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"Weekend Warrior" Exercise Pattern Protects Against MASLD and Mortality Comparable to Regular Exercise: National

Shira Zelber-Sagi1,2, James M Paik1,3, Dana Ivancovsky-Wajcmen1

  • 1The Global NASH Council, Washington, DC, USA.

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|July 28, 2025
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Summary
This summary is machine-generated.

Weekend warrior (WW) physical activity patterns, engaging in moderate-to-vigorous activity 1-2 days weekly, significantly reduce metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence and mortality. This pattern offers comparable protection to regular exercise for MASLD patients.

Keywords:
ASCVD riskMASLDactivityexercisemortality

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Area of Science:

  • Hepatology
  • Cardiology
  • Public Health

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) guidelines advocate for >150 minutes of weekly moderate-to-vigorous physical activity (MVPA).
  • The efficacy of the "weekend warrior" (WW) physical activity pattern, concentrating MVPA into 1-2 days, versus spreading it throughout the week for MASLD management remains unclear.

Purpose of the Study:

  • To evaluate the association between the WW activity pattern and MASLD prevalence.
  • To assess the impact of the WW pattern on mortality and atherosclerotic cardiovascular disease (ASCVD) risk in individuals with MASLD.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Survey (2003-2006) linked to mortality records through 2019.
  • Categorized participants into WW, active, and inactive groups based on accelerometer-measured MVPA.
  • Defined MASLD using the United States Fatty Liver Index (US FLI) ≥30 with at least one cardiometabolic risk factor.

Main Results:

  • Both WW and active groups exhibited lower odds of MASLD compared to the inactive group (WW OR: 0.36; active OR: 0.47).
  • Among MASLD patients, the WW pattern was associated with lower all-cause mortality (HR: 0.35) and reduced odds of high ASCVD risk (OR: 0.27).
  • The active group also showed benefits in mortality (HR: 0.48) and ASCVD risk (OR: 0.39) compared to inactive individuals.

Conclusions:

  • The weekend warrior physical activity pattern demonstrates protective effects against MASLD.
  • This concentrated activity pattern offers comparable benefits to regular, spread-out exercise regarding MASLD prevalence, mortality, and ASCVD risk.