Burden, Trends, and Predictions of Low Physical Activity-Related Diseases in China: Analysis from the Global Burden of Disease Study, 1990-2021, with Projections to 2035

Chuan Zhang ¹ Quanzhen Chen ¹ Fuqiang Yin ² Lanyan Qin ³ Shuna Zhang ^1*

• ¹ Guangxi Normal University, Guilin, China
• ² Wuhan Sports University, Wuhan, Hubei Province, China
• ³ Xiangnan University, Chenzhou, Hunan Province, China

Objective: To evaluate the burden of disease related to low physical activity in China, examine its trends over time, and predict future trends up to 2035 to inform preventive actions.Methods: Using Global Burden of Disease Study 2021 (GBD2021) data, we analyzed the burden of disease associated with low physical activity, employing Deaths and Disability-Adjusted Life Years (DALYs) as indicators. Trends from 1990 to 2021 were examined using the Estimated Annual Percentage Change (EAPC) method, and future projections were made using the BAPC model.The number of deaths attributable to low physical activity rose from 48,882 in 1990 to 148,152 in 2021, with the age-standardized death rate decreasing slightly from 8.39 to 8.18 per 100,000 (EAPC = 0.07). DALYs increased from 1,246,888 to 3,254,644, while the age-standardized DALYs rate fell from 168.93 to 162.52 per 100,000 (EAPC = -0.08). The DALY rate for diabetes increased from 30.12 to 36.54 per 100,000 (EAPC = 0.42); ischemic heart disease death rate rose from 2.86 to 3.52 per 100,000 (EAPC = 1.12), and the DALY rate increased from 40.72 to 46.05 per 100,000 (EAPC = 0.8). The highest death and DALY rates were observed in individuals over 95 years old.Females had higher death and DALY rates than males, with a death rate of 8.29 per 100,000 and a DALY rate of 197.98 in 2021. The BAPC model predicts that by 2035, deaths will reach 161,280 and DALYs will reach 3,523,135.From 1990 to 2021, the age-standardized death and DALY rates associated with low physical activity in China declined, yet the absolute number of deaths and DALYs increased due to population growth and aging. Special attention is needed for diabetes and ischemic heart disease, as their burdens have significantly risen. Although females are more affected by low physical activity than males, the increase in the burden among males has been more pronounced in recent years. The impact of low physical activity intensifies with age, particularly among the elderly. Thus, targeted strategies are essential to mitigate the burden of low physical activity in China.