{
  "abstract": "Background Physical inactivity affects 36.2% of adults in the European Union (EU), contributing substantially to the burden of non-communicable diseases (NCDs). The WHO’s Global Action Plan on Physical Activity 2018–2030 targets a 15% relative reduction in physical inactivity by 2030, supporting Sustainable Development Goal (SDG) 3.4.1 to achieve over 30% reduction in premature NCD mortality. This study estimates the number of averted deaths, premature deaths and cause-specific NCD deaths averted if physical activity targets are achieved across EU countries.Methods We applied the WHO Preventable Risk Integrated ModEl using baseline physical activity and body mass index from waves 2 and 3 of the European Health Interview Survey. The counterfactual scenario modelled a 15% increase in metabolic equivalent of task hours/week of moderate-to-vigorous physical activity and a 15% relative reduction in the proportion of adults who are physically inactive across the EU.Findings Increased physical activity is associated with an estimated 24 178 premature deaths averted by 2030 (95% uncertainty interval (UI): 23 253–25 103), equivalent to 3.3% of premature NCD mortality. Overall, 107 108 deaths (95% UI: 102 479–111 737) across all ages could be prevented, representing 4.7% of total NCD deaths in EU member states.Interpretation Increasing physical activity alone is unlikely to achieve the SDG 3.4.1 target of reducing premature NCD deaths by 2030. However, when combined with other WHO ‘best buy’ interventions, such as improved diet and reduced tobacco and alcohol use, this target could be attainable across the EU.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary",
        "Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary"
      ],
      "name": "Abdu Nafan Aisul Muhlis"
    },
    {
      "affiliations": [
        "Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"
      ],
      "name": "Nour Mahrouseh"
    },
    {
      "affiliations": [
        "Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary",
        "Department of Periodontology, Oro-Dental and Implant Surgery, Faculty of Medicine, University of Liège, CHU of Liège, Liège, Belgium"
      ],
      "name": "Carlos Alexandre Soares Andrade"
    },
    {
      "affiliations": [
        "Comprehensive Health Research Centre, Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal",
        "Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain"
      ],
      "name": "José Chen-Xu"
    },
    {
      "affiliations": [
        "Centre for Health Equity Analytics (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Trøndelag, Norway"
      ],
      "name": "Terje Andreas Eikemo"
    },
    {
      "affiliations": [
        "Research Centre for Education and the Labour Market (ROA), Maastricht University, Maastricht, The Netherlands"
      ],
      "name": "Mirza Balaj"
    },
    {
      "affiliations": [
        "Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus"
      ],
      "name": "Mary Economou"
    },
    {
      "affiliations": [
        "Department of Healthcare, Faculty of Health, University of Vlora, Vlora, Albania",
        "School of Medicine, University of Crete, Crete, Greece"
      ],
      "name": "Enkeleint A Mechili"
    },
    {
      "affiliations": [
        "Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy"
      ],
      "name": "Brigid Unim"
    },
    {
      "affiliations": [
        "Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway"
      ],
      "name": "Carl Michael Baravelli"
    },
    {
      "affiliations": [
        "School of Health Sciences, Örebro University, Örebro, Sweden",
        "Public Health Department, Babes-Bolyai University, Cluj-Napoca, Romania"
      ],
      "name": "Andreea Badache"
    },
    {
      "affiliations": [
        "Universitat Internacional de Catalunya, Barcelona, Spain",
        "Centre d’Estudis Demogràfics (CED-CERCA), Bellaterra, Spain"
      ],
      "name": "Jeroen Spijker"
    },
    {
      "affiliations": [
        "Center for Scientific Research in Public Health, Faculty of Medical Technical Sciences, European University of Tirana, Tirana, Albania"
      ],
      "name": "Jonila Gabrani"
    },
    {
      "affiliations": [
        "MEDCIDS, Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal",
        "CINTESIS@RISE, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"
      ],
      "name": "Rafael José Vieira"
    },
    {
      "affiliations": [
        "Technical University of Denmark, Lyngby, Denmark"
      ],
      "name": "Brian Lassen"
    },
    {
      "affiliations": [
        "CERPOP, UMR1295, unite mixte INSERM, University of Toulouse, Toulouse, Occitanie, France",
        "Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium"
      ],
      "name": "Romana Haneef"
    },
    {
      "affiliations": [
        "Health Technology Assessment Department, Health Services General Directorate, Ministry of Health of Türkiye, Ankara, Türkiye"
      ],
      "name": "Gülcan Tecirli"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Surgery, University of Malta, Msida, Malta"
      ],
      "name": "Sarah Cuschieri"
    },
    {
      "affiliations": [
        "Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA",
        "Colorado School of Public Health, Colorado State University, Fort Collins, Colorado, USA"
      ],
      "name": "David Rojas-Rueda"
    },
    {
      "affiliations": [
        "Department of Social & Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA",
        "Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"
      ],
      "name": "Hanno Hoven"
    },
    {
      "affiliations": [
        "Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"
      ],
      "name": "Ghenwa Chamouni"
    },
    {
      "affiliations": [
        "Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary",
        "Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary"
      ],
      "name": "Gabriella Laila Tarek"
    },
    {
      "affiliations": [
        "Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"
      ],
      "name": "Orsolya Varga"
    }
  ],
  "title": "Potential impact of increasing physical activity on NCD mortality in the EU: pathways to SDG 3.4.1 by 2030",
  "uid": "fd1a0f7b-a819-5826-bb8e-06ce716e14ce"
}