Prevalence and Correlates of Insufficient Physical Activity Among Adults Aged 18-69 Years in India: Findings From the National Noncommunicable Disease Monitoring Survey

Prevalence of insufficient physical activity among adult residents of Tehran: a cross-sectional report from Tehran Cohort Study (TeCS)

BACKGROUND

Insufficient physical activity (PA) is a major risk factor for non-communicable diseases (NCDs) and one of the leading causes of premature mortality worldwide. This study examined the prevalence and independent determinants of insufficient PA among adults resident of Tehran utilizing Tehran Cohort Study Data (TeCS).

METHOD

We used the recruitment phase data from the TeCS with complete data on PA. PA was assessed through a Likert-scaled question and categorized into three groups. Utilizing data from the 2016 national census, the age- and sex-weighted prevalence of insufficient PA in Tehran was determined. The adjusted logistic regression model is used to neutralize influencing factors and determine the factors associated with insufficient PA.

RESULT

The weighted prevalence of insufficient PA was 16.9% among the 8213 adult citizens of Tehran, with a greater prevalence among females (19.0% vs. 14.8% among males). Additionally, older age groups, unemployed, housewives, and illiterate educated participants displayed a much higher prevalence of insufficient PA (p < 0.001). Moreover, Tehran's central and southern districts had higher rates of insufficient PA. Concerning the adjusted regression model, older age (Odds ratio [OR]: 4.26, 95% confidence interval [95% CI]: 3.24-5.60, p < 0.001), a lower education level (p < 0.001), unemployment (OR: 1.80, 95% CI: 1.28-2.55, p = 0.001), being a housewife (OR: 1.44, 95% CI: 1.15-1.80, p = 0.002), higher body mass index (BMI) (OR for BMI > 30: 1.85, 95% CI: 1.56-2.18, p < 0.001), opium consumption (OR: 1.92, 95% CI: 1.46-2.52, p < 0.001), diabetes mellitus (OR: 1.25, 95% CI: 1.06-1.48, p = 0.008), hypertension (OR: 1.29, 95% CI: 1.11-1.50, p = 0.001), and coronary artery diseases (OR: 1.30, 95% CI: 1.05-1.61, p = 0.018), were significantly associated with insufficient PA.

CONCLUSIONS

The identified associated factors serve as a valuable guide for policymakers in developing tailored intervention strategies to address the needs of high-risk populations, particularly among older adults and females.

Ten-year risk assessment for cardiovascular disease & associated factors among adult Indians (aged 40-69 yr): Insights from the National Noncommunicable Disease Monitoring Survey (NNMS)

Background & objectives Cardiovascular diseases (CVDs) are extremely prevalent in India, making early detection of people at high risk for CVDs and prevention crucial. This study aimed to estimate CVD risk distribution in older adults (40-69 yr) in India using WHO's non-laboratory risk chart and identify factors associated with elevated CVD risk (10%). Methods The current study used a nationally representative sample of 40-69 yr adults in India. The population's 10-yr CVD risk was defined as very low-to-low (10%), moderate (10-20%) and high to very high (>20%). We attempted univariable and multivariable logistic regressions to identify factors related to higher CVD risk (≥10%). Results Out of 4480 participants, 50 per cent were younger participants (40-49 years). The proportions of the population with very low to low, moderate and high to very high CVD risk were 84.9, 14.4 and 0.7 per cent, respectively. The estimated 10-year CVD risk was higher for people with unemployed [Adjusted Odds Ratio (AOR): 5.12; 95% Confidence Interval (CI): 3.63, 7.24], followed by raised blood glucose (AOR: 1.81; 95%CI: 1.39, 2.34). Interpretation & conclusions The non-laboratory-based chart proves valuable in low-resource settings, especially at the primary healthcare level, facilitating efficient CVD risk assessment and resource allocation. Further research is needed to explore the association of second-hand smoke with CVD risk in the Indian population.

Accelerating policy response to curb non-communicable diseases: an imperative to mitigate the dual public health crises of non-communicable diseases and COVID-19 in India

Non-communicable Diseases (NCDs) are a threat to public health and sustainable development. NCDs were equated to being a 'pandemic' before COVID-19 originated. Globally, NCDs caused approximately 74% of deaths (2019). India accounted for nearly 14.5% of these deaths. NCDs and COVID-19 have a lethal bi-directional relationship with both exacerbating each other's impact. Health systems and populations, particularly in Low- and Middle-Income Countries (LMICs) like India have among the highest burden of COVID-19. This narrative review tracks key policy and programmatic developments on NCD prevention and control in India, with a focus on commercially-driven risk factors (tobacco and alcohol use, unhealthy diet, physical inactivity, and air pollution), and the corresponding NCD targets. It identifies lacunae and recommends urgent policy-focussed multi-dimensional action, to ameliorate the dual impact of NCDs and COVID-19. India's comprehensive response to NCDs can steer national, regional and global progress towards time-bound NCD targets and NCD-related Sustainable Development Goals (SDGs).

Funding

This work is supported by the Commonwealth Foundation. None of the authors were paid to write this article by a pharmaceutical company or other agency. The authors were not precluded from accessing data and accept responsibility to submit for publication.

Co-Benefit Assessment of Active Transportation in Delhi, Estimating the Willingness to Use Nonmotorized Mode and Near-Roadway-Avoided PM2.5 Exposure

This study aims to estimate the avoided mortalities and morbidities and related economic impacts due to adopting the nonmotorized transportation (NMT) policy in Delhi, India. To this aim, an integrated quantitative assessment framework is developed to estimate the expected environmental, health, and economic co-benefits from replacing personal motorized transport with NMT in Delhi, taking into account the inhabitants' willingness to use NMT (walking and cycling) mode. The willingness to accept NMT is estimated by conducting a cross-sectional survey in Delhi, which is further used to estimate the expected health benefits from both increased physical activity and near-roadway-avoided PM_2.5 exposure in selected traffic areas in 11 major districts in Delhi. The value of a statistical life (VSL) and cost of illness methods are used to calculate the economic benefits of the avoided mortalities and morbidities from NMT in Delhi. The willingness assessment indicates that the average per capita time spent walking and cycling in Delhi is 11.054 and 2.255 min, respectively. The results from the application of the NMT in Delhi show the annual reduction in CO₂ and PM_2.5 to be 121.5 kilotons and 138.9 tons, respectively. The model estimates the expected co-benefits from increased physical activities and reduced PM_2.5 exposure at 17,529 avoided cases of mortality with an associated savings of about USD 4870 million in Delhi.