From Single Movement Behaviors to Complete 24‐h Behaviors Profiles and Multiple Health Outcomes—A Cross‐Sectional Study Using Accelerometry

Movement behaviors research has evolved from focusing on single behaviors to multiple behaviors within a 24-h perspective. However, it is unknown if 24-h movement behavior profiles are consistently associated across multiple health outcomes. Thus, we aimed to investigate this. We used data from 807 adults who wore thigh accelerometers and recorded daily sleep/work times over 1-4 days and were categorized into four 24-h movement behavior profiles: "Chimpanzees" (balanced distribution of movement behaviors in work and leisure; n = 226, reference), "Lions" (more active work and sleep, and less active leisure; n = 179), "Ants" (more active overall, less sedentary work and similar sleep, n = 244), and "Koalas" (more sedentary and sleep, and less active overall n = 158). Cardiorespiratory fitness and systolic blood pressure were measured, while low back pain and self-rated health were self-reported. Linear or ordinal logistic regression assessed the cross-sectional associations between these profiles and outcomes, adjusting for age, sex, BMI, smoking, alcohol, occupational lifting/carrying, and work type. We found that referencing Chimpanzees, Lions were detrimentally associated with cardiorespiratory fitness (B = -2.70 mLO₂/min/kg, p < 0.01), but beneficially associated with systolic blood pressure (B = -3.49 mmHg, p < 0.05) and low back pain (odds ratio, OR = 0.67, p = 0.03). Koalas were detrimentally associated with systolic blood pressure (B = 3.66 mmHg, p < 0.05) and cardiorespiratory fitness (B = -2.83 mLO₂/min/kg, p < 0.01). Ants were detrimentally associated with self-reported health (OR = 1.78, p < 0.01). We conclude that no 24-h movement behavior profile was consistently (i.e., solely beneficial or detrimental) associated with the health outcomes. These findings indicate that research and practice about 24-h movement behaviors need to consider multiple outcomes.