Sociodemographic and lifestyle correlates of accelerometer-measured 24-hour physical behavior patterns: a cross-sectional analysis of the ELSA-Brasil cohort.
Vale W, Moura B, et al. • Cadernos de saude publica • 2026
Among 9,520 Brazilian middle-aged and older adults in ELSA-Brasil, three accelerometer-based 24-hour behavior clusters were identified, and compared with the cluster with higher physical activity, lower sedentary behavior and longer sleep (Cluster 3), the cluster with lower physical activity, higher sedentary behavior and shorter sleep (Cluster 1) was more likely to be male, have higher BMI, higher education and high income.
Key Findings
Results
Cluster analysis of accelerometer-measured physical activity, sedentary behavior and sleep identified three distinct 24-hour behavior patterns in Brazilian middle-aged and older adults.
Sample: 9,520 adults (mean age 59.2 ± 8.6 years) from the third wave of the ELSA-Brasil cohort.
Behaviors were measured with triaxial hip-worn accelerometers for seven consecutive days.
Clusters were defined with Partitioning Around Medoids cluster analysis based on daily time in physical activity, sedentary behavior and sleep.
Compared with Cluster 3, participants in Cluster 1 (least active, most sedentary, shortest sleep) were more likely to be male.
Multinomial logistic regression with Cluster 3 as the reference category.
Sex was among the sociodemographic correlates assessed by standardized questionnaires.
Results
Compared with Cluster 3, participants in Cluster 1 had a higher body mass index.
Multinomial logistic regression with Cluster 3 as the reference category.
BMI was one of the lifestyle/health-related correlates examined.
Results
Compared with Cluster 3, participants in Cluster 1 were more likely to have higher educational attainment and high income.
Multinomial logistic regression with Cluster 3 as the reference category.
Sociodemographic factors were assessed via standardized questionnaires.
Results
Cluster 2 (intermediate behavior pattern) showed associations similar to Cluster 1 but weaker.
Same reference category (Cluster 3) and multinomial logistic regression models.
Direction of associations matched those for Cluster 1, with smaller magnitude.
Conclusions
The authors conclude that distinct 24-hour physical behavior patterns among Brazilian adults are associated with sociodemographic and lifestyle factors, supporting targeted public health strategies.
The analysis was cross-sectional, so causal direction cannot be established.
Evidence on combined 24-hour behavior patterns in middle-income countries like Brazil has been limited.
What This Means
This study looked at how Brazilian adults in middle and older age spend their 24-hour day across physical activity, sitting, and sleep. About 9,520 participants in a large Brazilian health study (ELSA-Brasil), averaging 59 years old, wore a hip accelerometer for a week. Researchers grouped people into three patterns: one with less activity, more sitting and shorter sleep; one in the middle; and one with more activity, less sitting and longer sleep.
Compared with the most active, longest-sleeping group, people in the least active/most sedentary/shortest-sleep group were more likely to be men, to have a higher body mass index, and to have more education and higher income. The middle group showed similar but weaker patterns. This suggests that, in this population, higher socioeconomic status was linked to a less favorable overall movement pattern, perhaps reflecting more sedentary work or less physically demanding daily routines, though the study did not test reasons.
Because the study measured people at one point in time, it cannot show that these characteristics cause the behavior patterns. The authors suggest the findings could help target public health strategies toward groups more likely to have less healthy 24-hour behavior profiles.
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Vale W, Moura B, Griep R, Almeida M, Almeida R, Araujo M, et al.. (2026). Sociodemographic and lifestyle correlates of accelerometer-measured 24-hour physical behavior patterns: a cross-sectional analysis of the ELSA-Brasil cohort.. Cadernos de saude publica. https://doi.org/10.1590/0102-311XEN004226