Even ‘Weekend Warriors' Can Reduce GI Disease Risk

Medscape

08-05-2025

SAN DIEGO — The session started with a question that many in the audience at a May 4 session of Digestive Disease Week (DDW) 2025 seemed to relate to: 'How many of you find yourself squeezing workouts into a weekend after a hectic work week?'
Although regular exercise three or more times a week is often viewed as preferable, Shiyi Yu, MD, a resident physician in the Department of Gastroenterology at Guangdong Provincial People's Hospital in Guangzhou, China, had good news for weekend warriors.
Both patterns reduce digestive disease almost equally.
Her study compared weekend warriors with those she called 'active regulars' and sedentary folks to see how activity patterns affect digestive disease risks.
Her bottom line: 'Your gut does not care about your schedule.'
The researchers analyzed wrist-based accelerometer data from 89,595 participants in the UK Biobank. To categorize participants as active or inactive, they used the World Health Organization 2020 guidelines for physical activity, which recommend at least 150-300 minutes of moderate-intensity aerobic physical activity or at least 75-150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination throughout the week. Median age of participants was 63.3 years and 48.8% were men.
They divided participants into three groups:
About 43% were weekend warriors who met or exceeded 150 minutes of moderate to vigorous physical activity (MVPA), with 50% or more of total MVPA achieved in 1-2 days.
About 23% were active regulars who met or exceeded 150 minutes a week but spread over more days.
About 34% were inactive participants who were active less than 150 minutes a week.
The researchers followed the participants for a median of 7.9 years, looking for the incidence of multiple digestive diseases, identified using the International Classification of Diseases, 10th Revision, codes. These included diverticulosis, constipation, metabolic dysfunction–associated steatotic liver disease, cholelithiasis, and gastroesophageal reflux disease.
Both activity patterns 'showed similar risk reduction with no significant difference,' Yu said. At the threshold ≥ 150 minutes, for instance, hazard ratios for any digestive disease were 0.83 for weekend warriors and 0.79 for active regulars, compared with sedentary participants.
The analysis was repeated using a median threshold ≥ 230.4 minutes of MVPA a week, and the researchers found the same results.
As a validation cohort, the researchers used more than 6,000 participants from the National Institutes of Health's All of Us Research Program with over 6 months of wrist-based accelerometer data.
A recent meta-epidemiology study found that the weekend warrior pattern offers other health benefits, including reducing the risk for cardiovascular disease mortality, mental disorders, and metabolic syndrome.
A Pleasant Surprise
The digestive disease study's findings were 'a surprise and a pleasant one,' said Aasma Shaukat, MD, MPH, professor of medicine and a gastroenterologist at NYU Grossman School of Medicine, New York City.
'We often think if we're not able to exercise regularly, then there's no hope for us,' said Shaukat, who moderated the session. 'But this implies that even if we have time only during the weekend to engage in physical activity, it still confers benefits in reducing our risk of any GI health disorder, as well as cardiovascular or other health disorders, compared to people inactive at baseline.'
'It gives us flexibility in terms of how we structure our exercise. Obviously, people should try to get into the habit of doing regular activity; it's more sustainable. But a good alternative, according to this research, is that packing all of that in over the weekend seems to confer benefit. So all is not lost.'
Will this change her conversation with patients moving forward? Absolutely, Shaukat said. She generally recommends physical activity for at least 30 minutes three times a week. Now Shaukat said she can tell patients: 'If that's not possible, take that time out during the weekend for your health'.