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The weekend warrior phenomenon: comparable mortality reduction to regular exercise with enhanced neuroprotective
Xiaoyue Zhang1,2, Peiyuan Tang1,3, Ying Zhu1,2
1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China, Hunan, 410008.
Background:
The "weekend warrior" (WW) physical activity pattern-characterized by low-frequency, high-intensity exercise concentrated in 1-2 sessions per week-has gained popularity, yet its health implications remain controversial. This systematic review and meta-analysis aim to evaluate the benefits and risks of the WW pattern compared to regular or inactive PA regimens, focusing on mortality, cardiometabolic and neurological outcomes.
Methods:
Two independent investigators searched PubMed, Embase, Cochrane Library, and Web of Science for studies published from 01/01/1975 to 01/22/2025. Eligible studies compared health outcomes among WW, regularly active (RA), and inactive populations were included. Outcomes included all-cause/cause-specific mortality, cardiovascular disease (CVD), metabolic disorders, and neurological conditions. Pooled hazard ratios (HR) and odds ratios (OR) were calculated by either random-effects model or fixed-effects model, depending on heterogeneity.
Results:
Among the 21 included studies (14 cohort, 7 cross-sectional), WW was associated with reduced all-cause mortality risk versus inactive population (HR = 0.77; 95% CI: 0.68-0.87, P < 0.0001), comparable to the benefit observed with RA (HR = 0.70; 95% CI: 0.63-0.78, P < 0.00001). WW was also linked to reduced risks of CVD mortality (HR = 0.80; 95% CI: 0.66-0.97), cancer mortality (HR = 0.85; 95% CI: 0.77-0.95), and incident CVD (HR = 0.73; 95% CI: 0.64-0.82) when compared with inactivity. Notably, WW conferred greater neuroprotective effects than RA (HR = 0.71 vs. 0.76; P < 0.00001), with a substantial risk reduction compared with inactivity (HR = 0.71; 95% CI: 0.65-0.77). Risk of metabolic disease in WW showed a modest decrease (OR = 0.75; 95% CI: 0.65-0.88, P = 0.0004), although no significant improvements were observed in individual metabolic indices.
Conclusion:
Compared with inactivity, the WW pattern offers mortality and cardiometabolic benefits comparable to regular activity, along with uniquely enhanced neuroprotective effects, supporting its viability for time-constrained individuals.
Trial Registration:
PROSPERO: CRD42024583406.
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