About bouts; how many does it take to claim you are active?

What’s wrong with burning it up on the weekend?
Estimated Reading Time: 3 min, 29 sec
Physical activity guidelines for health and wellbeing are something that I have grappled with over the years. I’ve already written about some of those concerns (Health harshening the exercise buzz?). One of my worries is that those guidelines can drain the joy from activity – turning a pleasure into a chore. I also wonder about the intimidation of anticipation. While 30 mins of moderate, or 15 mins of vigorous physical activity (PA) at least five days per week (Ministry of Health, 2020) might sound OK at first listen, a couple of weekly resistance exercise sessions are also recommended. That’s a lot to suddenly fit in and probably overwhelming for many. I sense we put a lot off with the prospect that being fit/healthy/in shape is going to require so much commitment for so long!
I’ll put my hand up and admit that I’ve counselled spacing exercise out over several weekly sessions – a little often – as the best way to build up exercise tolerance and develop a sustainable exercise habit. I’ve discouraged binge exercising. I’m not sure of any evidence for that advice, but it always seemed logical and supported by the guidelines being promoted.
What that advice conveniently ignores is the demands and expectations of those PA guidelines are not inconsequential (Lee et al., 2004). Aside from likely financial cost, ‘regularly active’ imposes continual demands on energy and motivation. One hundred and fifty minutes a week can soon blow out when you add in travel, changing and showering time. Exercise professionals often argue that 150 mins is not a lot out of a week – and it isn’t! But we need to concede that 150 mins plus can be impractical and conflict with spending time with family, friends, meeting work commitments and finding time for other recreational interests. Exercise can be prioritised without it having to be the priority.
As we know, exercise comes with many variables and sources of conflicting advice. So much to consider – the best exercise mode, the best exercises, optimal session content, how hard, how long, and how often? Those things aside, there is a major loophole in the guidelines and therefore most research on the benefits of exercise. What happens if someone gets all of their 150 minutes of physical activity in fewer sessions? ‘Weekend warriors’, compressing their activity into 1 or 2 days, are not considered to be meeting the PA guidelines. Lee et al. (2004) were the first to explore the health benefits of weekend warriors, conducting a prospective study of a large cohort of healthy Harvard alumni. They examined exercise habits, cardiovascular disease (CVD) risk factors and mortality. Of the 8,400 men taking part in this study, 17% classified as sedentary, 13% insufficiently active, 7% weekend warriors, and 62% were regularly active, meeting the PA guidelines. Twenty-two percent of these weekend warriors exercised only once per week. Lee and colleagues found that 1 or 2 exercise sessions/week that met the activity guidelines( total minutes) appeared to offer health benefits and improve mortality. They argued that because the influence of exercise on risk factors may be transitory, those with higher risk factors might not benefit from a weekend warrior approach.

In a similar, but larger study (63,500 male and female participants), O’Donovan et al. (2017) had similar questions. Their study participants were more inactive (62.8%) with 22% insufficiently active, 4% weekend warriors and 11% regularly active. Their weekend warriors exercised once (45%) or twice (55%) per week. With greater statistical power O’Donovan et al. (2017) showed that 1 or 2 sessions of moderate or vigorous PA was enough to lower CVD and cancer mortality risk even if not meeting PA guidelines.. Shiroma et al. (2019) backed these findings up using accelerometery to verify the self-reported activity levels of weekend warriors.

None of these studies were able to address the common concern that binge exercising of weekend warriors may increase their risk of adverse medical events or injuries. Shiroma et al. (2019) did not look specifically at injuries but reported no increase in medical events.
These studies should prompt us to hit the PAUSE button and think carefully about the advice we dispense and the logic that we believe supports this advice. Clearly any exercise is preferable to a sedentary lifestyle. We worry about the risk of weekend exercise, but the evidence is not there to support our heightened concerns. Certainly those with existing medical conditions and elevated risk need to ‘(s)pace’ their weekly activity. A weekend warrior approach suits many people and might entice others to be more active. Many of the weekend warriors in O’Donovan et al.’s (2017) study were in desk-bound occupations (>40%) so weekend activity may represent the best time for their physical activity. Many were involved in weekend sport (O’Donovan et al., 2018), which when we think about it will often follow a 1 or 2 sessions/week pattern of activity. There are also many activities like outdoor pursuits, golf, cycling, and home maintenance/gardening where the only chunk of time available will be a weekend.

It’s great to be active, but it’s OK to make it fit any way that you are able – maybe we don’t need to be so rigid in our interpretation of guidelines.

  1. Hamer, M., O’Donovan, G., Lee, I-M., et al. ( 2017) The ‘weekend warrior’ physical activity pattern: how little is enough? Br J Sports Med 0:1–2. doi:10.1136/bjsports-2017-097538
  2. Lee, I.-M., Sesso, H.D., Oguma, Y., Paffenbarger, R.S. Jr (2004) The “Weekend Warrior” and Risk of Mortality Am J Epidemiol 160:636–641
  3. Ministry of Health (2020) Eating and Activity Guidelines for New Zealand Adults: Updated 2020. Wellington: Ministry of Health.
  4. O’Donovan, G., Lee, I., Hamer, M., et al. (2017) Association of “Weekend Warrior” and Other Leisure Time Physical Activity Patterns With Risks for All-Cause, Cardiovascular Disease, and Cancer Mortality. JAMA Intern Med. 177(3):335–342.
  5. O’Donovan, G., Sarmiento, O.L., Hamer, M. (2018) The Rise of the “Weekend Warrior” J Orthop Sports Phys Ther 48(8):604-606.
  6. Shiroma, E. J., Lee, I-M., Schepps, M.A. et al. (2019) Physical Activity Patterns and Mortality: The Weekend Warrior and Activity Bouts. Med. Sci. Sports Exerc. 51(1): 35–40

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