Weekend warrior and exercise snacks: potential patterns of physical activity to promote healthier lifestyle in primary care

Current international recommendations on physical activity (PA) suggest that adults should engage in at least 150–300 minutes of moderate- to vigorous-intensity physical activity (MVPA) per week.¹ Additionally, light-intensity PA in daily life is recommended as a replacement for sedentary behaviours.¹ While the importance of sufficient MVPA is well established, the health benefits of light-intensity PA have gained increasing attention in recent years.²

Several PA promotion initiatives have been established in primary care settings such as Green Prescription (New Zealand), Let’s Get Moving (United Kingdom) and Exercise is Medicine (United States).³ However, only a small proportion of primary care patients receive PA counselling from their healthcare providers.⁴ Systemic barriers, such as time constraints, are a major obstacle to PA promotion during clinical encounters.⁵ In addition, motivating patients to meet the recommended PA levels remains challenging due to personal limitations.⁵

“Weekend warrior” and “exercise snacks” are patterns of PA that are gaining recognition in both public perception and scientific literature. This letter explores these two PA patterns and proposes potential approaches to promoting PA in primary care.

Weekend warrior

The term “weekend warrior” has been used in medical literature for over 20 years. A landmark article published in 2004 defined a weekend warrior as an individual who expends ≥1,000kcal per week through sports or recreational activities performed 1–2 times per week.⁶ A more recent article, published in 2023, differentiated two patterns of achieving the recommended PA levels: 1) engaging in PA in 1–2 sessions per week, referred to as the “weekend warrior pattern’ and 2) distributing PA across multiple sessions per week, known as the “regularly active pattern”.⁷ In general, being a weekend warrior involves accumulating at least 150 minutes per week of moderate-intensity PA or 75 minutes per week of vigorous-intensity PA within 1 or 2 days.

A systematic review and meta-analysis of seven studies, including 426,428 participants, found significant reductions in cardiovascular mortality (relative risk [RR] 0.73, 95% confidence interval [95% CI] 0.60–0.90) and all-cause mortality (RR 0.83, 95% CI 0.77–0.90) in individuals following the weekend warrior pattern compared with those who were physically inactive.⁷ Additional analysis indicated that the weekend warrior and regularly active PA patterns resulted in similar risk reductions.⁷ Nevertheless, this PA pattern may increase musculoskeletal injuries and trauma.⁷

Exercise snacks

The term “exercise snacks” has gained public attention since 2007.⁸ Recent literature defines exercise snacks as “isolated bouts of vigorous exercise lasting ≤1 minute, performed multiple times throughout the day”⁸ or “engaging in multiple brief exercise sessions, each lasting less than or equal to 1 ​min, spaced at intervals of 1–4 ​hours throughout the day”.⁹ Based on the Borg Category Ratio 10 Perceived Exertion Scale (0=nothing at all; 10=maximal exertion), an exercise snack is rated at close to or greater than 5 (hard effort and above).⁸ There are some variations of the definition of exercise snacks, in terms of the bout duration and the intensity of activity. In addition, other terms under the umbrella term of intermittent PA are used interchangeably to refer to exercise snacks.¹⁰ Snacktivity is multiple 2–5-minute bouts of MVPA across the day, and vigorous intermittent lifestyle PA is up to 5-minute bouts of vigorous-intensity PA in daily living activities.¹⁰

Exercise snacks can be incorporated into routine activities in various settings, such as homes, schools and offices.⁹ For example, an individual may walk briskly up the stairs to use a toilet on a different floor.⁸ One key advantage of exercise snacks is that they do not require specific exercise equipment or settings.⁹ Exercise snacks can be categorised into two types: 1) vigorous intermittent exercise and 2) moderate intermittent exercise.⁹

Physiological outcomes, as surrogate markers, from exercise snacks have been documented, including improved cardiorespiratory fitness, reduced plasma glucose and lipid levels and enhanced muscle strength and blood flow.^8,9 However, the long-term effects of exercise snacks, such as their role in preventing major non-communicable diseases and reducing mortality, require further investigation. A consideration of exercise snacks is that brief and intermittent bouts of PA at moderate- to vigorous-intensity may pose a challenge and risk of injuries for physically inactive individuals.

Conclusion

Weekend warrior and exercise snacks offer additional options for promoting PA in primary care. Although these PA patterns are evidence-based, flexible, adaptable and potentially pragmatic, they are not the replacement of regular MVPA throughout the week. Weekend warrior can lead to meeting the recommended PA levels; however, it may not reduce daily sedentary behaviours. Exercise snacks help break sedentary time during the days; however, it may not be sufficient to meet the recommended PA levels. Both PA patterns may increase risks of injuries, especially in inactive individuals and patients with medical conditions. Therefore, safety issues should be considered, and the fundamental principle of “start low and go slow” is applicable to minimise the risk of adverse events.