When we talk about exercising with clients of our clinic we often hear from people that they are either ‘exercising’ or ‘not exercising’.  Many people do not have an in between where they exercise, but infrequently.

 

Giving some thought to why this may be the case, a major mental block we all get is that ‘it’s probably not worth it if I can only exercise once or twice a week’.

 

When we look at the studies on this topic they are typically fairly small, only focused on a single group (such as high income neighbourhoods) and have a short follow up period.

 

Despite this we have always felt that ANY EXERCISE IS BETTER THAN NO EXERCISE! 

 

In fact I wrote a whole blog on this a couple of years ago showing that there is a HUGE reduction in your risk of death by completing just one hour of cardiovascular activity weekly.  There was added benefit up to about 3 hours and then the benefit starts to slow down.

 

But what about true ‘weekend warriors’?

 

A parent on my kids basketball team told me he does zero physical activity (because he hates it) but plays full out in a pick up basketball league for 60-90 minutes once a week.

 

Is that good?

 

If you read the news you would think this is the type of guy that is at risk of a heart attack by doing no activity, and then challenging his heart infrequently but at a high level.

 

As with many things these days, you can’t always believe everything that you read!

 

In January of this year, the largest (by a lot) study to date was published on this topic.  The researchers conducted a prospective cohort study in Mexico City where they interviewed a stunning 154,882 people between 1998-2004 and then again between 2015-2019.  As part of the survey they asked about activity levels with 3 categories:

• No physical activity
• Exercising 1-2 times a week (the weekend warrior group)
• More than that (what the researchers called regular physical activity group).

 

They were able to then follow these folks along for an average of 18 years and see how their health fared.  Specifically how many people died and what they died from.

 

 

Adding even more robustness they included a second follow up of over 10,000 people after 19.7 years showing some very interesting findings.

 

A few interesting findings:

• Overall there were 26,006 deaths in the 154,882 adults.
• 70% of the ‘no physical activity’ group were women.
• The proportion in the lowest income tertile that did NO EXERCISE was 50%.

 

Here were the results:

 

 

This is a fairly self-explanatory chart but the key findings are something called a hazard ratio (the lower the better).  Even when they adjusted for age, sex, education, income, smoking, fruit and vegetable intake and alcohol intake, the weekend warrior group had a 0.88 hazard ratio AND the regular activity group had the same 0.88.  This means these two groups had about a 15% reduction in risk of all cause mortality.

 

This is compelling.

 

Does this mean just exercising once or twice weekly is enough?  I wouldn’t go that far.  But I do think it shows that exercising 1-2 times a week is FAR better than not exercising at all.

 

They then looked at other parameters.  For instance the length of time exercising each session.

 

You can see in the chart below there was a significant difference in exercising 30-60 minutes (hazard ratio’s of 0.84 in weekend warrior group and 0.88 in the regular exercise group) compared with 0-30 minutes where the hazard ratios were both really high.  Exercising OVER 60 minutes reduced the hazard ratio further to around 0.80 in both groups.

 

 

There were a few more really interesting findings that will hit home.  They resurveyed 10,023 of the study participants after 19.7 years.  Here’s what they found:

• Among those that reported being regularly active at baseline (20 years earlier), 62% now reported being INACTIVE.
• Conversely, among those that reported being inactive at baseline, 4% now were weekend warriors and 12% were regularly active.
• Overall this meant for those that were inactive and became a weekend warrior, the hazard ratio was 0.86 and for those becoming regularly active, the hazard ratio was 0.85.

 

This means it is never too late to start exercising!

 

Latin America is leading the charge with this.

 

In Latin America there is an amazing movement to promote more physical activity called the Ciclovia Recreativa.  This is a simple intervention where cities close main roads to cars and open them exclusively for a safe and free space to exercise.

 

How successful is the Ciclovia Recreativa?

 

Millions of people participate and say they would not exercise at all without it.  15 major cities take part and it is conservatively estimated to prevent 360 premature deaths per year and save over $200 million in healthcare costs.

 

In Mexico City over 50km of roads are closed Sundays and about 80,000 people enjoy physical activity is a safe, free of charge environment.  In Bogota Columbia, over 120km of roads are closed and OVER ONE MILLION PEOPLE use them to get active!

 

In this study, roughly 8% of those surveyed were deemed ‘weekend warriors’.  When you compare this with other world regions, the weekend warrior group only encompasses 3-4% of the population.  It is likely the Ciclovia Recreativa that is responsible for this where by giving a free and safe space to exercise, it doubles the amount of people exercising 1-2 times weekly.

 

This is also evolving.  They noticed men were more likely to take part so some cities began offering free dance and aerobic classes in parks along the route and that brought out more women.

 

What a great, easy to emulate initiative to get people moving.

 

So what have we learned?

1. This large study shows significant benefit for busy adults in partaking in just 1-2 exercise sessions weekly.
2. How beneficial is this? It seems to reduce the risk of all cause mortality by about 15%
3. You need to exercise at least 30-60 minutes to obtain this benefit, and there is added benefit if you go over 60 minutes.
4. People’s activity patterns change substantially over time where just because you were inactive doesn’t mean you can’t evolve into being a weekend warrior or regular exerciser.
5. BECOMING even just a weekend warrior will significantly lower your risk of all cause mortality.
6. In the survey 8 out of 10 participants said they would like to be doing more sport.