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. 2025 Mar;4(3):101603.
doi: 10.1016/j.jacadv.2025.101603. Epub 2025 Feb 15.

"Weekend Warrior" Physical Activity and Adipose Tissue Deposition

Shinwan Kany  1 , Mostafa A Al-Alusi  2 , Joel T Rämö  3 , James P Pirruccello  4 , Ezimamaka Ajufo  5 , Timothy W Churchill  6 , Steven A Lubitz  7 , Mahnaz Maddah  8 , J Sawalla Guseh  6 , Patrick T Ellinor  9 , Shaan Khurshid  10
Affiliations

"Weekend Warrior" Physical Activity and Adipose Tissue Deposition

Shinwan Kany et al. JACC Adv. 2025 Mar.

Abstract

Background: Attaining guideline-recommended levels of physical activity is associated with substantially lower risk of cardiometabolic diseases.

Objectives: Although physical activity commonly follows a weekend warrior pattern, in which most moderate-to-vigorous physical activity is concentrated in 1 to 2 days rather than spread more evenly across the week (regular), the effects of activity pattern on imaging-based biomarkers of cardiometabolic health are unknown.

Methods: We analyzed 17,146 UK Biobank participants who wore accelerometers for 1 week, and later underwent cardiac magnetic resonance imaging. Activity was categorized as inactive, regular, or "weekend warrior". Associations between activity pattern and magnetic resonance imaging-derived visceral adipose tissue (VAT) and epicardial and pericardial adipose tissue (EPAT) were assessed using multiple linear regression adjusted for confounding factors.

Results: Compared to inactive, VAT was progressively lower with weekend warrior (-0.71 L, 95% CI -0.78 to -0.64, P < 0.001) followed by regular activity (-0.96 L, 95% CI -1.04 to -0.88, P < 0.001). Observations were similar for EPAT (weekend warrior activity -2.84 cm2, 95% CI -3.20 to -2.49, P < 0.001; regular activity -3.62 cm2, 95% CI -4.03 to -3.20, P < 0.001). When compared directly, weekend warriors had modestly higher adipose tissue than regular activity (VAT difference 0.25 L, 95% CI 0.17-0.32, P < 0.001; EPAT 0.78 cm2, 95% CI 0.40-1.15, P < 0.001). No differences were observed after adjustment for total moderate-to-vigorous physical activity minutes (VAT 0.07 L, 95% CI -0.01 to 0.14, P = 0.09; EPAT 0.04 cm2, 95% CI -0.35 to 0.43, P = 0.84).

Conclusions: Guideline-adherent physical activity is associated with favorable quantitative measures of cardiometabolic health, with no differences based on activity pattern for a given activity volume.

Keywords: accelerometry; cardiovascular disease; physical activity; prevention; visceral adipose tissue.

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Conflict of interest statement

Funding support and author disclosures Dr Kany is supported by the Walter Benjamin Fellowship from the Deutsche Forschungsgemeinschaft (521832260). Dr Rämö is supported by a research fellowship from the Sigrid Jusélius Foundation. Dr Pirruccello is supported by the NIH (K08HL159346). Dr Churchill is supported by the National Institutes of Health (K23HL15926201A1). Dr Guseh is supported by the American Heart Association (19AMFDP34990046) and the President and Fellows of Harvard College (5KL2TR002542-04). Dr Ellinor is supported by grants from the National Institutes of Health (1RO1HL092577, 1R01HL157635, 5R01HL139731), from the American Heart Association (18SFRN34230127, 961045), and from the European Union (MAESTRIA 965286). Dr Lubitz previously received support from NIH grants R01HL139731 and R01HL157635, and American Heart Association18SFRN34250007. Dr Al-Alusi is supported by the NIH (T32-HL007208). Dr Khurshid is supported by the NIH (K23HL169839-01) and the American Heart Association (2023CDA1050571). Dr Ellinor receives sponsored research support from Bayer AG, IBM Research, Bristol Myers Squibb, Pfizer, and Novo Nordisk; he has also served on advisory boards or consulted for MyoKardia and Bayer AG. Dr Lubitz is an employee of Novartis as of July 2022; has received sponsored research support from Bristol Myers Squibb, Pfizer, Boehringer Ingelheim, Fitbit, Medtronic, Premier, and IBM; and has consulted for Bristol Myers Squibb, Pfizer, Blackstone Life Sciences, and Invitae. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Study Overview In 17,146 UK Biobank participants providing one week of accelerometer data and undergoing magnetic resonance imaging (MRI), we classified physical activity into 3 patterns: weekend warrior (WW), regular activity, and inactive, using the guideline-based threshold of ≥150 minutes of moderate-to-vigorous physical activity (MVPA)/week, and performed association testing with MRI-derived visceral adipose tissue (VAT) (N = 14,903) and epicardial and pericardial adipose tissue (EPAT) (N = 17,146). TDI = Townsend Deprivation Index.
Figure 2
Figure 2
Distributions of Activity and Adipose Tissue (A) The distribution of total MVPA minutes per activity category is shown in histograms relative to the total sample. (B) The distribution of visceral adipose tissue (upper panel) and epicardial and pericardial adipose tissue (lower panel) by activity group is depicted. MVPA = moderate-to-vigorous physical activity.
Central Illustration
Central Illustration
“Weekend Warrior” Physical Activity and Adipose Tissue Deposition Figure depicts the main findings of the study in a sample of 17,146 individuals who had accelerometer-derived physical activity measurement and quantification of MRI-derived visceral adipose tissue (VAT) (N = 14,903) and epicardial and pericardial adipose tissue (EPAT) (N = 17,146). MRI = magnetic resonance imaging.
See this image and copyright information in PMC

References

    1. Khurshid S., Weng L.C., Nauffal V., et al. Wearable accelerometer-derived physical activity and incident disease. NPJ Digit Med. 2022;5(1):131. - PMC - PubMed
    1. Khurshid S., Al-Alusi M.A., Churchill T.W., Sawalla Guseh J., Ellinor P.T. Accelerometer-derived “weekend warrior” physical activity and incident cardiovascular disease. JAMA. 2023;330(3):247–252. - PMC - PubMed
    1. Wang K., Xia F., Li Q., Luo X., Wu J. The associations of weekend warrior activity patterns with the visceral adiposity index in US adults: repeated cross-sectional study. JMIR Public Health Surveill. 2023;9 - PMC - PubMed
    1. Morrato E.H., Hill J.O., Wyatt H.R., Ghushchyan V., Sullivan P.W. Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care. 2007;30(2):203–209. - PubMed
    1. Dos Santos M., Ferrari G., Lee D.H., et al. Association of the “weekend warrior” and other leisure-time physical activity patterns with all-cause and cause-specific mortality: a nationwide cohort study. JAMA Intern Med. 2022;182(8):840–848. - PMC - PubMed