The finding suggests that less frequent bouts of activity, which might fit more easily into a busy lifestyle, offer significant health benefits, even in the obese and those with medical risk factors.
"It is very encouraging news that being physically active on just one or two occasions per week is associated with a lower risk of death, even among people who do some activity but don't quite meet recommended exercise levels," said the study's senior author, Associate Professor Emmanuel Stamatakis from the University of Sydney.
"However, for optimal health benefits from physical activity it is always advisable to meet and exceed the physical activity recommendations."
Regular physical activity is associated with lower risks of death from all causes, cardiovascular disease and cancer, and has long been recommended to control weight, cholesterol, and blood pressure. The World Health Organization recommends that adults do at least 150 minutes per week of moderate-intensity activity, or at least 75 minutes per week of vigorous-intensity activity, or equivalent combinations.
But research is yet to establish how the frequency and total weekly dose of activity might best be combined to achieve health benefits. For example, individuals could meet current guidelines by doing 30 minutes of moderate-intensity physical activity five days of the week or 75 minutes of vigorous-intensity physical activity on just one day of the week.
Those who do all their exercise on one or two days of the week are known as 'weekend warriors'.
About 'weekend warriors'
+ Fifty six percent of 'weekend warriors' were male
+ Forty five percent of 'weekend warriors' reported taking part in one session and 55 percent reported taking part in two sessions of physical activity per week
+ Ninety four percent of 'weekend warriors' participated in sports and 31 percent participating in walking of a brisk or fast pace
+ 'Weekend warriors' spent an average 300 minutes per week doing moderate- or vigorous-intensity physical activity.
Compared with those who reported no physical activity, the all-cause mortality hazard ratio was 0.69 (95% CI: 0.65, 0.77) in the insufficiently active, 0.70 (0.60, 0.82) in weekend warriors, and 0.65 (0.58, 0.73) in the regularly active (defined as meeting the recommendations and be active on three or more days per week).
This means that compared with those who reported no physical activity, all-cause mortality risk in the insufficiently active was 31 percent lower, 30 percent lower in weekend warriors and 35 percent lower in the regularly active.
Compared with the inactive, CVD mortality hazard ratio was 0.63 (0.55, 0.72) in the insufficiently active, 0.59 (0.48, 0.73) in weekend warriors, and 0.59 (0.48, 0.73) in the regularly active.
This means that compared with those who reported no physical activity, CVD mortality risk in the insufficiently active was 37 percent lower, 41 percent lower in weekend warriors and 41 percent lower in the regularly active.
Compared with the inactive, cancer mortality hazard ratio was 0.86 (0.77, 0.96) in the insufficiently active, 0.82 (0.63, 1.06) in weekend warriors, and 0.79 (0.66, 0.94) in the regularly active.
This means that compared with those who reported no physical activity, cancer mortality risk in the insufficiently was 14 percent lower, 18 percent lower in weekend warriors and 21 percent lower in the regularly active.
"Compared to inactive people, the results reveal that the insufficiently active, weekend warriors and people with regular physical activity patterns had reduced risks of all-cause, CVD and cancer mortality," says Stamatakis, who holds appointments at the University of Sydney's School of Public Health, The Charles Perkins Centre and Faculty of Health Sciences.
"This finding persisted after adjusting for potential confounders, prevalent chronic diseases and excluding those who died in the first two years of the study.
"These results mean that 'weekend warriors' and other leisure-time physical activity patterns characterised by one or two sessions per week may provide beneficial health outcomes event when they fall short of physical activity guidelines."
About the study:
Gary O'Donovan, I-Min Lee, Mark Hamer, Emmanuel Stamatakis. The 'weekend warrior' and other physical activity patterns and the risks of all-cause, cardiovascular disease, and cancer mortality,
JAMA Internal Medicine, 2017
Objective: to investigate associations between the weekend warrior and other physical activity patterns and the risks of all-cause, cardiovascular disease (CVD), and cancer mortality.
Design: Health Survey for England and Scottish Health Survey with prospective linkage to mortality records.
Setting: eleven general population household-based health examination surveys
Participants: 63,591 adults; 45.9 per cent male; average age 58.6±11.9 years (mean±SD)
Physical activity categories: Self-reported leisure-time physical activity, with activity patterns defined as 'inactive' (not reporting any moderate- or vigorous-intensity activities), 'insufficiently active' (reporting <150 min·wk-1 in moderate- and <75 min·wk-1 in vigorous-intensity activities), 'weekend warrior' (reporting ?150 min·wk-1 in moderate- or ?75 min·wk-1 in vigorous-intensity activities from one or two sessions), and 'regularly active' (reporting ?150 min·wk-1 in moderate- or ?75 min·wk-1 in vigorous-intensity activities from three or more sessions). The insufficiently active were also characterised by physical activity frequency.
Main outcomes: all-cause, CVD, and cancer death ascertained from death certificates. There were 8,802 deaths from all causes, 2,780 from CVD, and 2,526 from cancer during an average follow up of approximately 9 years.