Associations of “weekend warrior” and other physical activity patterns with sarcopenia among older adults in China: a cross-sectional study

BACKGROUND: Moderate-to-vigorous physical activity (MVPA) is effective in preventing sarcopenia. Current physical activity guidelines recommend ≥ 150 min/week of moderate-to-vigorous physical activity (MVPA) for health benefits. Based on volume and frequency, distinct MVPA patterns exist beyond the regularly active pattern. The “weekend warrior” pattern, which concentrates 150 min into one or two sessions, may represent an alternative regimen for sarcopenia prevention. This study examined associations between MVPA patterns and risk of sarcopenia in older Chinese adults. METHODS: This cross-sectional study was based on 3,579 participants aged ≥ 60 years in the China Health and Retirement Longitudinal Study (CHARLS). MVPA patterns were self-reported through questionnaires and categorized into four groups: inactive (no MVPA), insufficiently active (IA) (< 150 min of MVPA /week), weekend warrior (WW) (≥ 150 min of MVPA with ≤ 2 sessions/week), and regularly active (RA) (≥ 150 min of MVPA with > 2 sessions/week). Sarcopenia was operationalized based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria, incorporating the three components of muscle strength, physical performance, and appendicular skeletal muscle mass (ASM). Multivariable logistic regression models were employed to examine the associations of MVPA patterns with odds of sarcopenia, with subgroup analyses evaluating robustness across sociodemographic, lifestyle, and health-related characteristics. RESULTS: Participants were classified as inactive (n = 1492, 41.7%), IA (n = 175, 4.9%), WW (n = 131, 3.7%) and RA (n = 1781, 49.8%). Compared to inactive individuals, those engaging in the WW pattern (OR 0.62, 95% CI: 0.42–0.94), and RA pattern (OR 0.63, 95% CI: 0.53–0.74) showed significantly lower odds of sarcopenia in the fully adjusted model. However, the IA group did not exhibit significant association across any of the models. Subgroup analyses revealed that there were no significant moderators (all interaction P > 0.05). CONCLUSIONS: The WW pattern associates with lower odds of sarcopenia than the inactive group, offering a potential alternative for older adults who are unable to maintain regular weekly physical activity. These findings support incorporating the WW pattern into flexible physical activity recommendations for sarcopenia prevention in older adults.