As long as you are getting the recommended amount of physical activity each week, it may not matter to your heart health whether it’s through multiple shorter workouts or longer weekend sessions.
While guidelines from major medical organizations like the World Health Organization (WHO) and the American Heart Association (AHA) have advocated for at least 150 minutes of weekly exercise for optimal cardiovascular well-being, questions have arisen about the timing of exercise and whether it makes a difference if physical activity is distributed across several days of concentrated during weekends.
A recent study, published in JAMA on July 18, challenges these notions and suggests that the timing of exercise might not be as crucial as the total amount of activity. The study involved an examination of data from nearly 90,000 individuals who used accelerometers to objectively measure their activity levels.
An electrophysiologist at Massachusetts General Hospital and instructor at Harvard Medical School in Boston and lead study author of the study, Shaan Khurshid, MD, MPH, said, “Our findings suggest that it is likely the total duration of moderate to vigorous activity, rather than the pattern, that matters most for cardiovascular risk.”
“As a result, more concentrated activity appears to result in similar reductions in risk as more evenly distributed activity,” Dr. Khurshid says.
Consistent Exercise Benefits the Heart, Regardless of When it Occurs
Surprisingly, the study found that both “weekend warriors” and individuals who engaged in multiple workouts throughout the week experienced similar reductions in the risk of cardiovascular events, such as heart attacks and strokes.
To conduct the study, researchers equipped participants with accelerometers for a week, recording their levels of moderate-intensity physical activity (e.g., brisk walking or flat ground biking) and vigorous-intensity physical activity (e.g., running or hill cycling). The results showed that around 38,000 participants fell into the category of “active weekend warriors,” meaning they achieved at least 150 minutes of moderate – to vigorous–intensity physical activity (MVPA) and conducted at least half of their exercises on weekends.
Approximately 21,000 participants were labeled “active” because they completed at least 150 minutes of MVPA with less than half of their exercise on weekends, while the remaining 30,000 individuals were considered “inactive” as they engaged in less than 150 minutes of physical activity.
After approximately six years of follow-up, both weekend warriors and the active individuals who spread their workouts evenly throughout the week exhibited significantly lower risks of cardiovascular disease events compared to the inactive group.
Weekend warriors were found to be 27 percent less likely to experience a heart attack, 38 percent less likely to suffer heart failure, 22 percent less to develop atrial fibrillation (a heart rhythm disorder), and 21 percent less likely to have a stroke.
Likewise, active individuals who distributed their workouts across the week were 35 percent less likely to have a heart attack, 36 percent less likely to experience heart failure, 19 percent less likely to have atrial fibrillation, and 17 percent less likely to have a stroke.
However, one limitation of the study is that it measured activity levels for only a single week, potentially not capturing longer-term workout habits that might influence results.
Total Activity Per Week More Important Than Individual Workout Length
Nonetheless, these findings provide new evidence that exercise guidelines should focus on the total amount of activity individuals accumulate rather than the duration of individual workouts. This perspective is endorsed by Peter Katzmarzyk, PhD, a coauthor of an editorial accompanying the study in JAMA and the associate executive director for population and public health sciences at the Pennington Biomedical Research Center in Baton Rouge, Louisiana.
“This is why the public health recommendations have shifted over the years away from 30 minutes a day to 150 minutes per week. There was no strong evidence that physical activity needs to happen every day to accrue health benefits — and this study really shows that accumulating the same amount of activity over a couple of days per week, as opposed to spreading it out, has similar benefits,” Dr. Katzmarzyk says.
Furthermore, individuals who struggle to meet the 150-minute weekly exercise goal should take comfort in the idea that every bit of exercise they engage in can be beneficial, even if it doesn’t involve long or high-intensity workouts.
The most crucial factor is simply to start moving, and it doesn’t have to be a significant or strenuous effort, says Gregory Katz, MD, a cardiologist and assistant professor at the NYU Grossman School of Medicine in New York City, who was not involved in the study.
“Going from nothing to a little bit has the biggest magnitude of benefit of any type of change in exercise,” Katz adds. “For people who are overweight, or older and scared about the injury risk of doing exercise, the best thing you can do is just walk and get active.”
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