Physical activity patterns and environmental influences: Findings from the Kuwait diabetes epidemiology program

Insufficient physical activity (PA) is the fourth leading risk factor for cardiometabolic disease. This study assessed in Kuwait adults the spatial clustering of PA; relationships between PA, climatic factors and built environmental (BE) indicators; and ethnic group differences in PA.

A population-based cross-sectional study was conducted from 2011 to 2014 targeting adults in Kuwait ≥18 years old, using the World Health Organisation (WHO) Global Physical Activity Questionnaire (GPAQ) to assess five domains of physical activity. 2530 participants were classified as physically active or not physically active based on accruing at least 600 MET (min/week). Objectively measured residential-area BE indicators were extracted using the street address location of study participants. Climatic variables expressed as monthly aggregates were acquired from Kuwait's climate stations. Random effects logit analysis was used to assess the relationships between PA, climatic and BE variables.

The proportion of physically active respondents was 51.9 % (95 % CI: 49.9, 53.8 %). Insufficient PA was greater in women than men. Suburb-level PA ranged from 21.4 % to 81.9 %. Covariate-adjusted analyses of PA revealed a weak positive association between average temperature aOR = 1.03 (95 %CI: 1.00, 1.06), open space sports ground with synthetic grass (300 m) aOR = 1.28 (95 %CI: 0.88, 1.86), and weighted area road density (100 m) aOR = 1.06 (95 %CI: 0.96, 1.17). A lower odds of PA was apparent for respondents who were currently married (vs never married) aOR = 0.68 (95 %CI: 0.46, 0.99), and for women (vs men) aOR = 0.57 (95 %CI: 0.46, 0.72). A greater odds of PA was apparent for the South/Southeast Asian relative to Arab ethnic group aOR = 1.32 (95 %CI: 1.04, 1.67).

This study indicates that half the population in Kuwait did not meet the WHO recommended minimum PA level of at least 600 MET (min/week). Efforts to promote PA in Kuwait should consider addressing gender and ethnic disparities, local environmental factors, and demographic influences such as marital status.