Can You Play 'Catch-Up' and Be Healthy?

By Brenda Goodman, MA
WebMD Health News

Reviewed by Brunilda Nazario, MD

Jan. 9, 2017 -- We're about a week into the new year, and for many of us, that means our resolutions to eat better, get more sleep, and exercise are probably running headlong into real life.

Sure, it's great to get to the gym every day, but sometimes a daily workout has to go if you've been up all night with a sick child or you've got a pressing project that needs attention at work. Ditto for the idea of packing a healthy lunch and getting plenty of shut-eye.

But don't give up. Science shows that even if you've been less than perfect, you can still reap big health benefits if you catch up.

Didn't exercise enough last week? Being a weekend warrior has almost as many benefits as Monday-through-Friday workouts. Didn't get enough shut-eye? Extra ZZZs for a couple of nights can help undo some of the physical harms of cheating your sleep. Ate too much? Studies show that you can make up for overindulging -- and even lose some weight -- by just being a part-time calorie counter. In fact, experts say, embracing imperfection can help you reach your health goals.

Weekend Warriors Still Win

You've probably heard that you need to get about 150 minutes of moderate physical activity like brisk walking, or 75 minutes of vigorous activity like jogging, or some mix of the two, each week. But very few of us reach that goal, which is recommended by the CDC and World Health Organization.

In fact, most Americans get less than 10 minutes of moderate exercise every day, according to a 2015 study that used data collected on nearly 8,000 adults who wore activity monitors for a week. A tiny fraction of people in that study -- about 3% -- were barely active during the week, but they made up for it on weekends, averaging about an hour of moderate to vigorous physical activity on both Saturday and Sunday.

Now, a new study suggests these "weekend warriors" may be on to something. The study, which included data from more than 63,000 adults in the U.K., found that adults who reported meeting physical activity recommendations by squeezing all their exercise into just one or two sessions a week had a 30% lower risk of early death than people who got no exercise at all. They also had a lower chance of dying from cancer or heart disease than people who were sedentary.

Being a regular exerciser brought the biggest benefits, but being a weekend warrior seemed to come in a close second. In fact, even people who exercised a little but didn't hit the recommended amounts reduced their risk of death. The "insufficiently active" people were getting, on average, only about 60 minutes of physical activity each week. Weekend warriors got about 5 hours of exercise over the course of one or two sessions, while regular exercisers averaged almost 9 hours of planned exercise a week.

"Millions of people in the U.K. and U.S. do their physical activity in one or two bouts for week, and there have been concerns that they aren't doing enough," says study author Gary O'Donovan, PhD, a research associate in exercise and health sciences at Loughborough University in Loughborough, England.

The research echoes a smaller 2004 study by researchers at Harvard University that looked at patterns of physical activity in more than 8,000 men who were taking part in the long-running Harvard Alumni Study. The study found that men who were regular exercisers had the lowest odds of early death over the decade of the study, but even weekend warriors saw some benefit, as long as they didn't have any major things that raised their odds of disease, like being overweight, being a smoker, or having high blood pressure or high cholesterol.

"As long as you're doing exercise, something is better than nothing," O'Donovan says. "You are doing enough, even if you're only doing it once or twice a week."

At least one study has questioned whether weekend warriors might be more likely to get injured than regular exercisers, but O'Donovan thinks that has more to do with the type of exercise or sport people are choosing rather than the number of sessions they get in. In general, he says, everyone who's starting an exercise program should start slowly, with at least 12 weeks of moderate-intensity exercise -- like walking, for example -- before they raise the intensity.

Making Up for Lost Sleep

Plenty of us don't get enough sleep. A 2016 study by the CDC found that 35% of adults, or about 1 in 3, aren't getting the recommended 7 hours of sleep each night. Over the last 40 years, studies estimate that the number of young adults who sleep less than 7 hours a night has more than doubled. And sleep experts say that's a big problem.

Burning the midnight oil doesn't just make you bleary-eyed and brain-fogged the next day, it can also take a toll on your metabolism. Studies have shown that getting less than 6 hours of sleep a night reduces the body's ability to efficiently regulate blood sugar, increasing the odds of obesity and diabetes. Too little sleep is also associated with high blood pressure, heart disease, decreased sex drive, accidents, and an increased chance of early death.


Walking can maintain your body weight and lower many health risks. True or false? See Answer

But a rough night or two, or a weeklong sleep deficit, doesn't necessarily doom your health. Recent studies have shown that you can undo at least some of the damage by catching up -- either by sleeping longer on weekends or setting and following a reasonable goal to get a little more sleep. One 2015 study found that men and women who averaged about 6 1/2 hours of sleep a night improved their insulin resistance and fasting blood sugar by just sleeping an extra hour each day, bringing their nighty total to around 7 1/2 hours.

Another recent study took 19 healthy young men and slashed their sleep to about 4 hours a night for 4 nights. Researchers took blood samples and, to no surprise, found their sensitivity to the hormone insulin had dropped by about 23%, indicating they were on the road to diabetes.

After their sleep-deprived days, however, the men were allowed 2 days of catch-up sleep, where they averaged about 10 hours in bed. After the extra sleep, their insulin and blood sugar levels returned to normal, suggesting the damage had been undone.

"With sleep deprivation, as many, many other studies have shown, there was a reduction in insulin sensitivity and increased diabetes risk. The levels appeared to return, at least statistically, to the normal sleep levels after we did the catch-up sleep," says study author Esra Tasali, MD, director of the Sleep Research Center at the University of Chicago in Illinois.

"I don't want people to think this replaces the healthy sleep recommendation of 7 to 8 hours a night. But on occasion, if your situation doesn't allow you to extend your sleep on weekdays, this could be an alternative," she says.

A Part-Time Diet?

Having trouble sticking to a resolution to cut your daily calories? Try giving yourself a break. Supporters of an eating plan called the 5:2 diet, which is popular in Great Britain, eat normally for 5 days, but slash their caloric intake to just 25% of normal (about 500 daily calories for women and 600 for men) for 2 days. The 2 fasting days can be spread out so you're not fasting 2 days back-to-back.

Former first lady Jacqueline Kennedy Onassis reportedly favored a similar approach. Her friend, the late Letitia Baldrige, told Vanity Fair that Kennedy was very disciplined about keeping her weight at 120 pounds. If she gained even 2 pounds, she would fast for a day and then eat fruit and increase her exercise until she was back in her sweet spot.

There's some science behind the idea of cutting calories part-time, or intermittent fasting. Studies have found that it helps people lose about as much weight as other full-time dieting strategies, and it may be easier to maintain over the long term, though at least one 2015 evidence review found there just aren't enough high-quality studies of this approach yet to know.

"The 5-2 Diet is kind of a catch-up, in a sense. You don't feel you're on a diet all the time. You're just doing it two days a week," says doctor and journalist Michael Mosley, who wrote a book about intermittent fasting called "The Fast Diet" and uses it to control his type 2 diabetes.

He says that for himself, it was mentally easier to diet when he only had to do it part-time.

"You're thinking to yourself, 'I'm not going to eat a doughnut today because I can have it tomorrow,' " says Mosley.

With license to eat freely on your "off" days, it would seem easy to binge and undo all the progress you make on your "on" days. Remarkably, people don't seem to do that, says Krista Varady, PhD, an associate professor of kinesiology and nutrition at the University of Illinois in Chicago.

"Probably one of the most exciting things we found out when we started studying this was that people don't binge on that feast day," Varady says. "So you'd expect if you're only eating 500 calories the day before that maybe you'd totally make up for all the calories you didn't eat on the fast days, but people only eat about 10% more than they usually do on the feast day. The body, for some reason, won't let people binge on that day."

Varady spent 10 years studying an alternate-day fasting approach where people restrict their calories to just 25% of normal 3 to 4 days each week. She wrote a book about it called "The Every Other Day Diet."

She's still trying to understand why people don't overdo it on their days off. One theory is that the stomach shrinks during the fast day and just can't accommodate as much food when people go back to normal eating.

She says people in her studies usually wake up and make a huge breakfast on their "feast" days, but find they can only eat about half as much as they used to.

"They get pretty intense feelings of fullness right away the next day," she says.

The other reason seems to be psychological. They just don't want to undo all the progress they made from the day before.

Varady says overweight people eat lose about 1-3 pounds a week when they fast on alternate days. Normal-weight people lose less, about half a pound a week. More importantly, though, everybody sees beneficial changes.

Levels of unhealthy fats like LDL cholesterol and triglycerides go down, while good cholesterol, HDL, goes up. Insulin levels and insulin resistance go down. Blood pressure and heart rate also decrease.

She's followed people who were on an alternate-day fast diet for as long as a year.

"We found people could really stick to it for the first 3 months. From months 4 to 6, definitely people were doing fewer fast days a week, so their weight loss slowed down a bit. For the last 6 months, people consumed about 1,000 calories on their fast days, and they found they were really able to stick to that," she says.

All told, people lost between 10 and 50 pounds following the diet and were able to keep the weight off for as long as a year, she says.

"That's the major benefit to the diet in the sense that you kind of get every other day to just feel normal again," Varady says, "I think that really does help people stick to it."

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SOURCES: Gary O'Donovan, PhD, research associate, exercise and health sciences, Loughborough University, Loughborough, England Esra Tasali, MD, director, Sleep Research Center, University of Chicago, Illinois. Michael Mosley, journalist; author, "The Fast Diet." Krista Varady, PhD, associate professor of kinesiology and nutrition, University of Illinois, Chicago. CDC, Physical Activity Guidelines, June 4, 2015. O'Donovan, JAMA Internal Medicine, Jan 9, 2017. Lee, American Journal of Epidemiology, 2004. Liu, Morbidity and Mortality Weekly Report, Feb. 19, 2016. Leproult, Sleep, May 1, 2015. Broussard, Diabetes Care, March 2016. Zuo, Frontiers in Physiology, Aug. 2016. Mattson, Ageing Research Reviews, Oct. 31, 2016. Varady, K. Journal of Nutrition, Nov. 12, 2013.

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