommended levels of physical activity is associated with substantially lower risks of cardiometabolic diseases such as obesity or diabetes mellitus. Although physical activity commonly follows a weekend warrior pattern, in which most moderate-to-vigorous physical activity is concentrated in 1-2 days rather than spread more evenly across the week (regular), the effects of activity pattern on imaging-based biomarkers of cardiometabolic health are unknown.


Methods: Physical activity of 17,146 UK Biobank participants wore accelerometers for one week and later underwent cardiac and abdominal MRI was categorized as "weekend warrior" or "regular" based on accelerometer data. Associations with MRI-derived visceral adipose tissue (VAT [L]) and epi-and pericardial adipose tissue (EPAT [cm²]) were investigated and adjusted for lifestyle and demographic factors.


Results: Compared to inactive people, VAT was progressively lower with weekend warrior (-0.71 L, 95% CI -0.78 to -0.64, p=5.50×10-92) followed by regular activity (-0.96 L, 95% CI -1.04 to -0.88, p=5.9×10-118). We observed similar associations for EPAT (weekend warrior activity -2.84 cm2, 95% CI -3.20 to -2.49, p=2.7×10-55; regular activity -3.62 cm2, 95% CI -4.03 to -3.20, p=2.3×10-64). When compared directly, weekend warriors had modestly higher adipose tissue than regular activity (VAT difference 0.25 L, 95% CI 0.17 to 0.32, p=3.3×10-11; EPAT 0.78 cm2, 95% CI 0.40 to 1.15, p=4.9×10-05). No differences were observed after adjustment for total MVPA minutes (VAT 0.07 L, 95% CI -0.01 to 0.14, p=0.09; EPAT 0.04 cm2, 95% CI -0.35 to 0.43, p=0.84).


Conclusion: Guideline-adherent physical activity is associated with favorable quantitative measures of cardiometabolic health, with no differences based on activity pattern for a given activity volume. Volume of physical activity, not the way it is achieved, is associated with cardiometabolic health.



Figure 1 depicts the main findings of the study in a sample of 17,146 individuals who had accelerometer-derived physical activity measurement and quantification of MRI-derived visceral adipose tissue (VAT, N=14,903) and epi/-pericardial adipose tissue (EPAT, N=17,146).



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