Accelerometer-Derived "Weekend Warrior" Physical Activity and All-Cause and Cause-Specific Mortality

To examine the association of "weekend warrior" (WW) pattern and physical activity distributed throughout the week with mortality risk.

In this cohort study of 95,468 participants in the UK Biobank from 2013 through 2015, participants were grouped by accelerometer-derived physical activity levels: inactive (moderate to vigorous physical activity [MVPA] <150 min/wk using World Health Organization guidelines), active WW (≥150 minutes of MVPA per week and ≥50% of total MVPA over 1 to 2 days), and active regular (≥150 minutes of MVPA but not active WW). Cox regression analyzed associations of activity patterns with all-cause mortality and 10 categories of cause-specific mortality and whether the association differed by sedentary time (≤6, 7 to 12, or ≥13 hours) and light physical activity (≤60, 61 to 150, or ≥151 min/d).

During the median 7.92 years of follow-up, 3539 deaths occurred. Compared with the inactive participants, the hazard ratio for all-cause mortality was 0.74 (95% CI, 0.68 to 0.82) in active regular participants and 0.72 (95% CI, 0.67 to 0.78) in active WW participants. Similar risk reductions were noted in most cause-specific deaths, especially for those from cancer, cardiovascular disease, and respiratory diseases. These benefits were more profound among participants with 13 or more hours of sedentary time (active regular: 0.58 [0.41 to 0.83]; active WW: 0.70 [0.55 to 0.88]) or 60 min/d or less of light physical activity (active regular: 0.59 [0.42 to 0.83]; active WW: 0.47 [0.35 to 0.63]). A similar reduction in all-cause mortality risk was observed across different age groups regardless of activity frequency and timing.

Physical activity evenly distributed throughout the week and concentrated within 1 to 2 days are both associated with similar lower risks of all-cause mortality and most categories of cause-specific mortality.