Association Between ‘Weekend Warrior’ and Other Leisure-Time Physical Activity Patterns and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study Using Data from the Korea National Health and Nutrition Examination Survey (2014–2023)

Nonalcoholic fatty liver disease (NAFLD) is a major public health concern with a global prevalence of approximately 32%. This study examined the association between the “weekend warrior”, other leisure-time physical activity patterns, and NAFLD in Korean adults. We included 44,264 individuals from the Korea National Health and Nutrition Examination Survey (2014–2023). Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ), a self-reported instrument, and physical activity patterns were classified as inactive, weekend warrior (≥150 min/week of moderate-to-vigorous physical activity [MVPA] performed in 1–2 days), and regularly active. NAFLD was identified using the Hepatic Steatosis Index with a cutoff of >36. Weighted logistic regression was used to examine the association between physical activity patterns and NAFLD. The prevalence of NAFLD was 24%. After adjustment for sociodemographic and metabolic factors, both the weekend warrior (odds ratio [OR] = 0.80, 95% confidence interval [CI]: 0.64–0.99) and regularly active (OR = 0.83, 95% CI: 0.77–0.89) groups had significantly lower odds of NAFLD compared to the inactive group. When stratified by total MVPA level, both the weekend warrior and regularly active patterns with >300 min/week of MVPA showed even lower odds of NAFLD, compared to those with 150–300 min/week of MVPA. Both regularly active and weekend warrior patterns were associated with a lower prevalence of NAFLD, suggesting that the weekend warrior pattern may represent a feasible behavioral pattern associated with lower NAFLD prevalence for individuals with time constraints.