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Physical Activity Patterns and Mortality

The Weekend Warrior and Activity Bouts


Medicine & Science in Sports & Exercise: January 2019 - Volume 51 - Issue 1 - p 35–40
doi: 10.1249/MSS.0000000000001762

Purpose This study aimed to examine how accelerometer-assessed physical activity accumulation patterns (e.g., is activity performed daily or only 1 or 2 d·wk−1 or is activity accrued in bouts) may affect the association with mortality.

Methods Adults (N = 3438), age 40 yr and older, who wore an accelerometer (ActiGraph 7164), were drawn from the longitudinal follow-up of the National Health and Nutritional Examination Survey (2003–2006), a population-based survey of the United States. Accelerometer-assessed moderate-to-vigorous physical activity (MVPA) was described by activity patterns. Participants engaging in the majority of their activity on only 1 or 2 d·wk−1· were classified as “weekend warriors.” Activity bouts were defined as a period of at least moderate intensity lasting at least 10 min. Bout characteristics included bout frequency and length. Mortality was assessed through National Death Index matching through 2013. Mortality rates were compared among groups with different activity patterns.

Results Over an average follow-up of 77.4 months, 394 deaths occurred. Compared to participants with <37.5 min of MVPA per week, those with greater amounts of activity had a 60% to 69% mortality rate reduction after adjusting for relevant covariables. Similar risk reductions were found when contrasting weekend warriors with those who were more frequently active. An increase of one MVPA bout per week was associated with a 13% increased mortality rate. Bout duration was not associated with mortality.

Conclusion Physical activity is associated with decreased mortality rate, even among those who are active 1 or 2 d·wk−1.

1Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, MD;

2Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;

3Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA; and

4Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA

Address for correspondence: Eric J Shiroma, Sc.D., M.E.d., 7201 Wisconsin Ave, Gateway Bldg, Bethesda, MD 20814; E-mail:

Submitted for publication April 2018.

Accepted for publication July 2018.

© 2019 American College of Sports Medicine