Being physically active, even just a couple of days a week, may be key to better health

"You don't need to exercise every day to stay healthy. As long as you get 150 minutes of moderate to vigorous physical activity per week -- whether packed into one to two days or spread out -- you can significantly reduce your risk of dying from cardiovascular disease, cancer or other causes," said study corresponding author Zhi-Hao Li, Ph.D., an epidemiologist in the School of Public Health at Southern Medical University in Guangzhou, China.

"This message is encouraging news for busy people who struggle to fit in daily workouts but can manage a concentrated burst of activity on weekends or over a couple of days," Li said. "The research provides reassuring evidence that even sporadic physical activity can have lasting health benefits, making it easier for people to prioritize their well-being amid busy schedules."

To achieve health benefits, both the World Health Organization and the American Heart Association recommend that throughout a week adults engage in 150 to 300 minutes of moderate-intensity aerobic physical activity, or 75 to 150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate and vigorous-intensity activity.

Researchers examined health and physical activity data for more than 93,000 people in a large biomedical database in the U.K. to explore how different physical activity patterns may affect the risk of dying from all causes, specifically cardiovascular disease and cancer. They reviewed physical activity data collected from wrist accelerometers, devices that measure movement and are likely more accurate than asking participants about their activity.

The study categorized the data into three groups: "active weekend warrior" -- people who completed most of their exercise in one or two days; "active regular" -- those who spread their activity throughout the week; and "inactive" -- participants who did not complete the recommended minimum of 150 minutes of weekly physical activity.

Compared to the inactive group, the weekend warrior and active regular groups had a significantly lower risk of death from all causes, cardiovascular disease and cancer if they completed 150 minutes of physical activity a week.

The analysis also found:

• For weekend warriors, the risk of death from all causes was 32% lower; the risk of death from cardiovascular disease was 31% lower; and the risk of death from cancer was 21% lower.
• Among participants in the active regular group, the risk of death from all causes was 26% lower; the risk of death from cardiovascular disease was 24% lower; and the risk of death from cancer was 13% lower.
• No significant differences in the risk of death surfaced between the weekend warrior vs. the active regular group.

While the new research aligns with previous studies, it is the first to analyze the relationship between physical activity patterns measured by accelerometers and the risk of death from cardiovascular disease and cancer.

Some of the findings surprised the research team, who initially expected that spreading activity throughout the week would be more beneficial. They did not anticipate that weekend warriors' condensed physical activity would reduce the risk of death from disease.

"This reinforces the idea that meeting the 150-minutes of physical activity per week guideline is key to longevity, regardless of the activity pattern," Li said. "Any activity -- whether structured exercise such as jogging or daily tasks such as gardening -- can be included if the intensity is moderate to vigorous."

American Heart Association expert volunteer Keith Diaz, Ph.D., said the findings emphasize that the total volume of physical activity is the crucial factor for health benefits, rather than how it is distributed across a week. Diaz, the Florence Irving Associate Professor of Behavioral Medicine at Columbia University Medical Center in New York, was not involved in this research.

"Many people struggle to fit in daily exercise during the workweek; however, this research shows that even if you can only be active on the weekends, you can still gain meaningful health benefits," said Diaz, a member of the Association's Physical Activity Science Committee.

"One important caveat to remember is that trying to fit 150 minutes of exercise into just one or two days can be a lot on your body," he added. "Some research suggests that weekend warriors have a slightly higher risk of musculoskeletal injuries compared to those who exercise more regularly. However, the benefits of exercising just on the weekend far outweigh the potential risks. If you are going to be a weekend warrior, make sure you do proper warm-ups and build up and progress to higher volumes of activity over time. This will help to reduce your risk of injuries."

The study had several limitations, including that physical activity was only measured at baseline; participants lived in the U.K. and most were white, so the results may not apply to other populations. The researchers said future studies should be conducted to confirm these results in more diverse groups of people throughout the world and with more consideration for contradictory factors such as genetic predisposition or environmental exposures that may influence physical activity and the outcomes.

Study details, background and design:

• The research data focused on seven days of accelerometer-measured physical activity from 2013 to 2015 for 93,409 participants, aged 37 to 73, enrolled in the UK Biobank.
• More than 56% of the participants were women, 97% were white and their average age was 62 years old.
• Based on accelerometer data, more than 42% of participants were classified as weekend warrior, about 24% as active regular and nearly 34% as inactive.
• The accelerometers captured a range of activities, including walking, jogging, stationary cycling, elliptical exercises, household chores, gardening and leisure activities such as dancing.
• During eight years of follow-up, nearly 4,000 adults died from all causes, including about 17% from cardiovascular disease and about 45% from cancer.
• Compared to the inactive participants, those who exercised during two days each week were more likely to be men, younger, have a college degree, non-smokers, non-drinkers, less likely to have Type 2 diabetes and/or to have lower body mass index (an indicator of body fat to determine healthy weight).