Sex-specific socioeconomic patterns in physical activity trajectories from childhood to adulthood

Abstract Background Physical activity (PA) is a modifiable risk factor for cardiovascular disease, yet socioeconomic inequalities across adolescence and early adulthood remain underexplored. This study examines sex-specific associations between socioeconomic position (SEP) and PA trajectories. Methods Data were from the Avon Longitudinal Study of Parents and Children, a UK birth cohort born in 1991/1992. Maternal education was used as SEP indicator, self-reported by mothers at 32-weeks’ gestation. PA was assessed using waist-worn uniaxial accelerometers at ages 11, 13, 15, 24 years(y). Measures included total PA (counts/min, CPM), moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary time (SED). Linear spline multilevel models were used to examine sex-specific associations of SEP and PA trajectories. Results 5,693 participants (10,624 PA measures) were included. Overall, males had higher CPM, MVPA, LPA and lower SED than females. At 11y, higher maternal education was associated with lower CPM, lower LPA, and higher SED, with no association for MVPA in both sexes. By 25y, males with the highest maternal education had 39.6 (95% CI: −85.5,6.4) lower CPM, 60.9 mins/day (95% CI: -94.4, -27.5) lower LPA and 23.9 mins/day (95% CI: -19.8,67.8) higher SED compared to males with the lowest maternal education. There was little evidence of association with MVPA. Females with the highest maternal education had 14.8 mins/day (95 % CI:3.1,26.6) higher MVPA, 23.7 mins/day (95% CI: -46.6, -0.8) lower LPA and 22.6 mins/day (95% CI: -7.4,52.6) higher SED compared to females with the lowest maternal education. There was little evidence of association with CPM. Conclusions Socioeconomic disparities in PA were evident in early adolescence and persisted into adulthood. Higher SEP was associated with lower LPA and higher SED in both sexes and higher MVPA in females by 25y. These findings highlight the need for tailored, equity-focused interventions to promote PA across different SEP groups. Key messages • Socioeconomic position shapes physical activity patterns from adolescence to adulthood, with higher SEP linked to lower light activity and higher sedentary time in both sexes. • Sex-specific differences show females of higher SEP have more MVPA compared to those of lower SEP while males show CPM decline-underscoring need for targeted, equity-informed public health strategies.