Association between weekend warrior physical activity patterns, physical activity intensity, and osteoporosis in adults over 50 years old: a cross-sectional study based on the NHANES 2017-2020.

BACKGROUND: Against the backdrop of global aging, declining bone health and the rising prevalence of osteoporosis(OP) in adults over 50 years old have become significant public health concerns. Physical activity is recognized as an effective non-pharmacological intervention for OP prevention. While current guidelines recommend 150 + minutes of moderate-intensity physical activity(MPA) for general health promotion, the association between weekend warrior physical activity patterns, physical activity intensity, and OP in adults over 50 years old remains unclear. METHODS: This study utilized data from the National Health and Nutrition Examination Survey(NHANES) 2017–2020 to investigate the associations between physical activity patterns (inactive, weekend warrior, and regular activity), physical activity intensity, and OP in adults over 50 years old. Weighted multivariable logistic regression analysis was employed as the primary analytical method. RESULTS: A cohort of 3,539 participants was included in this study, among whom 52.9% were female. Among adults over 50 years old, compared to the inactive group, the weekend warrior group was associated with an 89% reduced risk of OP (OR: 0.11, 95% CI: 0.03–0.36, P = 0.024), demonstrated significantly higher femoral bone mineral density, regardless of the intensity level of physical activity performed. The results of the subgroup and sensitivity analyses were aligned with those of the primary analysis, further enhancing the robustness of the findings. CONCLUSION: Our study revealed that among adults over 50 years old, achieving the WHO-recommended 150 + minutes of MPA within 1–2 days per week was associated with significantly reduced OP risk compared to physical inactivity. Furthermore, for individuals unable to engage in daily exercise, low-frequency but goal-oriented attainment of the WHO-prescribed physical activity duration may provide a viable alternative strategy for OP risk mitigation.