aerobic exercise

Are Weekend Warriors As Healthy As Regular Exercisers?

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What Does This Study Mean For You? 

Author: Dr. Stephen Chaney 

It’s a new year and once again you have set New Year’s goals. If you are like millions of Americans your top 3 goals are probably to eat healthier, exercise more, and lose weight – not necessarily in that order. Now comes the hard part:

  • Setting realistic weight loss goals and developing strategies for achieving those goals.
  • Deciding on food choices and eating behaviors you will change.
  • Deciding on what kind of exercises you will do and how often you will do them.

With respect to exercise, the consensus is clear. We should be aiming for ≥150 minutes of moderate-to-vigorous physical activity per week. But how often should we be exercising? Here the answer is a bit murkier.

Most experts recommend we exercise 3-5 times a week. But that advice doesn’t work for everyone. For some people, their work schedule and family responsibilities make it difficult to find time during the week to exercise.

However, many of these individuals are very active during the weekend with things like yard work, organized sports, long hikes, and/or cycling excursions. We refer to these people as Weekend Warriors.

If you are one of these individuals, you are probably wondering if that’s enough. Are weekend warriors as healthy as people who exercise every day, or must you squeeze some exercise into your busy week?

Some recent studies have suggested that frequency of exercise is not important as long as you exceed the magical 150 minutes per week. However, each of these studies had limitations. For example:

  • They only looked at a few kinds of exercise and a few diseases.
  • Some studies depended on self-assessments of exercise frequency and intensity, which are notoriously unreliable.

The study (Circulation, 150: 1236-1247, 2024) I am reviewing today compares the health outcomes of weekend warriors and people who exercise throughout the week and was designed to eliminate the limitations of previous studies.

How Was This Study Done?

clinical studyThe authors used data obtained from the UK Biobank Study, which is an ongoing study following the health outcomes of individuals from all corners of the United Kingdom who enrolled in the study between 2006 and 2010. Each participant underwent a health assessment when they enrolled.

This study used data from a subset of 89,573 participants (average age 62, percent women 56%) who wore a wrist accelerometer to measure activity levels for one week between June 8, 2013, and December 30, 2015. The accelerometer measured activity levels every 5 seconds, so it was able to record the intensity, frequency, and duration of exercise during the week.

Participants were divided into three groups based on their accelerometer measurements:

  • Inactive: <150 minutes per week of moderate-to vigorous physical activity (34% 0f participants).
  • Weekend Warriors: ≥150 minutes per week of moderate-to vigorous physical activity with the bulk of the activity spread over 1-2 days (42% of participants).
  • Regular Exercisers: ≥150 minutes per week of moderate-to vigorous physical activity with the activity spread over multiple days (24% of participants).

The participants were followed for an average of 6.3 years with 94% of participants having >5 years of follow up. The outcome was frequency of incident diseases (diseases that were not present during the accelerometer measurements but were diagnosed during the follow-up period).

Because the United Kingdom is one of the countries with a “Big Brother knows all” health care system, the investigators were able to correlate the exercise levels of each participant with 678 diseases and health conditions. The study compared the disease incidence of weekend warriors with the inactive group, regular exercisers with the inactive group and weekend warriors with the regular exercisers.

Are Weekend Warriors As Healthy As Regular Exercisers?

Let me start with the big picture and then I will give some specific statistics.

  • Both the weekend warrior and regular exercise patterns were associated with lower risk for >200 diseases compared to the inactive group.
    • For both exercise patterns there were a small number of associations with higher disease risks – primarily musculoskeletal disorders and dermatological conditions (think sports injuries and excessive sun exposure).
    • However, both exercise patterns were associated with a lower risk of over a dozen musculoskeletal conditions such as osteoarthritis and spinal degenerative spinal conditions.
  • While both exercise patterns were associated with the risk of >200 diseases, the risk reduction was greatest for cardiometabolic diseases associated with obesity. For example, the risk reduction for:
    • Hypertension was reduced by 23% and 28%, respectively, for weekend warriors and regular exercisers.
    • Diabetes was reduced by 43% and 46%, respectively, for weekend warriors and regular exercisers.
    • Obesity was reduced by 45% and 56%, respectively, for weekend warriors and regular exercisers.
    • Sleep apnea (which is associated with obesity) was reduced by 43% and 51%, respectively, for weekend warriors and regular exercisers.
    • Chronic renal failure (Chronic renal failure can be caused by a fatty liver, which is associated with obesity) was reduced by 36% and 35%, respectively, for weekend warriors and regular exercisers.
    • Gallstones (which are associated with obesity) were reduced by 36% and 43%, respectively, for weekend warriors and regular exercisers.
  • You will notice that risk reduction was generally greater for regular exercisers than for weekend warriors. That is because the regular exercisers averaged higher weekly totals for moderate-to-vigorous activity levels than weekend warriors. When the two groups were compared at the same weekly activity level, there was no significant difference between the two groups.

What Did The Authors Say About This Study?

The authors discussed the limitations of the study in detail in the discussion section of their paper. The three biggest limitations are:

  • This study measured associations. It does not prove cause and effect.
  • The study only measured exercise patterns and intensities for one week. Some participants may have changed their exercise patterns during the follow-up period.
  • The wrist accelerometer used in this study has been validated for a variety of aerobic activities. It may be less accurate at measuring some strength training exercises. And it will be unable to measure isometric exercises, which have been shown to have some cardiometabolic health benefits.

However, this is a very large, well-designed study which is consistent with several earlier studies.

The authors also expanded on the significance of their findings with these comments:

1) “Efforts to optimize physical activity may be expected to have wide-ranging health benefits that extend beyond previously published associations with cardiovascular disease…We observed strong associations between physical activity and lower risk of up to 264 diseases.”

2) “Our results suggest that the achievement of guideline-adherent physical activity volumes [≥150 minutes per week of moderate-to-vigorous activity] is the key factor relevant to incident disease risk, as opposed to the pattern by which physical activity may be accrued…We did not identify a single condition for which risk appeared substantially different for one pattern versus the other.”

3) “Although we noted beneficial associations across a wide variety of diseases, our findings suggest that physical activity may be particularly effective for modifying risk of cardiometabolic conditions, including hypertension, obesity, diabetes, and sleep apnea.”

The authors concluded, “Achievement of measured physical activity volumes consistent with guideline recommendations [≥150 minutes per week of moderate-to-vigorous activity] is associated with lower risk of >200 diseases, with prominent effects on cardiometabolic conditions. Associations appear to be similar whether the physical activity follows a weekend warrior pattern or is spread more evenly throughout the week.”

What Does This Study Mean For You?

QuestionsThis study has three major take-home messages:

1) If you weren’t already motivated to increase your exercise levels in 2025, this study is a wake-up call. You already know that exercise improves your mood, makes weight control easier, and reduces the risk of major diseases like diabetes, hypertension, and heart disease.

This study just added another 200 reasons to increase your exercise levels. (If you want to know the 200+ diseases that are positively impacted by exercise, read the study.

2) If you are someone whose schedule makes it difficult to find time during the week, this study is good news. This study suggests that weekend warriors can be as fit and healthy as people who exercise daily. However, there are a couple of important caveats:

    • This study used a wrist accelerometer, so it was able to select only those weekend warriors whose total activity exceeded 150 minutes of moderate-to-vigorous activity. Unfortunately, many weekend warriors overestimate how much exercise they get during the weekend. For example:
      • Mowing the lawn is exercise, but the amount of exercise you get is vastly different if you use a riding mower instead of a push mower.
      • Weekend sports are a fun way to exercise, but the amount of exercise you get from an hour of soccer is probably different from an hour of softball.
    • I could go on, but you get the idea. If you choose the weekend warrior route, be realistic about the amount of exercise you are getting.

3) This study found that people who exercised often during the week were likely to accumulate higher weekly totals of activity than weekend warriors. Simply put, it is easier to accumulate higher exercise totals when you exercise more frequently.

So, even if your schedule is busy, it’s worthwhile to try and find some time to exercise during the week rather than limiting all your exercise to the weekend.

The Bottom Line

A recent study asked whether weekend warriors got the same benefits from exercise as people who exercised on multiple days during the week (regular exercisers). The key findings from the study were:

  • Weekly exercise levels of ≥150 minutes of moderate-to-vigorous activity were associated with reduced risk of over 200 diseases.
  • The reduction in risk was greatest for obesity and cardiometabolic diseases like diabetes and hypertension.
  • Once the ≥150 minutes of moderate-to-vigorous activity was reached, there was no significant difference in risk reduction between the weekend warrior and regular exercise patterns of activity.

For more details on this study and what this means for you read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

___________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

 

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Which Exercise Is Best For Reducing Blood Pressure?

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How Can You Keep Your Blood Pressure Under Control? 

Author: Dr. Stephen Chaney 

high blood pressureHypertension (high blood pressure) is called a silent killer. That’s because you often don’t notice any symptoms until you die from a stroke or heart attack.

Nearly half of all American adults (120 million or 48%) have high blood pressure. Of Americans with high blood pressure:

  • About half (46%) of them don’t know it.

And of those who know they have high blood pressure:

  • Only half of them have it under control.
    • In case you weren’t doing the math, that means that only 1 in 4 Americans with high blood pressure has it under control.

That is scary because every 20 mm Hg increase in systolic blood pressure:

  • Doubles your risk of death from a stroke or heart attack.

And if the personal costs of high blood pressure were not enough, the cost of high blood pressure to our health care system is enormous.

  • The CDC estimates that the cost of high blood pressure in the United States is around $131 to $198 billion per year. And this may be an underestimate because it does not include productivity losses from non-fatal illnesses caused by high blood pressure.

Medications are effective at reducing blood pressure, but they have significant side effects. And those side effects have two unintended consequences.

  • Around half of patients stop taking their blood pressure medication within the first year because of side effects or cost.
  • For patients who continue taking blood pressure medication, they are usually prescribed other medications to reduce the side effects from their blood pressure medication.

This is often the start of a downward spiral in which they need more medications to reduce the side effects of the medicines they were just prescribed. And they end up on multiple medications, and a poor quality of life because of it.

Because of this, many patients and health care practitioners are looking for natural ways to keep blood pressure under control. One of the most recommended approaches is to increase exercise, and the type of exercise most frequently recommended is aerobic exercise.

But is that the best advice? That advice is based on clinical studies performed 20 to 30 years ago. And those studies were an excellent example of “the tail wagging the dog”.

Let me explain. In the early days most experts believed that aerobic exercise would be the most effective exercise for reducing blood pressure. So, most of the original studies on the effect of exercise at reducing blood pressure were done using aerobic exercise.

From those studies we knew that aerobic exercise was effective at reducing blood pressure, but we didn’t really know whether it was the most effective exercise for reducing blood pressure. And more recent studies have suggested a more nuanced view of exercise and blood pressure control.

For that reason, the authors of the current article (JJ Edwards et al, British Journal of Sports Medicine, 57: 1317-1326, 2023) decided to conduct a comprehensive review of all randomized controlled studies between 1990 and February 2023 on the effect of exercise on reducing blood pressure.

How Was The Study Done? 

clinical studyThe investigators performed a comprehensive, systematic review of all randomized controlled studies (meaning patients were randomly assigned to an exercise or non-exercise group) looking at reductions in blood pressure following an exercise intervention of ≥ 2 weeks.

They excluded studies that:

  • Included dietary counseling or exercise recommendations in the control group.
  • Included dietary counseling, supplementation, or medication in the exercise group.

However, there were no exclusions based on the health or disease state in the patient population.

Their analysis included 270 randomized controlled trials with a total of 15,827 participants. All the studies reported systolic and/or diastolic blood pressure before and after the exercise intervention.

Exercise interventions were divided into five classifications:

  • Aerobic exercises.
  • Resistance exercises.
  • Combined exercises (a combination of aerobic and resistance exercises).
  • High-intensity interval exercises (high-intensity, short-duration exercises).
  • Isometric exercises.

Several of these exercise classifications were further subdivided into individual exercises (see below)

Which Exercise Is Best For Reducing Blood Pressure? 

When the reduction in systolic blood pressure was considered, the rank order of exercise effectiveness was:

  • High-intensity interval exercise (4.08 mm Hg reduction).
  • Aerobic exercise (4.48 mm Hg reduction).
  • Resistance exercise (4.53 mm Hg reduction).
  • Combined aerobic and resistance exercise (6.04 mm Hg reduction).
  • Isometric exercise (8.24 mm Hg reduction).

When the reduction in diastolic blood pressure was considered, the amount of reduction was less but the rank order of exercise effectiveness was the same:

  • High-intensity interval exercise (2.50 mm Hg reduction).
  • Aerobic exercise (2.53 mm Hg reduction).
  • Resistance exercise (3.04 mm Hg reduction).
  • Combined aerobic and resistance exercise (3.54 mm Hg reduction).
  • Isometric exercise (4.00 mm Hg reduction).

When the exercise classifications were subdivided into individual exercises.

  • Running and cycling were significantly more effective than walking for aerobic exercise, with running being the most effective form of aerobic exercise.
  • Cycling was the most effective form of high-intensity interval exercise.
  • No effect of exercise type was seen for the effectiveness of resistance training.
  • Isometric wall squats and leg extensions were much more effective than isometric handgrip exercises.

There was not enough data from diastolic blood pressure studies to subdivide into individual exercises.

There were two other results of interest.

  • Aerobic exercise interventions were slightly more effective with lower exercise frequency, suggesting that 3 times a week may be more effective than 5 or more times a week.
  • All exercise interventions were much more effective for people with significantly elevated blood pressure than for people with slightly elevated blood pressure or normal blood pressure.

Of course, the important question for people with normal blood pressure is the effectiveness of exercise in preventing future increases in blood pressure, and this study is not designed to answer that question.

The authors concluded, “Various exercise training modes improve resting blood pressure, particularly isometric exercise. The results of this analysis should inform future exercise guideline recommendations for the prevention and treatment of arterial hypertension.”

What Does This Study Mean For You? 

Question MarkThe takeaways from this study are clear.

If you wish to reduce your blood pressure:

  • Any kind of exercise is helpful, but current recommendations that prioritize aerobic exercise may be misleading.
  • If you want to get the most “bang for your buck”:
    • Isometric exercise is the most effective and high intensity interval exercise is the least effective.
    • Aerobic and resistance exercise are equally effective.
    • A combination of aerobic and resistance exercise is more effective than either alone.
  • And if you want to know the most effective individual exercises:
    • Wall squats and leg extensions are the most effective isometric exercises.
    • Running and cycling are the most effective aerobic exercises.
    • Any kind of resistance exercise is equally effective.

Here are my thoughts about this study:

  • If you haven’t been keeping up with clinical studies on exercise and blood pressure (like me), the conclusions of this comprehensive review are probably a surprise. I would not have expected isometric exercises to be more effective than aerobic exercises for lowering blood pressure.
  • The authors of this review postulated that isometric exercise decreases blood flow to the muscles involved. When those muscles relax, blood flow increases which sends metabolic signals that cause blood vessels to relax.
  • This study is good news for people with health conditions that limit their ability to do aerobic exercises or traditional resistance exercises.
  • We also need to remember that lowering blood pressure is not the only value of exercise.
    • Aerobic exercise improves cardiovascular function.
    • Resistance exercise increases muscle mass, which is particularly important for seniors who are trying to maintain muscle mass and function. Regular resistance exercise also helps minimize bone loss as we age.

Isometric exercise can be considered a form of resistance exercise, but it may need to be supplemented with resistance exercises that target other muscle groups.

  • As I said above, this study shows that all forms of exercise reduce blood pressure. The most effective exercise for you is the one you enjoy and will do on a regular basis.
  • Finally, while this study looked at the effectiveness of different exercises at reducing high blood pressure, these findings are probably also applicable to the types of exercise that can reduce risk of developing high blood pressure as we age.

How Can You Keep Your Blood Pressure Under Control?

dash dietExercise alone is not a “magic bullet” for controlling blood pressure. And therein lies a story.

One reason so many people choose medications to control their blood pressure is that there is no “magic bullet” natural approach for controlling blood pressure. Exercise is just one part of a holistic approach for controlling blood pressure that also includes:

  • The DASH (Dietary Approaches To Stop Hypertension) was designed to prevent high blood pressure. I refer to it as an Americanized version of the Mediterranean diet.

Both diets are rich in fruits, vegetables, and whole grains and limit high fat meats and dairy products. And both diets have been shown to reduce the risk of high blood pressure.

  • Weight control. Overweight and obesity are both associated with increased risk of high blood pressure. One estimate is that every two pounds of weight gain increases blood pressure by 1 mm Hg.
  • Supplementation. The most effective supplements appear to be:
    • Omega-3 fatty acids.
    • Supplements containing grape seed extract and/or nitrates from beetroots and leafy greens.
    • Calcium and magnesium if dietary intakes are not optimal.

Diet, weight control, supplementation, and exercise are the top 4 lifestyle factors for keeping blood pressure under control, but a comprehensive holistic approach to controlling blood pressure includes:

  • Low sodium/potassium ratio. I mention it here for completeness, but it is an integral part of the DASH diet.
  • Stress management. Chronic stress can increase blood pressure.
  • Adequate sleep.

We may be outliers, but my wife and I have followed this approach for years and in our 80s have the blood pressure of teenagers.

The Bottom Line 

Most experts recommend aerobic exercise for reducing blood pressure, but these recommendations are based on outdated studies. A recent study examined the effectiveness of various exercises at reducing blood pressure based on all randomized controlled clinical trials between 1990 and 2023.

This study shows:

If you wish to reduce your blood pressure:

  • Any kind of exercise is helpful, but current recommendations that prioritize aerobic exercise may be misleading.
  • If you want to get the most “bang for your buck”:
    • Isometric exercise is the most effective and high intensity interval exercise is the least effective.
    • Aerobic and resistance exercise are equally effective.
    • A combination of aerobic and resistance exercise is more effective than either alone.

For more information on this study, what it means for you, and recommendations for a holistic approach for controlling blood pressure naturally, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

The Benefits of Sprint Interval Training

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Are You Still Doing Cardio?

Author: Kai Fusser, MS

Sprint Interval TrainingLast month I told you about functional fitness training and why I think it is superior to workouts on the machines that fill most gyms and sports clubs. This month my topic is sprint interval training, and why it beats the traditional cardiovascular or aerobic exercises.

Walk into any gym and the first thing you see is people straddling treadmills, ellipticals or bikes for 45 minutes or more trying to burn calories and improving their aerobic fitness.

It is not an easy task for me to explain in a short fitness tip why we should stay away from the typical low to moderate-intensity continuous training (“CARDIO”) and instead do sprint interval training (SIT, or burst training), but here are the key points.

The Problem With Cardio Exercise

 

Slow cardio:

  • is very time intensive (the number one reason people skip their workouts)
  • only works on your aerobic fitness (and that fairly inefficient)
  • burns some calories during the activity but has no impact on your overall metabolism
  • stresses your joints due to repetitive impact (especially if you are running for your cardio)
  • increases inflammation

 

The Benefits of Sprint Interval Training

 

Now here is a solution for you. SIT (sprint interval training) training:

  • will only take about 4-8 minutes 3 days a week
  • works your aerobic and anaerobic system at the same time
  • will raise your metabolism for several hours after you have completed the exercise
  • is very effective for fat loss
  • will build “fast muscles”
  • reduces impact on your joints and helps reduce inflammation

Sprint training can burn the same calories as slow cardio in 1/15th of the time! In addition, slow cardio exercise produces a lot of stress hormones (cortisol) while sprint training stimulates growth hormone (have you ever compared the physique of a sprinter to a marathon runner? It’s your choice).

It is the intensity, not duration that effects the adaptation to exercise.

 

Making Sprint Interval Training Work For You

 

There are different ways to implement SIT training:

It can be done on equipment like a:

  • treadmill (using a steep incline rather than high speed)
  • stationary bike
  • upper body ergo meter
  • or a X-iser

Or it can be done with no equipment at all, like

  •  sprinting (athletes only)
  • running up a flight of stairs
  • running up a hill
  • or with full body calisthenics like a Turkish Getup.

I recommend that you start with 4 min workouts (add 2-3 min of warm up before) with a sprint to rest ratio of 1-3, say 10 sec sprint with 30 sec rest (slow pace). As you feel more comfortable you should work your way down to a ratio of 1-1 like 20 sec sprint with 20 sec rest. The maximum total time you would want to do is 8 min. (more is not better in this case).

Please remember that the sprints should be “high intensity” which is of course relative to your fitness level. The intensity will be different for a fully trained athlete than for a de-conditioned couch hugger.

 

The Bottom Line:

 

Sprint interval training (SIT) is a quick and efficient way to burn calories and get the cardiovascular exercise your body needs.

You will be surprised how quickly your:

  • body will adapt to the new and positive exercise stress
  •  energy level will increase
  • performance will improve,
  • metabolism will pick up

You will save time and wear on your joints. Most of all, it can be fun !

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor