@article {Garcia-Hermosobjsports-2022-106189, author = {Antonio Garcia-Hermoso and Jos{\'e} Francisco L{\'o}pez-Gil and Robinson Ram{\'\i}rez-V{\'e}lez and Alicia Mar{\'\i}a Alonso-Mart{\'\i}nez and Mikel Izquierdo and Yasmin Ezzatvar}, title = {Adherence to aerobic and muscle-strengthening activities guidelines: a systematic review and meta-analysis of 3.3 million participants across 31 countries}, elocation-id = {bjsports-2022-106189}, year = {2022}, doi = {10.1136/bjsports-2022-106189}, publisher = {British Association of Sport and Excercise Medicine}, abstract = {Objective To estimate the global prevalence of meeting the WHO guidelines for both aerobic and muscle-strengthening activities (MSA) in populations aged >=5 years, and whenever possible to explore this prevalence according to sociodemographic and lifestyle factors.Design A systematic review and meta-analysis.Data sources Five databases were systematically searched for studies published from inception to September 2022.Eligibility criteria for selecting studies Articles with representative samples aged >=5 years reporting the prevalence of meeting both aerobic and MSA guidelines were included.Results Twenty-one studies comprising 3 390 001 individuals from 31 countries were included. Overall adherence to the aerobic and MSA guidelines was 17.15\% (95\% CI 15.44\% to 18.94\%) in adults >=18 years (n=3 337 603). Among adolescents aged 12{\textendash}17 years, adherence to both guidelines was 19.45\% (95\% CI 16.34\% to 22.75\%) (n=52 398). No studies reported data for children aged 5{\textendash}11 years. Women, older age, low/medium education levels, underweight or obesity, and poor and moderate self-rated health were associated with lower adherence to the physical activity guidelines (p\<0.001) among adults, although the prevalence remained very low in all cases. Subgroup analyses were not conducted with children and adolescents due to a lack of studies.Conclusions Only one out of five adolescents and adults met the recommended combined aerobic and MSA guidelines. Large-scale public health interventions promoting both types of exercise are needed to reduce the associated burden of non-communicable diseases.PROSPERO registration number CRD42022338422.}, issn = {0306-3674}, URL = {https://bjsm.bmj.com/content/early/2022/11/23/bjsports-2022-106189}, eprint = {https://bjsm.bmj.com/content/early/2022/11/23/bjsports-2022-106189.full.pdf}, journal = {British Journal of Sports Medicine} }