Physical activity and sedentary behaviour in the Middle East and North Africa: An overview of systematic reviews and meta-analysis

Abstract

to support the global strategy to reduce risk factors for obesity, we synthesized the evidence on physical activity (pA) and sedentary behaviour in the Middle east and north Africa (MenA) region. Our systematic overview included seven systematic reviews reporting 229 primary studies. The metaanalysis included 125 prevalence measures from 20 MENA countries. After 2000, 50.8% of adults (ranging from 13.2% in Sudan to 94.9% in Jordan) and 25.6% of youth (ranging from 8.3% in Egypt to 51.0% in Lebanon) were sufficiently active. Limited data on PA behaviours is available for MENA countries, with the exception of Gulf Cooperation Council countries. The meta-regression identified gender and geographical coverage among youth, and the pA measurement as predictors of pA prevalence for both adults and youth. Our analysis suggests a significant PA prevalence increase among adults over the last two decades. the inconsistency in sedentary behaviour measurement is related to the absence of standardized guidelines for its quantification and interpretation. The global epidemic of insufficient PA is prevalent in MENA. Lower PA participation among youth and specifically females should be addressed by focused lifestyle interventions. the recognition of sedentary behaviour as a public health issue in the region remains unclear. Additional data on pA behaviours is needed from lowand middle-income countries in the region. Non-communicable diseases (NCDs) kill 41 million people worldwide each year-equivalent to 71% of all deaths 1. The Middle East and North Africa (MENA) region has one of the highest rates of NCDs in the world. In 2017, the region reported the second highest prevalence of diabetes in the world (10.8%) 2 and is recording a rapid increase in obesity 3,4. Insufficient physical activity (PA) and sedentary behaviour are key risk factors for obesity and other NCDs 5-15 leading to premature mortality 10,11,16-18. It has been suggested that PA has the potential to effectively control and reduce the burden of obesity during the various phases of human development 19. Regular PA can also improve self-esteem, cognitive performance, and academic achievement in young people 7,20,21 and is positively related to cardiorespiratory and metabolic health 6. Recently, sedentary behaviour has received global attention as prolonged sedentary time is associated with an increased risk of chronic disease and an increase in all-cause mortality, regardless of individuals meeting the recommended levels of PA 13,15. The World Health Organization (WHO) and the Global Observatory for Physical Activity (GoPA) are targeting a relative reduction of 10% in the global prevalence of physical inactivity among adults by 2025 22,23. Currently, one of the most pressing needs to improve population health is to develop appropriate policies and implement interventions to address the global pandemic of physical inactivity 24,25. However, to support this action, country-level evidence on PA behaviour in various population groups is essential. Both regional-and coun...

Barriers and Facilitators Associated with Physical Activity in the Middle East and North Africa Region: A Systematic Overview

“…We conducted a systematic overview of published systematic reviews (SRs) on the epidemiology of PA in the MENA region. In a previous publication, we synthesized data on the prevalence of PA and sedentary behavior [ 3 ]. In this present study, we focus on synthesizing country-specific barriers and facilitators associated with PA in the MENA region.…”

“…A broad search strategy was developed to systematically identify any type of review on all health issues in any MENA country [ 3 , 17 ]. We used search terms related to the names of MENA countries, regions and sub-regions.…”

“…No restrictions to a specific health condition or language of publication were applied at this stage [ 18 ]. The detailed search strategy is available in our previous publications [ 3 , 17 ]. Two independent reviewers systematically searched the Medical Literature Analysis and Retrieval System Online (MEDLINE) through the search engine PubMed.…”

“…From each included SR, the following characteristics were extracted: reported factors associated with PA, study period, geographical coverage of the literature search, the corresponding MENA countries for which data was available, and literature sources, as well as the number of included studies and the study target population. The characteristics of the primary studies included in our overview, along with the methodological quality assessment and study selection process, are described in a previous publication [ 3 ]. Where available, we extracted factors associated with PA specific to different age groups (youth and adults) and gender (boys/girls or males/females).…”

“…For optimal health benefit, it is recommended for adults to accumulate at least 150 min of moderate-intensity physical activity (PA) per week [ 1 ]; whereas, at least 60 min per day of moderate-to-vigorous-intensity PA helps children and youth maintain a healthy cardiorespiratory and metabolic risk profile [ 2 ]. Within the Middle East and North Africa (MENA) region, it is estimated that about 49% of adults and 75% of the youth population are not sufficiently active to meet the recommended international guidelines for PA [ 3 ].…”