Background:
“Weekend warrior” and regularly active physical activity patterns have been associated with reduced mortality risk in the general population. The association in patients with diabetes is unknown.
Objective:
To examine the associations of different physical activity patterns, particularly weekend warrior and regularly active behavior, with all-cause, cardiovascular, and cancer mortality among adults with diabetes.
Design:
Prospective cohort study.
Setting:
National Health Interview Survey (1997 to 2018) linked to the National Death Index records through 31 December 2019.
Participants:
51 650 U.S. adults with self-reported diabetes.
Measurements:
Participants categorized by 4 physical activity groups: inactive (reporting no moderate-to-vigorous physical activity [MVPA]), insufficiently active (MVPA <150 minutes per week), weekend warrior (MVPA ≥150 minutes per week in 1 to 2 sessions), and regularly active (MVPA ≥150 minutes per week in ≥3 sessions).
Results:
During a median follow-up of 9.5 years, 16 345 deaths (cardiovascular, 5620; cancer, 2883) were documented. Compared with inactive participants, multivariable-adjusted hazard ratios (HRs) for all-cause mortality were significantly lower across physical activity groups: insufficiently active persons (HR, 0.90 [95% CI, 0.85 to 0.95]), weekend warriors (HR, 0.79 [CI, 0.69 to 0.91]), and regularly active persons (HR, 0.83 [CI, 0.78 to 0.87]). These reductions were mostly due to benefits with cardiovascular mortality: insufficiently active persons (HR, 0.98 [CI, 0.89 to 1.07]), weekend warriors (HR, 0.67 [CI, 0.52 to 0.86]), and regularly active persons (HR, 0.81 [CI, 0.74 to 0.88]). There were fewer differences by cancer mortality: insufficiently active persons (HR, 0.88 [CI, 0.78 to 1.00]), weekend warriors (HR, 0.99 [CI, 0.76 to 1.30]), and regularly active persons (HR, 0.85 [CI, 0.75 to 0.96]).
Limitation:
Physical activity was self-reported and assessed at a single time point.
Conclusion:
Weekend warrior and regularly active physical activity patterns meeting current physical activity recommendations (MVPA ≥150 minutes per week) were associated with 21% and 17% lower risks for all-cause mortality and 33% and 19% lower hazards of cardiovascular mortality among adults with diabetes compared with those with diabetes who are physically inactive.
Primary Funding Source:
Capital’s Funds for Health Improvement and Research, and National Natural Science Foundation of China.
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