The Impact of Concentrated Weekend Physical Activity on Cardiovascular Health: Insights from a JAMA Study

2023-09-01 03:02:47

Why is this important?

American and WHO recommendations encourage the practice of moderate-intensity endurance physical activity for a minimum of 150 minutes per week to reduce cardiovascular morbidity and mortality. In France and for adults, ANSES recommends the practice of 30 minutes of physical activity of moderate to high intensity, at least 5 days a week, avoiding staying 2 consecutive days without practicing 2. But that in of the distribution of physical activity over the week in terms of benefits on cardiovascular health? In other words, is concentrating your physical activity time on the weekend as effective as regular physical activity throughout the week? This question was the subject of a retrospective cohort study published in the journal JAMA.

Methodology

From the UK Biobank prospective cohort, 502,629 participants were enrolled. Among them, 103,695 subjects participated in a sub-study aimed at measuring physical activity by wearing a wrist accelerometer for a week. Participants were stratified according to their physical activity profile: moderate-to-vigorous intensity physical activity ≥150 minutes per week performed on weekends (≥50% of total activity performed over 1 or 2 days), regularly throughout the week, or not performed (physical activity <150 minutes/week).

Then the association between physical activity profile and the incidence of various self-reported cardiovascular events (atrial fibrillation – AF –, myocardial infarction, heart failure and stroke) was studied following adjustment on the age, gender, ethnicity, smoking status, alcohol consumption, Townsend’s material and social deprivation index, occupational status, self-reported health and diet quality.

Principle results

In the end, the analysis was able to cover 89,573 subjects (median age 62 years, 56% women) between June 2013 and December 2015, with a median follow-up of 6.3 years. Activity profiles were represented as follows: 37,872 (42.2%) were active on weekends, 21,473 (24.0%) regularly active throughout the week, and 30,228 inactive (33.7%).

In multivariate analysis, both moderate-to-vigorous intensity physical activity profiles (regularly active and weekend active) had similarly lowered risks of incident cardiovascular events for durations of activity ≥150 minutes per week compared to the inactive group:

FA : hazard ratio (HR) 0,78 [0,74-0,83] for the weekend active group, 0.81 [0,74-0,88] for the regularly active group; Myocardial infarction: HR 0.73 [0,67-0,80] et 0,65 [0,57-0,74] respectively ; Heart failure: HR 0.62 [0,56-0,68] et 0,64 [0,56-0,73] ; AVC : HR 0,79 [0,71-0,88] et 0,83 [0,72-0,97].

Similar results were found for other weekly activity duration thresholds.

Principales limitations

Physical activity was only measured over a week and participants were able to modify their behavior over this short period of time. Moreover, the optimal physical activity thresholds measured by wrist accelerometer are not yet clearly established. The cohort comprising only subjects of Caucasian origin, this limits the generalization of the results.

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