Physical inactivity

in developing countries Lear and colleagues1 observed much stronger relationships between the own-ership of household devices and obesity and diabetes in adults from low-income countries compared with those from high- and middle-income countries. Although these devices were rela-tively uncommon among participants from low-income countries, ownership may increase with rapid economic development. This transition may have dire consequences for the health sys-tems of low-income countries, which are already struggling with a high prev-alence of infectious diseases2 and road traffic injuries.3 Evidence suggests that the majority of youth and adults in low-income countries fail to meet current physical activity guidelines.4 In sub-Saharan Africa, higher socioeconomic status and living in an urban area were associ-ated with greater engagement in seden-tary behaviours (including screen time) among children and youth.5 Even more surprising are the relatively low rates of active transportation to and from school observed in population-based samples of youth in many low-income countries in Africa.6,7 This suggests that although privately owned cars are relatively scarce in these countries, other forms of motorized travel are routinely used by a large proportion of inhabitants. The findings of Lear and colleagues1 underscore the importance of promot-ing an active lifestyle in low-income countries. The United Nations ’ political declaration on noncommunicable dis-eases8 is a good step in the right direc-tion, but there remains a clear need for raising the political priority for devel-oping and implementing effective and culturally relevant interventions to pre-vent noncommunicable diseases in low-income countries.