Physical activity, sedentary behaviour and psychological wellbeing among young adults in Bangladesh: A one-year prospective study

Abstract

Background: The transition to young adulthood offers more autonomy in making lifestyle choices, many of which can be unhealthy. Lack of physical activity (PA) and prolonged sedentary behaviour (SB) can have adverse effects on the concurrent and future health and wellbeing of young adults. However, little is known about PA and SB among young adults in low-and-middle-income countries (LMICs), where rapid urban-industrial transformation may promote a sedentary lifestyle and affect wellbeing. Bangladesh is an LMIC with young adults representing one-fifth of the country’s population. Major causes of poor health in this age group are attributed to non-communicable diseases and psychosocial disorders. Given the established associations with health and wellbeing, it is essential to understand PA and SB of young adults in Bangladesh. Objectives: To assess the (i) prevalence and sociodemographic patterns of PA and SB, (ii) individual-level correlates of PA, SB, and changes in PA and SB, and (iii) associations of PA and SB with psychological distress and sleep difficulties among university-based young adults in Bangladesh.Design and Methods: A one-year prospective study with two assessment points was conducted to collect data. The self-administered written survey included the Global Physical Activity Questionnaire (GPAQ) to assess PA and SB. Wellbeing was assessed using the Kessler 6 Psychological Distress scale and a single item on sleep difficulties. Data on sociodemographic, health, wellbeing, lifestyle, and environmental factors were also collected.Setting/participants: Participants were undergraduate students aged 18 to 24 years from six universities (3 public and 3 private) in Dhaka city, Bangladesh (Wave 1=573; response rate 92%, 45% female; Wave 2=395).Results: Overall, 17% of participants at Wave 1 and 23% at Wave 2 met the World Health Organization recommendations to do ≥150 mins/week of moderate-to-vigorous PA (MVPA). Significantly more males than females were meeting the recommendations at both waves (Wave 1: 27% vs. 6%; Wave 2: 34% vs. 12%). Median duration of MVPA was significantly higher (p<.0001) for males [120 mins/week] than females [90 mins/week]. Jogging/running was the most common recreational PA, with 20% males and 12% females doing this at least once per week. Females participated more in indoor activities (e.g., yoga, stationary exercise), and males did more outdoor activities (e.g., cricket, football) at Wave 1.Overall, 45% participants at Wave 1 and 39% at Wave 2 had high SB (≥480 mins/day). More females than males had high SB at both waves (Wave 1: 52% vs. 39%; Wave 2: 46% vs. 32%). Females reported more time than males in sitting-talking and telephone time during both weekends and weekdays, and television time during weekend days, at Wave 1. Based on Wave 1 data on perceived environmental barriers to PA, poor street lighting at night (62%) and lack of convenient places for PA (56%) were the most common environmental barriers to PA. Analysis of Wave 1 data found that lack of safety and lack of convenient places were more salient to females than males.Multivariable modelling of prospective data showed that PA efficacy and participation in organised sports were positively associated with both females and males’ PA. PA outcome expectations, healthy sleep duration, life satisfaction, and increased age were positive correlates of females’, but not males’, PA. Being male, high phone time, and not participating in organised sports at Wave 1 were associated with a decrease in PA over one year. Prospective data modelling of SB found that female gender, increased age, studying in a public university, and living with the family were positively associated with SB. Prospective data modelling indicated that insufficient PA (<150 mins/week) was independently associated with both distress and sleep difficulties. High SB (≥480 mins/day) was not significantly associated with either wellbeing measures. Participants with insufficient PA+high SB or insufficient PA+low SB had more distress than those with sufficient PA+low SB. Participants with insufficient PA+high SB had higher odds of often experiencing sleep difficulties than those with sufficient PA+low SB.Conclusions: Findings suggest a high prevalence of insufficient PA and prolonged SB among university-based young adults in urban Bangladesh, in particular among females. There were gender-based differences in correlates of PA. Insufficient PA, irrespective of SB, was significantly associated with poor psychological wellbeing. Findings of this research can be instrumental in developing strategies to promote an active and healthy lifestyle among young adults in Bangladesh. Proposed initiatives include organised and weekend sports, female-friendly PA facilities at universities as well as in local residential areas, and female only gym or dedicated hours for females. Recommendations also include government initiatives and a national PA policy for the development of infrastructures that foster healthy activity behaviours, implementation of the existing policies for active lifestyle, and investment in national surveillance. Long-term prospective research is needed with population-based representative samples, including regional and metropolitan areas, to understand the trajectory of these behaviours, and to assess the direction of associations between PA, SB and wellbeing.