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Barriers and Facilitators Associated with Physical Activity in the Middle East and North Africa Region: A Systematic Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041647. [PMID: 33572229 PMCID: PMC7914747 DOI: 10.3390/ijerph18041647] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
Increasing physical inactivity levels in the Middle East and North Africa (MENA) region is a public health concern. We aimed to synthesize barriers and facilitators to physical activity and make appropriate recommendations to address physical inactivity. We conducted an overview of systematic reviews on physical activity barriers and facilitators in 20 MENA countries by systematically searching MEDLINE/PubMed and Google Scholar for systematic reviews published between 2008 and 2020. Our overview included four systematic reviews and 119 primary studies with data from 17 MENA countries. Lack of suitable sports facilities, time, social support and motivation, gender and cultural norms, harsh weather, and hot climate were the most commonly reported barriers to physical activity. Socio-demographic factors negatively associated with physical activity participation include advanced age, being female, less educated, and being married. Motivation to gain health benefits, losing/maintaining weight, being male, dietary habits, recreation, and increased Body Mass Index are positively associated with increased levels of physical activity. Interventions promoting physical activity in MENA should target schoolchildren, women and girls, working parents, and the elderly. Country-specific sociocultural and environmental factors influencing physical activity should be considered in the design of interventions. Current and future policies and national interventions must be consistently evaluated for effectiveness and desired outcomes.
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Chaabane S, Chaabna K, Abraham A, Mamtani R, Cheema S. Physical activity and sedentary behaviour in the Middle East and North Africa: An overview of systematic reviews and meta-analysis. Sci Rep 2020; 10:9363. [PMID: 32518254 PMCID: PMC7283267 DOI: 10.1038/s41598-020-66163-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 05/14/2020] [Indexed: 12/12/2022] Open
Abstract
To support the global strategy to reduce risk factors for obesity, we synthesized the evidence on physical activity (PA) and sedentary behaviour in the Middle East and North Africa (MENA) region. Our systematic overview included seven systematic reviews reporting 229 primary studies. The meta-analysis included 125 prevalence measures from 20 MENA countries. After 2000, 50.8% of adults (ranging from 13.2% in Sudan to 94.9% in Jordan) and 25.6% of youth (ranging from 8.3% in Egypt to 51.0% in Lebanon) were sufficiently active. Limited data on PA behaviours is available for MENA countries, with the exception of Gulf Cooperation Council countries. The meta-regression identified gender and geographical coverage among youth, and the PA measurement as predictors of PA prevalence for both adults and youth. Our analysis suggests a significant PA prevalence increase among adults over the last two decades. The inconsistency in sedentary behaviour measurement is related to the absence of standardized guidelines for its quantification and interpretation. The global epidemic of insufficient PA is prevalent in MENA. Lower PA participation among youth and specifically females should be addressed by focused lifestyle interventions. The recognition of sedentary behaviour as a public health issue in the region remains unclear. Additional data on PA behaviours is needed from low- and middle-income countries in the region.
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Affiliation(s)
- Sonia Chaabane
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature. BMC Public Health 2018; 18:639. [PMID: 29776343 PMCID: PMC5960209 DOI: 10.1186/s12889-018-5472-z] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 04/17/2018] [Indexed: 01/08/2023] Open
Abstract
Background Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context. Methods We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants. We also included national survey reports on physical activity, and searched for analyses of the social context of physical activity. Results We found 172 articles meeting inclusion criteria. Standardized data are available from surveys by the World Health Organization for almost all countries, but journal articles show great variability in definitions, measurements and methodology. Prevalence of inactivity among adults and children/adolescents is high across countries, and is higher among women. Some determinants of physical inactivity in the region (age, gender, low education) are shared with other regions, but specific aspects of the cultural context of the region seem particularly discouraging of physical activity. We draw on social science studies to gain insights into why this is so. Conclusions Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions. Electronic supplementary material The online version of this article (10.1186/s12889-018-5472-z) contains supplementary material, which is available to authorized users.
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Jung SW, Lee KJ, Lee HS, Kim GH, Lee JG, Lee JH, Kim JJ. Relationship of activities outside work to sleep and depression/anxiety disorders in Korean workers: the 4th Korean working condition survey. Ann Occup Environ Med 2017; 29:51. [PMID: 29046812 PMCID: PMC5637281 DOI: 10.1186/s40557-017-0206-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/28/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sleep disorders and depression/anxiety disorders are long-standing and significant problem for mental health. Also there are already known so many negative health effect of these disorders. But there were few studies to examine the association between activities outside work and forementioned disorders. So this study aimed the association of those things by using the Republic of Korean data. METHODS Data from 32,232 wage workers were used in the 4th Korean Working Condition Survey. General and occupational characteristics, sleep disorders, depression/anxiety disorders and activities outside work are included in questionnaire. To find the relationship between activities outside work and sleep, depression/anxiety disorders, multivariate logistic regression analysis was used after adjusting for general and occupational characteristics. RESULTS We observed that volunteer activities increased the odds ratio of both sleep disorders and depression/anxiety disorders(Odds ratio[OR] = 1.35, 95% confidence interval[CI]: 1.03-1.78 and OR = 1.54, 95% CI: 1.29-1.84, respectively). And self-development activities increase the odds ratio of sleep disorders(OR = 1.35, 95% CI: 1.17-1.57). Gardening activities lowered the odds ratio of depression/anxiety disorders(OR = 0.74, 95% CI: 0.59-0.94). CONCLUSION Some of activities outside work were related to sleep disorders and depression/anxiety disorders among Korean wage workers. Our results showed negative health effect of some kinds of activities outside work such as volunteering and self-devlopment compared to other studies that emphasized positive effect of those activities for health.
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Affiliation(s)
- Sung Won Jung
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Kyung-Jae Lee
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Hee Sung Lee
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Guang Hwi Kim
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Jae Gwang Lee
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - June-Hee Lee
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Joo Ja Kim
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, South Korea
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Women in Saudi Arabia and the Prevalence of Cardiovascular Risk Factors: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2016; 2016:7479357. [PMID: 27777590 PMCID: PMC5061969 DOI: 10.1155/2016/7479357] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/09/2016] [Accepted: 08/23/2016] [Indexed: 12/15/2022]
Abstract
Background. Cardiovascular disease (CVD) is one of the leading causes of death in Saudi Arabia. Saudi women in particular are more susceptible as there are sociocultural restrictions on female physical activities that may lead to high prevalence of CVD risks, especially obesity, and physical inactivity. This study aims to systematically review the published articles related to the prevalence of CVD risk among women in Saudi Arabia. The search strategy covers all published articles that assess the risk factor of CVD in Saudi Arabia from January 2000 to December 2015, using the following sources: Medline, Embase, and PsycINFO. A total of 61 studies were included. Results. Prevalence among Saudi women of smoking ranged from 1.1% to 9.1%, hypertension was 21.8%, diabetes ranged from 9.6% to 27.6%, overweight was 27%, and obesity was 40.23%, and physical inactivity ranged from 53.2% to 98.1%. Hypercholesterolemia prevalence on Saudi women on average was 24.5%, while metabolic syndrome ranged from 13.6% to 40.3%. Conclusion. The prevalence of CVD risk factors is high among women in Saudi Arabia especially in obesity and physical inactivity. Public health authorities must implement solutions from a gender specific aspect to reverse the trend and decrease the prevalence of CVDs among Saudi women.
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Alkahtani SA. Convergent validity: agreement between accelerometry and the Global Physical Activity Questionnaire in college-age Saudi men. BMC Res Notes 2016; 9:436. [PMID: 27608684 PMCID: PMC5016864 DOI: 10.1186/s13104-016-2242-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 09/01/2016] [Indexed: 11/24/2022] Open
Abstract
Background The Global Physical Activity Questionnaire (GPAQ) has been recommended for the international tracking of physical activity (PA). This study aimed to investigate the agreement between the GPAQ and accelerometry, as well as the test–retest reliability of the GPAQ in Saudi college-age men. Methods The participants included 62 male students, aged 20.0 ± 1.1 year, with a mean body mass index (BMI) of 24.1 ± 6.3 kg/m2. This study used a cross-sectional comparison of measures design. Participants completed the GPAQ twice (2 weeks apart) and wore accelerometers for seven consecutive days. Results The agreement between the GPAQ and accelerometry for moderate to vigorous PA (MVPA) was weak (r ≤ 0.32). Participants underreported sedentary time relative to accelerometer measurements (∆ = 3.4 h/day). BMI was statistically associated with increased bias between the two methods. However, correlations between the GPAQ test and retest for MVPA and sedentary time were moderate to strong (r = 0.44–0.78). Conclusion The GPAQ is reliable, but had low agreement with accelerometry for estimating MVPA, and very low agreement with accelerometry for estimating sedentary time in college-age Saudi men. Individual participant characteristics should be considered when using the GPAQ to estimate sedentary time. Adapting the current GPAQ to build a regional PA questionnaire is recommended. Electronic supplementary material The online version of this article (doi:10.1186/s13104-016-2242-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shaea A Alkahtani
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, PO Box 1949, Riyadh, 11441, Saudi Arabia.
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Gualteros JA, Torres JA, Umbarila-Espinosa LM, Rodríguez-Valero FJ, Ramírez-Vélez R. A lower cardiorespiratory fitness is associated to an unhealthy status among children and adolescents from Bogotá, Colombia. ACTA ACUST UNITED AC 2015; 62:437-46. [PMID: 26302665 DOI: 10.1016/j.endonu.2015.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/20/2015] [Accepted: 05/22/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Several studies have shown that low cardiorespiratory fitness (CRF) is a significant independent risk factor for future cardiometabolic disease in adult life. The aim of this study was to examine the relationship between CRF and health status in children and adolescents in Bogotá, Colombia. METHODS A cross-sectional study was conducted in 921 children and adolescents aged 9-17 years living in the metropolitan area of the District of Bogotá, Colombia (2,480m asl). CRF was assessed with the 20m shuttle run test (Course-Navette) according to ALPHA-FITNESS and FITNESSGRAM standards. Blood pressure, waist circumference, hip circumference, body composition (body fat percentage, fat body mass, and fat-free mass by bioimpedance), skin fold calipers, body mass index, and sexual maturity (Tanner) were used as indicators of physical health. RESULTS After adjusting for sex, age, and sexual maturity, significant inverse relationships were seen between CRF and body mass index (r=-0.107), body fat percentage (r=-0.197), fat body mass (r=-0.159), skin fold (r=-0.246), and waist circumference (r=-0.169); P<.001. Schoolchildren with low CRF levels showed OR 6.06 (95% CI 3.98-9.24) increase in body fat by bioimpedance; OR 4.04 (95% CI 1.83-9.11) risk of overweight/obese by body mass index and OR 2.47 (95% CI 1.14-5.37) abdominal obesity due to increased waist circumference. CONCLUSION Approximately two thirds of participants had a CRF level suggesting future cardiovascular disease. Early identification of children and adolescents with low CRF levels will allow for implementing interventions to prevent cardiometabolic disease in adulthood.
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Affiliation(s)
- Julián Alberto Gualteros
- Facultad de Salud, Programa de Maestría en Ciencias y Tecnologías del Deporte y la Actividad Física, Universidad Manuela Beltrán, Bogotá, D. C., Colombia
| | - Jorge Andrés Torres
- Facultad de Salud, Programa de Maestría en Ciencias y Tecnologías del Deporte y la Actividad Física, Universidad Manuela Beltrán, Bogotá, D. C., Colombia
| | - Luz Marina Umbarila-Espinosa
- Facultad de Salud, Programa de Maestría en Ciencias y Tecnologías del Deporte y la Actividad Física, Universidad Manuela Beltrán, Bogotá, D. C., Colombia
| | - Francisco Javier Rodríguez-Valero
- Facultad de Salud, Programa de Maestría en Ciencias y Tecnologías del Deporte y la Actividad Física, Universidad Manuela Beltrán, Bogotá, D. C., Colombia
| | - Robinson Ramírez-Vélez
- Facultad de Salud, Programa de Maestría en Ciencias y Tecnologías del Deporte y la Actividad Física, Universidad Manuela Beltrán, Bogotá, D. C., Colombia; Grupo de Ejercicio Físico y Deporte, Facultad de Salud, Universidad Manuela Beltrán, Bogotá, D. C., Colombia.
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Amin TT, Al Sultan AI, Mostafa OA, Darwish AA, Al-Naboli MR. Profile of non-communicable disease risk factors among employees at a Saudi university. Asian Pac J Cancer Prev 2015; 15:7897-907. [PMID: 25292084 DOI: 10.7314/apjcp.2014.15.18.7897] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is paucity of studies defining the prevalence of non-communicable disease (NCD) risk factors in Saudi Arabia despite the surging epidemic of obesity, change in dietary habits and sedentary lifestyle. OBJECTIVES This cross-sectional study aimed to assess the prevalence of NCDs risk factors among employees at King Faisal University in Al Hassa, Saudi Arabia and to determine the possible correlates for clustering of NCDs risk factors among them. MATERIALS AND METHODS All employees were invited to participate; the World Health Organization STEPwise approach was used for data collection which consisted of a personal interview to collect socio-demographic characteristics, NCD history, tobacco use, vegetables and fruit consumption, and physical activity (PA), followed by anthropometric measurements namely weight, height and waist circumference and blood pressure measurements, subjects were finally subjected to biochemical tests with determination of fasting plasma glucose, serum triglycerides, cholesterol and high density lipoproteins. RESULTS Of the surveyed employees (n=691), daily current smokers accounted for 22.7%. 94.9%, 95.1% and 86% consumed < 5 servings per day of vegetables, fruits and both fruits and vegetables respectively, 73% were physically inactive, 64% were overweight or obese, 22.1% had hypertension, and 21.5% were diabetics. Elevated cholesterol levels were found in 36.6%, low high density lipoproteins in 36.8%, and elevated triglycerides in 36.1%. Only 3% had no NCD risk factors, and 57.6% had ≥3 factors. Multivariate logistic regression showed that gender (being male, adjusted odds ratio 'aOR'=1.51), aged ≥ 50 years (aOR=3.06), < college education (aOR=1.75), current smokers (aOR=2.37), being obese (aOR=6.96) and having a low PA level (aOR=4.59) were the significant positive predictors for clustering of NCD risk factors. CONCLUSIONS Over fifty percent of the studied university's employees had multiple (≥3) NCD risk factors. Screening and health promotion initiatives should be launched at least targeting the modifiable factors to avert the excessive risk for cardiovascular disease, diabetes mellitus and several types of cancers.
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Affiliation(s)
- Tarek Tawfik Amin
- Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt E-mail :
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Al-Azri M, Al-Rasbi K, Al-Hinai M, Davidson R, Al-Maniri A. Awareness of risk factors for cancer among Omani adults--a community based study. Asian Pac J Cancer Prev 2015; 15:5401-6. [PMID: 25041009 DOI: 10.7314/apjcp.2014.15.13.5401] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer is the leading cause of mortality around the world. However, the majority of cancers occur as a result of modifiable risk factors; hence public awareness of cancer risk factors is crucial to reduce the incidence. The objective of this study was to identify the level of public awareness of cancer risk factors among the adult Omani population. MATERIALS AND METHODS A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three areas of Oman to measure public awareness of cancer risk factors. Omani adults aged 18 years and above were invited to participate in the study. SPPSS (ver.20) was used to analyse the data. RESULTS A total of 384 participated from 500 invited individuals (response rate =77%). The majority of respondents agreed that smoking cigarettes (320, 83.3%), passive smoking (279, 72.7%) and excessive drinking of alcohol (265, 69%) are risks factors for cancer. However, fewer respondents agreed that eating less fruit and vegetables (83, 21.6%), eating more red or processed meat (116, 30.2%), being overweight (BMI>25) (123, 32%), doing less physical exercise (119, 31%), being over 70 years old (72, 18.8%), having a close relative with cancer (134, 34.9%), infection with human papilloma virus (HPV) (117, 30.5%) and getting frequent sunburn during childhood (149, 38.8%) are risk factors for cancer. A significant association was found between participant responses and their educational level. The higher the educational level, the more likely that respondents identified cancer risk factors including smoking (p<0.0005), passive smoking (p= 0.007), excessive drinking of alcohol (p<0.0005), eating less fruit and vegetables (p= 0.001) and infection with HPV (p<0.0005). CONCLUSIONS The majority of respondents in this study in Oman were not aware of the common risk factors for cancer. It may be possible to reduce the incidence of cancers in Oman by developing strategies to educate the public about these risk factors.
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Affiliation(s)
- Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Oman E-mail :
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