Which countries move the most?

Just in time for this year’s Olympics, a new series of articles on physical activity published in the July issue of the Lancet puts the spotlight on physical activity levels worldwide. Analyzing data from 122 countries — that’s nearly 90 per cent of the world’s population — from the World Health Organization’s (WHO) data base, experts looked how much of the population is inactive in different countries and regions.

The troubling findings:  overall, 31.1 per cent of adults age 15 and over are considered inactive — that is, they fail to meet the minimum recommendations for physical activity. (These numbers should sound familiar: 30 minutes of moderate-intensity physical activity five days a week or 20 minutes of vigorous-intensity physical activity at least three days a week — or a combination of the two.)

While physical activity is lower overall than it has been in past decades, the proportion of adults who are inactive varies by region. In southeast Asia, only 17 per cent of people are considered inactive, and Africa is also below the world average at 27.5 per cent.  Europe and the western Pacific hover just over the average at about 35 per cent and 34 per cent respectively. People living in the Americas and the Mediterranean were well above average — and not in a good way — both with about 43 per cent of their adult population considered to be inactive.

So how do individual countries measure up? Here’s a look at the best and the worst.

The world’s laziest countries

The dubious honour of being in the top 10 goes to:

Malta (where nearly 72 per cent of people are inactive)
Swaziland (69 per cent)
Saudi Arabia (68.8 per cent)
Serbia (68.3 per cent)
Argentina (68.3 per cent)
Micronesia (66.3 per cent)
Kuwait (64.5 per cent)
United Kingdom (63.3 per cent)
United Arab Emirates (65.2 per cent)
Malaysia (61.4 per cent)

Also above the 50 per cent mark are Japan, Dominican Republic, Turkey, Italy, Ireland, Spain and Portugal.

The most active countries

No country is perfect, but these places take the lead when it comes to physical activity:

Bangladesh (just 4.7 per cent of the population is inactive)
Mozambique (7.1 per cent)
Comoros (8.3 per cent)
Benin (9.1 per cent)
Mongolia (9.4 per cent)
Malawi (10.2 per cent)
Cambodia (11.2 per cent)
Guinea (12.1 per cent)
Myanmar (12.7 per cent)
Vietnam (15.3 per cent)

Greece — home of the first Olympic games — isn’t too far behind at 15.6 per cent. (A number nearly matched by India and Nepal.)  The Ukraine and Netherlands (famous for its bicycles) are keeping good company at 18.4 and 18.2 per cent.

Where do we fit in?  Near the middle: Canadians rate slightly better than their southern neighbours with about 34 per cent of Canada’s population considered inactive compared to the U.S.’s 41 per cent.

(To see how other countries ranked, check out the results tables in the UK Guardian.)

What other trends emerged? Despite having the leisure time to spend on sports or at the gym, people in high-income countries tend to be less active than people in low- and middle-income countries. In most countries, people age 60 and over are the least active demographic group. (There’s a lot of variation, however — seniors in some countries are more active than teens and young adults in other countries.)

And sorry, ladies, but men in most countries tend to be more active than women — though in Canada, we’re pretty close.

And if you think adults have it bad, the numbers are worse for adolescents — nearly 80 per cent of the world’s youth aren’t getting enough physical activity. In high-income countries, experts note that how much physical activity a child gets depends on their parents’ influence. In low- and middle-income countries, youth aren’t so reliant on their parents to stay active.

Why some countries may be more active than others

Experts have long known that lack of physical activity plays a role in chronic disease. So what can we learn from the best practices of the most active countries? Unfortunately, the answer is not so simple.  Here are some factors that experts say affect the numbers:

Better health monitoring. Unfortunately, there aren’t standard measures of health being used in all countries. Health monitoring systems are expensive and not all governments can afford them. The authors warn that there are many gaps in the data — for example, data is missing or incomplete for many countries in Africa and South Asia, and some countries had to be excluded because there wasn’t any information at all. The ranking system relies on the availability and accuracy of information.

Another potential pitfall: even where data is plentiful, much of it is self-reported — that is, we have to trust that people’s survey responses are accurate.

Amount of physical labour. In the past few decades, technology has made it easier to get things done with less physical effort. We aren’t just becoming more sedentary at work — we’re also spending more of our leisure time in passive pursuits such as surfing online or watching TV. Not all countries can afford these luxuries.

If rankings don’t match with what you’ve heard in the past, remember that experts only recently started considering occupational labour and housework as physical activity. Low- and middle-income countries — where there are more workers doing physical labour — may therefore be more active than countries who heavily rely on technology.

Does this mean we should ditch our desk jobs and take up manual labour? Perhaps not, but experts warn we need to compensate for all those inactive hours.

Active transportation options. How we get to work is important too. Some of the most active countries have a higher proportion of people who regularly walk or bike to work (not to mention running errands or visiting). In Canada, as in other countries, the percentage of commuters who power their own transportation is already small, and has decreased in the past couple of decades.

Environment plays a large role, and we aren’t just talking about the weather. It stands to reason that bike-friendly places see an increase in cycling activity. (In Denmark, better infrastructure has led to a 50 per cent increase in cycling, experts say.) Same goes for pedestrians. If communities want their citizens to be more active, they need to provide accessible and safe ways for them to do so. In some places, that means tackling air pollution too.

More opportunities for low cost exercise. Not surprisingly, researchers noted that accessible, affordable opportunities to exercise during leisure time increased people’s activity levels. These opportunities might mean low-cost sports leagues, more access to parks, walking or cycling paths and athletic facilities. Studies have shown that while we’re losing ground when it comes to active transportation and physical labour, leisure time exercise is on the rise.

ON THE WEB

To see the full results and discussion, read the Physical Activity series on TheLancet.com

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