National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants

Abstract

Background: Insufficient physical activity increases the risk of non-communicable diseases, poor physical and cognitive function, weight gain, and mental ill-health. Global prevalence of adult insufficient physical activity was last published for 2016, with limited trend data. We aimed to estimate the prevalence of insufficient physical activity for 197 countries and territories, from 2000 to 2022.

Methods: We collated physical activity reported by adults (aged ≥18 years) in population-based surveys. Insufficient physical activity was defined as not doing 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or an equivalent combination per week. We used a Bayesian hierarchical model to compute estimates of insufficient physical activity by country or territory, year, age, and sex. We assessed whether countries or territories, regions, and the world would meet the global target of a 15% relative reduction of the prevalence of insufficient physical activity by 2030 if 2010-22 trends continue.

Findings: We included 507 surveys across 163 countries and territories. The global age-standardised prevalence of insufficient physical activity was 31·3% (95% uncertainty interval 28·6-34·0) in 2022, an increase from 23·4% (21·1-26·0) in 2000 and 26·4% (24·8-27·9) in 2010. Prevalence was increasing in 103 (52%) of 197 countries and territories and six (67%) of nine regions, and was declining in the remainder. Prevalence was 5 percentage points higher among female (33·8% [29·9-37·7]) than male (28·7% [25·0-32·6]) individuals. Insufficient physical activity increased in people aged 60 years and older in all regions and both sexes, but age patterns differed for those younger than 60 years. If 2010-22 trends continue, the global target of a 15% relative reduction between 2010 and 2030 will not be met (posterior probability <0·01); however, two regions, Oceania and sub-Saharan Africa, were on track with considerable uncertainty (posterior probabilities 0·70-0·74).

Interpretation: Concerted multi-sectoral efforts to reduce insufficient physical activity levels are needed to meet the 2030 target. Physical activity promotion should not exacerbate sex, age, or geographical inequalities.

Funding: Ministry of Public Health, Qatar, and World Health Organization.

Translations: For the Spanish and Portuguese translations of the abstract see Supplementary Materials section.

Figure 1

Map of (A) age-standardised prevalence of insufficient physical activity among adults aged 18 years and over in 2022, (B) data coverage and representativeness, and (C) country progress during 2010–22 toward the global target of a 15% relative reduction in insufficient physical activity prevalence among adults aged 18 years and over between 2010 and 2030 For visibility, small-area countries are listed next to a box indicating their corresponding values. Country progress towards the global target is assessed based on whether the estimated trend in insufficient physical activity during 2010–22 would be sufficient to meet the global target if trends were to continue to 2030. Higher and lower certainty indicate certainty about whether the estimated rate of change would be sufficient to meet the global target, if continued to 2030 (appendix 3 p 13).

Figure 2

Male versus female age-standardised prevalence of insufficient physical activity in 2022, for adults aged 18 years and older, by country and region Countries with included survey data are plotted. The Pearson correlation coefficient for male and female values is 0·91. The median country difference between female and male prevalence of insufficient physical activity in 2022 was 6 percentage points (IQR 2–12). Countries with the largest difference in prevalence in each direction are labelled. AFG=Afghanistan. BHS=Bahamas. CHN=China. CUB=Cuba. FIN=Finalnd. GUY=Guyana. IDN=Indonesia. IRN=Iran. IRQ=Iraq. JOR=Jordan. KIR=Kiribati. NPL=Nepal. PAK=Pakistan. PHL=Philippines. PLW=Palau. TTO=Trinidad and Tobago.

Figure 3

Age pattern of insufficient physical activity prevalence in 2022 by region and sex Shaded areas show 95% uncertainty intervals.

Figure 4

Trends in age-standardised insufficient physical activity prevalence 2000–22 for adults aged 18 years and older, by region and sex Country trends are shown as faint lines, regional average shown as a bold line with shaded uncertainty interval.