Measurement and prevalence of adult physical activity levels in Arab countries

Abstract

Physical activity (PA) has a profound effect on health. The World Health Organization (WHO) has determined that physical inactivity is the fourth leading global risk for mortality, responsible for raising the risk of non-communicable diseases (NCDs) and affecting countries across all income groups.1 It is estimated that worldwide physical inactivity causes 6% of the burden of disease from coronary heart disease, 7% of type 2 diabetes, 10% of breast cancer and 10% of colon cancer.2

While globally more than one-third of adults are estimated to not accumulate sufficient PA to meet public health guidelines,3 there are large differences between regions. The highest prevalence of inactivity is seen in the Eastern Mediterranean Region (43.2%) and the Americas (43.3%).3 The aforementioned burden of NCDs associated with physical inactivity in the Eastern Mediterranean Region is 8% of coronary heart diseases, 10% of type 2 diabetes, 14% of breast cancer and 14% of colon cancer.2 However, life expectancy in the region has increased from 51 years of age in 1970 to almost 70 years in 2016; the rapid rise in NCDs has been described as alarming.4 The Arab world and Greater Middle Eastern region are forecasted to experience a further rise in preventable deaths due to NCDs if no serious action is taken.5

Promoting PA will form a key role in preventing and treating NCDs,6 and this requires an understanding of the challenges associated with this task across regions. The WHO has set a target of a 15% relative reduction in the global prevalence of physical inactivity in adults and adolescents by 2030.6 This is supported by an earlier call to action by the WHO Regional Office for the Easter Mediterranean.7 Alongside commonly cited barriers to PA globally, specific issues experienced by those living in Arab countries have been identified. Physical obstacles (e.g., hot weather, unfriendly built environment) and low value placed on PA (e.g., car culture, physical exertion associated with lower status occupations, parental preferences) translate into low interest and motivation to engage in PA.8 That said, socially and culturally congruent interventions to promote PA in Arab countries are increasing.9 A thorough grasp of current levels of PA and ongoing monitoring and surveillance is essential if gains in population-level PA are to be realised. The aforementioned global action plan encourages countries to strengthen reporting of physical inactivity.6

Recent years have seen a rise in the number of studies examining the prevalence of PA in Arab countries across the Middle East and North Africa. A synthesis of studies across countries and an evaluation of the instruments used to attain prevalence estimates are warranted. Thus, the present systematic review sought to (1) examine the reported prevalence of sufficient PA among adults in Arab countries and (2) determine the use of validated instruments for assessing PA.