Cardiovascular Disease / Exercise / Mortality

The Wisdom of Weekend Warriors

I was recently talking to a colleague of mine (Hi Dan!) who uttered this phrase: “I do nothing during the week anymore.”  He’s an avid runner who, because of the increased demands of family and work, is currently running only on Saturdays and Sundays.  I conducted a quick internal judgement question: Witless or wise?

Graph  taken from Metzer et al. MSSE 2008According to NHANES 2003-2004 data, there are five classes of exercisers in the U.S., grouped by how many minutes of moderate to vigorous physical activity (MVPA) they obtain each day. Sadly, while about half (56.1%) of Americans get little to no MVPA each day, there are additional physical activity patterns that classify the remaining adults: avid exercisers who get 90 minutes of MVPA every day with even more on the weekends (0.6%); moderate exercisers who get 30-60 minutes of MVPA almost every day (4%), and the weekend warriors, who get the bulk of their MVPA on weekends (1.8%).

Graph taken from Kruger et al. MSSE 2007The actual definition of a weekend warrior is one who gets > 150 min of MVPA in 2 days.  These folks tend to be largely male, often middle-aged individuals who report struggling to balance the demands of life and work during the weekday with their desire to be physically active. So, they make up for it big time on the weekends. Again, this begs the question: is this a healthy approach?

Common criticisms of the weekend warrior lifestyle are that risk of overuse injury is higher, the effect of training may be reduced, and the impact of exercise on outcomes such as weight control and disease risk may be less if exercise is only performed 2 consecutive days/week. While there’s not a substantial body of work on this topic– not surprising given how few adults fall into the weekend warrior category– there are some studies that can address these questions.

Graph taken from Gettman et al. Res Q 1976For example, one study looked at the impact of 12 weeks of exercise training on changes in VO2max (maximal oxygen uptake, or the primary indicator of aerobic fitness). In this study there was a control group, a standard exercise training group (5 bouts of 30 min exercise training/day conducted over the course of a week), and a weekend warrior group (2 bouts of 75 min exercise training/ day over two consecutive days each week). At the end of 12 weeks, improvements in VO2max were similar in both exercise groups, showing that the weekend warrior group successfully improved aerobic fitness using this training method. Interestingly, injury rates and compliance to the training protocol were also not different between the two groups. Although this was only a 12 week study, these results indicate that two other concerns– that weekend warriors run a higher likelihood of injury and may also be at greater risk of “falling off the exercise wagon” into physical inactivity– may be unfounded, at least over the short-term.

Graph taken from Lee et al. 2004 American Journal of EpidemiologyMore importantly, data from the 12,000+ men in the Harvard Alumni Health Study (a sample in which approximately 7% of subjects were weekend warriors) suggest that in low-risk men (those at low risk for cardiovascular disease), a regular pattern of physical activity (expending approximately 1000 calories/week) is protective against mortality regardless of whether it occurs over the entire week or over the course of 2 days.  By contrast, in men at high risk of cardiovascular disease (with high blood pressure, cholesterol, body weight, family history, etc.), the weekend warrior pattern of physical activity is not effective at reducing mortality (in contrast to regular daily physical activity), perhaps in part because these higher risk individuals require the benefits conferred by acute daily bouts of exercise.

So, there you have it (…Dan)!  Being a weekend warrior is far more beneficial than being a Saturday-Sunday sloth, so own the title with pride.

Oh yes, and the term Witless or Wise? Comes from a great song:

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