July 19, 2023 – It is well-known that exercise has a positive effect on health and specifically protects against heart disease. But how much exercise should people do? And how should they divide their exercise time?
Current guidelines (reminiscent of those of the World Health Organization and that American Heart Association) recommend at the least 150 minutes (2.5 hours) of moderate to vigorous physical activity per week to scale back the chance of heart problems and death, but these guidelines don't specify how these hours must be divided. The The British Health Service recommends Spread the exercises evenly over 4 to five days or do some every day.
The query is whether or not exercise is just as helpful when targeting one or two days. This is typically called the “weekend warrior” pattern because many individuals who can't exercise throughout the busy work week could make time to achieve this on the weekend.
A recent study has encouraging news for weekend athletes: What matters is the quantity of coaching and never the training pattern, even when the training sessions are usually not evenly distributed throughout the week.
Improvement of cardiovascular risk
Lead study creator Shaan Khurshid, MD, MPH, an instructor of drugs at Massachusetts General Hospital in Boston, explained the researchers' motivation for conducting the study.
“The weekend warrior pattern has been studied before, but usually based on self-reported data that may be biased or too small to examine specific cardiovascular effects,” Khurshid said. The researchers wanted a more objective measure of how much exercise individuals were actually doing, and likewise wanted to look at the query using a much larger sample.
To do that, they studied 89,573 participants within the UK Biobank, an enormous biomedical database and research resource that holds comprehensive genetic and health information on half one million people within the United Kingdom.
The average age of the participants was 62, and just over half were women. For one week, participants wore a tool on their wrist that recorded their total physical activity in addition to the time they spent doing different exercise intensities.
The researchers compared three training patterns:
- Active weekend warrior (at the least 150 minutes of sunshine to moderate physical activity, with the overall amount of coaching spread over 1 to 2 days)
- Active-regular (same amount of exercise, but spread over an extended time period)
- Inactive (lower than 150 minutes).
“We saw an opportunity to use the largest sample of measured activity to date to more accurately answer the question of whether activity patterns differentially affect certain major cardiovascular diseases,” said Khurshid.
Participants were followed for a median of 6.3 years to find out whether or not they had developed any of 4 forms of heart problems: atrial fibrillation, heart attack, heart failure and stroke.
Just over a 3rd of participants (33.7%) were classified as inactive, while almost a fifth (24%) were frequently lively. The largest percentage (42.2%) were lively weekend warriors.
After accounting for other aspects which will affect the chance of developing heart problems (reminiscent of age, gender, ethnicity, tobacco use, and health and weight loss program information), the researchers found that each exercise patterns were related to a lower risk of developing these conditions:
- Heart attack: 25% lower for lively weekend fighters, 35% lower for lively regular fighters
- Heart failure: 38% lower in lively weekend athletes, 36% lower in lively normal athletes
- Atrial fibrillation: 22% lower in lively weekend athletes, 19% lower in lively normal athletes
- Stroke: 21% lower for lively weekend fighters, 17% lower for lively regular
“The bottom line is that efforts to optimize activity, even if focused on just one or two days per week, are likely to result in improvements in cardiovascular risk profile,” Khurshid said.
Maintain good habits
Pinchas King, a 53-year-old publisher from Passaic, New Jersey, works out frequently.
“I try to exercise on the treadmill every day and start with high-intensity training,” he said.
King exercises for a lot of reasons. “It gives me constant energy and also has many health benefits, for example, it prevents cancer, heart disease and neurodegenerative diseases like Parkinson's,” he said.
He considers himself lucky that he can exercise frequently, but is aware that many individuals are usually not in a position to achieve this. “The results of this study sound good and for those who do not have time during the week, [to exercise]the study is useful,” he said.
However, he expressed concern that people who already exercise throughout the week “may quit this good habit and postpone exercise until the weekend, after which perhaps do no more or do lower than the really helpful amount.”
King believes the “2-day option” is a “good substitute whenever you need it” – for example, if you've been sick or particularly busy and couldn't train in a particular week. “But I feel it's higher if people find time to suit exercise into their each day routine, because for those who wait until the weekend, it is likely to be harder to do it.”
“Every minute counts”
According to the CDC, only 28% of adults in the United States exercise as much as recommended by guidelines.
One reason many people don't get enough exercise is because their busy schedules may not allow them time. Peter Katzmarzyk, PhD, associate executive director of population and health sciences at Pennington Biomedical Research Center in Baton Rouge, LA, said the study's results are encouraging for people in that situation.
“These findings are essential because they show that physical activity might be gathered in other ways throughout the week, giving busy people more options to get physical activity,” said Katzmarzyk, co-author of an accompanying editorial in which he writes, “Every minute counts” – especially among the three-quarters of U.S. adults who don't meet the recommended exercise goal.
Khurshid agrees. “Patients must be encouraged to realize the really helpful activity level and never discouraged if, for whatever reason, they'll only engage in dedicated exercise on one or a number of days per week,” he said. “Instead, our results suggest that it's the amount of activity relatively than the pattern of activity that matters.”