Physical activity levels and associated socio-demographic factors in Bangladeshi adults: a cross-sectional study

Distribution and disparities of healthy lifestyles and noncommunicable diseases risk factors between men and women aged 20-59 years in Bangladesh: Evidence from a nationwide survey

Background

Noncommunicable diseases (NCDs) are public health threats globally and recognized impediments to socioeconomic development. This study aimed to identify the prevalence and clustering of NCDs risk factors among Bangladeshi men and women aged 20-59 years using nationally representative data.

Methods

This study was conducted in 82 rural, nonslum urban, and slum clusters across all eight administrative divisions of Bangladesh using multistage cluster sampling. A total of 4917 men and 4905 women aged 20-59 years were included in the study. Descriptive analyses were performed to report the prevalence and distribution of behavioral and clinical risk factors. Multivariable binary logistic regression was performed to identify factors associated with the coexistence of three or more NCD risk factors.

Results

The prevalence of tobacco use (any form), insufficient physical activity, inadequate fruit and vegetable consumption, overweight and obesity, and central obesity were 38.3%, 13.6%, 87.1%, 42.3%, and 36.0%, respectively. Furthermore, 21.9% and 4.9% participants had hypertension and self-reported diabetes, respectively. Regarding the clustering of risk factors, 37.1% men and 50.8% women had at least three NCD risk factors. Only 3.0% men and 1.8% women reported no NCD risk factors. Age, place of residence, education, and wealth status were associated with the presence of at least three risk factors for both sexes.

Conclusion

Since a large proportion of Bangladeshi 20-59 years old population had multiple risk factors, population-based programs with multisectoral approaches are essential to reduce NCDs among Bangladeshi women and men.

Factors associated with physical inactivity among Palestinians with type 2 diabetes mellitus treated in resource-limited settings

This study determined the prevalence and the associated factors with meeting the recommended amount of physical activity among type 2 diabetes mellitus (T2DM) patients receiving care in resource-limited settings of the West Bank of Palestine. Physical activity was assessed using the World Health Organization's Global Physical Activity Questionnaire. Associations were examined using multivariate logistic regression. Of the 302 patients included, 117 (38.7%) met the recommended amount of physical activity. Being younger than 58 years [aOR = 2.1 (95% CI 1.0-4.3], were employed [aOR = 2.3 (95% CI 1.1-4.9)], had high income [aOR = 3.9 (95% CI 1.3-11.9)], had thought that physical activity was crucial for T2DM patients [aOR = 32.7 (95% CI 3.9-275.5)], did not have comorbidities [aOR = 2.2 (95% CI 1.1-4.4)], had normal weight [aOR = 2.8 (95% CI 1.3-6.0)], and those who were overweight [aOR = 2.6 (95% CI 1.1-6.0)] were more likely to meet the recommended amount of physical activity compared to the patients who were 58 years or older, had low income, did not think that physical activity was crucial for T2DM patients, had comorbidities, and were obese, respectively. There is a need to increase physical activity among T2DM patients in resource limited settings.

The burden of hypertension, diabetes, and overweight/obesity by sedentary work pattern in Bangladesh: Analysis of Demographic and Health Survey 2017-18

Most low- and middle-income countries, including Bangladesh, are currently undergoing epidemiologic and demographic transitions with an increasing burden of hypertension, diabetes, and overweight/obesity. Inadequate physical activity is a risk factor for these conditions and work-related activities contribute to most of the physical activities in Bangladesh. We investigated the association of the sedentary nature of occupation with hypertension, diabetes, and overweight/obesity in Bangladesh. If a person's systolic/diastolic blood pressure, fasting plasma glucose concentration, and body mass index were ≥130/80 mmHg, ≥7 mmol/l, and ≥23 kg/m2, respectively, they were classified as hypertensive, diabetic, and overweight/obese. The nature of occupation/work was classified into three types: non-sedentary workers (NSW), sedentary workers (SW), and non-workers (NW). After describing the sample according to exposure and outcomes, we performed simple and multivariable logistic regression to investigate the association. Among 10900 participants (60.7% females, mean age: 40.0 years), about 43.2%, 13.2%, and 42.8% were NSW, SW, and NW, respectively. NSW, SW, NW, and overall people, respectively, had 6.7%, 14.5%, 11.7%, and 9.9% prevalence rates for diabetes; 18.0%, 32.9%, 28.3%, and 24.4% prevalence rates for overweight/obesity; and 18.0%, 32.9%, 38.3%, and 28.0% prevalence rate for hypertension. SW had higher odds of diabetes (AOR: 1.44, 95% CI: 1.15-1.81), overweight/obesity (AOR: 1.83, 95% CI: 1.52-2.21), and hypertension (AOR: 1.47, 95% CI: 1.21-1.77) than NSW. NW had higher odds of diabetes (AOR: 1.43, 95% CI: 1.19-1.71) or hypertension (AOR: 1.37, 95% CI: 1.22-1.56) but not higher odds of overweight/obesity (AOR: 1.11, 95% CI: 0.98-1.27) than NSW. We found higher prevalence and odds of the studied conditions among SW than NSW. Workplace physical activity programs may improve the physical activity and health of SW.

Quality of life of COVID-19 recovered patients: a 1-year follow-up study from Bangladesh

BACKGROUND

The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings.

METHODS

COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants' QoL scores between the two interviews.

RESULTS

Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0-1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4-0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5-0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3-2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1-1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time.

CONCLUSIONS

The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19.

Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia

Introduction

The current study evaluated obesity prevalence, physical activity, and dietary practices among Saudi adults in the Makkah region of the Kingdom of Saudi Arabia (KSA). The current survey was accomplished between November 2021 and March 2022.

Method

A validated questionnaire, Arab Teens Lifestyle Study (ATLS), was used to evaluate all participants' physical activities, sedentary behaviors, and nutritional habits in addition to demographic data.

Result

A total of 2,115 people [1,238 (58.5%) women and 877 (41.5%) men] participated in this survey. Being overweight was prevalent in 32.8% of the population (41% of men and 28.9% of women), obesity was prevalent in 23% of the population (males 23.1% and females 24.2%). Obese people consumed more soft drinks, and overweight people did not consume enough vegetables (fresh/cooked). Obese people consumed fast food (e.g., burgers, sausage, pizza, or Arabic shawarma) over three times each week. The mean (SD) number of days of practice walking was 2.51 (2.05) vs. 1.3 (1.87) (p < 0.001) for lean and obese individuals, respectively. In addition, individuals with normal BMI had more days of jogging, moderate and high-intensity exercise, dancing, and strength training than those with obesity. The odds of being obese increased with age (OR: 1.07; p < 0.001), in males (OR: 2.16; p < 0.001), in participants earning <5,000 SR/month (1.3 thousand $) and 10-15 thousand SR/month (1.34-2.66 thousand $) (OR: 2.36; P = 0.01). Obesity was inversely associated with moderate-intensity exercise (OR: 0.802; p = 0.009), and regular walking (OR: 0.685; CI: 0.624-0.752; p < 0.001).

Discussion

Overweight and obesity were prevalent in 32.8% and 23% of the population, respectively. Sociodemographic factors associated with obesity. Focused intervention strategies are needed to overcome the obesity issue.

Prevalence and Associated Factors with Ideal Cardiovascular Health Metrics in Bangladesh: Analysis of the Nationally Representative STEPS 2018 Survey

This study aims to find out the prevalence of the American Heart Association's (AHA)'s cardiovascular health metrics and associated socio-demographic factors. A secondary analysis of the World Health Organization (WHO) STEPwise approach to surveillance survey 2018 (STEPS 2018) data was conducted. Ideal Cardiovascular Health (ICH) was defined as the presence of 5-7 ideal metrics as defined by the AHA. Design-adjusted multivariable logistic regression was used to determine the associated factors of ICH. In total, 5930 respondents were included in our analysis, and 43.1% of the participants had ICH. The odds of ICH decreased with age [compared to 18-29 years old individuals, 30-49 years: AOR (Adjusted Odds Ratio): 0.4; 95% Confidence Interval (CI): 0.4-0.5; 50-69 years: AOR: 0.7; 95% CI: 0.6-0.8], and higher educational attainment (compared to those who received no formal education, being educated up to primary level: AOR:0.7; 95% CI: 0.6-0.8; being educated up to secondary level: AOR: 0.4; 95% CI: 0.4-0.5; being educated up to college and higher: AOR: 0.4; 95% CI: 0.3-0.5). Compared with female and urban residents, the odds were 30% and 40% less among male and rural residents, respectively. The public health promotion programs of Bangladesh should raise awareness among high-risk groups to prevent cardiovascular diseases.

Parents/primary caregivers' perspectives on the well-being, and home-based learning of children with neurodevelopmental disorders during COVID-19 in Bangladesh

Background and Aims: The coronavirus pandemic (CP) leading to prolonged lockdown, and restriction of movement for almost two years in Bangladesh severely affected not only the well-being (physical and mental health) of both children and adults but also their access to home-based learning. The present study aimed to explore the mental, and physical health problems of children with neurodevelopmental disorders (NDDs), their use of telehealth services, and the status of their home-based learning by asking questions to their parents/primary caregivers (N = 149) during the second year of lockdown (November and December 2021). Methodology: The present study was a cross-sectional self-reported survey covering as many parents/primary caregivers as possible within Bangladesh. The survey questions were selected from a larger study by Masi et al. named 'COVID-19 impact survey' with permission. A total of 149 parents/primary caregivers with one or more children (mean age = 5.54) having any of the NDDs took part in the survey. Data were collected via physical sitting, telephone interview, and anonymous Google form. Results: Almost one-third of parents/caregivers felt that the NDD symptoms of their children were worsening with time, and half of them reported that their children's health and well-being were negatively impacted. More than 90% of the caregivers felt that their children are facing challenges following the rules of social distancing. Whereas more than 80% of parents agreed that their children's learning was disrupted during covid-19, and they were not getting enough online/offline support from the authorities. Conclusions: The outcome of this study suggested that CP had a significant impact on the wellbeing and home-based learning of children with NDDs and their families in Bangladesh. Most of the caregivers reported that the NDDs symptoms of their children are worsening with disrupted routine, facing problems following social distancing and maintaining fruitful relationships. In terms of home-based learning, most caregivers reported insufficient support from school authorities. The parents recommended the development of an adequate system for telehealth services and policies to help the vulnerable individuals in the future.

Prevalence and determinants of obesity and abdominal obesity among rural workers in Southeastern Brazil

The objectives of this study were to assess the nutritional status of rural workers from a municipality in Southeastern Brazil and estimate the association of sociodemographic, labor, lifestyle, and dietary pattern factors with obesity and abdominal obesity of men and women of this rural area. This is a cross-sectional, epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females). The sociodemographic, labor, lifestyle and dietary patterns determinants were assessed. Food intake data were obtained by applying three 24-hour recalls and dietary patterns were determined by Principal Component Analysis with Varimax orthogonal rotation. Poisson regression with robust variance stratified by sex was applied. The general prevalence of overweight status was 31.5% (95% CI 28.2-34.8%), 19.7% of obesity (95% CI 16.8-22.6%) and 31.5% of abdominal obesity (95% CI 28.2-34.8%), with higher rates in women (P < 0.001). Men of higher socioeconomic class had a 2.3 times higher prevalence of obesity (95% CI 1.08-4.90). In addition, the shorter travel time to purchase food increased the prevalence of abdominal obesity in males. For women, the older the age group, the greater the general and central obesity. A lower adherence to traditional dietary patterns (approximately PR [prevalence ratio] 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher rates of obesity in women. Finally, women farmers with a higher workload had a 20% lower prevalence of central obesity (PR 0.80; 95% CI 0.65-0.97). Such findings demonstrate that obesity must be an issue in the health care of remote and rural populations. There is a need to promote healthier environments that respect traditional food culture through multiple approaches that consider the heterogeneity of rural areas and the differences between sexes.

Associations of Serum Albumin With Disability in Activities of Daily Living, Mobility and Objective Physical Functioning Regardless of Vitamin D: Cross-Sectional Findings From the Chinese Longitudinal Healthy Longevity Survey

Objective

To examine the associations of serum albumin, a nutrition indicator, with disability in activities of daily living (ADL), mobility, and objective physical functioning among Chinese older adults.

Materials and Methods

Cross-sectional data of 2233 older adults (≥65 years) who participated in the 2011/2012 main survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the 2012 biomarker sub-study was used. Serum albumin was measured by immunoturbidimetric assay. Physical functioning included subjectively (ADL and mobility) and objectively measured disability (standing up from a chair, picking up a book from the floor, and turning around 360°). Multivariable logistic regression models were performed.

Results

After adjusting for age and sex, compared with participants in the lowest quartile group of serum albumin, those in the highest quartile group had 45% lower odds of disability in ADL (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.38, 0.80); 48% lower odds of disability in mobility (OR: 0.52; 95% CI: 0.38, 0.71); 46% lower odds of disability in standing up from a chair (OR: 0.54; 95% CI: 0.34, 0.85); and 37% lower odds of disability in picking up a book from the floor (OR: 0.63; 95% CI: 0.40, 0.97). We did not observe a statistically significant interaction effect between serum albumin and vitamin D on disability in physical functioning.

Conclusion

Serum albumin level was associated with physical functioning among Chinese older adults, regardless of vitamin D level. The findings indicate that appropriate management of poor nutritional status, in particular low serum albumin levels, may contribute to maintaining physical functioning in older adults.

Prevalence and Predictors of Physical Inactivity among Adults - A Cross-Sectional Study

Background

Physical inactivity is detrimental to health. It is a risk factor for noncommunicable diseases.

Aim and Objective

The aim of this study was to find the prevalence and predictors of physical inactivity among adults.

Methodology

A cross-sectional community-based study was conducted among 374 adults aged 20-50 years. Trained field investigators administered the Global Physical Activity Questionnaire. Data were analyzed using Epi Info software for Windows. Logistic regression model was used to study the factors associated with physical inactivity.

Results

The prevalence of physical inactivity among the study participants was 52.1%. Females (OR=1.9[1.2-3.1]), literate individuals (OR = 1.8 [1.04-3.2]), and current tobacco users (OR = 2.2 [1.8-4.1]) were significantly more physically inactive; as compared to their counterparts.

Conclusions

Nearly half of the study participants were physically inactive, according to the World Health Organization guidelines. This highlights the need for strengthening the existing interventions for promoting physical activity among adults.

Socio-demographic Determinants of Low Physical Activity in Peruvian Adults: Results of a Population-based Survey Performed in 2017-2018

Objectives

The objective of this study was to determine the prevalence of low physical activity (PA) in Peruvian adults and to identify associated factors.

Methods

An analytical study was performed using data from the 2017-2018 Nutritional Food Surveillance by Life Stages survey. The outcome variable was low PA (yes or no), assessed using the International Physical Activity Questionnaire-short form. Prevalence ratios were estimated as a measure of association.

Results

Among the 1045 persons included in the analysis, the age-standardized prevalence of low PA was 61.9%. The adjusted model showed that being female and migrating from a rural to an urban area in the last 5 years were associated with a higher probability of having low PA than males and individuals who had not migrated, while residing in rural highlands and jungle areas was associated with a reduced probability of having low PA compared to people residing in other geographic domains.

Conclusions

Being a female and migration from a rural to an urban area in the last 5 years were associated with a higher likelihood of having low PA. Therefore, promotion and prevention strategies related to PA are required, especially in the female and migrant populations.

Concordance between Different Criteria for Self-Reported Physical Activity Levels and Risk Factors in People with High Blood Pressure in a Rural District in Bangladesh

Self-reported assessment of physical activity (PA) is commonly used in public health research. The present study investigated the concordance of self-reported PA assessed using the global physical activity questionnaire (GPAQ) and two different measurement approaches. Participants (n = 307, aged 30–75 years with hypertension) were recruited from a rural area in Bangladesh. We analyzed the difference between the World Health Organization (WHO) recommendations of more than 600 metabolic-equivalent time-minutes (MET-min) and the self-reported active hours, at least 2.5 h per week. Tests of sensitivity and specificity were conducted to determine concordance between the two measures. According to the WHO criteria, 255 (83%) participants were active more than 600 MET-min per week and 172 (56%) people were physically active 2.5 h or more per week, indicating a 27% difference in self-reported PA. The sensitivity, specificity, positive and negative predictive values and concordance between the two measures were 64%, 92%, 98%, 34% and 70%, respectively. Considering the WHO MET-min as the appropriate measure, 89 (35%) were false negative (FN). Older age, professionals and businesspersons were associated with a higher proportion of FN. There is a gap between self-reported PA, thus a better estimate of PA may result from combining two criteria to measure PA levels.

A negative association between prevalence of diabetes and urban residential area greenness detected in nationwide assessment of urban Bangladesh

Residential area greenness may influence diabetes, but limited studies have explored this relationship in developing countries. This study assessed the association between residential area greenness and diabetes among urban adults in Bangladesh. The mediation effect of the body mass index (BMI) was also assessed. A total of 2367 adults aged ≥ 35 years were extracted from a nationally representative survey. Diabetes was characterised as fasting plasma glucose level be ≥ 7.0 mmol/L or taking prescribed medications to reduce blood sugar level. Residential area greenness was estimated by enhanced vegetation index. Binary logistic regression models were employed to estimate the association between residential area greenness and diabetes adjusting for sociodemographic factors. Mediation analysis was performed to assess whether BMI mediated the association between greenness and diabetes. Greater area greenness was associated with lower odds of diabetes (adjusted odds ratio 0.805, 95% confidence interval 0.693–0.935, p = 0.0052). BMI significantly mediated 36.4% of the estimated association between greenness and diabetes. Presence of areas of greenness adjacent to living area tends to be associated with lower diabetes prevalence. Findings emphasised the importance of preserving the local environment to tackle the growing diabetes prevalence in Bangladesh.

Prevalence and associated factors of insufficient physical activity among elderly people in Bangladesh: a nationally representative cross-sectional study

OBJECTIVES

Insufficient physical activity (IPA) is a crucial risk factor for non-communicable diseases (NCDs). The elderly population has a higher likelihood of suffering from NCDs. We aimed to estimate the prevalence of and factors associated with IPA among the elderly people in Bangladesh.

METHODS

We analysed data from the Bangladesh Food Security and Nutrition Surveillance round 2018-2019, collected from 82 rural, non-slum urban and slum clusters selected using multistage cluster sampling. IPA was defined as <150 min of moderate intensity or <75 min of vigorous intensity or equivalent in a typical week. The weighted prevalence of IPA was estimated by gender and across different variables. Crude and adjusted prevalence ratios were calculated using Poisson regression with robust variance.

RESULTS

The weighted prevalence of IPA among elderly people was 38.4%, with a slightly higher prevalence in women (39.7% vs 37.3%). Factors associated with higher prevalence of IPA in both sexes were-higher age, living in non-slum urban areas, unemployed or homemaker, not currently married, sedentary behaviour and self-reported hypertension. Further, >10 years of education, inadequate fruits and vegetable consumption, self-reported asthma and higher waist circumference among men; and higher household income and self-reported diabetes among women were associated with a higher prevalence of IPA.

CONCLUSIONS

IPA is highly prevalent among Bangladeshi elderly men and women. Sedentary behaviour, inadequate fruits and vegetable consumption and higher waist circumference were the modifiable factors of IPA. Evidence from this study can guide the development of appropriate interventions to promote healthy ageing in Bangladesh.

Knowledge of and Intention to Participate in Physical Activity Programs and Their Associated Sociodemographic Factors in People with High Blood Pressure in a Rural Area of Bangladesh: Initial Investigation from a Cluster Randomized Controlled Trial

This initial investigation aimed to investigate the knowledge of the health benefits of physical activity (PA) and attitudes towards participation in PA. The study recruited 307 people aged 30-75 years with hypertension as part of a cluster randomized controlled trial from a rural area in Bangladesh. Of the 307 participants, 135 participated less than 2.5 h of physical activity per week, from which we collected data on attitudes toward PA. Regression analysis and Rasch analysis were used. More than 85% of homemakers, employees or businesspersons were willing to take part in PA. Based on the combined score from the knowledge and attitude items, 46% of people endorsed PA programs; proportions were higher in men than women (53% vs. 41%). After adjusting for covariates, men (odds ratio, 95% confidence interval (CI) 3.50, 1.72-7.11) compared to women and people with at least primary levels of schooling (OR 3.06, 95% CI, 1.27-7.38) compared with those with no education were more likely to organize or take part in any PA programs. People have positive attitudes towards PA but do not feel obligated to participate in PA programs. Future programs are needed to promote awareness and motivational interventions for PA, especially targeting women and people with low education levels, should be developed and implemented.

Prevalence of and factors associated with insufficient physical activity among adolescents: evidence from a nationwide survey in Bangladesh

The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018-19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10-14 years) than late adolescents (15-19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.

Factors Associated with Physical Activity among People with Hypertension in a Rural Area in Bangladesh: Baseline Data from a Cluster Randomized Control Trial

The health benefits of physical activity (PA) are well recognized, and PA levels vary in different populations. The study aimed to investigate PA levels and associated sociodemographic factors among people with hypertension in a rural area in Bangladesh. Baseline data were part of a cluster randomized controlled trial of 307 adults aged 30-75 years to study the effectiveness of PA and lifestyle changes in lowering blood pressure. The outcome variables were PA at work, commuter, recreation, metabolic equivalent task (MET)-minute per week and sitting time. Total 68 (22.1%) people participated in vigorous-intensity activity, 23 (7.5%) participated in moderate-intensity sports. Overall, 83% of people were physically active more than 600 MET-min. Women (OR 2.95, 95% CI, 1.36-6.39) compared to men, and people with no education (OR 4.47, 95% CI, 1.62-12.33) compared to people with secondary school certificates or above were less physically active. Of total PA, 63% were work-related, and 1% were recreation-related for women, and these figures were 55% and 3% for men. The study reports that vigorous-intensity PA is low, and recreation time is minimal. Routine PA, especially for women and people with low education levels, should be encouraged to increase PA to manage hypertension.

F. Farah N, Mohd Amin H, Hanafiah H, Shamsulkamar NS. Relationship between Physical Activity and Cardiovascular Risk Factors: A Cross-Sectional Study among Low-Income Housewives in Kuala Lumpur

Cardiovascular disease is a significant public health concern worldwide, including in Malaysia. Various attempts have been made to resolve this issue. One of the most important methods of controlling cardiovascular risk factors is physical exercise. However, today’s women, especially housewives, are often identified by a lack of physical activity. This is alarming to society, as cardiovascular disease can affect the quality of their life. The aim of this study is to determine the relationship between physical activity and cardiovascular risk factors among low-income housewives in Kuala Lumpur. A total of 63 housewives participated in this cross-sectional study. All participating housewives were asked to fill out a sociodemographic questionnaire and the short version of the International Physical Activity Questionnaire (IPAQ). To evaluate cardiovascular risk factors, anthropometric measurements and blood samples were taken. Findings showed that an average of 70.5 ± 232.4 min/week was spent on moderate-to-vigorous physical activity (MVPA), which indicated a low level of physical activity. Data showed that 90.5% of the subjects had low physical activity, 6.3% were moderate, and 3.2% were considered as having a high level of physical activity. For body mass index (BMI), 58.7% of the respondents were obese, 28.6% were overweight (29.10 ± 5.67 kg m^–2), and 81.0% of subjects had a waist circumference (WC) value above the normal range (92.74 ± 16.40 cm). A two-way ANOVA test revealed significant mean differences between systolic blood pressure (mm/Hg) and age groups (p > 0.05). Nevertheless, there was a significant association between MVPA and cardiovascular risk factors using negative binomial regression (p < 0.01). The findings of this study highlight the need for health promotional programs to raise awareness, educate, and engage low-income housewives in lifestyle-enhancing behaviors.

Objective and Subjective Investigation of Physical Activity Levels and Its Relation with Socio-Demographic Characteristics among Medical Students

Background

Combining the results of objective and subjective assessments of physical activity (PA) can provide a more complete assessment of PA patterns in medical students. This study aimed to determine the relationships between objective and subjective measured PA and its relation with socio-demographic characteristics among different stages of medical training.

Methods

This cross-sectional study was conducted on 186 students of four stages of medical training. The International Physical Activity Questionnaire Short-Form (IPAQ-SF) and pedometer were used.

Results

There were significant differences in total PA in terms of gender, weight, and serious illness. Differences between four stages of medical training in total (p = 0.002), vigorous (p < 0.001), and moderate PA (0.026) based on IPAQ-SF as well as pedometer-counted steps in Tuesday (p = 0.002) and Wednesday (p = 0.006) were significant. The results demonstrated a positive significant relationship between total PA based on IPAQ-SF and pedometer-determined steps in four days of the week.

Conclusion

There were positive low correlations between PA based on IPAQ-SF and pedometer among medical students. The PA of medical students at different years of medical training was different based on both IPAQ-SF and pedometer, which shows the need to pay attention to the special needs of students in terms of PA at each stage.

Physical activity levels and related sociodemographic factors among Iranian adults: Results from a population-based national STEPS survey

Background: Physical inactivity (PA) is one of the leading modifiable risk factors for noncommunicable diseases (NCDs) worldwide. This study aimed to determine PA levels and related sociodemographic factors as risk factors for NCDs among Iranian adults.

Methods: In this cross sectional study, data were collected from the sixth nationwide STEPS survey in 31 provinces of Iran. A total of 6100 individuals aged 18-64 years were selected by a multistage cluster sampling method, and their PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). Data were analyzed using descriptive methods and analytical tests, including chi-square, ANOVA, and independent t tests in SPSS version 21 software.

Results: The prevalence of vigorous, moderate, and low levels of PA was 36.3% (95%CI:35.1-37.5), 29.2% (95%CI:28-30.3), and 34.5% (95%CI:33.3-35.7) in participants, respectively. The mean ± SD of total MET-min/week was 1842.3±2619.3. Total mean ± SD duration of PA was 98.2 ± 115 min/week (125.8±142.6 and 77.2±84.5 min/week in men and women, respectively). Transport-related PA and severe PA at work had large and small contributions to overall PA, respectively. Urbanization, sex, age, family size, and occupation status were identified as factors associated with PA levels (p<0.001).

Conclusion: This study revealed a significant prevalence of low PA among the target population and some sociodemographic characteristics identified as factors associated with PA. Identification of these factors can develop more effective interventions to promote PA.

Prevalence of Physical Inactivity and Sedentary Behavior Among Adults in Armenia

Physical inactivity and sedentary behavior are risk factors for developing non-communicable diseases. This study analyzed current levels of physical inactivity and sedentary behaviors among the adult population of Armenia. Data were collected through a national STEPS survey of non-communicable diseases risk factors on a nationally-representative sample of 2,380 participants aged 18–69 years in Armenia in 2016. The Global Physical Activity Questionnaire was used to assess physical activity levels. Two out of ten people (21.6%) in Armenia did not meet the minimum levels of physical activity recommended by WHO to protect health. 13.2% of population spent over 8 h per day sitting, 47.2% were inactive at work and 32.4% did not do any transport-related physical activity. Only 13.8% of participants were physically active during leisure time. Specific groups with relatively high levels of physical inactivity were older adults, residents of Yerevan, people with lower levels of education, the unemployed and people who were retired. Sedentary behavior was more common among men, students, people who were retired, unemployed, residents of Yerevan, and adults aged under 30 and over 45 years.

Prevalence of Total and Domain-Specific Physical Activity and Associated Factors Among Nepalese Adults: A Quantile Regression Analysis

AIM

To analyze the data from the World Health Organization Nepal STEPS survey 2013 to determine the prevalence of total and domain-specific physical activity (PA) and associated factors among Nepalese adults.

METHODS

A multistage cluster sampling technique was used to proportionately select participants from the 3 ecological zones (Mountain, Hill, and Terai) in Nepal. The Global PA Questionnaire was used to assess PA. The data were analyzed using quantile and ordinary least square regression.

RESULTS

Only 4% of the adults did not meet the World Health Organization PA guidelines. Age had a negative monotonic association with total PA and occupational PA, with the highest difference at the upper tails of the PA distribution. Lower total PA and occupational PA were associated with secondary or higher education, being retired or in unpaid employment, living in Terai or urban areas, and nonsmoking. Age, higher education, unpaid employment, and Terai or urban residence were negatively associated, while being currently married was positively associated with transport-related PA.

CONCLUSION

Increasing age, higher education, unpaid employment, unemployment or retirement, and urban residence were associated with lower PA, with the stronger association at the upper tails of the distribution. The correlates had dissimilar associations across the quantiles of PA distribution.

Mediators of the association between low socioeconomic status and poor glycemic control among type 2 diabetics in Bangladesh

Although low socioeconomic status (SES) is related to poor glycemic control, the underlying mechanisms remain unclear. We examined potentially modifiable factors involved in the association between low SES and poor glycemic control using data from the baseline survey of a multicenter, prospective cohort study. Five hundred adult type 2 diabetes patients were recruited from three diabetes centers. Glycemic control was poorer in diabetic individuals with low SES than in those with higher SES. Adverse health-related behaviors, such as non-adherence to medication (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] 1.04–1.13) and diet (AOR = 1.04, 95% CI 1.02–1.06); existing comorbidities, such as depressive symptoms (AOR = 1.05, 95% CI 1.04–1.09); and non-adherence to essential health service-related practices concerning diabetes care, such as irregular scheduled clinic visits (AOR = 1.04, 95% CI 1.03–1.06) and not practicing self-monitoring of blood glucose (AOR = 1.05, 95% CI 1.03–1.07), mediated the relationship between social adversity and poor glycemic control specially in urban areas of Bangladesh. Those identified factors provide useful information for developing interventions to mitigate socioeconomic disparities in glycemic control.

Physical activity and sedentary behaviour in Bangladesh: a systematic scoping review

OBJECTIVES

Lack of physical activity (PA) contributes to increasing prevalence of non-communicable diseases (NCDs) globally. However, little is known about PA and sedentary behaviour (SB) among populations in low- and middle-income countries (LMICs). This systematic review examined prevalence of PA and SB in Bangladesh.

STUDY DESIGN

Systematic review of the literature.

METHODS

A systematic electronic search in eight databases and a manual search of retrieved articles' references were conducted. Original research conducted in Bangladesh with PA- and/or SB-related outcome(s) were included.

RESULTS

Out of 1,162 retrieved titles, 33 articles (32 cross-sectional and one case-control study) met the inclusion criteria. Twenty-nine studies were with healthy populations: adults (n = 19); children and adolescents (n = 7); and children, adolescents and adults (n = 3). Five studies used nationally representative samples of adults and one of adolescents. Most studies (n = 26) assessed PA only; three only SB, and four both PA and SB. All studies used self-reported measures. Among healthy adults, prevalence of insufficient PA ranged from 5% to 83%. Occupational and transport-related PA contributed the most towards total PA with negligible contribution of recreational PA. Among children and adolescents, the prevalence of insufficient PA ranged between 20% and 67%. Females engaged in less PA compared to males. Limited evidence currently exists about the prevalence of SB, especially among adults.

CONCLUSIONS

PA and SB research has received little attention in Bangladesh. Critical knowledge gaps identified in this review should be taken into account when designing new research and programmes in Bangladesh and other LMICs with similar socio-economic and cultural settings.

Seasonal Variations in Physical Activity Domains among Rural and Urban Bangladeshis Using a Culturally Relevant Past Year Physical Activity Questionnaire (PYPAQ)

While the effect of weather and seasons on physical activity (PA) is well documented for leisure-time physical activities in western countries, scant information is available for developing countries where lifestyle PA is the major source of energy expenditure (EE). In Bangladesh, the traditional calendar divides the year to six seasons that last two months each: summer, rainy, autumn, late autumn, winter, and spring. We developed the Past Year Physical Activity Questionnaire to record culturally relevant physical activities and to help assess the seasonal variation in total and domain-specific PA in Bangladesh. We have applied this tool to 162 men and women aged 18-60 years residing in Dhaka city and in the northern rural district of Thakurgaon. Repeated measures analysis of variance (RMANOVA) was used to test for evidence of variation in PA between place and seasons. The age- and gender-adjusted model revealed significantly lower levels of EE in urban residents compared to rural residents across all seasons and domains. We also found evidence of seasonal variations in moderate-to-vigorous physical activity (MVPA) MET-min/weekamong rural participants only; for total PA (ranging from 3192 in autumn to 4124 in winter; p = 0.0001) and for two domains: the occupation domain (ranging from 935 in autumn to 1645 in winter; p = 0.0001) and the leisure time domain(ranging from 229 in late autumn to 272 in rainy season; p = 0.005). Seasonality in gardening was also noted (ranging from 2.46 in late autumn to 29.28 in rainy season; p = 0.0001). There were no seasonal differences of total and domain-specific MVPA in urban except household-related PA. Among rural participants, PA was higher in the summer, rainy, and winter seasons and lower in autumn and late autumn. The most common leisure-time physical activities were walking, bicycling, and swimming with higher participation in the rural area. Leisure-time physical activity needs to be promoted to urban residents all year long but more focused on autumn, late autumn, and spring in rural areas.

Gendered perceptions of physical activity and diabetes in rural Bangladesh: a qualitative study to inform mHealth and community mobilization interventions

Background Diabetes prevalence is increasing rapidly in Bangladesh, and there is an urgent need to promote preventive behaviours for type 2 diabetes, such as maintaining a healthy body weight, eating healthily, avoiding tobacco and being active for 150 minutes per week. Methods We used a qualitative methodology informed by the capability, opportunity, motivation theory of behaviour change to explore the factors affecting physical activity among men and women in rural Bangladesh. We conducted semi-structured interviews and focus group discussions with 64 purposively sampled participants with and without diabetes, and five health workers. From the results of descriptive content analysis, we identified key capabilities, opportunities and motivations to engage with in our mHealth and community mobilization interventions. Results Men and women without diabetes lacked awareness about the need to remain physically active to prevent diabetes, and most felt that their activity levels were sufficient. Housework was not commonly perceived as physical activity among all respondents. These knowledge and capability gaps could be addressed through mHealth messaging and community mobilization providing information on sufficiency and types of physical activity to prevent and control diabetes. Men were physically active while working outside the home, whereas women felt unsafe and conspicuous, and were constrained by family commitments and social expectations of appropriate behaviour. Women engaged in strategies to protect their own and their family’s reputations. These opportunity factors affecting physical activity indicated the need for strategies developed through participatory processes to challenge unhealthy gender norms and increase women’s safety. Conclusion Formative research data can enable the development of contextually relevant interventions. Data show that mHealth interventions should consider gendered barriers to physical activity, tailoring information to meet men’s and women’s needs, and that community mobilization interventions should enable unhealthy, gendered community norms to be challenged. Participatory interventions can enable communities to push the boundaries of socially acceptable behaviours to increase physical activity, helping to prevent and control diabetes.

Sociodemographic Associations of Physical Activity in People of Working Age

The aim of this study was to identify relationships between the physical activity and sociodemographic status of respondents aged 18–64 years. The research was conducted in 2014 and 2015 in Wrocław, Poland. The study group comprised 4460 people. The sample selection was random and stratified. The research tool was the International Physical Activity Questionnaire—Short Form. Levels of physical activity declared by respondents were compared with the recommendations of the American College of Sports Medicine (ACSM). Data on respondents’ sociodemographic status was also obtained. The Mann–Whitney U test for samples, Kruskal–Wallis test by ranks, and total and binary logistic regression were used in statistical analysis. Among the respondents, the ACSM health recommendations were met by 43.7% in total (43.2% women and 44.3% men). All analyzed sociodemographic variables differentiated respondents’ physical activity. The youngest respondents were found to be the most physically active. Wrocław residents with a secondary education declared the highest level of physical activity. Among the respondents, manual workers revealed the highest, and the unemployed the lowest odds of meeting the ACSM standards of health-related physical activity. The level of physical activity of unmarried respondents was higher than that of married respondents. The highest percentage of respondents (50.9% women and 54.2% men) with sufficient physical activity levels was found among people living alone. Measures aimed at reducing hypokinesia should be addressed primarily in vulnerable groups, i.e., the unemployed and oldest men.

Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City

OBJECTIVES

Among all South Asians, Bangladeshis have the highest prevalence of cardiovascular disease (CVD). The purpose of our study was to compare the understanding of CVD risk factors among Bangladeshi immigrants to the general Caucasian population in the U.S.

DESIGN

We surveyed Bangladeshi immigrants in Queens, New York using a CVD risk factor knowledge instrument used in the Coronary Artery Risk Development in Young Adults (CARDIA) study to assess awareness of risk factors. Using multivariate regression modeling, we compared scores on the knowledge instrument between Bangladeshis we surveyed and Caucasians from the CARDIA study, controlling for potential confounders. We subsequently examined the frequency of mentioning each risk factor to understand what was driving the difference in the overall score.

RESULTS

The proportion of Bangladeshis scoring low on the knowledge assessment was 0.53, where as the proportion of whites scoring low in the CARDIA study was 0.32 (p value < .001). Whites were 34% more likely to score high than Bangladeshis (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.19-1.52). Bangladeshis were more likely to mention diet and cholesterol as risk factors and less likely to mention lack of exercise, being overweight, and smoking as risk factors.

CONCLUSION

Understanding of cardiovascular disease risk factors was lower among Bangladeshis than whites. This was driven by Bangladeshis having less awareness regarding how exercise and being overweight contribute to CVD. Community based interventions and community health partnerships should target these behavioral risk factors in the Bangladeshi population.

Changes in the configuration and patterns of physical activity among Mongolian adults, 2005-2013

Objective: This study examined the change in physical activity status and patterns and their associations with urban and rural residence and employment status in Mongolia.

Methods: We analyzed data from 7,738 adults aged from 20 to 64 years (n = 2,877 and 4,861 for 2005 and 2013, respectively) from the Mongolian STEPS Survey on the Prevalence of Non-Communicable Disease Risk Factors (NCD-STEPS survey). Physical activity in three domains, including work (occupational and household work); transport (walk or cycling); and leisure (sport or fitness) was measured by Global Physical Activity Questionnaire (GPAQ). Physical activity levels were classified into three groups: low, moderate, and high according to the GPAQ analysis framework. The associations between physical activity time, residential area, and employment status were examined using a multivariate negative binomial regression model.

Results: The percentage of respondents with low-level physical activity increased from 10.9% in 2005 to 27.2% in 2013. The median minutes of physical activity time per week were 1,020 in 2005 and 600 in 2013. Physical activity time at work, transport and overall decreased in 2013. Work-related physical activity was the most dominant component of physical activity time (55.6% in 2005 and 54.6% in 2013), the transport domain was the second-highest contributor of physical activity time in 2005 (24.0%) and was replaced by the leisure domain (26.8%) in 2013. Rural residents practiced more physical activity at work, transport, and leisure than urban residents did in 2005 (prevalence ratio [PR]: 1.33, 95% confidence interval [CI]: 1.20–1.47; PR: 1.21, 95%CI: 1.14–1.29; and PR: 1.21, 95%CI: 1.13–1.30, respectively), but there was no significant difference by residential area in 2013. Mongolian adults with higher educational attainment, employee status, and non-employment status were less likely to engage in physical activity compared to those among adults with lower educational attainment and self-employed status.

Factors Associated with Physical Activity and Sedentary Behavior in Older Adults from Six Low- and Middle-Income Countries

Rising life expectancy in low- and middle-income countries (LMIC), coupled with the increasing burden of non-communicable diseases, accentuates the importance of generating information to support public health strategies. With this aim in mind, the purpose of this study was to identify correlates of physical activity and sedentary behavior in LMIC. We analyzed Wave 1 data (collected 2007–2010) from the World Health Organization’s longitudinal Study on global AGEing and adult health (SAGE), which focuses on nationally representative samples of adults aged 50 years and older from six countries (China, n = 13,157; India, n = 6560; Mexico, n = 2301; Russian Federation, n = 3763; South Africa, n = 3836; and Ghana, n = 4305). Associations of physical activity (operationalized as meeting physical activity guidelines of ≥150 min/week of moderate-to-vigorous physical activity or not) and sedentary behavior (≥4 h/day versus <4 h/day) with demographic, health and health risk, functional, interpersonal, and environmental factors were assessed using multivariate logistic models. Across the six countries, we found fairly consistent and reasonably strong associations between both physical activity and sedentary behavior and several demographic factors (age and employment, in particular), self-reported health, instrumental activities of daily living, factors relating to socializing, and household location. Correlates of physical activity and sedentary behavior in LMIC appear to be similar to those found in high-income countries.

Understanding the Relationship between Socio-Economic Status, Physical Activity and Sedentary Behaviour, and Adiposity in Young Adult South African Women Using Structural Equation Modelling

Socio-economic status (SES) is an important predictor of obesity, but how it is associated with differences in physical activity and sedentary behaviour is less clear. This cross-sectional study examined the association between SES (sum of household assets), physical activity and sedentary time, and how they predict adiposity. Socio-demographic, anthropometric, and physical activity data on rural (n = 509) and urban (n = 510) South African women (18–23 years) were collected. Overweight and obesity prevalence, and sedentary time, were higher; and moderate-vigorous intensity physical activity (MVPA) was lower, in the urban sample. Structural equation models (SEMs) were constructed for BMI and waist circumference. In the urban sample SES had a direct inverse effect on MVPA (ß; 95% CI, −41.69; −73.40 to −9.98), while in the rural sample SES had a direct effect on BMI (ß; 95% CI, 0.306; 0.03 to 0.59). In the pooled sample, SES had a direct inverse effect on MVPA (ß; 95% CI, −144; −170.34 to −119.04), and MVPA was directly associated with BMI (ß; 95% CI, 0.04; 0.01 to 0.08). The influence of SES, and the role of physical activity and sedentary time on adiposity differs between the urban and rural samples, and the importance of other environmental and behavioural factors must be considered in the development of obesity and the design of effective interventions.

Prevalence and sociodemographic patterns of physical activity among Bangladeshi young adults

BACKGROUND

Physical activity offers physical and psychosocial health benefits that are important during young adulthood and later in life. However, little is known about the physical activity of young adults in low- and middle-income countries. The purpose of this study was to estimate the participation of physical activity in Bangladeshi young adults and to assess differences by gender, age and family income.

METHODS

This cross-sectional study with a self-administered survey used a convenience sample of 573 young adults aged 18-24 years from six purposively selected universities in Dhaka City, Bangladesh. Data were collected during September-November 2015. Medians and their interquartile ranges of weekly time spent in total physical activity, and in different domains of physical activity, were computed. Non-parametric equality of medians test was used to examine gender differences in the median values. Chi-square test and Fisher's exact test were used to examine gender differences in the prevalence of meeting physical activity recommendations and frequency of participation in different leisure-time physical activities, and differences in meeting the activity recommendations by age and family income.

RESULTS

Seventeen percent of the participants were meeting moderate-to-vigorous physical activity (MVPA) recommendations with a significantly higher proportion of males than females (27 vs. 6%, p < .0001). Median duration of MVPA was significantly higher (p < .0001) for males [120 min/week (80, 190)] than females [90 min/week (50, 120)]. Jogging/running was the most commonly reported leisure-time physical activity, with 20% of males and 12% of females doing this at least once a week. Age and family income were not significantly associated with meeting MVPA recommendations.

CONCLUSIONS

Four out of five young adults in Dhaka City did not meet the physical activity recommendations. Additional population-based studies, including regional and metropolitan areas, and using objective measurement, are needed to understand the physical activity patterns of Bangladeshi young adults.