150 minutes of flexible Weekly Exercise Patterns Lower CV Risk in Overweight Adults: Study
China: Researchers have found in a new study that among adults with overweight or obesity, achieving at least 150 minutes of moderate-to-vigorous physical activity per week significantly reduces cardiovascular risk, regardless of whether the activity is concentrated into 1–2 days or spread across the week. Flexible exercise patterns may therefore provide a practical and effective approach to improve long-term adherence while maintaining cardiovascular benefits in high-risk populations.
The study was published online on BMC Medicine on 16 February 2026.
Cardiovascular disease (CVD) remains the leading cause of death globally, and excess body weight substantially increases this risk. While guidelines recommend at least 150 minutes of moderate-to-vigorous physical activity (MVPA) per week, they typically advise spreading activity across multiple days. Whether concentrating exercise into one or two days offers similar protection has been unclear, particularly in individuals with overweight or obesity.
To investigate this, Kai Mu from The Second Qilu Hospital of Shandong University and colleagues conducted a prospective cohort study using UK Biobank data. The analysis included 49,368 adults with overweight or obesity (mean age 63.5 years; 51.4% women) who had no prior history of CVD. Physical activity was measured using accelerometers between 2006 and 2010.
Participants were categorized into three groups: inactive (<150 minutes/week of MVPA), regularly active (≥150 minutes/week spread over at least three days), and concentrated activity (≥150 minutes/week with at least half performed within one to two days). Over a median follow-up of 7.9 years, researchers recorded incident fatal and nonfatal CVD events, including myocardial infarction, atrial fibrillation, heart failure, and stroke.
The study led to the following findings:
- In fully adjusted analyses, both the concentrated activity and regularly active groups demonstrated similar reductions in overall cardiovascular disease (CVD) risk compared to inactive individuals.
- The hazard ratio (HR) for composite CVD was 0.79 in the concentrated activity group and 0.76 in the regularly active group.
- Reduced risks were also observed for specific cardiovascular outcomes.
- For myocardial infarction, the HR was 0.77 in the concentrated activity group and 0.64 in the regularly active group.
- Comparable protective associations were noted for atrial fibrillation, heart failure, and stroke in both active groups.
- The findings remained consistent across subgroup and sensitivity analyses, supporting the robustness of the results.
The study suggests that meeting the recommended weekly volume of MVPA is key, regardless of how it is distributed. For adults with overweight or obesity, concentrating exercise into one or two days appears to provide cardiovascular benefits similar to those achieved with more evenly distributed activity.
These findings highlight the value of flexible exercise strategies, which may improve adherence and help reduce long-term cardiovascular risk in high-risk populations.
Reference:
Mu, K., Qiao, Y., Lin, R. et al. Physical activity patterns and cardiovascular disease risk in adults with overweight or obesity: a prospective cohort study. BMC Med (2026). https://doi.org/10.1186/s12916-026-04701-6
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