Association of physical activity patterns including "weekend warrior" with mortality in adults with chronic lower...

Chronic lower respiratory diseases (CLRD), including asthma, COPD, and asthma-COPD overlap (ACO), are significant public health challenges. Physical activity (PA) is a key non-pharmacological intervention, but adherence to regular exercise is often poor. The "weekend warrior" (WW) pattern, involving concentrated exercise over weekends, may be a practical alternative. This study investigates the associations of different PA patterns with mortality in adults with CLRD using data from the National Health and Nutrition Examination Survey (NHANES).

We analyzed data from 17,152 participants aged ≥ 20 years from NHANES (2007-2018). PA patterns were categorized as inactive (IA), insufficiently active (Insuff-A), weekend warrior (WW), and regularly active (RA). Disease status was determined via self-reported physician diagnoses. Mortality outcomes were linked to the National Death Index. Cox proportional hazards regression models were used to assess associations between PA patterns and mortality, adjusting for demographic, lifestyle, and clinical covariates.

In the non-disease population, the regularly active (RA) pattern was associated with significantly lower all-cause (HR = 0.63, 95% CI 0.50-0.79) and non-cardiovascular mortality (HR = 0.66, 95% CI 0.49-0.89) compared with the inactive (IA) group. Among COPD patients, the insufficiently active (Insuff-A) pattern showed a significant reduction in all-cause (HR = 0.35, 95% CI 0.17-0.74) and non-cardiovascular mortality (HR = 0.34, 95% CI 0.15-0.79) compared with IA. The "weekend warrior" (WW) pattern demonstrated a non-significant mortality trend compared with IA, likely due to the small sample size.

Regular physical activity significantly reduces mortality risk in both healthy individuals and those with COPD. Even activity below recommended levels confers some benefits.