Accuracy and inequalities in physical activity research
Authors: Gary O'Donovan
Journal: The Lancet Global Health (2019)

I agree with Regina Guthold and colleagues1Guthold R Stevens GA Riley LM Bull FC Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants.Lancet Glob Health. 2018; 6: e1077-e1086Summary Full Text Full Text PDF PubMed Scopus (1822) Google Scholar and Ding Ding in the accompanying Comment2Ding D Surveillance of global physical activity: progress, evidence, and future directions.Lancet Global Health. 2018; 6: e1046-e1047Summary Full Text Full Text PDF PubMed Scopus (32) Google Scholar that large-scale interventions are needed to increase physical activity. Colombia has been labelled the least active country in the world3The EconomistSedentary living has reached epidemic proportions.http://www.economist.com/news/international/21663218-sedentary-living-has-reached-epidemic-proportions-you-have-waked-me-too-soonDate: 2015Date accessed: August 1, 2017Google Scholar and Latin America and the Caribbean had some of the highest levels of insufficient physical activity in the analysis by Guthold and colleagues.1Guthold R Stevens GA Riley LM Bull FC Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants.Lancet Glob Health. 2018; 6: e1077-e1086Summary Full Text Full Text PDF PubMed Scopus (1822) Google Scholar However, far from being inactive, Colombia and Latin America are pioneers in large-scale physical activity interventions.4Sarmiento OL Diaz Del Castillo A Triana CA Acevedo MJ Gonzalez SA Pratt M Reclaiming the streets for people: insights from Ciclovias Recreativas in Latin America.Prev Med. 2017; 103S: S34-S40Crossref PubMed Scopus (50) Google Scholar Colombia was labelled the least active country in the world by The Economist;3The EconomistSedentary living has reached epidemic proportions.http://www.economist.com/news/international/21663218-sedentary-living-has-reached-epidemic-proportions-you-have-waked-me-too-soonDate: 2015Date accessed: August 1, 2017Google Scholar however, the article cited a WHO report5WHOGlobal status report on noncommunicable diseases.http://www.who.int/nmh/publications/ncd_report2010/en/Date: 2010Date accessed: August 1, 2017Google Scholar in which physical activity was not actually assessed in Colombia, only estimated. The methods used to assess physical activity in Colombia in the analysis by Guthold and colleagues are unclear: a 2003 study of 2945 people in Bogotá, a 2010 study of 2421 people in the Santander region, and a 2005 report of 14 228 participants in the National Nutrition Survey are mentioned in the appendix.1Guthold R Stevens GA Riley LM Bull FC Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants.Lancet Glob Health. 2018; 6: e1077-e1086Summary Full Text Full Text PDF PubMed Scopus (1822) Google Scholar Guthold and colleagues acknowledged that data coverage was low in Latin America and the Caribbean and that physical activity estimates should be interpreted with caution. Colombia and at least six other countries in Latin America have Ciclovías,4Sarmiento OL Diaz Del Castillo A Triana CA Acevedo MJ Gonzalez SA Pratt M Reclaiming the streets for people: insights from Ciclovias Recreativas in Latin America.Prev Med. 2017; 103S: S34-S40Crossref PubMed Scopus (50) Google Scholar where roads are closed to motor vehicles on Sunday mornings and public holidays to enable people to participate in physical activity (figure). Between 1 km and 114 km of road are closed for each event, which can attract up to 1·5 million people from all socioeconomic backgrounds.4Sarmiento OL Diaz Del Castillo A Triana CA Acevedo MJ Gonzalez SA Pratt M Reclaiming the streets for people: insights from Ciclovias Recreativas in Latin America.Prev Med. 2017; 103S: S34-S40Crossref PubMed Scopus (50) Google Scholar Bold policy making, public funding, and community appropriation are key to the success of the Ciclovía. The Ciclovía is the flagship programme in Colombia, but it is not the only large-scale physical activity intervention. Several cities have world-class sports facilities that are free for anyone to use. The Liga Pony Fútbol is a nationwide football competition in which 35 000 boys and girls participate every year. The Juegos Supérate is an annual nationwide sports competition in which more than 1 million children and youths participate. Physical activity needs to be better measured in Latin America because the region might well be home to some of the most successful physical activity interventions. I declare no competing interests. Accuracy and inequalities in physical activity researchIn their Article on global estimates and trends of insufficient physical activity in adults, Regina Guthold and colleagues (October, 2018)1 included data from nearly 2 million participants who were representative of 96% of the global population. A key finding was that about a quarter (27·5%) of adults worldwide do not get enough physical activity to meet current public health guidelines. However, this estimate was based on self-reported questionnaires and probably misrepresents the true burden of physical inactivity around the world. Full-Text PDF Open AccessAccuracy and inequalities in physical activity research – Authors' replyWe thank Jelle Van Cauwenberg and colleagues, Jean-Philippe Chaput, and Gary O'Donovan for their comments on our recent study, in which we analysed the prevalence of insufficient physical activity in 168 countries, and estimated regional and global trends. Full-Text PDF Open AccessAccuracy and inequalities in physical activity researchRegina Guthold and colleagues1 should be congratulated on their rigorous efforts to harmonise and analyse physical activity data from 358 surveys across 168 countries. The Article highlights global patterns of physical inactivity. We agree with the authors' call to prioritise and scale up policy to increase population levels of physical activity, but we feel that their analysis overlooks important social inequalities in physical activity that need to be taken into account by policy and research. Full-Text PDF Open AccessWorldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participantsIf current trends continue, the 2025 global physical activity target (a 10% relative reduction in insufficient physical activity) will not be met. Policies to increase population levels of physical activity need to be prioritised and scaled up urgently. Full-Text PDF Open Access