Association between weekend warrior physical activity pattern and bone mineral density among adults: national health and nutrition examination survey.

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This study aims to explore the association between PA patterns and femoral neck BMD, and to examine the difference between the WW and RA patterns. Data were obtained from NHANES participants aged ≥ 18 years. PA patterns were self-reported through questionnaires and categorized into four groups: inactive, insufficiently active, weekend warrior, and regularly active. Multivariable linear regression analyses were conducted to evaluate the association between PA patterns and femoral neck BMD. Subgroup analyses and interaction effects were used to examine the potential differences across subgroups. Sensitivity analyses were used to examine the robustness and consistency of the findings. A total of 16,937 adults (mean age 53.6 ± 17.2 years) were included, comprising 8677 men (51.2%) and 8260 women (48.8%). Based on PA patterns, participants were classified as inactive (n = 9123), insufficiently active (n = 2559), weekend warriors (n = 952), and regularly active (n = 4303). After adjusting for relevant covariates, both the WW and RA groups showed significantly higher femoral neck BMD compared to the inactive group (WW: β = 0.027, 95% CI: 0.020, 0.033, P < 0.001; RA: β = 0.034, 95% CI: 0.025, 0.044, P < 0.001). No statistically significant difference in BMD was found between the WW and RA groups (P = 0.151). These findings were consistent across sensitivity and subgroup analyses. Further subgroup analysis suggested that younger adults (< 50 years old), males, and unmarried individuals may derive greater BMD benefits from the WW and RA patterns. Among US adults, the WW PA pattern was significantly associated with increased femoral neck BMD, with benefits comparable to those observed in the RA pattern.