Trends in Patterns of Physical Activity Among US Adults (1997–2018): The Untapped Weekend Warrior Potential for Enhancing Population Health

Objectives To evaluate trends and correlates of adherence to moderate to vigorous physical activity (MVPA) guidelines through regular MVPA and the weekend warrior (WW) pattern among US adults from 1997 to 2018. Design This serial cross-sectional study used data from the National Health Interview Survey. Setting and Participants The final sample included encompassing 633,949 adults aged ≥18 years who provided complete physical activity (PA) data between 1997 and 2018. Methods PA patterns were categorized as (1) not meeting MVPA guidelines, (2) meeting guidelines through a regular active pattern, and (3) meeting guidelines via the WW pattern, defined as accumulating ≥50% of total MVPA over 1–2 sessions per week. Weighted prevalence estimates were calculated, and temporal trends were assessed using linear regression models. Logistic regression models examined sociodemographic and health-related correlates of PA patterns. Results Over the 22-year period, the prevalence of adults not meeting MVPA guidelines declined by 10.2 percentage points (95% CI, −11.6 to −8.9; P < .001), while adherence through a regular active pattern increased by 11.6 percentage points (95% CI, 10.6–13.1; P < .001). Conversely, the prevalence of the WW pattern remained relatively stable, with a slight decrease of 1.6 percentage points (95% CI, −2.3 to −1.0; P = .005). Conclusions and Implications From 1997 to 2018, overall adherence to MVPA guidelines among US adults improved, primarily driven by increases in regular active patterns. The WW pattern remained consistently low despite its time efficiency and comparable health benefits. Enhancing awareness and promotion of the WW pattern may offer a viable strategy for individuals facing barriers to regular MVPA participation.