To explore the associations between three accelerometer-derived moderate-to-vigorous physical activity (MVPA) patterns and the risk of dry eye disease (DED). This prospective cohort study included UK Biobank participants who provided a full week of accelerometer-derived MVPA data collected between June 8, 2013, and December 30, 2015. Participants were categorized according to weekly MVPA volume using WHO guidelines (≥ 150 min/week): inactive (< 150 min), active weekend warrior (active WW, ≥ 150 min with ≥ 50% of weekly MVPA accumulated within 1–2 days), and active regular (≥ 150 min but not meeting active WW criterion). The association between MVPA patterns and the risk of DED was assessed using multifactorial Cox models and restricted cubic spline models. A total of 84,065 participants (55.82 ± 7.84 years; 54.13% women) without DED at baseline were included. During the follow-up period, 726 individuals developed DED. In multivariable-adjusted models, higher weekly MVPA was significantly associated with a lower risk of incident DED (P < 0.0001). The association was non-linear (P < 0.0001), with the steepest decline in risk observed between 0 and approximately 150 min/week, beyond which the risk plateaued. Compared to the inactive group, both active WW (hazard ratio HR 0.83, 95% CI 0.70–0.99) and active regular (HR 0.76, 95% CI 0.61–0.94) patterns were associated with a significantly lower risk of DED, with no evidence of a difference in protection between the two active patterns (P for difference = 0.894). Importantly, this trend persisted across multiple definitions of the WW pattern in the sensitivity analyses. Specially, subgroup analysis revealed a significant interaction by sex (P-interaction = 0.002), with women showing a marked protective association (active WW: HR 0.76 0.62–0.94; active regular: HR 0.57 0.43–0.75), while no significant association was observed in men (active WW: HR 1.14 0.79–1.63; active regular: HR 1.36 0.93–2.01). Achieving guideline-recommended MVPA levels is associated with a lower risk of DED. The benefit is similar for WW and active regular patterns, and is more pronounced in women. Future studies are warranted to explore the underlying biological mechanisms.
Jin et al. (Fri,) studied this question.