Epidemiology of Physical activity, global and specifically in the MIddle East. Barriers to physical activity in the Middle East.

1. Professor Tarek Tawfik Amin
Public Health and Community Medicine,
Faculty of Medicine, Cairo University.
amin55@myway.com
The second International
Public Health Conference,
Cairo, Egypt.

2. Physical activity (PA) is defined as any
bodily movement produced by skeletal
muscles that requires energy
expenditure.

3. Recreational
or leisure-
time PA
Active
transport or
commuting
Work-
related
activity,
household
chores
Play, games,
and sports or
planned
exercise
sessions

5. • Regular moderate intensity PA (walking,
cycling, or participating in sports).
- Reduce the risk of cardiovascular diseases,
diabetes (type II), colon and breast cancer,
and depression.
- Adequate levels of PA decrease the risk of a
hip or vertebral fracture and help control
weight.
1. WHO. Fact sheet N°385

6. -35
-30
-25
-20
-15
-10
-5
0
Ischemic Heart Diabetes Colon cancer
Post menopuasl
BC
% risk reduction of certain non-
communicable diseases attributed to regular
physical activity.
Source: Global status report on non-communicable diseases 2010. Geneva: World Health Organization; 2011
(http://www.who.int/nmh/publications/ncd_report_full_en.pdf)

7. http://gamapserver.who.int/mapLibrary/Files/Maps/Global_NCD_deaths_2012.png

8. o At least 150 minutes of moderate-intensity
aerobic PA/ week or at least 75 minutes of
vigorous-intensity aerobic PA/week, or an
equivalent combination of moderate- and
vigorous-intensity activity.
o Aerobic activity: in bouts of at least 10 minutes
duration.
o Muscle-strengthening activities: on 2 or more
days a week.
2. WHO. Promoting physical activity in the Eastern Mediterranean Region through a life-course approach. WHO, 2014.

9.  One of the 10 leading risk factors for global
mortality, causing ≈ 3.2 million deaths each year 3.
 In 2010, insufficient physical activity caused 69.3
million DALYs [2.8% of the total – globally] 3.
 Adults who are insufficiently PA have a 20−30%
increased risk of all-cause mortality 4.
 It is a key determinant in weight control and
prevention of obesity 3.
3. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk
factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224−60.
doi:10.1016/S0140-6736(12)61766-8.
4. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010 (http://
whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf, accessed 4 November 2014)

10.  Globally1,2, around 31% of adults aged 15+ are
insufficiently active in 2008 (men 28% and women
34%).
 Approximately 3.2 million deaths each year are
attributable to insufficient PA.
 In 2008, prevalence of insufficient PA highest in
Americas and EMR.
 In all WHO Regions, men more active than
women, with the biggest difference in EMR.

11. http://apps.who.int/gho/data/node.main.A893?lang=en

12. http://apps.who.int/gho/data/node.main.A893?lang=en

13. http://apps.who.int/gho/data/node.main.A893?lang=en

14. 32.2
19.7
53.2
33.4
43.9
49.2
52.8
24.1
25.1
27.7
44.6
27.3
68.7
49.7
33.8
63.9
45.8
42.9
39.4
41.2
United
Arab
Emirates
Tunisia Saudi
Arabia
Qatar Lebanon Kuwait Iraq Iran Egypt Algeria
Figure 1. Insufficeintly active adult population (% prevalence
estimates by genders) year 2010, Middle East.
Insufficiently active (age-standardized estimate) Male
Insufficiently active (age-standardized estimate) Female
Source: WHO observatory 2015

15. 11.3
17.3
19.8
20.9
23.1
25.6
26.7
18.1
24.4
26.8
27.8
27.3
37.1
37.8
14.7
20.9
23.3
24.5
25.2
31.1
32.4
SEAsia
Africa
Global
Europe
WPacific
EMR
Americas
Figure 2. Insufficient physical activity (estimate prevalence in %)
among adults by WHO regions, 2010.
Male Female Both sexes
Source: WHO observatory 2015.

17. 1. Most common are ‘lack of time’ and the ‘presence
of health conditions’.
2. Some believed that exercise would be painful.
3. Fatigue and tiredness reported especially among
women.
4. Lack of interest, motivation, and information
benefits, fear of injury, stress, excessive screen
use and no past ‘habit’ of exercise.
5. Grooming and traditional dress for women.

18. 1. Accompanied by a male family member reduces
opportunities for PA.
2. Traditional dress in public difficult to participate in certain
types of PA.
3. Cultural norms and expectations regarding women’s role.
4. General lack of social support for exercise, especially for
women.
5. Family obligations took precedence over engagement in
PA.
6. General lack of parental support and peer role modeling.
7. Education is afforded higher priority than PA.
8. Receiving mixed messages (concerns regarding weight
gain, but provided only conditional support for PA).
9. The availability and use housemaids.

19.  Allocation of funding for sports, especially for
women.
 Villages received less funding for sport
programs.

20. 1. The ‘weather’ and ‘lack of exercise facilities’.
2. Lack of culturally appropriate and affordable exercise
facilities or outdoor spaces for activities (e.g., parks),
especially for women.
3. Women’s safety.
4. Daily use of private driver/cars interfered with PA.
5. lack of adequate public transport systems, and a lack
of ‘walkable’ neighborhoods.

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