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A quarter of people are not being active enough to stay healthy

BMJ 2018; 362 doi: (Published 05 September 2018) Cite this as: BMJ 2018;362:k3796
  1. Jacqui Thornton
  1. London

More than a quarter of the world’s adult population—1.4 billion people—are at risk of disease from not doing enough physical activity, a study has found.

Researchers from the World Health Organization found that the highest rates of insufficient activity in 2016 were in adults in Kuwait (67%), American Samoa (53%), Saudi Arabia (53%), and Iraq (52%), where more than half of people do not do enough to stay healthy.1 Around 40% of adults in the United States, 36% in the United Kingdom, and 14% in China were insufficiently active, putting them at greater risk of cardiovascular disease, type 2 diabetes, dementia, and some cancers.

Countries with the lowest rates of insufficient physical activity in 2016 were Uganda and Mozambique (6% each).

The study, the first of its kind, was based on self reported activity—at work, at home, for transport, and in leisure time—in adults aged 18 over from 358 population based surveys in 168 countries, including 1.9 million participants, from 2001 to 2016.

The researchers considered sufficient activity to be at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity physical activity a week.

Prevalence of insufficient physical activity in high income countries rose by 5% between 2001 and 2016 and was more than twice that of low income countries in 2016. The amount of physical activity around the world did not improve over the study period.

The research, published in the Lancet Global Health, indicates that if current trends continue, the 2025 global target of a 10% relative reduction in insufficient physical activity will not be met.

The regions with the biggest rise in insufficient activity over time were high income Western countries (from 31% in 2001 to 37% in 2016), and Latin America and the Caribbean (33% to 39%). Countries driving this trend included Argentina, Brazil, Germany, New Zealand, and the US.

Regina Guthold, who led the study, said: “Unlike other major global health risks, levels of insufficient physical activity are not falling worldwide, on average, and over a quarter of all adults are not reaching the recommended levels of physical activity for good health.”

Researchers found a marked gender difference; around one in three women (32%) and one in four men (23%) did not do enough physical activity. Women were less active than men in all regions of the world, apart from East and South East Asia.

In 2016, the difference in rates of insufficient activity between women and men was 10 percentage points or more in three regions: South Asia (43% versus 24%), Central Asia, Middle East, and north Africa (40% versus 26%), and high income Western countries (42% versus 31%).

Coauthor Fiona Bull said: “Addressing these inequalities in physical activity levels between men and women will be critical to achieving global activity targets and will require interventions to promote and improve women’s access to opportunities that are safe, affordable, and culturally acceptable.”

In wealthier countries, the transition towards more sedentary occupations and motorised transport could explain the higher levels of inactivity, whereas in lower income countries, more activity is undertaken at work and for transport, the authors said.

In a linked commentary,2 Melody Ding, from the University of Sydney in Australia, said that although high income countries have a higher prevalence of insufficient physical activity, low and middle income countries still bear the larger share of the global disease burden of physical inactivity.

She said: “It is essential to incentivise transport and leisure time physical activity in emerging economies through improving public and active transportation infrastructure, promoting social norms for physical activity through mass sports and school level participation, and implementing sustainable programmes at scale that could yield economic, environmental, and social co-benefits, while promoting physical activity.”


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