Physical inactivity and metabolic syndrome in the UAE: a systematic review and meta-analysis of parallel epidemics

Background: Metabolic syndrome (MetS), a cluster of cardiovascular risk factors strongly associated with physical inactivity, has emerged as a critical global public health concern. The United Arab Emirates (UAE) exhibits elevated prevalence rates of both conditions, driven by rapid urbanization and lifestyle transitions. However, a comprehensive synthesis of the epidemiological evidence remains lacking.
Objective: This systematic review and meta-analysis evaluated the prevalence of physical inactivity and MetS in the UAE general population.
Methods: Data were obtained from systematic searches of eight databases (CINAHL, Embase, Medline, PsycInfo, Scopus, Web of Science, Cochrane Library, SPORTDiscus). Inclusion criteria encompassed observational studies reporting prevalence data on physical inactivity (primarily defined as not meeting WHO guidelines: ≥150 minutes/week moderate-intensity activity) and/or MetS in UAE adults. Sixty prevalence studies were included, with data pooled using random-effects meta-analysis.
Results: Three meta-analyses estimated physical activity (PA) prevalence using different methods across 39 studies (n = 77,360), yielding a pooled prevalence of 32.2% (95% CI 24.8-40), substantially lower than the WHO global average of 69%. Accelerometer data (2 studies, n = 296) showed 23.5% (95% CI 18.8-28.5), while survey-based reports (11 studies, n = 18,034) indicated 51.1% (95% CI 37.9-64.3). MetS prevalence was 31.2% (95% CI 23.6-39.4) from 14 studies (n = 22,835). Both conditions showed high heterogeneity and sex-related differences, with lower PA and distinct MetS patterns in women. Physical inactivity was associated with 34% increased odds of MetS.
Conclusion: Physical inactivity and MetS represent important public health priorities in the UAE, with notable demographic variations warranting targeted interventions. Building on existing government health initiatives, addressing this burden requires comprehensive, multisectoral interventions encompassing urban environmental redesign, culturally adapted health promotion programmes, and context-specific diagnostic frameworks tailored to the UAE's distinct environmental, sociocultural, and economic context.

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