Internal medicine

Public health

Obesity

Family medicine

Meta-analysis

Aerobic exercise

Psychiatry

Nursing

Political science

Physical therapy

Psychological intervention

Systematic review

MEDLINE

Overweight

Underweight

Gerontology

Medicine

Environmental health

British Journal of Sports Medicine

Objective To estimate the global prevalence of meeting the WHO guidelines for both aerobic and muscle-strengthening activities (MSA) in populations aged ≥5 years, and whenever possible to explore this prevalence according to sociodemographic and lifestyle factors. Design A systematic review and meta-analysis. Data sources Five databases were systematically searched for studies published from inception to September 2022. Eligibility criteria for selecting studies Articles with representative samples aged ≥5 years reporting the prevalence of meeting both aerobic and MSA guidelines were included. Results Twenty-one studies comprising 3 390 001 individuals from 32 countries were included. Overall adherence to the aerobic and MSA guidelines was 17.12% (95% CI 15.42% to 18.88%) in adults ≥18 years (n=3 346 723). Among adolescents aged 12–17 years, adherence to both guidelines was 19.74% (95% CI 14.72% to 25.31%) (n=43 278). No studies reported data for children aged 5–11 years. Women, older age, low/medium education levels, underweight or obesity, and poor and moderate self-rated health were associated with lower adherence to the physical activity guidelines (p&lt;0.001) among adults, although the prevalence remained very low in all cases. Subgroup analyses were not conducted with children and adolescents due to a lack of studies. Conclusions Only one out of five adolescents and adults met the recommended combined aerobic and MSA guidelines. Large-scale public health interventions promoting both types of exercise are needed to reduce the associated burden of non-communicable diseases. PROSPERO registration number CRD42022338422.

Adherence to aerobic and muscle-strengthening activities guidelines: a systematic review and meta-analysis of 3.3 million participants across 32 countries