Physical Activity Indicators Among Children and Adolescents in Lebanon, Qatar, and the United Arab Emirates: Comparative Synthesis of Active Healthy Kids Report Card Data From 1998 to 2022.

Background: Physical inactivity and sedentary behavior are important modifiable risk factors for noncommunicable diseases. High prevalences of physical inactivity among children and adolescents continue to represent a significant public health challenge globally, with approximately two-thirds of children worldwide not achieving the recommended daily amount of physical activity (PA). Countries in the Middle East exhibit some of the highest levels of physical inactivity and sedentary behavior, which contribute to the increasing rates of obesity among children and adolescents. Objective: This study aims to provide a comparative synthesis of PA indicators among children and adolescents in Lebanon, Qatar, and the United Arab Emirates (UAE) based on the Active Healthy Kids Global Alliance (AHKGA) PA Report Cards and further compare the findings with regional and global trends. Methods: Data were synthesized from previous AHKGA PA Report Cards published by researchers from Lebanon, Qatar, the UAE in the years 2016 (Global Matrix 2.0; 1998-2014 data), 2018 (Global Matrix 3.0; 2016-2017 data) and 2022 (Global Matrix 4.0; 2017-2022 data). We evaluated 10 key PA indicators across these countries to identify trends and gaps in PA levels among children and adolescents. These findings were further compared with regional and global data gathered and published in previous iterations of the AHKGA Global Matrix. Results: Based on data collected between 1998 and 2022, less than one-third (15%-33%) of children and adolescents in Lebanon, Qatar, and the UAE achieved the recommended daily average of 60 minutes of moderate- to vigorous-intensity PA. Additionally, more than one-half (45%-74%) of children and adolescents exceeded the recommended limit of 2 hours of recreational screen time per day. Overall, boys were more physically active than girls; however, PA levels declined with increasing age. Other behavioral indicators such as participation in organized sports and active transportation revealed insufficient PA levels. The results were slightly better for sources of influence indicators especially with the opportunities provided by schools and governments. Compared with global estimates, PA levels in the Middle Eastern countries were similar to the averages observed across Asian countries participating in the AHKGA; however, they were generally lower than PA levels in other regions of the world. Conclusions: Data from a 25-year period show consistently low levels of PA and high levels of sedentary behavior among children and adolescents from these 3 Arab Middle Eastern countries. Despite governmental investments in implementation of PA initiatives, there seems to be a lag in eliciting increases in PA at the population level. Evidence points to a critical need for behavioral and lifestyle modifications among children and adolescents. These concerns are exacerbated by a lack of national surveillance systems and evidence-based policy interventions to improve PA levels.