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Physical activity patterns and correlates among adults from a developing country: the Sri Lanka Diabetes and Cardiovascular Study

  • Prasad Katulanda (a1) (a2), Ranil Jayawardana (a1) (a3), Priyanga Ranasinghe (a1) (a4), MH Rezvi Sheriff (a1) and David R Matthews (a2)...

To evaluate patterns of physical activity (PA), the prevalence of physical inactivity and the relationships between PA and sociodemographic, clinical and biochemical parameters among Sri Lankan adults.


Descriptive cross-sectional study.


Nationally representative population-based survey conducted in Sri Lanka.


Data on PA and associated details were obtained from 5000 adults. PA was assessed using the International Physical Activity Questionnaire (short-form). A binary logistic regression analysis was performed using the dichotomous variable ‘health-enhancing PA’ (0 = ‘active’, 1 = ‘inactive’).


Sample size was 4485. Mean age was 46·1 (sd 15·1) years, 39·5 % were males. The mean weekly total MET (metabolic equivalents of task) minutes of PA among the study population was 4703 (sd 4369). Males (5464 (sd 5452)) had a significantly higher weekly total MET minutes than females (4205 (sd 3394); P < 0·001). Rural adults (5175 (sd 4583)) were significantly more active than urban adults (2956 (sd 2847); P < 0·001). Tamils had the highest mean weekly total MET minutes among ethnicities. Those with tertiary education had lowest mean weekly total MET minutes. In all adults 60·0 % were in the ‘highly active’ category, while only 11·0 % were ‘inactive’ (males 14·6 %, females 8·7 %; P < 0·001). Of the ‘highly active’ adults, 85·8 % were residing in rural areas. Results of the binary logistic regression analysis indicated that female gender (OR = 2·1), age >70 years (OR = 3·8), urban living (OR = 2·5), Muslim ethnicity (OR = 2·7), tertiary education (OR = 3·6), obesity (OR = 1·8), diabetes (OR = 1·6), hypertension (OR = 1·2) and metabolic syndrome (OR = 1·3) were all associated with significantly increased odds of being physically ‘inactive’.


The majority of Sri Lankan adults were ‘highly active’ physically. Female gender, older age, urban living, Muslim ethnicity and tertiary education were all significant predictors of physical inactivity. Physical inactivity was associated with obesity, diabetes, hypertension and metabolic syndrome.

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1.World Health Organization (2010) Global Recommendations on Physical Activity for Health. Geneva: WHO.
2.World Health Organization (2009) Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: WHO.
3.Bassuk, SS & Manson, JE (2005) Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol 99, 11931204.
4.Barengo, NC, Hu, G, Lakka, TAet al. (2004) Low physical activity as a predictor for total and cardiovascular disease mortality in middle-aged men and women in Finland. Eur Heart J 25, 22042211.
5.Tanasescu, M, Leitzmann, MF, Rimm, EBet al. (2003) Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes. Circulation 107, 24352439.
6.Powell, KE & Blair, SN (1994) The public health burdens of sedentary living habits: theoretical but realistic estimates. Med Sci Sports Exerc 26, 851856.
7.Katulanda, P, Constantine, GR, Mahesh, JGet al. (2008) Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka – Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabet Med 25, 10621069.
8.Wijewardene, K, Mohideen, MR, Mendis, Set al. (2005) Prevalence of hypertension, diabetes and obesity: baseline findings of a population based survey in four provinces in Sri Lanka. Ceylon Med J 50, 6270.
9.Katulanda, P, Jayawardena, MA, Sheriff, MHet al. (2010) Prevalence of overweight and obesity in Sri Lankan adults. Obes Rev 11, 751756. Silva, KS, Wickramasinghe, VP & Gooneratne, IN (2006) Metabolic consequences of childhood obesity – a preliminary report. Ceylon Med J 51, 105109.
11.Jayasekara, R & Schultz, T (2007) Health status, trends, and issues in Sri Lanka. Nurs Health Sci 9, 228233.
12.World Health Organization (2010) Global Status Report on Noncommunicable Diseases. Geneva: WHO.
13.Haskell, WL & Kiernan, M (2000) Methodologic issues in measuring physical activity and physical fitness when evaluating the role of dietary supplements for physically active people. Am J Clin Nutr 72, 2 Suppl., 541S550S.
14.IPAQ Data Management Group (2010) International Physical Activity Questionnaire. (accessed February 2012).
15.Arambepola, C, Fernando, D & Ekanayake, R (2008) A simple valid tool for measuring obesity-related-CHD risk in Sri Lankan adults. Prev Control 3, 1119.
16.American College of Sports Medicine Position Stand (1998) The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 30, 975991.
17.Department of Census and Statistics Sri Lanka (2001) Census of population and housing. Population, intercensal growth and average annual rate of growth by district, 1981 and 2001. (accessed June 2012).
18.Misra, A, Chowbey, P, Makkar, BMet al. (2009) Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 57, 163170.
19.World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic, Report of a WHO Consultation. WHO Technical Report Series no. 894. Geneva: WHO.
20.Alberti, KG, Zimmet, P & Shaw, J (2006) Metabolic syndrome – a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 23, 469480.
21.Centers for Disease Control and Prevention (2011) The benefits of physical activity. (accessed February 2012).
22.Rastogi, T, Vaz, M, Spiegelman, Det al. (2004) Physical activity and risk of coronary heart disease in India. Int J Epidemiol 33, 759767.
23.Samir, N, Mahmud, S & Khuwaja, AK (2011) Prevalence of physical inactivity and barriers to physical activity among obese attendants at a community health-care center in Karachi, Pakistan. BMC Res Notes 4, 174.
24.Khuwaja, AK & Kadir, MM (2010) Gender differences and clustering pattern of behavioural risk factors for chronic non-communicable diseases: community-based study from a developing country. Chronic Illn 6, 163170.
25.Hayes, L, White, M, Unwin, Net al. (2002) Patterns of physical activity and relationship with risk markers for cardiovascular disease and diabetes in Indian, Pakistani, Bangladeshi and European adults in a UK population. J Public Health Med 24, 170178.
26.Ghaffar, A, Reddy, KS & Singhi, M (2004) Burden of non-communicable diseases in South Asia. BMJ 328, 807810.
27.Mather, HM & Keen, H (1985) The Southall Diabetes Survey: prevalence of known diabetes in Asians and Europeans. Br Med J (Clin Res Ed) 291, 10811084.
28.Chaturvedi, N (2003) Ethnic differences in cardiovascular disease. Heart 89, 681686.
29.Bauman, A, Bull, F, Chey, Tet al. (2009) The International Prevalence Study on Physical Activity: results from 20 countries. Int J Behav Nutr Phys Act 6, 21.
30.Ministry of Finance and Planning (2005) Sri Lanka New Development Strategy. Colombo: Department of National Planning.
31.Somatunga, LC (2004) NCD Risk Factor Survey in Sri Lanka: STEP Survey. Colombo: Ministry of Health Care & Nutrition.
32.Guthold, R, Ono, T, Strong, KLet al. (2008) Worldwide variability in physical inactivity a 51-country survey. Am J Prev Med 34, 486494.
33.Boutcher, SH (2011) High-intensity intermittent exercise and fat loss. J Obes 2011, 868305.
34.Hawley, JA & Gibala, MJ (2009) Exercise intensity and insulin sensitivity: how low can you go? Diabetologia 52, 17091713.
35.Abeywardena, MY (2003) Dietary fats, carbohydrates and vascular disease: Sri Lankan perspectives. Atherosclerosis 171, 157161.
36.Sassen, B, Cornelissen, VA, Kiers, Het al. (2009) Physical fitness matters more than physical activity in controlling cardiovascular disease risk factors. Eur J Cardiovasc Prev Rehabil 16, 677683.
37.van Horen, B & Pinnawala, S (2006) Sri Lanka. In Urbanization and Sustainability in Asia: Good Practice Approaches in Urban Region Development, pp. 310340 [B Roberts and T Kanaley, editors]. Manila: Asian Development Bank.
38.Edwards, P & Tsouros, A (2006) Promoting Physical Activity and Active Living in Urban Environments: The Role of Local Governments. Copenhagen: WHO Regional Office for Europe.
39.Berrigan, D & Troiano, RP (2002) The association between urban form and physical activity in US adults. Am J Prev Med 23, 7479.
40.Emmons, KM, Barbeau, EM, Gutheil, Cet al. (2007) Social influences, social context, and health behaviors among working-class, multi-ethnic adults. Health Educ Behav 34, 315334.
41.Schnohr, C, Hojbjerre, L, Riegels, Met al. (2004) Does educational level influence the effects of smoking, alcohol, physical activity, and obesity on mortality? A prospective population study. Scand J Public Health 32, 250256.
42.Vaz de Almeida, MD, Graca, P, Afonso, Cet al. (1999) Physical activity levels and body weight in a nationally representative sample in the European Union. Public Health Nutr 2, 105113.
43.Laaksonen, M, Talala, K, Martelin, Tet al. (2008) Health behaviours as explanations for educational level differences in cardiovascular and all-cause mortality: a follow-up of 60 000 men and women over 23 years. Eur J Public Health 18, 3843.
44.Centers for Disease Control and Prevention (2007) Prevalence of regular physical activity among adults – United States, 2001 and 2005. MMWR Morb Mortal Wkly Rep 56, 12091212.
45.Rzewnicki, R, Vanden Auweele, Y & De Bourdeaudhuij, I (2003) Addressing overreporting on the International Physical Activity Questionnaire (IPAQ) telephone survey with a population sample. Public Health Nutr 6, 299305.
46.Ainsworth, BE, Macera, CA, Jones, DAet al. (2006) Comparison of the 2001 BRFSS and the IPAQ Physical Activity Questionnaires. Med Sci Sports Exerc 38, 15841592.
47.Ainsworth, BE, Haskell, WL, Herrmann, SDet al. (2011) 2011 Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 43, 15751581.
48.Hall, LM, Moran, CN, Milne, GRet al. (2010) Fat oxidation, fitness and skeletal muscle expression of oxidative/lipid metabolism genes in South Asians: implications for insulin resistance? PLoS One 5, e14197.
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