The Lebanese Active Healthy Kids Work Group (LAHKWG) synthesized literature published on physical activity (PA) indicators among ages 5- to 17- year-olds, using a recommended harmonized process by the Active Healthy Kids Global Alliance (AHKGA), to explore Lebanon's performance since its previous report card publication. Peer reviewed literature, national surveys, and gray literature published since 2017, on 10 common AHKGA and two LAHKWG recommended indicators were examined. Common indicators included overall PA, organized sport and PA, active play, active transportation, community and environment, sedentary behaviors, physical fitness, family and peers, school, and government. LAHKWG recommended indicators were sleep and weight status. LAHKWG members reviewed 764 records, of which 28 were selected for full review. A grade was assigned for each indicator using AHKGA's grading rubric and established benchmarks on data from nationally representative samples for children and youth. Data from one nationally representative sample were available for ages 13–17 years (i.e., no data <13 years). Five indicators received “Incomplete” (organized sport and PA; active Play; physical fitness; family and peers; community and environment); overall PA received a D-; active transportation and sleep received a D+; school and government received a D; sedentary behaviors received a C; and weight status received a B-. The LAHKWG strongly encourages stakeholders to take concrete actions towards prioritizing PA promotion at a national level especially in the education sector. Offering more quality PA opportunities for Lebanese children and youth will be beneficial for their physical and mental health in any context.

Background: Physical inactivity and sedentary behavior are important modifiable risk factors for noncommunicable diseases. High prevalences of physical inactivity among children and adolescents continue to represent a significant public health challenge globally, with approximately two-thirds of children worldwide not achieving the recommended daily amount of physical activity (PA). Countries in the Middle East exhibit some of the highest levels of physical inactivity and sedentary behavior, which contribute to the increasing rates of obesity among children and adolescents. Objective: This study aims to provide a comparative synthesis of PA indicators among children and adolescents in Lebanon, Qatar, and the United Arab Emirates (UAE) based on the Active Healthy Kids Global Alliance (AHKGA) PA Report Cards and further compare the findings with regional and global trends. Methods: Data were synthesized from previous AHKGA PA Report Cards published by researchers from Lebanon, Qatar, the UAE in the years 2016 (Global Matrix 2.0; 1998‐2014 data), 2018 (Global Matrix 3.0; 2016‐2017 data) and 2022 (Global Matrix 4.0; 2017‐2022 data). We evaluated 10 key PA indicators across these countries to identify trends and gaps in PA levels among children and adolescents. These findings were further compared with regional and global data gathered and published in previous iterations of the AHKGA Global Matrix. Results: Based on data collected between 1998 and 2022, less than one-third (15%‐33%) of children and adolescents in Lebanon, Qatar, and the UAE achieved the recommended daily average of 60 minutes of moderate- to vigorous-intensity PA. Additionally, more than one-half (45%‐74%) of children and adolescents exceeded the recommended limit of 2 hours of recreational screen time per day. Overall, boys were more physically active than girls; however, PA levels declined with increasing age. Other behavioral indicators such as participation in organized sports and active transportation revealed insufficient PA levels. The results were slightly better for sources of influence indicators especially with the opportunities provided by schools and governments. Compared with global estimates, PA levels in the Middle Eastern countries were similar to the averages observed across Asian countries participating in the AHKGA; however, they were generally lower than PA levels in other regions of the world. Conclusions: Data from a 25-year period show consistently low levels of PA and high levels of sedentary behavior among children and adolescents from these 3 Arab Middle Eastern countries. Despite governmental investments in implementation of PA initiatives, there seems to be a lag in eliciting increases in PA at the population level. Evidence points to a critical need for behavioral and lifestyle modifications among children and adolescents. These concerns are exacerbated by a lack of national surveillance systems and evidence-based policy interventions to improve PA levels.

BACKGROUND Public health restrictive measures adopted during the COVID-19 pandemic led to significant changes in lifestyles. Global declines in physical activity (PA) and increases in sedentary behavior were noted. These trends were observed within different regions of the world, pointing toward potential long-term implications for PA behaviors. OBJECTIVE This mixed methods study aims to assess variations in daily step counts in Qatar using device-driven data throughout all 3 COVID-19 waves (February 2020 to February 2023) compared with a full pre–COVID-19 year. In-depth interviews were further conducted with randomly selected participants to gain insights into determinants, perceptions, and barriers of PA during the pandemic. METHODS A total of 362 participants (60/362, 16.6% female) from the Step Into Health community-based program reported daily step counts using pedometers (170/362, 47%) or a mobile phone app (192/362, 53%). Linear mixed models examined changes in daily step counts across 19 phases of implementation and lifting of restrictions. Overall, 9 participants also completed semistructured interviews that were analyzed thematically and phenomenologically. Triangulation of quantitative and qualitative data was applied to interpret convergences and divergences between device-measured activity patterns and lived experiences. RESULTS Significant declines in daily step counts (ie, from 689 to 1013 steps) were observed at the onset of each wave (P<.001), were especially marked at wave 2, and were followed by a recovery of step count following the lifting of restrictions at each wave (ie, increase of 609 to 1147 steps). Different patterns of change in step count emerged within sex (P=.03), age (P=.03), and BMI (P=.01) groups, where larger variations were seen among male individuals, pedometer users, and normal-weight participants. Qualitative themes (ie, disrupted routines, reliance on home-based exercise, and media influence) contextualized these patterns and explained subgroup differences. CONCLUSIONS The largest drops in daily step count coincided with increased case severity and Ramadan. Integration of quantitative and qualitative findings showed that declines in activity were shaped not only by restrictions but also by fear, motivation, and contextual factors. These results underscore the importance of designing interventions that encourage outdoor activity and provide reliable social media–based guidance during public health crises.

BACKGROUND High prevalence of physical inactivity amongst children and adolescents continues to represent a significant health challenge globally with approximately two-thirds of children worldwide not achieving the recommended daily Physical Activity (PA) levels. Countries in the Middle East exhibit some of the highest levels of physical inactivity and sedentary behaviour, paralleled with increasing obesity rates amongst children and adolescents in the region. OBJECTIVE This study aims to summarize and compare findings on PA indicators amongst children and adolescents in Lebanon, Qatar, and the United Arab Emirates (UAE) based on the Active Healthy Kids Global Alliance (AHKGA) PA Report Cards and compare these results with regional and global trends. METHODS Previous Report Cards from Lebanon, Qatar, the UAE were utilised to evaluate and compare PA indicators amongst children and adolescents, and to compare these findings with global data. Report Cards were published in 2016 (1998−2014 data), 2018 (2016−2017 data) and 2022 (2017−2022 data). Data addressing 10 key PA indicators were analysed to identify trends and gaps in PA levels and influencing factors amongst children and adolescents across these countries. RESULTS Based on data collected between 1998 and 2022, less than one-third (15%−33%) of children and adolescents in Lebanon, Qatar, and the UAE achieved the recommended daily average of 60 minutes of moderate- to vigorous-intensity PA. Additionally, more than half (45%−74%) of children and adolescents exceeded the recommended limit of two hours of recreational screen time per day. Other behavioural indicators revealed insufficient PA levels, though the results were slightly better for sources of influence indicators. In comparison with global averages from the Global Matrix, our results were generally lower across indicators. Comparable low levels of PA were commonly observed across other Asian countries. CONCLUSIONS Data from a 25-year period show consistent low levels of PA and high levels of sedentary behaviour amongst children and adolescents from these three Arab Middle Eastern countries. Despite governmental investment in implementation of PA initiatives, there seems to be a lag in eliciting increases in PA at a population-level. The evidence points to a critical need for systematic PA surveillance programmes utilising nationally representative samples, with the aim to measure self-report and objective estimates of PA across different domains.

Background: Public health restrictive measures adopted during the COVID-19 pandemic led to significant changes in lifestyles. Global declines in physical activity (PA) and increases in sedentary behavior were noted. These trends were observed within different regions of the world, pointing toward potential long-term implications for PA behaviors. Objective: This mixed methods study aims to assess variations in daily step counts in Qatar using device-driven data throughout all 3 COVID-19 waves (February 2020 to February 2023) compared with a full pre–COVID-19 year. In-depth interviews were further conducted with randomly selected participants to gain insights into determinants, perceptions, and barriers of PA during the pandemic. Methods: A total of 362 participants (60/362, 16.6% female) from the Step Into Health community-based program reported daily step counts using pedometers (170/362, 47%) or a mobile phone app (192/362, 53%). Linear mixed models examined changes in daily step counts across 19 phases of implementation and lifting of restrictions. Overall, 9 participants also completed semistructured interviews that were analyzed thematically and phenomenologically. Triangulation of quantitative and qualitative data was applied to interpret convergences and divergences between device-measured activity patterns and lived experiences. Results: Significant declines in daily step counts (ie, from 689 to 1013 steps) were observed at the onset of each wave (P<.001), were especially marked at wave 2, and were followed by a recovery of step count following the lifting of restrictions at each wave (ie, increase of 609 to 1147 steps). Different patterns of change in step count emerged within sex (P=.03), age (P=.03), and BMI (P=.01) groups, where larger variations were seen among male individuals, pedometer users, and normal-weight participants. Qualitative themes (ie, disrupted routines, reliance on home-based exercise, and media influence) contextualized these patterns and explained subgroup differences. Conclusions: The largest drops in daily step count coincided with increased case severity and Ramadan. Integration of quantitative and qualitative findings showed that declines in activity were shaped not only by restrictions but also by fear, motivation, and contextual factors. These results underscore the importance of designing interventions that encourage outdoor activity and provide reliable social media–based guidance during public health crises.