Abstract: Articles Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants Regina Guthold, Gretchen A Stevens, Leanne M Riley, Fiona C Bull Summary Background Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends. Methods We pooled data from population-based surveys reporting the prevalence of insufficient physical activity, which included physical activity at work, at home, for transport, and during leisure time (ie, not doing at least 150 min of moderate-intensity, or 75 min of vigorous-intensity physical activity per week, or any equivalent combination of the two). We used regression models to adjust survey data to a standard definition and age groups. We estimated time trends using multilevel mixed-effects modelling. Findings We included data from 358 surveys across 168 countries, including 1·9 million participants. Global agestandardised prevalence of insufficient physical activity was 27·5% (95% uncertainty interval 25·0–32·2) in 2016, with a difference between sexes of more than 8 percentage points (23·4%, 21·1–30·7, in men vs 31·7%, 28·6–39·0, in women). Between 2001, and 2016, levels of insufficient activity were stable (28·5%, 23·9–33·9, in 2001; change not significant). The highest levels in 2016, were in women in Latin America and the Caribbean (43·7%, 42·9–46·5), south Asia (43·0%, 29·6–74·9), and high-income Western countries (42·3%, 39·1–45·4), whereas the lowest levels were in men from Oceania (12·3%, 11·2–17·7), east and southeast Asia (17·6%, 15·7–23·9), and sub-Saharan Africa (17·9%, 15·1–20·5). Prevalence in 2016 was more than twice as high in high-income countries (36·8%, 35·0–38·0) as in low-income countries (16·2%, 14·2–17·9), and insufficient activity has increased in high-income countries over time (31·6%, 27·1–37·2, in 2001). Lancet Glob Health 2018; 6: e1077–86 Published Online September 4, 2018 http://dx.doi.org/10.1016/ S2214-109X(18)30357-7 See Comment page e1046 Department for Prevention of Noncommunicable Diseases, WHO, Geneva, Switzerland (R Guthold PhD, L M Riley MSc, Prof F C Bull PhD); Department for Information, Evidence and Research, WHO, Geneva, Switzerland (G A Stevens DSc); and Department of Sport and Exercise Science, University of Western Australia, Perth, WA, Australia (Prof F C Bull) Correspondence to: Dr Regina Guthold, World Health Organization, 1211 Geneva, Switzerland gutholdr@who.int Interpretation If current trends continue, the 2025 global physical activity target (a 10% relative reduction in insufficient physical activity) will not be met. Policies to increase population levels of physical activity need to be prioritised and scaled up urgently. Funding None. Copyright This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article’s original URL.