Physical activity and sedentary behavior among school-going adolescents in low-and middle-income countries: insights from the global school-based health survey

Background: The Global School Student Health Survey (GSHS) is being carried out by students in various countries across the globe to advance improved health programs for youth. However, in comparison to high -income countries, adolescents in lowand middle -income countries (LMICs) are generally at an early stage of understanding regarding physical activity (PA) and sedentary behavior (SB), often exhibiting low levels of PA and high levels of SB. Furthermore, there is limited evidence connecting PA and SB in school -going adolescents from LMICs. Purpose: The objective of this review was to synthesize the available evidence regarding PA and sedentary behavior among school -going adolescents in LMICs using data from the GSHS. Method: On March 18, 2023, a systematic literature search was performed across four electronic databases, namely Web of Science, PubMed, ScienceDirect, and EBSCO with n odaterestrictions. Studies were eligible if they: (1) utilization of data sourced from the Global Student -based Health Survey; (2) exploration of physical activity; (3) speci fi c focus on adolescents; (4) conducted in lowand middle -income countries; (5) study design encompassing observational; (6) published as English journal articles. Results: Among the 29 studies included in the analysis, the majority revealed elevated levels of sedentary behavior and diminished levels of PA in lowand middle -income countries. Furthermore, notable disparities in physical engagement and sedentary behavior were noted between male and female adolescents ( p < 0.001). Augmented PA among teenagers was observed to correlate with higher consumption of vegetables and fruits (AOR = 1.30; 95% CI [1.13 - 1.50]; p < 0.001), decreased alcohol consumption, and a reduced prevalence of loneliness and depression (aOR 1.37, 95% CI [1.18 - 1.59]). Conclusions: The results of this review af fi rm that in contrast to high -income countries, adolescents in lowand middle -income countries (LMICs) are in the early stages of comprehending physical activity, marked by low levels of PA. Physical activity and sedentary behavior in school -going adolescents from LMICs appear to be in fl uenced by factors such as policies, cultural norms, socioeconomic conditions, as well as gender, and age.