Millions of years ago, when our ancestors were roaming the plains of Africa, physical activity was part of everyday life. Even 100 years ago, people were more active in daily life: Jobs were more likely to be manual, and if you needed to get somewhere, you usually had to walk.

Today, thanks to modern technology, we are much more sedentary. However, to maintain good health, we need to move our bodies. The World Health Organization (WHO) recommends “at least 150 minutes of moderate-intensity physical activity per week.”

Although scientists have established that keeping active is linked to a reduced risk of a wide range of diseases, questions still remain. One important outstanding question is whether weekend warriors get the same benefits as people who spread their activity throughout the week.

However, little research has been done to date into how this modern exercise pattern impacts overall disease risk or cardiometabolic disease risk. The latest study helps answer this question.

The authors used data from almost 90,000 people in the United Kingdom with an average age of 62. They all wore an accelerometer for 1 week to track physical movement. Using this activity data, they divided people into three groups:

1. Inactive: Less than 150 minutes of moderate-to-vigorous activity per week.
2. Weekend warriors: At least 150 minutes of moderate-to-vigorous activity per week, mostly over 1 or 2 days.
3. Regular activity: At least 150 minutes of moderate-to-vigorous activity per week, spread more evenly throughout the week.

Compared with the inactive group, both the weekend warriors and regular activity groups had lower disease risks. The strongest associations were for cardiometabolic conditions, such as hypertension, diabetes, obesity, and sleep apnea.

In total, compared with the inactive participants, both active groups had a reduced risk of more than 200 diseases. Interestingly, the scientists found no significant differences between the risk reductions in the two active groups.

In other words, weekend warriors do get the same benefits as those who spread exercise more evenly across their week.

Medical News Today contacted Rigved Tadwalkar, MD, a board certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the research, and asked him about the study’s strengths and limitations.

“The study’s use of accelerometer data to objectively measure physical activity levels is a strength, as it overcomes some limitations of previous studies that relied on self-reported activity,” he said.

He also praised the large dataset. However, there were also limitations.

“Using a single UK-based sample, predominantly comprising white individuals, may limit the generalizability of the findings to other populations,” Tadwalkar explained.

Also, they only captured one week of activity data, which may not accurately represent an individual’s long-term activity.

Bradley Serwer, MD, an interventional cardiologist and chief medical officer at VitalSolution, an Ingenovis Health company, who was not involved in the research, outlined another limitation: “The authors only looked at people who were on average 62+/- 8 years of age. The results of this study may or may not translate to a younger population.”

“Nevertheless, for people seeking to incorporate a more active lifestyle, these findings offer encouraging insights. While regular and evenly spread physical activity is still beneficial, the study suggests that even if people find it challenging to exercise daily, they can still achieve health benefits by exercising just a couple of days per week.”
— Rigved Tadwalkar, MD

MNT also contacted John Bahadorani, MD, a board-certified interventional cardiologist at MemorialCare Heart and Vascular Institute at Saddleback Medical Center in Laguna Hills, CA. Bahadorani, who was not involved in the research, was similarly upbeat:

“Understanding that one can have an equal improvement of cardiovascular outcomes with 1–2 days of exercise per week versus daily exercise spread over the course of the week, will provide substantial positive reinforcement, and improve overall compliance of individuals to an exercise routine.”

It will come as no surprise to anyone that exercise benefits health. However, fewer people know why it is so effective at protecting health.

MNT asked Serwer to explain:

“Regular exercise can help improve cardiovascular fitness by improving peripheral circulation and vascular tone, controlling comorbidities such as high blood pressure, diabetes, sleep apnea, high cholesterol levels, and help increase vagal tone.”

Exercise, vagal tone, and health

“Vagal tone is part of the autonomic nervous system that helps slow the heart following stressful activities, such as exercise. High vagal tone is associated with reduced inflammation, lower heart rates, better stress resiliency, and enhanced cardiovascular function.”
— Bradley Serwer, MD

Dr. Jennifer Dunphy, a Doctor of Public Health and co-founder of the WIN Network outlined some other mechanisms:

“Exercise is thought to encourage the liver to produce more high-density lipoproteins (HDL) particles, which are sometimes called ‘good’ cholesterol.”

Also, “exercise expends calories and increases your overall metabolic rate so you are less likely to develop obesity. This reduces your risk of developing related conditions, like diabetes,” she said.

Dunphy also mentioned exercise’s anti-inflammatory effects: “Over the long term, exercise reduces systemic inflammation in the body, which improves the health of blood vessels and thus overall heart health.”

For people who are not currently active, getting started can seem daunting. We asked Bahadorani to provide some tips:

1. Find enjoyable activities: Choose exercises you like, such as walking, swimming, dancing, or cycling, to make it easier to stick with a routine.
2. Set realistic goals: Start with achievable targets and gradually increase the intensity and duration as your fitness level improves.
3. Create a schedule: Plan specific times for exercise throughout the week, treating it as an essential appointment with yourself.
4. Include physical activity in daily routines: Walk or bike for short trips, take the stairs instead of the elevator, and perform stretching exercises during breaks.
5. Buddy up: Exercise with friends or family to stay motivated and make it a fun, social activity.
6. Try different activities: Mix up your workouts to prevent boredom and target different muscle groups.
7. Track your progress: Keep a record of your exercise achievements, celebrate milestones, and stay on track.

“If you haven’t exercised in a while, the first step is to ensure you’re healthy enough to start an exercise program. I recommend discussing your health goals with your medical team,” suggested Serwer.

“I would caution people who only exercise on the weekend to not overdo it,” he continued. “Sporadic exercise may increase the incidence of musculoskeletal issues. Listen to your body and if you are starting to have pain, that is your body telling you to adjust how or what you are doing.”

“As a cardiologist embracing digital health, I see the potential for technology to play a vital role in promoting physical activity and improving cardiovascular health,” Tadwalkar told MNT.

“As we continue to make advances in digital health, the hope is that we will better leverage technology to promote physical activity, making the possibility of achieving optimal cardiovascular health increasingly accessible and effective.”

He hopes that, by “integrating personalized data, virtual coaching, social support, and tailored exercise plans, we can empower individuals to take charge of their cardiovascular well-being and lead healthier, more active lives.”

The overarching message is to get active when possible. Hitting that 150-minute per week target can significantly reduce the risk of hundreds of health conditions.