Association of “Weekend Warrior” and other leisure time physical activity patterns with risks for all-cause, cardiovascular disease, and cancer mortality

Importance: More research is required to clarify relationships between physical activity and health in ‘weekend warriors’ who do all their exercise in one or two sessions per week. Objective: The main objective was to investigate associations between the weekend warrior and other physical activity patterns and the risks of all-cause, cardiovascular disease (CVD), and cancer mortality. Design: Health Survey for England and Scottish Health Survey with prospective linkage to mortality records. Setting: Eight general population household-based surveys. Participants: 63,591 adults; 45.9% male; 58.6±11.9 years (mean±SD). Exposures: Self-reported leisure-time physical activity, with activity patterns defined as ‘inactive’ (not reporting any moderate- or vigorous-intensity activities), ‘insufficiently active’ (reporting <150 min·wk-1 in moderate- and <75 min·wk-1 in vigorous-intensity activities), ‘weekend warrior’ (reporting ≥150 min·wk-1 in moderate- or ≥75 min·wk-1 in vigorous-intensity activities from one or two sessions), and ‘regularly active’ (reporting ≥150 min·wk-1 in moderate- or ≥75 min·wk-1 in vigorous-intensity activities from three or more sessions). The insufficiently active were also characterized by physical activity frequency. Main outcomes and measures: All-cause, CVD, and cancer mortality ascertained from death certificates. Results: There were 8,802 deaths from all causes, 2,780 from CVD, and 2,526 from cancer during 561,159 person-years of follow-up. Compared with the inactive, all-cause mortality hazard ratio was 0.66 (95% CI: 0.62, 0.72) in the insufficiently active who reported one or two sessions per week, 0.70 (0.60, 0.82) in weekend warriors, and 0.65 (0.58, 0.73) in the regularly active. Compared with the inactive, CVD mortality hazard ratio was 0.60 (0.52, 0.69) in the insufficiently active who reported one or two sessions per week, 0.60 (0.45, 0.82) in weekend warriors, and 0.59 (0.48, 0.73) in the regularly active. Compared with the inactive, cancer mortality hazard ratio was 0.83 (0.73, 0.94) in the insufficiently active who reported one or two sessions per week, 0.82 (0.63, 1.06) in weekend warriors, and 0.79 (0.66, 0.94) in the regularly active. Conclusions and relevance: Weekend warrior and other leisure-time physical activity patterns characterized by one or two sessions per week may be sufficient to reduce all-cause, CVD and cancer mortality risks regardless of adherence to prevailing physical activity guidelines.