Accelerometer-Derived "Weekend Warrior" Physical Activity and All-Cause and Cause-Specific Mortality

Objective: To examine the association of "weekend warrior" (WW) pattern and physical activity distributed throughout the week with mortality risk. Participants and Methods: In this cohort study of 95,468 participants in the UK Biobank from 2013 through 2015, participants were grouped by accelerometer-derived physical activity levels: inactive (moderate to vigorous physical activity [MVPA] <150 min/wk using World Health Organization guidelines), active WW (>= 150 minutes of MVPA per week and >= 50% of total MVPA over 1 to 2 days), and active regular (>= 150 minutes of MVPA but not active WW). Cox regression analyzed associations of activity patterns with all-cause mortality and 10 categories of cause-specific mortality and whether the association differed by sedentary time ( <= 6, 7 to 12, or >= 13 hours) and light physical activity ( <= 60, 61 to 150, or >= 151 min/d). Results: During the median 7.92 years of follow-up, 3539 deaths occurred. Compared with the inactive participants, the hazard ratio for all-cause mortality was 0.74 (95% CI, 0.68 to 0.82) in active regular participants and 0.72 (95% CI, 0.67 to 0.78) in active WW participants. Similar risk reductions were noted in most cause-specific deaths, especially for those from cancer, cardiovascular disease, and respiratory diseases. These benefits were more profound among participants with 13 or more hours of sedentary time (active regular: 0.58 [0.41 to 0.83]; active WW: 0.70 [0.55 to 0.88]) or 60 min/d or less of light physical activity (active regular: 0.59 [0.42 to 0.83]; active WW: 0.47 [0.35 to 0.63]). A similar reduction in all-cause mortality risk was observed across different age groups regardless of activity frequency and timing. Conclusion: Physical activity evenly distributed throughout the week and concentrated within 1 to 2 days are both associated with similar lower risks of all-cause mortality and most categories of cause (c) 2024 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights are reserved, including those for text and data