Associations of Weekend Warrior and Other Leisure-time Physical Activity Patterns with the Risk of Insulin Resistance——Evidence from NHANES 2007-2018

Background: Insulin resistance (IR) is a critical precursor to various metabolic disorders, including type 2 diabetes and cardiovascular diseases. This study aims to explore the relationship between weekend warrior (WW) and other LTPA patterns with IR risk among American adults. Methods: Data from 6 National Health and Nutrition Examination Survey (NHANES) cycles (2007-2008 to 2017-2018) were analyzed, with the final sample consisting of 10150 adults. Participants were assessed for IR using 6 indices: HOMA-IR, QUICKI, TyG index, TG/HDL-c, METS-IR, and TyG-BMI. LTPA patterns were determined using self-reported frequency and duration based on the global physical activity questionnaire and then categorized into inactive, insufficiently active, weekend warrior and regularly active. Analyses of variances and Rao-Scott adjusted chi-square tests were employed to compare the characteristics across LTPA patterns, and multivariate weighted logistic regression models were conducted to explore the associations of LTPA patterns and IR risk. Weighted restricted cubic splines were utilized to examine the dose-response associations of LTPA patterns and IR risk. Results: The final sample included 10150 participants representative for approximately 170.4 million adults, with WW prevalence being 4.66%. Both WW and regularly active adults exhibited lower IR risk compared to inactive participants, and no significant differences in IR risk between weekend warriors and regularly active participants were observed. The relationship between LTPA pattern and IR risk was consistent across different subgroups, and 3 interaction effects were observed. Significant nonlinear relationships between LTPA and IR risk were only observed in TyG and TyG-BMI indices. Conclusion: This study underscores the importance of WW and regular physical activity in mitigating IR risk, highlighting that even less frequent but intense physical activity can confer significant metabolic benefits.