Abstract
ObjectiveWeekend warrior physical activity (PA) is an emerging pattern associated with health benefits comparable to regular activity. This prospective cohort study investigated the association between weekend warrior PA and all-cause and cardiovascular disease (CVD) mortality in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD), using linked mortality data from NHANES 2007-2018.MethodsPA patterns were classified based on recommended total PA duration (≥150 min/week) and sessions. Weekend warrior PA was defined as achieving this in 1-2 sessions, while regularly active individuals completed ≥3 sessions. MASLD was identified via hepatic steatosis (Fatty Liver Index) and metabolic disturbances.ResultsAmong 10,410 participants with MASLD, meeting recommended PA duration was associated with lower all-cause and CVD mortality versus inactivity. PA frequency inversely correlated with mortality risk up to limited sessions, with no further gains from excess. In fully adjusted models, weekend warrior PA was associated with lower all-cause (HR 0.423, 95% CI 0.233-0.767) and CVD mortality (HR 0.172, 95% CI 0.044-0.677) compared to inactivity. Versus regularly active, it showed no increased risk for all-cause (HR 0.713, 95% CI 0.383-1.329) or CVD mortality (HR 0.261, 95% CI 0.070-1.372). The all-cause mortality benefit was evident only in those aged <60 years.ConclusionsWeekend warrior PA was associated with significantly lower all-cause and CVD mortality in MASLD patients, offering benefits comparable to regular PA, particularly for those under 60. This supports it as a practical option associated with lower mortality.