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 the association between physical activity and health in weekend warriors who perform all their exercise in 1 or 2 sessions per week. OBJECTIVE To investigate associations between the weekend warrior and other physical activity patterns and the risks for all-cause, cardiovascular disease (CVD), and cancer mortality. DESIGN, SETTING, AND PARTICIPANTS This pooled analysis of household-based surveillance studies included 11 cohorts of respondents to the Health Survey for England and Scottish Health Survey with prospective linkage to mortality records. Respondents 40 years or older were included in the analysis. Data were collected from 1994 to 2012 and analyzed in 2016. EXPOSURES Self-reported leisure time physical activity, with activity patterns defined as inactive (reporting no moderate-or vigorous-intensity activities), insufficiently active (reporting < 150 min/wk in moderate-intensity and < 75 min/wk in vigorous-intensity activities), weekend warrior (reporting >= 150 min/wk in moderate-intensity or >= 75 min/wk in vigorous-intensity activities from 1 or 2 sessions), and regularly active (reporting >= 150 min/wk in moderate-intensity or >= 75 min/wk in vigorous-intensity activities from >= 3 sessions). The insufficiently active participants were also characterized by physical activity frequency. MAIN OUTCOMES AND MEASURES All-cause, CVD, and cancer mortality ascertained from death certificates. RESULTS Among the 63 591 adult respondents (45.9% male; 44.1% female; mean [SD] age, 58.6 [11.9] years), 8802 deaths from all causes, 2780 deaths from CVD, and 2526 from cancer occurred during 561 159 person-years of follow-up. Compared with the inactive participants, the hazard ratio (HR) for all-cause mortality was 0.66 (95% CI, 0.62-0.72) in insufficiently active participants who reported 1 to 2 sessions per week, 0.70 (95% CI, 0.60-0.82) in weekend warrior participants, and 0.65 (95% CI, 0.58-0.73) in regularly active participants. Compared with the inactive participants, the HR for CVD mortality was 0.60 (95% CI, 0.52-0.69) in insufficiently active participants who reported 1 or 2 sessions per week, 0.60 (95% CI, 0.45-0.82) in weekend warrior participants, and 0.59 (95% CI, 0.48-0.73) in regularly active participants. Compared with the inactive participants, the HR for cancer mortality was 0.83 (95% CI, 0.73-0.94) in insufficiently active participants who reported 1 or 2 sessions per week, 0.82 (95% CI, 0.63-1.06) in weekend warrior participants, and 0.79 (95% CI, 0.66-0.94) in regularly active participants. CONCLUSIONS AND RELEVANCE Weekend warrior and other leisure time physical activity patterns characterized by 1 or 2 sessions per week may be sufficient to reduce all-cause, CVD, and cancer mortality risks regardless of adherence to prevailing physical activity guidelines.