Accelerometer-derived “weekend warrior” physical activity pattern and risk of age-related eye diseases: a prospective cohort study

TL;DR

This study finds that doing most of your weekly physical activity on weekends, known as the 'weekend warrior' pattern, can still protect against age-related eye diseases, similar to regular daily activity.

Contribution

The study is the first to show that concentrated weekend physical activity reduces eye disease risk as effectively as regular activity.

Findings

Weekend warrior activity reduced cataract risk by 11% compared to inactivity.

The weekend pattern also lowered risks of diabetic retinopathy and macular degeneration.

No significant differences were found between weekend and regular activity for most eye diseases.

Abstract

International guidelines recommend at least 150 min of weekly moderate-to-vigorous physical activity (MVPA), but whether concentrated versus distributed activity patterns differ in their associations with age-related eye diseases remains unclear.

This prospective cohort study included 86,271 UK Biobank participants free of age-related eye diseases at baseline. Physical activity was assessed using wrist-mounted triaxial accelerometers (Axivity AX3) over seven consecutive days. Two MVPA thresholds were examined: ≥ 150 min/week (primary) and ≥ 300 min/week (secondary). Participants were categorized as: inactive (below threshold), weekend warriors (WW; meeting threshold with ≥ 50% MVPA concentrated within 1–2 days), or regularly active (meeting threshold without WW criteria). Cox proportional hazards regression models were used to assess associations over a median follow-up of 7.9 years.

At the ≥ 150 min/week threshold, both WW (hazard ratio [HR] = 0.89, 95% confidence interval [CI]: 0.84–0.94, P < 0.001) and regularly active patterns (HR = 0.93, 95% CI: 0.87–0.99, P = 0.028) were associated with a reduced risk of cataract compared to inactivity. The WW pattern was also associated with a reduced risk of diabetic retinopathy (DR, HR = 0.74, 95% CI: 0.55–0.99, P = 0.043) and age-related macular degeneration (AMD, HR = 0.85, 95% CI: 0.75–0.97, P = 0.016). Direct comparisons between the WW and regularly active patterns showed no significant differences for these conditions (all P > 0.05), except for a nominal difference in glaucoma (P = 0.036). At the ≥ 300 min/week threshold, only the WW pattern remained significantly associated with reduced risk of cataract (HR = 0.91, 95% CI: 0.86–0.97, P = 0.002) and glaucoma (HR = 0.86, 95% CI: 0.75–0.97, P = 0.019).

Both the WW and regularly active patterns demonstrate protective associations with age-related eye diseases compared to inactivity, with no statistically significant differences between the two active groups for most outcomes. These findings suggest that the WW approach is a viable and flexible alternative for individuals who find it difficult to maintain daily physical activity.

The online version contains supplementary material available at 10.1186/s40662-026-00480-6.

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