Physical activity is any voluntary movement of body skeletal muscles that requires more energy expenditure than the resting metabolic rate [1]. Doing physical activity on a regular basis has long been acknowledged as a protective factor against many common chronic diseases, including coronary heart disease, obesity, and type 2 diabetes [2]. Physical activity also aids in the improvement of mental health and overall quality of life [3, 4]. In contrast, physical inactivity is known as the absence of moderate to high physical activity in a person’s lifestyle [5]. Current evidence emphasized that over one-fourth of the world’s adults are physically inactive [6]. Physical inactivity has been identified as a global public health issue connected to increased morbidity and mortality among adults [7, 8]. Accordingly, the World Health Organization (WHO) has set a goal of reducing the global incidence of physical inactivity in adults and adolescents by 15% by 2030 [5].

Saudi Arabia has passed through a socioeconomic transformation in the last few decades that coincide with changes in the lifestyles of the community toward sedentary behaviors as a result of urbanization and motorization [9]. These modifications in the lifestyle are occurring parallel with the rising prevalence of obesity and other chronic diseases among the Saudi population [10]. The upsurge in the prevalence of obesity and chronic diseases in Saudi Arabia is owing to the increased consumption of unhealthy foods and decreased physical activity [11–13].

Physical inactivity rates among adults vary dramatically between countries and among subpopulations. Physical inactivity among adults is highest in the Eastern Mediterranean, the Americas, Europe, and the Western Pacific region, while it is lowest in South-East Asia [14]. Numerous factors, including economic development, transportation forms, technology usage, and cultural values, could influence these rates [15]. Saudi Arabia has seen a massive arrival of migrant workers in recent decades, most of whom were young and middle-aged men from many Middle Eastern and Asian countries [16]. Non-Saudi residents formed about 31% of the population living in Saudi Arabia; 70% of them were males [17]. Physical activity levels among men from various countries living in Saudi Arabia varies significantly [18]. These disparities could be due to diversity in lifestyle aspects, including work type, transportation, leisure time activities [14]. Fortunately, investigating these disparities in physical activity levels can aid in identifying and implementing effective strategies for promoting physical activity in various population subgroups. This study was conducted to assess physical activity levels and factors associated with physical inactivity among a multi-ethnic sample of middle-aged men living in Saudi Arabia.

Table 1 shows the sociodemographic characteristics and BMI of the participants. This study comprised 1,800 middle-aged men living in Riyadh, Saudi Arabia, from twelve Middle Eastern and Asian countries. The average age of the participants was 40.9 ± 3.8 years, and they had lived in Saudi Arabia for 13.2 ± 10.6 years on average. The majority of the participants (63.1%) live in non-family households. The sample consisted of 88.1% married men, and the rest of participants were single. About two-thirds of the participants (65.7%) had completed high school or less, while more than half of the participants (55.4%) had a low monthly income (less than 1,000 USD). Finally, participants had a mean BMI of 26.6 ± 3.6.

Table 2 shows the physical activity characteristics of all participants and participants stratified by nationalities. Low physical activity level (physical inactivity) was reported among 35.3% of the participants. Moreover, 25.3% of participants were found with a moderate level of physical activity, while 39.4% were found with a high level of physical activity. Participants with different nationalities differ in the prevalence of physical inactivity (see Figure 1). While the prevalence of physical inactivity among participants from the Philippines was 15.5%, it was 57.8% among participants from Saudi Arabia. About three-quarters of the participants (74.1%) met WHO recommendations for physical activity for health. Participants spent an average of 143.9 ± 186.3 min per day on physical activity. Moreover, the mean daily minutes spent by the participants on work, transport, and recreation-related physical activities were 110.9 ± 167.2 min, 21.4 ± 49.3 min, and 11.6 ± 27.8 min, respectively. Likewise, participants spent an average of 68.5 ± 146.9 min per day on vigorous-intensity active activities and 75.3 ± 108.3 min per day on moderate-intensity physical activities. Finally, participants spent an average of 274.8 ± 186.0 min per day on sedentary behaviors.

The proportion of weekly minutes spent in different physical activity domains (work, transport, and recreation) and vigorous-intensity and moderate-intensity physical activities from total weekly minutes spent doing physical activity is calculated. The means of the proportion of weekly minutes spent in physical activities related to work, transport, and recreation from total physical activity were 0.53 ± 0.42, 0.29 ± 0.36, and 0.19 ± 0.31, respectively. In the same way, the means of the proportion of weekly minutes spent in vigorous-intensity physical activities and moderate-intensity physical activities from total physical activity were 0.27 ± 0.38 and 0.73 ± 0.38, respectively. In addition, the percentages of participants who did not engage in any physical activity were recorded for various domains of physical activity. The percentages of participants who did not engage in any physical activity related to work, transport, recreation, vigorous-intensity and moderate-intensity physical activities were 39.9, 42.1, 58.2 62.7, and 16.9%, respectively.

Table 3 shows the risk of physical inactivity for all participants based on nationality, sociodemographic variables and BMI. Compared with participants from the Philippines, subject form several other countries had a significantly higher risk of being physically inactive, including Saudi Arabia [adjusted odds ratio (OR) = 3.01, p = 0.043], Yemen (adjusted OR = 3.26, p = 0.004), Syria (unadjusted OR = 2.94, p = 0.003), Jordan (adjusted OR = 2.24, p = 0.039), Turkey (adjusted OR = 5.56, p = 0.001), Pakistan (adjusted OR = 2.23, p = 0.004), Afghanistan (adjusted OR = 2.49, p = 0.027), India (adjusted OR = 5.28, p = 0.001), and Bangladesh (adjusted OR = 5.85, p = 0.001). Moreover, longer residency period in Saudi Arabia was significantly associated with a higher risk of physical inactivity (unadjusted OR = 1.03, p = 0.001). The participants those who live within a family household had a significantly higher risk of physical inactivity compared with those who live within non-family household (adjusted OR = 2.18, p = 0.001). Participants have at least a college degree had a significantly higher risk of physical inactivity compared with those with lower education level (adjusted OR = 1.45, p = 0.048). In the same fashion, participants having high monthly income (1,000 USD or more) had a significantly higher risk of physical inactivity compared with those who have low monthly income (unadjusted OR = 1.88, p = 0.001). Finally, Increasing BMI was significantly associated with a higher risk of physical inactivity (adjusted OR = 1.07, p = 0.001).

This study investigated the physical activity levels of a multi-ethnic sample of middle-aged men living in Saudi Arabia. About one-third of the participants are physically inactive. On a worldwide scale, Saudi Arabia has a high prevalence of physical inactivity [24–26]. A population-based national survey revealed that 66.6% of the population in Saudi Arabia (60.1% of males and 72.9% of females) were physically inactive [24]. Another study reported that 96.1% of Saudi adults aged 30–70 years were physically inactive [25]. A recent population-based study reported that the prevalence of physical inactivity was 82.6% among Saudi citizens (71.7% of males and 91.1% of females) and 86.1% among non-Saudi residents (83.9% of males and 92.0% of females) aged 15 years or more [26]. Several barriers, such as the absence of motivation, growing urbanization, crowded traffic, hot desert weather, cultural obstacles, absence of social support, and inadequate time and resources, prevent regular physical activity among people in Saudi Arabia [9].

The current study found considerable differences in physical activity levels among participants from different countries. Several lifestyle factors, such as work type, transportation, leisure time activities, and the intensity and duration of physical activity, could be accountable for these differences [11]. Manual labor jobs such as farming, housekeeping, and culinary are often associated with higher physical activity levels than office labor jobs such as the secretary, data entry and accounting [27]. For example, the majority of middle-aged Saudi men work in office labor occupations. However, the majority of middle-aged Afghan men living in Saudi Arabia work in manual labor occupations. Moreover, typical modes of transportation can have an impact on people’s levels of physical activity. Walking or riding a bicycle has been linked to higher levels of physical activity when compared to using automobiles for short-distance commuting [28]. For example, the vast majority of middle-aged Bangladeshi men living in Saudi Arabia use bikes frequently to commute short travels. In contrast, middle-aged Saudi men depend mainly on cars for transportation, even for short-distance trips. The leisure-time physical activities of middle-aged men from diverse nations are influenced by cultural standards, available free time, and resources and appropriate sites availability for completing workouts and engaging in recreational physical activities [29]. Our results showed that middle-aged Saudi men, for example, were found to be more involved in recreational physical activities than middle-aged Sudanese men. Fortunately, examining these differences in physical activity characteristics can help identify and implement relevant approaches to reduce physical inactivity in high-prevalence groups.

Monitoring factors associated with physical inactivity for various population subgroups is an essential part of health-promoting activities to reduce physical inactivity [30]. According to our findings, several sociodemographic characteristics were shown to be connected with increased physical inactivity risk. One of these characteristics was nationality, which might be attributed to cross-cultural differences in jobs, modes of transportation, and lifestyles, including typical leisure activities, among participants from different countries [14]. Longer residency in Saudi Arabia was linked to a higher risk of physical inactivity, which could be explained by the country’s urbanization and motorization and their impact on people’s lifestyles [11]. This outcome was consistent with findings from prior studies from Saudi Arabia [18, 31]. Emigrants’ health is assumed to deteriorate with the length of time they spend in a new host country due to cultural variances, social and financial changes, as well as lifestyle modifications related to usual diet and physical activity level [32]. Our results showed that physical inactivity was found to be linked with living in a family household. In Saudi Arabia, social gatherings are a typical element of family life. Unfortunately, these get-togethers tend to center on sedentary activities like sharing meals and watching television [9]. Moreover, physical inactivity was found to be linked with higher education and income. In Saudi Arabia, educated and/or financially stable men generally work in office occupations that require them to sit for long periods of time and rely on cars for mobility, which can lead to physical inactivity [27].

Saudi Arabia has one of the highest overweight and obesity rates worldwide [10]. Obesity is associated with the incidence of several chronic diseases and health disorders [33, 34]. It is recognized that physical inactivity is a significant factor that contributes to overweight and obesity incidence [35]. The Saudi population’s high rates of overweight and obesity can be attributed to a high prevalence of physical inactivity and sedentary lifestyles [36]. According to our findings, a greater BMI was associated with a higher risk of physical inactivity among the participants. This outcome was in line with prior research findings reported in Saudi Arabia [25, 27, 37–39].

Several projects were launched in Saudi Arabia to promote physical activity. The majority of them were disconnected, short-term initiatives that lacked a coordinating body and objective evaluations of their results. A national policy that fosters active living while discouraging sedentary behavior is required, including input from all stakeholders [40]. The healthy city initiative is one of these projects applied in twenty-five Saudi cities and involved various activities, including awareness about the health benefits of physical activity, and friendly roads and public places for walking for people of all ages [40]. The ministry of health in Saudi Arabia established many programs for physical activity promotion for various population subgroups around the country. These programs included a range of activities, including lectures, workshops, training courses for health care professionals, brochures, posters, and media awareness campaigns [40]. The Saudi national transformation program of the vision 2030 is a strategic plan established in Saudi Arabia to develop various public service sectors, including public health. This program is targeting healthy lifestyle promotion and public participation in physical activity at the population level [40].

The WHO Global Action Plan on Physical Activity 2018–2030 was developed to ensure that everyone has access to safe and enabling environments, as well as a variety of opportunities to be physically active in their daily lives, as a means of improving individual and community health and contributing to all nations’ social, cultural, and economic development [5]. This action plan comprises a combination of guiding principles, strategic objectives and recommended policy actions designed to disseminate physical activity culture at the population level [5]. Each country is encouraged to determine a strategic combination of these policy actions for execution over the short, medium, and long terms to promote physical activity in different members of the community [5]. The chosen policy actions should be adjusted to the demands of varying population subgroups based on the country context. Consequently, each country needs to evaluate the physical activity levels of various population subgroups to examine gaps and relevant policy actions that may be enhanced the current situation [5]. This study’s outcomes provide for decision-makers in Saudi Arabia an evaluation of physical activity levels for a multi-ethnic population of middle-aged men and factors associated with physical inactivity.

There are some limitations to this study that should be taken into account. A cross-sectional design has the disadvantage of being unable to discern causality. The second limitation is that the main variables, physical activity levels, are self-reported outcome measures susceptible to recall and social desirability biases. Finally, because our data is limited to Riyadh, we may not generalize our findings to the rest of Saudi Arabia. Nevertheless, the current study still provides relevant information about physical activity levels and factors associated with physical inactivity in a multi-ethnic sample of middle-aged men living in Saudi Arabia.

In conclusion, physical inactivity was found to be considerably prevalent among middle-aged men in Saudi Arabia. Findings revealed significant differences in physical activity levels among middle-aged men from twelve Middle Eastern and Asian countries living in Saudi Arabia. Physical inactivity risk is substantially linked with nationality, residency length in Saudi Arabia, household type, education level, monthly income, and BMI among a multi-ethnic sample of middle-aged men in Saudi Arabia.