Abstract
BACKGROUND: Although guidelines on physical activity recommend at least 150 minutes of moderate-to-vigorous exercise weekly for optimal health outcomes, the distinction between concentrated and evenly distributed activity patterns remains unclear. We explored the relationships between accelerometer-measured weekend warrior and evenly spread moderate-to-vigorous physical activity (MVPA) and the risks of all-cause, cardiovascular disease, and cancer mortality. METHODS: Accelerometer-based physical activity data from the UK Biobank (Cohort 1 [June 8, 2013-December 30, 2015]: 89 488 individuals) and the US National Health and Nutrition Examination Survey (Cohort 2 [2003-2006]: 6198 individuals) were included in this study. Accelerometer-derived MVPA was categorized as inactive, weekend warrior, or regularly active. Activity patterns were further evaluated using population-specific MVPA thresholds at the 25th, 50th, and 75th percentiles. All-cause, cardiovascular disease, and cancer mortalities were ascertained from death certificates. RESULTS: Over median follow-up periods of 6.9 and 6.0 years, we recorded 3759 and 1404 deaths in Cohorts 1 and 2, respectively. Compared with inactivity, both activity patterns, at ≥150 minutes of MVPA per week, were correlated with similarly lower risks of all-cause, cardiovascular disease, and cancer mortality at any threshold in both cohorts. These findings were consistent at the 25th percentile threshold and higher for MVPA per week. CONCLUSIONS: Physical activity concentrated within 1 to 2 days is associated with reduced risks of all-cause, cardiovascular, and cancer mortality, with benefits comparable with those of activity spread more evenly throughout the week.