Prevalence and correlates of sedentary behaviour among adults in Tonga: Trends of national cross-sectional surveys in 2004, 2011, and 2017

The study aimed to evaluate trends in the prevalence and correlates of low physical activity (PA) and sedentary behaviour (SB) in adults from 2004 to 2017 in Tonga. Cross-sectional data were analysed from 6,961 persons (2064 years), 907 in 2004, 2,457 in 2011, and 3,597 in 2017 who participated in STEPS surveys in Tonga. Self-reported PA and SB and various health measures were assessed. Overall, 40.1% had low, 24.4% moderate, and 35.5% high PA. The proportion of SB was 26.9% 4 to < 8 hours/day and 6.6% ≥8 hours/day. Compared to participants from 2004, participants from 2011 (Adjusted Odds RatioAOR: 0.44, 95% confidence interval-CI: 0.37-0.52) had significantly lower odds of low PA. Male sex (AOR: 0.49, 95% CI: 0.43-0.55) decreased the odds and having higher education (≥12 years) (AOR: 1.51, 95% CI: 1.28-1.77) increased the odds of low PA. Inadequate fruit and vegetable intake (AOR: 1.68, 95% CI: 1.39-2.04) and having hypertension (AOR: 1.17, 95% CI: 1.04-1.32) were positively associated, and current tobacco smoking (AOR: 0.85, 95% CI: 0.75-0.97) was negatively associated with low PA. Current tobacco smoking (ARRR: 0.73, 95% CI: 0.54-0.98) was negatively associated with high sedentary behaviour (≥8 hours). Higher education (ARRR: 1.26, 95% CI: 1.05-1.53) and high total cholesterol (ARRR: 1.33, 95% CI: 1.07-1.40) were positively associated, and male sex (AOR: 0.79, 95% CI: 0.69-0.91) and overweight (AOR: 0.75, 95% CI: 0.57-0.98) were negatively associated with moderate sedentary behaviour. Two in five adults in Tonga had inadequate PA and one in three had SB. Sociodemographic and health factors were found to be associated with low PA and SB.