Epidemiology of physical activity in the Middle East
Professor Tarek Tawfik Amin
Public Health and Community Medicine,
Faculty of Medicine, Cairo University.
The second International
Public Health Conference,
Physical activity (PA) is defined as any
bodily movement produced by skeletal
muscles that requires energy
and sports or
• Regular moderate intensity PA (walking,
cycling, or participating in sports).
- Reduce the risk of cardiovascular diseases,
diabetes (type II), colon and breast cancer,
- Adequate levels of PA decrease the risk of a
hip or vertebral fracture and help control
1. WHO. Fact sheet N°385
Ischemic Heart Diabetes Colon cancer
% risk reduction of certain non-
communicable diseases attributed to regular
Source: Global status report on non-communicable diseases 2010. Geneva: World Health Organization; 2011
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
o Aerobic activity: in bouts of at least 10 minutes
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.
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.
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)
Globally1,2, around 31% of adults aged 15+ are
insufficiently active in 2008 (men 28% and women
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.
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
Figure 2. Insufficient physical activity (estimate prevalence in %)
among adults by WHO regions, 2010.
Male Female Both sexes
Source: WHO observatory 2015.
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
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.
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
5. Family obligations took precedence over engagement in
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.
Allocation of funding for sports, especially for
Villages received less funding for sport
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.
5- Al-Kaabi J, Al-Maskari F, Saadi H, Afandi B, Parkar H, Nagelkerke N. Physical activity and reported barriers to activity among
type 2 diabetic patients in the United Arab Emirates.Rev Diabet Stud. 2009;6(4):271 –278.
6- Ali HI, Baynouna LM, Bernsen RM. Barriers and facilitators of weight management: perspectives of Arab women at riskfor type
2 diabetes. Health Soc Care Commun. 2010;18(2):219–228.
7- AlQuaiz AM, Tayel SA. Barriers to a healthy lifestyle among patients attending primary care clinics at a universityhospital in
Riyadh.Ann Saudi Med. 2009;29(1):30–35.
8- Amin TT, Suleman W, Ali A, Gamal A, Al Wehedy A. Pattern, prevalence, and perceived personal barriers toward
physical activity among adult Saudis in Al-Hassa, KSA.J Phys Act Health. 2011;8(6):775–784.
9- Berger G, Peerson A. Giving young Emirati women a voice: participatory action research on physical activity.Health Place.
10- Caperchione CM, Kolt GS, Mummery WK. Physical activity in culturally and linguistically diverse migrant groups to
Western society: a review of barriers, enablers and experiences.Sports Med.2009;39(3):167–177.
11- Donnelly TT, Al Suwaidi J, Al Enazi NR, Idris Z, Albulushi AM, Yassin K, Rehman AM, Hassan AH. Qatari women livingwith
cardiovascular diseases – challenges and opportunities to engage in healthy lifestyles.Health Care Women Int.
12- Donnelly TT, Al-Suwaidi J, Al Bulushi A, Al Enazi N, Yassin K, Rehman AM, Abu Hassan A, Idris Z. The influence of cultural
and social factors on healthy lifestyle of Arabic women.Avicenna. 2011;2011(3):1 –13, [http://www.qscience.
14- Serour M, Alqhenaei H, Al-Saqabi S, Mustafa AR, Ben-Nakhi A. Cultural factors and patients’ adherence to lifestyle
measures.Br J Gen Pract. 2007;57(537):291–295.
15- Kahan D. Arab American college students’ physical activity and body composition: reconciling Middle East-West differences
using the socioecological model.Res Q Exerc Sport. 2011;82(1):118–128.
16- Shemesh AA, Rasooly I, Horowitz P, Lemberger J, Ben-Moshe Y, Kachal J, Danziger J, Clarfield AM, Rosenberg E. Health
behaviors and their determinants in multiethnic, active Israeli seniors.Arch Gerontol Geriatr. 2008;47(1):63–77.
17- Shuval K, Weissblueth E, Araida A, Brezis M, Faridi Z, Ali A, Katz DL. The role of culture, environment, and religion in
thepromotion of physical activity among Arab Israelis.Prev Chronic Dis. 2008;5(3):A88.
18- Tami SH, Reed DB, Boylan M, Zvonkovic A. Assessment of the effect of acculturation on dietary and physical activity
behaviors of Arab mothers in Lubbock, Texas.Ethn Dis. 2012;22(2):192–197.
19- Qahoush R, Stotts N, Alawneh MS, Froelicher ES. Physical activity in Arab women in Southern California. Eur J Cardiovasc