Skip to main content

Advertisement

SpringerLink
Log in

The associations of weekend warrior and other physical activity patterns with the risk of all-cause and cardiovascular disease mortality in people with diabetes mellitus and chronic kidney disease: from NHANES 2007–2020

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Aim

To investigate the associations of the weekend warrior and other physical activity (PA) patterns with all-cause, cardiovascular disease (CVD) mortality risk in people with diabetes mellitus (DM) and chronic kidney disease (CKD).

Methods

This study pooled the data from NHANES 2007–2020. Participants with DM and CKD were included. PA was assessed using a self-reported questionnaire. According to the characteristics of recreational activities, individuals were categorized as inactive (no activities), insufficiently active (total PA duration <  150 min/week), weekend warrior (total PA duration ≥  150 min/week for 1–2 sessions), and regularly active (total PA duration ≥  150 min/week for ≥  3 sessions). Weighted Cox regression models with adjusting sociodemographic, behavioral, and metabolic factors were performed to investigate the relationship of PA patterns with all-cause and CVD mortality risk. Stratification and interaction analyses were further performed.

Results

Among 1702 participants (46.53% female; 64 ± 0.46 years old), 536 died (163 cardiovascular) during the follow-up of 68 (39–104) months. The hazard ratio (HR) of all-cause death was 0.618 (95% CI 0.406–0.942) for insufficiently active PA pattern, 0.338 (95% CI 0.116–0.988) for weekend warrior PA pattern, and 0.536 (95% CI 0.395–0.726) for regularly active PA pattern compared with inactive PA pattern. HR of CVD death was 0.545 (95% CI 0.250–1.189) for the PA pattern of insufficiently active, 0.165 (95% CI 0.020–1.343) for weekend warrior, and 0.393 (95% CI 0.218–0.710) for regularly active compared with the inactive PA pattern. The associations present no difference in subgroups. Moreover, there was no discernible difference between weekend warrior and regularly active PA patterns for all-cause and CVD deaths. The risk of death declined relatively quickly When exercise was initiated and to a total of 450 min or 4 times per week.

Conclusion

In a population of DM and CKD, the weekend warrior pattern was similar to regular activity to lower the risk of all-cause mortality, compared with inactivity. The weekend warrior pattern was recommended for people who only have time to exercise on the weekend. However, longer and larger sample cohort studies are needed to validate our findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

Data analyzed in this study are available on the NHANES website: https://wwwn.cdc.gov/nchs/nhanes/.

References

  1. International Diabetes Federation (2021) IDF diabetes atlas, 10th edn. International Diabetes Federation, Brussels, Belgium

    Google Scholar 

  2. American Diabetes Association Professional Practice Committee (2022) 11. Chronic kidney disease and risk management: standards of medical care in diabetes—2022. Diabetes Care 45:S175–S184. https://doi.org/10.2337/dc22-S011

    Article  Google Scholar 

  3. de Boer IH et al (2022) Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and kidney disease: Improving Global Outcomes (KDIGO). Kidney Int 102(5):974–989. https://doi.org/10.1016/j.kint.2022.08.012

    Article  PubMed  Google Scholar 

  4. Han M, Fang J, Zhang Y, Song X, Jin L, Ma Y (2023) Associations of sleeping, sedentary and physical activity with phenotypic age acceleration: a cross-sectional isotemporal substitution model. BMC Geriatr 23(1):165. https://doi.org/10.1186/s12877-023-03874-6

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bowlby W et al (2016) Physical activity and metabolic health in chronic kidney disease: a cross-sectional study. BMC Nephrol 17(1):187. https://doi.org/10.1186/s12882-016-0400-x

    Article  PubMed  PubMed Central  Google Scholar 

  6. Agarwal R, Light RP (2008) Physical activity and hemodynamic reactivity in chronic kidney disease. Clin J Am Soc Nephrol 3(6):1660–1668. https://doi.org/10.2215/CJN.02920608

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Roshanravan B et al (2013) Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol 24(5):822–830. https://doi.org/10.1681/ASN.2012070702

    Article  PubMed  PubMed Central  Google Scholar 

  8. De Boer IH et al (2020) KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int 98(4):S1–S115. https://doi.org/10.1016/j.kint.2020.06.019

    Article  Google Scholar 

  9. O’Donovan G, Sarmiento OL, Hamer M (2018) The Rise of the ‘Weekend Warrior.’ J Orthop Sports Phys Ther 48(8):604–606. https://doi.org/10.2519/jospt.2018.0611

    Article  PubMed  Google Scholar 

  10. O’Donovan G, Lee I-M, Hamer M, Stamatakis E (2017) Association of ‘Weekend Warrior’ and other leisure time physical activity patterns with risks for all-cause, cardiovascular disease, and cancer mortality. JAMA Intern Med 177(3):335–342. https://doi.org/10.1001/jamainternmed.2016.8014

    Article  PubMed  Google Scholar 

  11. Levey AS et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006

    Article  PubMed  PubMed Central  Google Scholar 

  12. “NHANES - NCHS Research Ethics Review Board Approval. https://www.cdc.gov/nchs/nhanes/irba98.htm. Accessed 21 Jun 2023

  13. Almohamad M, Krall Kaye E, Mofleh D, Spartano NL (2022) The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011–2012. J Clin Periodontol 49(8):758–767. https://doi.org/10.1111/jcpe.13669

    Article  PubMed  Google Scholar 

  14. Piercy KL et al (2018) The physical activity guidelines for Americans. JAMA 320(19):2020–2028. https://doi.org/10.1001/jama.2018.14854

    Article  PubMed  PubMed Central  Google Scholar 

  15. “Data Access - National Death Index”. https://www.cdc.gov/nchs/ndi/index.htm. Accessed 25 Aug 2023

  16. “NHANES Survey Methods and Analytic Guidelines”. https://wwwn.cdc.gov/nchs/nhanes/AnalyticGuidelines.aspx. Accessed: 25 Aug 2023

  17. Böhm M et al (2022) Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk. Cardiovasc Diabetol 21(1):12. https://doi.org/10.1186/s12933-021-01429-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Beddhu S, Baird BC, Zitterkoph J, Neilson J, Greene T (2009) Physical activity and mortality in chronic kidney disease (NHANES III). Clin J Am Soc Nephrol 4(12):1901–1906. https://doi.org/10.2215/CJN.01970309

    Article  PubMed  PubMed Central  Google Scholar 

  19. Johansen KL et al (2013) Association of physical activity with survival among ambulatory patients on dialysis: the comprehensive dialysis study. Clin J Am Soc Nephrol 8(2):248–253. https://doi.org/10.2215/CJN.08560812

    Article  PubMed  Google Scholar 

  20. Rosas SE, Reese PP, Huan Y, Doria C, Cochetti PT, Doyle A (2012) Pretransplant physical activity predicts all-cause mortality in kidney transplant recipients. Am J Nephrol 35(1):17–23. https://doi.org/10.1159/000334732

    Article  PubMed  Google Scholar 

  21. Lopes AA et al (2014) Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS. Clin J Am Soc Nephrol 9(10):1702–1712. https://doi.org/10.2215/CJN.12371213

    Article  PubMed  PubMed Central  Google Scholar 

  22. Greenwood SA et al (2015) Effect of exercise training on estimated GFR, vascular health, and cardiorespiratory fitness in patients with CKD: a pilot randomized controlled trial. Am J Kidney Dis 65(3):425–434. https://doi.org/10.1053/j.ajkd.2014.07.015

    Article  PubMed  Google Scholar 

  23. Beddhu S, Wei G, Marcus RL, Chonchol M, Greene T (2015) Light-intensity physical activities and mortality in the United States general population and CKD subpopulation. Clin J Am Soc Nephrol 10(7):1145–1153. https://doi.org/10.2215/CJN.08410814

    Article  PubMed  PubMed Central  Google Scholar 

  24. Khurshid S, Al-Alusi MA, Churchill TW, Guseh JS, Ellinor PT (2023) Accelerometer-derived ‘weekend warrior’ physical activity and incident cardiovascular disease. JAMA 330(3):247. https://doi.org/10.1001/jama.2023.10875

    Article  PubMed  PubMed Central  Google Scholar 

  25. Shuval K, Li Q, Gabriel KP, Tchernis R (2017) Income, physical activity, sedentary behavior, and the ‘weekend warrior’ among U.S. adults. Prev Med 103:91–97. https://doi.org/10.1016/j.ypmed.2017.07.033

    Article  PubMed  Google Scholar 

  26. Sarmiento OL, Díaz Del Castillo A, Triana CA, Acevedo MJ, Gonzalez SA, Pratt M (2017) Reclaiming the streets for people: insights from ciclovías recreativas in Latin America. Prev Med 103S:S34–S40. https://doi.org/10.1016/j.ypmed.2016.07.028

    Article  PubMed  Google Scholar 

  27. Wang K, Xia F, Li Q, Luo X, Wu J (2023) The associations of weekend warrior activity patterns with the visceral adiposity index in US adults: repeated cross-sectional study. JMIR Public Health Surveill 9:e41973. https://doi.org/10.2196/41973

    Article  PubMed  PubMed Central  Google Scholar 

  28. Chen R et al (2023) Weekend warrior physical activity pattern is associated with lower depression risk: findings from NHANES 2007–2018. Gen Hosp Psychiatry 84:165–171. https://doi.org/10.1016/j.genhosppsych.2023.07.006

    Article  PubMed  Google Scholar 

  29. Hartnett DA, Milner JD, DeFroda SF (2022) The weekend warrior: common shoulder and elbow injuries in the recreational athlete. Am J Med 135(3):297–301. https://doi.org/10.1016/j.amjmed.2021.08.015

    Article  PubMed  Google Scholar 

  30. “Environmental factors associated with adults’ participation in physical activity: a review - PubMed”. https://pubmed.ncbi.nlm.nih.gov/11897464/. Accessed 28 Aug 2023

  31. Wilkinson TJ, Watson EL, Vadaszy N, Baker LA, Viana JL, Smith AC (2020) Response of the oxygen uptake efficiency slope to exercise training in patients with chronic kidney disease. Kidney Res Clin Pract 39(3):305–317. https://doi.org/10.23876/j.krcp.20.032

    Article  PubMed  PubMed Central  Google Scholar 

  32. Odden MC, Whooley MA, Shlipak MG (2004) Association of chronic kidney disease and anemia with physical capacity: the heart and soul study. J Am Soc Nephrol 15(11):2908–2915. https://doi.org/10.1097/01.ASN.0000143743.78092.E3

    Article  PubMed  Google Scholar 

  33. Wang XH, Mitch WE, Price SR (2022) Pathophysiological mechanisms leading to muscle loss in chronic kidney disease. Nat Rev Nephrol 18(3):138–152. https://doi.org/10.1038/s41581-021-00498-0

    Article  CAS  PubMed  Google Scholar 

  34. Giha HA, Sater MS, Alamin OAO (2022) Diabetes mellitus tendino-myopathy: epidemiology, clinical features, diagnosis and management of an overlooked diabetic complication. Acta Diabetol 59(7):871–883. https://doi.org/10.1007/s00592-022-01860-9

    Article  PubMed  Google Scholar 

  35. Zelle DM, Klaassen G, Van Adrichem E, Bakker SJL, Corpeleijn E, Navis G (2017) Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol 13(3):152–168. https://doi.org/10.1038/nrneph.2016.187

    Article  PubMed  Google Scholar 

  36. van Ballegooijen AJ, van der Ploeg HP, Visser M (2019) Daily sedentary time and physical activity as assessed by accelerometry and their correlates in older adults. Eur Rev Aging Phys Act 16:3. https://doi.org/10.1186/s11556-019-0210-9

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kohler M, Schänzer W, Thevis M (2015) Effects of exercise on the urinary proteome. Adv Exp Med Biol 845:121–131. https://doi.org/10.1007/978-94-017-9523-4_12

    Article  PubMed  Google Scholar 

  38. Sun Y et al (2017) Changes in proteinuria on the risk of all-cause mortality in people with diabetes or prediabetes: a prospective cohort study. J Diabetes Res 2017:8368513. https://doi.org/10.1155/2017/8368513

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We appreciate the personnel of NHANES, enabling us to access high-quality data for our clinical study.

Author information

Authors and Affiliations

  1. Department of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China

    Qing Yang & Fang Liu

  2. Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China

    Qing Yang & Fang Liu

  3. Department of Project Design and Statistics, West China Hospital of Sichuan University, Chengdu, China

    Wenjie Yang

Authors
  1. Qing Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wenjie Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

FL and QY conceptualized the study. QY and W.Y analyzed the data. QY wrote the original draft. FL gave advice on entire procedure and edited the manuscript. All authors agreed to the final manuscript.

Corresponding author

Correspondence to Fang Liu.

Ethics declarations

Conflict of interest

The authors declared that they have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 28 KB)

Supplementary file2 (DOCX 966 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, Q., Yang, W. & Liu, F. The associations of weekend warrior and other physical activity patterns with the risk of all-cause and cardiovascular disease mortality in people with diabetes mellitus and chronic kidney disease: from NHANES 2007–2020. Int Urol Nephrol 56, 1703–1712 (2024). https://doi.org/10.1007/s11255-023-03863-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-023-03863-z

Keywords

Search

Navigation