Accelerometer-measured moderate-to-vigorous physical activity and incident pancreatitis: a cohort study in the UK Biobank

Background The preventive role of objectively measured physical activity in pancreatitis remains unclear. We investigated whether accelerometer-assessed moderate-to-vigorous physical activity (MVPA) and its temporal distribution (‘weekend-warrior’ vs regular) were associated with incident pancreatitis in the UK Biobank. Methods Among 82,408 participants in the UK Biobank accelerometer subcohort (2013–2015; median potential follow-up, 6.8 years [IQR, 6.3–7.4]), MVPA was quantified using wrist-worn Axivity AX3 accelerometer data. Cox proportional hazards models were used to estimate hazard ratios (HRs) for incident pancreatitis across MVPA levels and temporal patterns. Exploratory joint analyses combined MVPA volume and temporal activity patterns with a polygenic risk score (PRS). Sensitivity analyses excluded events occurring early during follow-up and used alternative MVPA categorizations and weekend-warrior definitions. Results During follow-up, 680 incident pancreatitis cases occurred. Higher MVPA was nonlinearly associated with a lower risk of pancreatitis. Compared with participants accumulating < 150 min/week of MVPA, those accumulating ≥ 300 min/week had a 36% lower risk of incident pancreatitis (adjusted HR, 0.64; 95% CI, 0.55–0.74; P < 0.001). Both regularly active (HR, 0.69; 95% CI, 0.55–0.86; P = 0.001) and weekend-warrior patterns (HR, 0.67; 95% CI, 0.56–0.80; P < 0.001) were associated with lower pancreatitis risk than inactivity. The exploratory joint estimates do not establish genetic effect modification. Conclusions Objectively measured higher MVPA, whether accumulated regularly or in a weekend-warrior pattern, was associated with a lower risk of incident pancreatitis. These findings support further investigation of physical activity as a potentially modifiable factor in pancreatitis prevention.