PT - JOURNAL ARTICLE AU - Antonio Garcia-Hermoso AU - José Francisco López-Gil AU - Robinson Ramírez-Vélez AU - Alicia María Alonso-Martínez AU - Mikel Izquierdo AU - Yasmin Ezzatvar TI - Adherence to aerobic and muscle-strengthening activities guidelines: a systematic review and meta-analysis of 3.3 million participants across 31 countries AID - 10.1136/bjsports-2022-106189 DP - 2022 Nov 23 TA - British Journal of Sports Medicine PG - bjsports-2022-106189 4099 - http://bjsm.bmj.com/content/early/2022/11/23/bjsports-2022-106189.short 4100 - http://bjsm.bmj.com/content/early/2022/11/23/bjsports-2022-106189.full AB - 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 12–17 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 5–11 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.