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BACKGROUND

Physical activity is defined as any voluntary body movement requiring energy expenditure produced by skeletal muscles. (1)

Physical activity epidemiology is the study, in human populations, of the frequencies, distributions, and dynamics of physical activity or inactivity. (2) Insufficient physical activity is defined as physical inactivity. Sufficient physical activity is defined as adults having at least 150 minutes of moderate physical activity, or at least 75 minutes of vigorous physical activity per week, or any combination of the two. (3) Insufficient physical activity would hence be defined as the inability to meet the aforementioned WHO recommendations. Insufficient physical activity has been linked to prevention of several chronic diseases and premature deaths as compared to sufficient physical activity. (4)

Globally, physical inactivity was seen in 23% of men and 32% of women over 18. Physical inactivity levels have remained relatively constant throughout the years, with only a 1% decrease from 2001 to 2016. (5) As of 2016, Kuwait had the highest prevalence of physical inactivity of 67%, while Uganda had the lowest prevalence of physical inactivity of 5.5, i.e. Uganda was the most physically active country, and Kuwait is the least physically active country in the world. (6)

Since physical activity levels can be measured through many means, including questionnaires, accelerometers, pedometers, calorimetry and direct observation, statistics on the epidemiology of physical activity vary between sources. (7) Survey questionnaires are the most frequently used method of measuring physical activity worldwide, making it easier to compare across countries to obtain physical activity epidemiology. (8)

AFRICA AND THE MEDITERRANEAN

African countries generally have higher levels of physical activity compared to other continents. Countries in Sub-Saharan Africa have a higher prevalence of sufficient physical activity than the Mediterranean. (6)

The prevalence of physical activity in Sub-Saharan African countries is 78.6% overall, with 82.1% and 75.2% prevalence of sufficient physical activity in adult men and women respectively. (9)

The prevalence of sufficient physical activity in Mediterranean countries is 61.2%, with 74.1% and 60.1% prevalence of sufficient physical activity in adult males and females respectively. (9)

Algeria The prevalence of physical activity in Algerian adults is 66%. The prevalence of sufficient physical activity in adult Algerian males and females is 72% and 59% respectively. (9)

In 2011, it was found that 20.7% of Algerian adolescents aged 13-15 were sufficiently physically active, following the standard of having at least 60 minutes of physical activity per day for 5 or more days a week. Algerian boys and Algerian girls had 31.5% and 11.0% prevalence of sufficient physical activity. (10)

Ghana 84% of Ghana adults were sufficiently physically active, and men and women had 87% and 82% prevalence of sufficient physical activity respectively. (9)

Kenya 81% of Kenyan adults were sufficiently physically active, and men and women had 83% and 79% prevalence of sufficient physical activity respectively. (9)

Nigeria The prevalence of sufficient physical activity in Nigeria is 78%, with 79% and 76% prevalence of sufficient physical activity in adult males and females respectively. (9)

South Africa The prevalence of sufficient physical activity in South Africa is 53%, with 58% and 43% prevalence of sufficient physical activity in adult males and females respectively.(9) South Africa has been ranked the richest and most advanced African country in 2018, (11) so the citizens can afford luxury items providing convenience and thus encouraging sedentary behaviour.

Uganda Uganda is the most physically active country of the world, with 94.5% physical activity as of 2016. (9) The nature of employment and economic status are believed to contribute to the high levels of physical activity in Uganda.

The agriculture industry is physically demanding and requires a lot of physical activity to maintain. Agriculture is the biggest industry in Uganda, due to its favourable soil conditions and climate that provides crops with adequate rain. (12)

Uganda is among the world’s poorest countries, with a GDP per capita of USD 606. (13) With the poor economy, majority of the locals cannot afford to purchase luxury items such as cars for their commute. Citizens may opt for cheaper alternatives, such as walking or cycling, which in turn require more physical activity. However, the capital city of Uganda, Kampala, is not friendly towards walking or cycling, and the country’s first cycle lane was established in 2018, spanning 500 metres in Kololo. (14)

ASIA

In general, Asian countries have decreasing prevalence of activity due to mechanization of work and transport and the spread of sedentary lifestyle. The prevalence of obesity and physical inactivity are both generally high in Asia at around 60%, with Saudi Arabia with the lowest physical activity in the world at 39%. (6)

China Physical activity prevalence in China is at 76%, with 78% in men and 78% in women. (9) Statistically recorder physical activity of men is usually higher than that of women, but the data shows similar activity level between two sexes in China. This is possibly due to the family culture, which the wife is responsible for domestic work, accounting for a certain level of physical activity of female in China. (15)

Japan The prevalence of physical activity in Japan is 66%, with 69% in males and 64% in females. (9)

South Korea The prevalence of sufficient physical activity in Korea is 67%, with 71% in males and 62% in females. (9)

Nepal As of 2018, Nepal had the highest physical activity at 86.6%. (6) In 2003, physical activity prevalence in adults was 25.5% in males and 8.8% in females (16). While most of the jobs taken up by Nepalese people are physically demanding, the levels of physical inactivity during leisure dominates the physical activity when working, leading to the low prevalence. However, insufficient information has been provided to explain the shift in physical activity levels.

Saudi Arabia The economy of Saudi Arabia is one of the top twenty economies in the world (17), so citizens can afford luxury items and can afford to engage in sedentary behaviour. The prevalence of physical activity in Saudi Arabia is 54.1% for male and 34.9% for females. (8)

EUROPE

The prevalence of physical activity in Europe is 76.6%, with 78% prevalence in males and 73.3% prevalence in females. Moldova has the highest physical activity of 88.5%, and Serbia has the lowest prevalence at 60.5%. (6)

England 59% of the population of England is sufficiently physically active, with 67% of men and 55% of women being physically active. (9)

Finland 77% of the Finnish population is physically active, with 78% and 75% of sufficiently active men and women respectively. (9)

France In France, 76% of the population is physically active. 81% of men and 72% of women are sufficiently physically active. (9)

Germany The prevalence of sufficient physical activity in Germany is 79%, with 81% among men and 77% among women. (9)

Moldova The prevalence of physical activity in Moldova is the highest, at 88.5%, with 88% prevalence in men and 87% prevalence in women. (9) The World Health Organisation is cooperating with schools in Moldova by teaching school children about the importance of adequate physical activity, which could explain the high levels of physical activity. (18)

The Netherlands In the Netherlands, 61% of the population is physically active, with 63% of men and 60% of women being sufficiently physically active. (9)

Serbia In Serbia, the overall prevalence of physical activity is 60.5%, with 67% and 56% of sufficiently active men and women respectively. (9) Transport in Serbia is mainly by rail or by road, so citizens do not have the chance to be active during their commute.

LATIN AMERICA AND THE CARIBBEAN

Argentina 58.4% of Argentina’s population is physically active, with 62.4% of men and 54.7% of women being sufficiently physically active. (9)

Bahamas 56.7% of the Bahamas population is physically active, with 70% of men and 44.4% of female being physically active. (9)

Brazil In Brazil, 59.6% of adult men and 46.7% of adult women is physically active. In general, 53% of its population is measured to be physically active. (9)

Chile Chile has a relatively high physical activity among other Latin American countries, with 73.4% of population being physically active. 75.6% of men and 71.4% of women are physically active within its population. (9)

OCEANIA AND THE PACIFIC

Australia 69.6% of Australia’s adult population is physically active, with 73% of men and 66.4% of women being sufficiently physically active. (9)

New Zealand The general physical activity in New Zealand is relatively low, with 57.6% of adults being physically active. 60.7% of men and 54.7% of women are measured as sufficiently physically active. (9)

Fiji Physical activity in Fiji is relatively high, with 83.4% of its adult population being physically active. 82.8% of men and 84% of women are physically active and the difference between 2 sexes is very small as compared to other countries. (9)

USA 60% of adult citizens in the USA are physically active, with 68.3% of men and 52% of women being sufficiently active. (9)

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