Epidemiology of physical activity in the Middle East
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Transcript of Epidemiology of physical activity in the Middle East
EPIDEMIOLOGY OF PHYSICAL
ACTIVITY IN THE MIDDLE EAST. Professor Tarek Tawfik Amin
Public Health and Community Medicine, Faculty of Medicine,
Cairo [email protected]
The second International Public Health Conference,
Cairo, Egypt.
Physical activity (PA) is defined as any bodily movement produced by skeletal muscles that requires energy expenditure.
DOMAINS OF PA
Recreational or
leisure-time PA
Active transpor
t or commuti
ng Work-
related activity, household chores
Play, games,
and sports or planned exercise sessions
INTENSITY OF PA
HEALTH BENEFITS1
• 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
Ischemic Heart Diabetes Colon cancer
Post menopuasl
BC
-35
-30
-25
-20
-15
-10
-5
0
% 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)
http://gamapserver.who.int/mapLibrary/Files/Maps/Global_NCD_deaths_2012.png
W.H.O.: RECOMMENDATIONS ON PHYSICAL ACTIVITY [PA] (ADULTS 18-64 YEARS)2
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.
INSUFFICIENT PHYSICAL ACTIVITY 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)
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.
http://apps.who.int/gho/data/node.main.A893?lang=en
http://apps.who.int/gho/data/node.main.A893?lang=en
http://apps.who.int/gho/data/node.main.A893?lang=en
United
Ara
b Emira
tes
Tunis
ia
Saudi
Arabia
Qatar
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non
Kuwait Ira
qIra
n Eg
ypt
Algeria
32.2
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33.4
43.9
49.2
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27.7
44.6
27.3
68.7
49.7
33.8
63.9
45.8
42.9
39.4
41.2
Figure 1. Insufficeintly active adult population (% preva-lence estimates by genders) year 2010, Middle East.
Insufficiently active (age-standardized estimate) MaleInsufficiently active (age-standardized estimate) Female
Source: WHO observatory 2015
SE A
sia
Afric
a
Glob
al
Euro
pe
W P
acifi
c
EMR
Amer
icas
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
Figure 2. Insufficient physical activity (estimate preva-lence in %) among adults by WHO regions, 2010.
Male Female Both sexes
Source: WHO observatory 2015.
BARRIERS TO PA IN THE MIDDLE EAST 5-19.
I- INDIVIDUAL BARRIERS1. 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.
II- CULTURAL/SOCIAL 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.
III- POLICY BARRIERS Allocation of funding for sports,
especially for women. Villages received less funding for sport
programs.
IV- ENVIRONMENTAL BARRIERS1. 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.
REFERENCES 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. 2009;15(1):117–124. 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.
2012;33(12):1114–1134. 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. com/doi/full/10.5339/avi.2011.3].
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. [http://www.cdc.gov/pcd/issues/2008/jul/07_0104.htm].
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 Nurs. 2010;9(4):263–271.
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