Abstract

Objective: The present study aimed to identify factors associated with distinct trajectories of physical activity (PA) patterns in Mexican adults during a 16-year follow-up. Methods: We included 9,958 adults aged 35 years or older enrolled in The Mexico City Prospective Study, a prospective cohort study conducted from 1998 to 2004 to 2015–2019. PA was assessed through self-reported questionnaires and categorized into three patterns: inactive, weekend warrior, and regularly active. PA pattern trajectories were derived from the two assessment periods and classified into four categories: inactive stable, decreased, increased/weekend warrior stable and regularly active stable. Sociodemographic characteristics, nutritional status, lifestyle factors, and health history were collected at baseline. Results: Of the total sample, 66.7% were inactive stable, 14% decreased, 15% increased/weekend warriors stable, and 4.3% regularly active stable. Results revealed that women (OR = 1.75, 95%CI: 1.33–2.30), no educational level (OR = 14.72, 95%CI: 5.83–37.15) and obesity (OR = 1.75, 95%CI: 1.48–2.08) were associated with higher odds of being inactive stable. Among women, middle-aged was associated with lower odds of being inactive stable (OR = 0.71; 95%CI: 0.53–0.95), while no educational level (OR = 20.69; 95%CI: 6.25–68.52), obesity (OR = 1.91; 95%CI: 1.45–2.51), fruit and vegetable consumption “<5x/week” (OR = 2.05; 95%CI: 1.53–2.74) were associated with greater odds of being inactive stable. For men, no educational level (OR = 7.30; 95%CI: 1.65–32.25), fruit and vegetable consumption “<5x/week” (OR = 2.73; 95%CI: 1.91–3.90) were associated with higher odds of being inactive stable. Conclusion: Sex, age, education level, obesity, and fruit and vegetable consumption were associated with distinct trajectories of PA patterns. The factors associated with these trajectories varied by sex. © The Author(s) 2025.