Prevalence of Low Physical Activity Among Children and Adolescents in the Middle East and North Africa Region: A Systematic Review and Meta-Analysis Publisher



Habibzadeh A ; Khanmohammadi S ; Fallahtafti P ; Farshbafnadi M ; Tabatabaei Malazy O ; Djalalinia S ; Payab M ; Ejtahed H S ; Sohrabi H ; Ostovar A ; Rezaei N
Source: Journal of Diabetes and Metabolic Disorders Published:2026

Abstract

Low physical activity (LPA) is a growing public health concern among youth, contributing to chronic disease risk. In this review, LPA was operationally defined as failing to meet the World Health Organization (WHO) recommendation of at least 60 min of moderate-to-vigorous physical activity (MVPA) per day for children and adolescents aged 5–19 years, although studies using alternative cut-points were included and documented. This systematic review and meta-analysis estimated the pooled prevalence of LPA among children and adolescents in the Middle East and North Africa (MENA) region. PubMed, Embase, Web of Science, and Scopus were searched up to May 2025 for observational studies reporting LPA prevalence among individuals aged 5–19 years in MENA countries. Random-effects models were used to calculate pooled estimates, with subgroup analyses by sex, age, and measurement instrument. A total of 54 studies across 19 MENA countries were included, covering 71 population-specific observations and a total of 257,208 participants. The overall pooled prevalence of LPA across all studies was 64% (95% CI: 59–69%). Adolescents had the highest prevalence at 71% (95% CI: 66–75%). Girls had a significantly higher prevalence of LPA (72%, 95% CI: 63–80%) compared to boys (45%, 95% CI: 34–56%). Country-specific prevalence ranged widely, from 44% in Iran to 93% in Algeria. Substantial heterogeneity was observed across all analyses (I² > 99%), reflecting genuine contextual and methodological variation. The risk of bias assessment (Joanna Briggs Institute (JBI) tool) indicated that included studies were generally of low to moderate risk, with no studies rated as high risk. However, the overall certainty of evidence was graded as low due to substantial heterogeneity. Interpretation of pooled estimates should consider the substantial heterogeneity and variability in measurement tools. Across all measurement instrument subgroups, girls consistently exhibited higher inactivity levels. LPA is highly prevalent among youth in the MENA region, particularly among girls and adolescents, with large inter-country variations warranting targeted interventions. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2026.