Study Explores Patterns of Exercise and Disease Risk
Key Findings
- New research shows that "weekend warriors" derive the same lower disease risk from exercise as people who exercise more frequently throughout the week
- This concentrated pattern of exercise led to a significantly lower risk of 264 diseases, as compared with people who did not exercise regularly
- Physical activity was associated with lower risk of cardiometabolic disease and many other conditions throughout the body
New research from Massachusetts General Hospital shows that "weekend warriors" have a substantially lower risk of 264 diseases compared with people who are inactive. The study found that concentrating physical activity into longer sessions only one or two days a week is just as beneficial as spreading activity more evenly throughout the week.
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"For various reasons, more and more people are adopting more of a concentrated activity pattern. If the benefits were different, it would be important to know that," says Shaan Khurshid, MD, MPH, a cardiac electrophysiologist at Mass General. "We found that with regard to disease risk, it's the total volume of physical activity that appears to matter the most, rather than the pattern."
Weekend Warriors and Exercise Guidelines
National and international guidelines recommend 150 minutes of moderate to vigorous exercise every week. This level is associated with a lower risk of cardiovascular disease, cancer, and other conditions.
Many Americans are weekend warriors, defined as people who get the recommended 150 minutes of moderate to vigorous exercise — but achieve at least 50% of their total weekly activity in only one or two days.
However, many healthcare providers and some official guidelines, such as those from the National Health Service in the United Kingdom, encourage people to distribute that activity over five days a week for about 30 minutes a day. Dr. Khurshid says that advice is more reflexive and perhaps intuitive — but not backed by evidence.
Both Patterns of Exercise Reduce the Risk of Many Diseases
Dr. Khurshid's study, published in Circulation, assessed the effects of different exercise patterns on 678 unique diseases. The study enrolled almost 90,000 people, who wore activity trackers on their wrists for one week. The researchers established three groups based on their patterns of physical activity: inactive, weekend warrior activity, and regular activity. After an average follow-up of six years, the researchers analyzed the incidence of the 678 diseases and compared those rates among the three cohorts.
The group who participated in regular activity and weekend warriors both had substantially lower rates of many of the diseases. The strongest associations were cardiometabolic diseases such as diabetes, hypertension, sleep apnea, and obesity. But the study also saw strong associations across the spectrum, including chronic kidney disease, gallstones, esophageal diseases, mental health disorders such as anxiety, and more.
Weekend warriors did not have a higher risk of any disease than more frequent exercisers.
Support for Activity That Fits People's Lifestyles
These findings support the well-established guidance that people get the recommended volumes of physical activity.
"However, our study shows that the pattern in which you get that activity doesn't appear to matter as much for disease risk and overall health. The pattern in which you do so can be dictated more by your lifestyle and what works for you, whatever helps you be successful and consistent," Dr. Khurshid says. "This can manifest itself in a variety of ways: for example, skiing for a day, playing soccer in a game that lasts two hours, or going for a long run on Saturday."
For many healthcare providers and patients, this may be a significant shift in thinking. Based on this new evidence, healthcare providers need not prescribe a particular schedule with specific frequencies and durations.
Dr. Khurshid also recently published research in the Journal of the American College of Cardiology showing that high levels of sedentary behavior increase the risk of cardiovascular conditions and death — even in people who also get the recommended amount of exercise per week. He encourages healthcare providers to use the new information to provide more specific information to their patients to enhance current guidance on exercise.
Expanding Understanding of Exercise and Disease
Mass General is an ideal place to conduct this kind of work, Dr. Khurshid adds.
"To do research like this, you need collaborations with other clinical researchers, machine learning engineers, people with robust experience in epidemiology and cutting-edge methods. At Mass General and the Eli and Edythe L. Broad Institute of MIT and Harvard, teams with varying levels of background and experience collaborate to execute projects like this."
In the future, he would like to expand this line of research. He says additional studies may ask subjects to wear activity trackers for longer periods of time to better capture long-term exercise patterns. He also would like to extend the follow-up to assess the long-term incidence of diseases among cohorts with differing activity habits.