In a recent study published in The Lancet Global Health, researchers used data from 163 countries and autonomous territories to investigate the global incidence of inadequate physical activity among adults from 2000 to 2022.

Their results indicate that the prevalence of lower-than-adequate exercise increased from 23.4% in 2000 to 31.3% in 2022. These trends suggest that a relative reduction of 15% by 2030, targeted by global health bodies, will be challenging to meet.

Study: 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. Image Credit: grandbrothers / Shutterstock

Background

Physically active people are at lower risk of developing non-communicable illnesses, have better weight maintenance and mental health outcomes, and show better cognitive and physical function.

The most recent exercise guidelines from the World Health Organization (WHO) recommend that adults perform moderate-intensity exercise for 150 minutes or more every week or vigorous activity for at least 75 minutes.

People who do not meet this recommendation for aerobic activity are insufficiently physically active. The World Health Assembly (WHA) has set a goal to reduce the relative prevalence of inadequate physical activity by 15% by 2030.

However, sufficient and consistent monitoring of behaviors like sedentary time, balance activities among older adults, and muscle strengthening are also needed to set global targets and estimates.

Regarding insufficient exercise among adults, the most recent time trend analyses indicated that the global prevalence of this phenomenon remained stable from 2001 to 2016 but with considerably varying trajectories between regions and countries.

About the study

Since several countries have collected updated data from 2016 onwards, compiling these findings could yield valuable insights into changes in the global estimates of adult insufficient physical activity.

This study aimed to estimate the prevalence of insufficient exercise among adults aged 18 years and older in 197 countries and territories from 2000 to 2022.

Based on WHO recommendations, insufficient physical activity was defined. Data were collated from population-level surveys, including individual-level anonymized data and summary statistics, covering various domains such as work, travel, and leisure.

A Bayesian hierarchical model was used to estimate the prevalence by country, year, age, and sex, incorporating data from multiple sources and adjusting for factors like survey design and urban representation.

The model accounted for variability in questionnaire types and included obesity prevalence as a covariate. Estimates were produced for each country and aggregated globally, by region, and by income group.

The study also projected trends to 2030 to assess progress towards the global target of a 15% reduction in the prevalence of insufficient physical activity. Uncertainty intervals were calculated using Bayesian credible intervals, and posterior probabilities were computed to evaluate the likelihood of meeting the target.

Map of (A) age-standardized 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.

Findings

The study included data from 507 surveys across 163 out of 197 countries, covering 93% of the global population. Most surveys (452) were nationally representative, with high coverage in regions like high-income Asia Pacific, Oceania, and South Asia but lower in sub-Saharan Africa (61.5% population coverage).

The analysis revealed that nearly a third of adults worldwide were insufficiently physically active in 2022, with a global prevalence of 31.3%. The highest prevalence was in high-income Asia Pacific and South Asia, while the lowest was in Oceania and sub-Saharan Africa.

Females had a higher prevalence (33.8%) than males (28.7%), with significant country-specific and regional variations. Insufficient levels of physical activity were also most prevalent among older age groups.

Trends from 2010 to 2022 indicated an increase in global prevalence, with the steepest rises in high-income Asia Pacific and South Asia. If current trends persist, the prevalence is projected to reach 34.7% by 2030, making it unlikely that the global target of a 15% reduction will be met.

Conclusions

In 2022, nearly one-third of adults worldwide (31.3%; 1.8 billion) were insufficiently physically active, showing a marked increase from 23.4% (900 million) in 2000. This trend counters the 2030 global target of a 15% reduction in inactivity from 2010.

Female individuals and adults over 60 showed higher inactivity rates, with variations by country and region. Compared to previous WHO estimates, this analysis included more surveys (507 compared to 358) and countries (108 compared to 65), revealing a global increase in inactivity that previous data had missed.

High-income Western countries and Oceania showed some positive trends, likely due to effective policies. However, based on current temporal trajectories, most countries will not meet the 2030 target, highlighting the need for greater investment in physical activity promotion.

Limitations include the absence of data from some countries, potential biases in self-reporting, and data collection disruptions due to the coronavirus disease 2019 (COVID-19) pandemic.

Future research should focus on increasing female and older adult engagement in physical activity, improving data collection methods, including device-based measures, and addressing socio-economic disparities.