Accelerometer-Derived "Weekend Warrior" Physical Activity and Incident Cardiovascular Disease Among People with Diabetes

Background Current guidelines recommend ≥150 weekly minutes of moderate-to-vigorous physical activity (MVPA) for health, but how activity patterns affect outcomes is unclear. This study examined whether the "weekend warrior" (WW) pattern (i.e., most MVPA achieved over 1-2 days) was associated with a similar risk of incident cardiovascular disease (CVD) events as regular activity (RA) in adults with diabetes, using UK Biobank data. Methods Physical activity was assessed via wrist-worn accelerometers and questionnaires. Participants were grouped by MVPA pattern and duration: WWs, RA, or inactive. Cox regression models estimated hazard ratios (HRs) and 95% CIs for associations between physical activity patterns and CVD incidence. Results Among 3,061 participants with diabetes (mean [SD] age, 65.0 [7.1] years; 59.6% men), accelerometer-measured physical activity patterns were classified as WW (n=976), RA (n=503), and inactive (n=1,582). During a median follow-up of 6.6 years, a total of 254 (8.3%) incident CVD cases were identified. Compared with the inactive group, the multivariable-adjusted HRs for incident CVD in the RA and WW groups were 0.57 (95% CI: 0.38, 0.85) and 0.48 (95% CI: 0.34, 0.67), respectively. A comparison of WW versus RA for CVD risk showed no significant difference in the multivariable-adjusted HR of 0.85 (95% CI: 0.54, 1.34, p=0.50). Similar results were found in an additional analysis of 16,503 participants whose physical activity data were obtained via a questionnaire. Conclusion This study shows that among participants with diabetes, WWs have a CVD risk similar to that of RA individuals, compared with inactive individuals.