{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T09:01:33Z","timestamp":1768899693218,"version":"3.49.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1,16]]},"abstract":"<jats:p>The aim of this study is to examine the association between physical activity patterns and all-cause mortality among U.S. adults with osteopenia or osteoporosis. Data from adults with osteopenia or osteoporosis were obtained from the National Health and Nutrition Examination Survey 2007 to 2018, a nationally representative survey of U.S. adults, with mortality follow-up through 2019. Bone mineral density was assessed at 4 femoral sites using dual-energy X-ray absorptiometry. Physical activity was self-reported and categorized as physically inactive (&lt;150 minutes\/week) or active (\u2265150 minutes\/week). Active participants were further classified as weekend warriors (1\u20132 sessions\/week) or regularly active (\u22653 sessions\/week). Cox proportional hazards models estimated hazard ratios (HRs) for all-cause mortality. Among 5522 participants (mean age: 61.74 years), 991 (17.95%) died during a mean follow-up of 85.0 months. Compared to regularly active participants, weekend warriors had no statistically significant difference in all-cause mortality risk (HR: 1.12; 95% confidence interval (CI): 0.62\u20132.03). Further subdivision of weekend warriors by frequency (1 vs 2 days\/week) yielded similar results. In contrast, physical inactivity was associated with significantly higher mortality risk (HR: 1.78; 95% CI: 1.38\u20132.28). Among adults with osteopenia or osteoporosis, meeting physical activity guidelines, even over 1 or 2 days per week, was associated with lower mortality risk. These findings support the weekend warrior pattern as a viable strategy for improving longevity in this at-risk population.<\/jats:p>","DOI":"10.1097\/md.0000000000047293","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T19:01:37Z","timestamp":1768849297000},"page":"e47293","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Physical activity patterns and all-cause mortality in U.S. adults with osteopenia or osteoporosis: A prospective cohort study"],"prefix":"10.1097","volume":"105","author":[{"given":"Jun","family":"Xu","sequence":"first","affiliation":[{"name":"School of Computer Science and Artificial Intelligence, Guangdong University of Education, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7678-5254","authenticated-orcid":false,"given":"Pincheng","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway, Galway, Ireland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8640-6609","authenticated-orcid":false,"given":"Yanxue","family":"Lian","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway, Galway, Ireland."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20260119","doi-asserted-by":"crossref","first-page":"870905","DOI":"10.3389\/fendo.2022.870905","article-title":"Global, regional, and national burden of low bone mineral density from 1990 to 2019: results from the global burden of disease study 2019.","volume":"13","author":"Dong","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R2-20260119","doi-asserted-by":"crossref","first-page":"c3324","DOI":"10.1136\/bmj.c3324","article-title":"Functional decline after incident wrist fractures \u2013 -study of osteoporotic fractures: prospective cohort study.","volume":"341","author":"Edwards","year":"2010","journal-title":"BMJ"},{"key":"R3-20260119","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1359\/jbmr.2000.15.10.1974","article-title":"Rate of bone loss is associated with mortality in older women: a prospective study.","volume":"15","author":"Kado","year":"2000","journal-title":"J Bone Miner Res"},{"key":"R4-20260119","first-page":"105","article-title":"The epidemiology of osteoporosis.","volume":"133","author":"Clynes","year":"2020","journal-title":"Br Med Bull"},{"key":"R5-20260119","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1007\/s00198-010-1419-7","article-title":"Medical costs of osteoporosis in the elderly medicare population.","volume":"22","author":"Blume","year":"2011","journal-title":"Osteoporos Int"},{"key":"R6-20260119","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.mayocp.2014.09.011","article-title":"Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States.","volume":"90","author":"Singer","year":"2015","journal-title":"Mayo Clin Proc"},{"key":"R7-20260119","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S2213-8587(20)30408-3","article-title":"Osteoporosis: overlooked in men for too long.","volume":"9","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"R8-20260119","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2337\/dc23-0800","article-title":"Optimal dose and type of physical activity to improve glycemic control in people diagnosed with type 2 diabetes: a systematic review and meta-analysis.","volume":"47","author":"Gallardo-G\u00f3mez","year":"2024","journal-title":"Diabetes Care"},{"key":"R9-20260119","doi-asserted-by":"crossref","first-page":"e2350680","DOI":"10.1001\/jamanetworkopen.2023.50680","article-title":"Occupational sitting time, leisure physical activity, and all-cause and cardiovascular disease mortality.","volume":"7","author":"Gao","year":"2024","journal-title":"JAMA Netw Open"},{"key":"R10-20260119","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s00384-025-04811-2","article-title":"The global, regional, and national disease burden of colorectal cancer attributable to low physical activity from 1990 to 2021: an analysis of the global burden of disease study 2021.","volume":"40","author":"Lian","year":"2025","journal-title":"Int J Colorectal Dis"},{"key":"R11-20260119","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1001\/jamaoncol.2023.1830","article-title":"Vigorous intermittent lifestyle physical activity and cancer incidence among nonexercising adults.","volume":"9","author":"Stamatakis","year":"2023","journal-title":"JAMA Oncol"},{"key":"R12-20260119","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3803\/EnM.2018.33.4.435","article-title":"Effects of resistance exercise on bone health.","volume":"33","author":"Hong","year":"2018","journal-title":"Endocrinol Metabol (Seoul, Korea)"},{"key":"R13-20260119","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/aje\/kwh274","article-title":"The \u201cweekend warrior\u201d and risk of mortality.","volume":"160","author":"Lee","year":"2004","journal-title":"Am J Epidemiol"},{"key":"R14-20260119","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1186\/s12944-024-02278-8","article-title":"The association between different leisure-time physical activity patterns and the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in adults: national health and nutrition examination survey 2007\u20132018.","volume":"23","author":"Lian","year":"2024","journal-title":"Lipids Health Dis"},{"key":"R15-20260119","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1161\/CIRCULATIONAHA.124.068669","article-title":"Associations of \u201cweekend warrior\u201d physical activity with incident disease and cardiometabolic health.","volume":"150","author":"Kany","year":"2024","journal-title":"Circulation"},{"key":"R18-20260119","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1007\/s00198-008-0594-2","article-title":"Improved precision with Hologic Apex software.","volume":"19","author":"Fan","year":"2008","journal-title":"Osteoporos Int"},{"key":"R19-20260119","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1002\/jbmr.55","article-title":"Estimates of the proportion of older white men who would be recommended for pharmacologic treatment by the new US national osteoporosis foundation guidelines.","volume":"25","author":"Donaldson","year":"2010","journal-title":"J Bone Miner Res"},{"key":"R20-20260119","doi-asserted-by":"crossref","first-page":"102826","DOI":"10.1016\/j.pmedr.2024.102826","article-title":"Association between dietary inflammatory index and all-cause mortality in patients with osteopenia or osteoporosis: a retrospective cohort study from the NHANES 2007\u20132018.","volume":"45","author":"Ke","year":"2024","journal-title":"Prev Med Rep"},{"key":"R21-20260119","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1007\/s001980050093","article-title":"Updated data on proximal femur bone mineral levels of US adults.","volume":"8","author":"Looker","year":"1998","journal-title":"Osteoporos Int"},{"key":"R23-20260119","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour.","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"R24-20260119","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/jamainternmed.2022.2488","article-title":"Association of the \u201cweekend warrior\u201d and other leisure-time physical activity patterns with all-cause and cause-specific mortality.","volume":"182","author":"dos Santos","year":"2022","journal-title":"JAMA Intern Med"},{"key":"R25-20260119","first-page":"1","article-title":"Measuring progress in healthy people 2010.","volume":"25","author":"Keppel","year":"2004","journal-title":"Healthy People 2010 Statistical Notes: From the Centers for Disease Control and Prevention\/National Center for Health Statistics"},{"key":"R27-20260119","doi-asserted-by":"crossref","first-page":"e015533","DOI":"10.1161\/JAHA.119.015533","article-title":"Association between blood lead level and uncontrolled hypertension in the US population (NHANES 1999\u20132016).","volume":"9","author":"Miao","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"R28-20260119","doi-asserted-by":"crossref","first-page":"S62","DOI":"10.2337\/dc10-S062","article-title":"Diagnosis and classification of diabetes mellitus.","volume":"33","year":"2010","journal-title":"Diabetes Care"},{"key":"R29-20260119","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.amjmed.2015.07.016","article-title":"Regular physical activity: forgotten benefits.","volume":"129","author":"Lewis","year":"2016","journal-title":"Am J Med"},{"key":"R30-20260119","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.mayocp.2024.10.022","article-title":"Accelerometer-derived \u201cweekend warrior\u201d physical activity and all-cause and cause-specific mortality.","volume":"100","author":"Huang","year":"2025","journal-title":"Mayo Clin Proc"},{"key":"R31-20260119","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1186\/s13098-024-01455-0","article-title":"Association between weekend warrior physical activity pattern and all-cause mortality among adults living with type 2 diabetes: a prospective cohort study from NHANES 2007 to 2018.","volume":"16","author":"Mahe","year":"2024","journal-title":"Diabetol Metab Syndr"},{"key":"R32-20260119","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1002\/jbmr.4681","article-title":"Bone mineral density is inversely associated with mortality in chronic kidney disease patients: a meta-analysis.","volume":"37","author":"Jiang","year":"2020","journal-title":"J Bone Miner Res"},{"key":"R33-20260119","doi-asserted-by":"crossref","first-page":"938399","DOI":"10.3389\/fendo.2022.938399","article-title":"The associations between bone mineral density and long-term risks of cardiovascular disease, cancer, and all-cause mortality.","volume":"13","author":"Shi","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R34-20260119","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1002\/jbmr.2795","article-title":"Bone mineral density and parathyroid hormone as independent risk factors for mortality in community-dwelling older adults: a population-based prospective cohort study in Brazil. The S\u00e3o Paulo Ageing & Health (SPAH) Study.","volume":"31","author":"Domiciano","year":"2016","journal-title":"J Bone Miner Res"},{"key":"R35-20260119","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.mayocp.2021.07.019","article-title":"Osteoporosis and its association with cardiovascular disease, respiratory disease, and cancer: findings from the UK biobank prospective cohort study.","volume":"97","author":"Rodr\u00edguez-G\u00f3mez","year":"2022","journal-title":"Mayo Clin Proc"},{"key":"R36-20260119","doi-asserted-by":"crossref","first-page":"S107","DOI":"10.1016\/S1297-319X(10)70004-X","article-title":"Osteoporosis and mortality.","volume":"77","author":"Leboime","year":"2010","journal-title":"Joint Bone Spine"},{"key":"R37-20260119","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1001\/jama.2009.50","article-title":"Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women.","volume":"301","author":"Bliuc","year":"2009","journal-title":"JAMA"},{"key":"R38-20260119","doi-asserted-by":"crossref","first-page":"937","DOI":"10.2147\/TCRM.S72456","article-title":"A systematic review of the outcomes of osteoporotic fracture patients after hospital discharge: morbidity, subsequent fractures, and mortality.","volume":"10","author":"Shuid","year":"2014","journal-title":"Ther Clin Risk Manag"},{"key":"R39-20260119","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1503\/cmaj.051351","article-title":"Health benefits of physical activity: the evidence.","volume":"174","author":"Warburton","year":"2006","journal-title":"CMAJ"},{"key":"R40-20260119","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00198-022-06592-8","article-title":"Exercise and the prevention of major osteoporotic fractures in adults: a systematic review and meta-analysis with special emphasis on intensity progression and study duration.","volume":"34","author":"Hoffmann","year":"2023","journal-title":"Osteoporos Int"},{"key":"R41-20260119","first-page":"1143","author":"Booth","year":"2012","journal-title":"Lack of Exercise Is a Major Cause of Chronic Diseases"},{"key":"R42-20260119","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1136\/bjsports-2021-104634","article-title":"Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis.","volume":"56","author":"Brooke-Wavell","year":"2022","journal-title":"Br J Sports Med"},{"key":"R43-20260119","doi-asserted-by":"crossref","first-page":"101677","DOI":"10.1016\/j.eclinm.2022.101677","article-title":"Living alone and all-cause mortality in community-dwelling adults: a systematic review and meta-analysis.","volume":"54","author":"Zhao","year":"2022","journal-title":"EClinicalMedicine"},{"key":"R44-20260119","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1093\/ageing\/afab155","article-title":"Why is living alone in older age related to increased mortality risk? A longitudinal cohort study.","volume":"50","author":"Abell","year":"2021","journal-title":"Age Ageing"},{"key":"R45-20260119","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/abm\/kay038","article-title":"Smoking and physical activity explain the increased mortality risk following marital separation and divorce: evidence from the english longitudinal study of ageing.","volume":"53","author":"Bourassa","year":"2019","journal-title":"Annal Behav Med"},{"key":"R46-20260119","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.cpr.2016.03.006","article-title":"The effects of physical activity interventions on psychosocial outcomes in adolescents: a meta-analytic review.","volume":"45","author":"Spruit","year":"2016","journal-title":"Clin Psychol Rev"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000047293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T19:01:42Z","timestamp":1768849302000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000047293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000047293","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]},"assertion":[{"value":"2025-08-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}