Recent studies have shown that a “weekend warrior” exercise pattern that focuses physical activity on one to two days a week provides similar heart health benefits as evenly distributed exercise throughout the week. Both active groups were shown to have a lower risk of heart-related disease compared to the inactive group.

Compared with inactivity, both weekend warriors or more evenly distributed physical activity patterns were associated with similarly lower risks of heart attack, heart failure, atrial fibrillation (abnormal heart rhythm), and stroke.

People who find it difficult to allocate time for exercise during their busy week may choose to focus moderate-to-vigorous physical activity on one or two days of the week, usually on weekends.

A recent study conducted by researchers at Massachusetts General Hospital (MGH) found that JAMAthis ‘weekend warrior’ pattern was associated with similar reductions in heart disease and stroke risk compared with more evenly distributed exercise throughout the week.

Current guidelines recommend at least 150 minutes of moderate-to-vigorous physical activity per week for overall health. However, it is unclear whether this intensive exercise has the same benefits as a more even distribution of activity over the course of the week.

Largest study on the subject

“Our analysis represents the largest study ever to address this question,” said lead author Shaan Khurshid, M.D., MPH, a faculty member at MGH’s Demouras Cardiac Arrhythmia Center.

Kulshid and colleagues analyzed data from 89,573 individuals from a prospective study in the UK Biobank. Study participants wore accelerometers on their wrists to record total physical activity and time spent at different intensities for a week.

Activity Patterns and Heart Health

Participants were classified into three categories. 33.7% were inactive (less than 150 minutes of moderate-to-vigorous physical activity per week), 42.2% were active weekend warriors (at least 150 minutes, at least half completed in 1-2 days), and 24.0% were active and regular (at least 150 minutes, most of the exercise spread over several days).

After adjusting for potential confounders, both active groups showed a similarly lower risk of heart attack compared with the inactive group (27% and 35% lower risk for weekend active fighters and active regulars, respectively, compared to the inactive group), heart failure (38% and 36% lower risk), atrial fibrillation (22% and 19% lower risk), and stroke (21% and 17% lower risk).

Implications and future research

“Our findings suggest that interventions to increase physical activity, even if concentrated within one to two days per week, may improve cardiovascular disease outcomes,” said senior author Patrick T. Eleanor, M.D., Ph.D., acting chief of cardiology at MGH and co-director of the Corrigan-Minehan Heart Center.

The researchers are also looking to assess whether activities such as weekend warriors lead to risk reduction for broader diseases.

Reference: Shaan Khurshid, MD, MPH, Physical Activity and Cardiovascular Disease Occurrence in ‘Weekend Warriors’ by Accelerometers. Mostafa A. Al-Arsi, MD. Timothy W. Churchill, MD. J. Sawara Guse, M.D., Patrick T. Eleanor, M.D., 18 July 2023, JAMA.
Doi: 10.1001/jama.2023.10875

Additional co-authors include Mostafa A. Al-Alusi, MD, Timothy W. Churchill, MD, and J. sawala Guseh, MD.

This work, National Institutes of HealthAmerican Heart Association, European Union, President and Fellow of Harvard University.




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