Abstract
Objectives
The aim of this study was to determine temporal trends in sports and exercise participation frequency among European Union adults.
Methods
We analysed Eurobarometer survey data collected among 96 948 adults from 26 European Union countries in 2009, 2013, 2017 and 2022. Self-reported frequency of sports and exercise participation was categorised as: ‘never’, ‘less than once a month’, ‘monthly’ (1–3 times per month) and ‘weekly’ (at least once a week). Multilevel ordinal logistic regression was used to analyse trends in sports and exercise participation frequency for the overall sample and by gender, age, marital status, employment, place of residence, number of household members and country.
Results
The prevalence of no participation in sports and exercise increased from 41.7% (95% confidence interval [CI] 40.6% to 42.7%) in 2009 to 45.8% (95% CI 44.8% to 46.8%) in 2022. The frequency of sports and exercise participation decreased from 2009 (reference year) to 2017 (adjusted odds ratio [OR] for 2013=0.96; 95% CI 0.92 to 0.99; OR for 2017=0.87; 95% CI 0.84 to 0.91) and then increased in 2022 (OR=0.92; 95% CI 0.89 to 0.95), suggesting a U-shaped trend (p<0.001). The most concerning trends were found for females, middle-aged adults, those living alone, Denmark, Hungary, Poland, Portugal and Sweden.
Conclusion
The persistently high prevalence of no sports participation highlights the need to strengthen the promotion of sports and exercise in the European Union. The focus should be on the population groups and countries with declining frequency of sports and exercise participation.
Keywords: Physical activity, Sports, Risk factor, Epidemiology, Exercise
WHAT IS ALREADY KNOWN ON THIS TOPIC
In the European Union, the prevalence of regular sports and exercise participation (ie, at least once a week) among adults remained relatively stable from 2009 to 2022.
WHAT THIS STUDY ADDS
The percentage of adults in the European Union who never participate in sports and exercise was persistently high, with a slight overall increase from 2009 to 2022.
Overall trend in sports and exercise participation frequency among European Union adults between 2009 and 2022 was U-shaped.
Trends in sports and exercise participation frequency differed across European Union member states and population groups, with most concerning trends found for females, middle-aged adults, those living alone, Denmark, Hungary, Poland, Portugal and Sweden.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
There is a need to strengthen the promotion of sports and exercise in the European Union, especially among females, middle-aged adults and those living alone, as well as in Denmark, Hungary, Poland, Portugal and Sweden.
Introduction
Sports and exercise participation is a common type of physical activity that is associated with various physical health benefits, including reduced risk of cardiovascular and cancer mortality and improved cardio-metabolic and fitness markers such as maximal oxygen consumption and lean body mass.1 Evidence also shows that sports and exercise participation is associated with significant psychological and social benefits, such as reduced symptoms of anxiety and depression, improved self-esteem, enhanced social connectedness and greater life satisfaction.2–5 Despite these benefits, the prevalence of regular sports and exercise participation (ie, at least once a week) is relatively low; in some European member states as low as 18.7%.6
Trends in sports and exercise participation can be shaped by various factors. For example, from a sociological perspective, they can be affected by a complex interplay between the expansion/pluralisation of sports culture (ie, increased penetration of sports into everyday lives and various population groups), modernisation of social structure, destructuring of traditional institutions that have historically organised social life and individualisation of sports participation (ie, disembedding of individuals from traditional social structures).7 According to the Ecological Model of Four Domains of Active Living, sports and exercise participation is influenced by intrapersonal characteristics, individual perceptions of environment and the actual informational, social, cultural, natural and policy environment.8 Given that these factors can substantially change over time, it is important to regularly monitor trends in sports participation.
A few previous studies have assessed temporal changes in sports and exercise participation among adults. For example, a 9-year study from the UK found an inverted U-shaped trend in sports and exercise participation, with a negligible overall increase in prevalence from 40.8% to 41.2% among men and a slight increase from 31.2% to 33.9% among women.9 Scheerder et al10 found a negligible change in sports and exercise participation in Belgium in the first 10 years of their study and an increase from 40.6% to 51.6% in the second 10 years. A study from Mexico found that sports and exercise participation increased from 15.8% to 29.3% in a 12-year period.11 Similarly, in 10 years, the prevalence of sports and exercise participation among men and women in Spain increased from 45.8% to 52.1% and from 27.3% to 33.3%, respectively.12 In contrast, an Australian study found a decrease in sports and exercise participation from 43% to 40% in a 6-year period.13 The differences between findings of previous studies highlight the need to examine temporal changes in sports and exercise in each country specifically.
A large number of physical activity promotion initiatives have been developed and implemented in the European Union, with the aim to increase sports and exercise participation rates.14 To evaluate the overall progress in this aspect of physical activity promotion, it is necessary to track the population prevalence of sports and exercise participation over time. Data on trends in sports and exercise participation can be used to justify and inform the development of sport-promoting policies and interventions. For example, as in the Council Recommendation on promoting health-enhancing physical activity,15 one of the key physical activity policies in the European Union.
There is a lack of recent data on trends in sports and exercise participation for most European Union member states. A recent study found that the prevalence of regular sports and exercise participation (ie, at least once a week) among adults in the European Union remained relatively stable from 2009 to 2022.16 However, they did not analyse trends for each member state specifically, and they did not consider irregular/occasional sports and exercise participation. Furthermore, most previous studies on trends in sports and exercise participation provided data for the overall sample only11 or stratified by age9 and gender.9 16 Hence, evidence on trends in sports and exercise participation among other population groups is limited. Understanding the time trends in each European Union member state and among different sociodemographic groups may help policymakers and public health practitioners in selecting target populations for future sports promotion initiatives.
Significant sports and exercise promotion efforts are made at the European Union level; for example, by the European Commission, Council of the European Union and European umbrella sports associations.17 To help evaluate their effects, it is important to analyse combined temporal trends in sports and exercise participation for all member states. However, in the European Union, sports and exercise participation varies significantly across countries; generally being higher in the North and West, compared with the South and East, respectively.6 18 19 These differences may be explained by various country-level factors, such as comprehensiveness of national physical activity policies, quality of governance, organisation of sports systems, national economic standard, financial investments in the sports sector and sport culture.20–22 The ways in which these factors change over time may differ across the European Union member states, potentially leading to different national trends in sports and exercise participation. To capture potential between-country differences, it is important to explore sports and exercise trends in each European Union member state separately. Furthermore, previous studies found that country-level factors only partially explain sports and exercise participation.20 22 Therefore, to identify key target groups for future public health interventions in the European Union, the analysis of temporal trends should also consider key intrapersonal and interpersonal factors influencing sports and exercise participation.7 8
According to the Exercise Participation Explained in Relation to Time model, the key temporal dimensions of sports and exercise participation are total duration, frequency, duration of individual sessions, timing, sequencing, regularity, synchronisation with internal and external rhythms and collateral time costs.23 However, the total duration and frequency of sports and exercise participation seem to be the most commonly studied ones in the scientific literature.1
The aim of this study was to determine the temporal trends in the frequency of sports and exercise participation among European Union adults, stratified by gender, age, marital status, employment, place of residence, number of household members and country. The present study extends prior work by: (1) analysing trends across all frequency categories (never, less than once a month, monthly and weekly), instead of focusing only on weekly participation; (2) providing country-specific trend estimates; and (3) examining trends across a broad range of sociodemographic characteristics, beyond just age and gender.
Methods
Study design and participants
The data used in this study were collected as part of the four Eurobarometer surveys conducted in October 2009 (Special Eurobarometer 334; wave 72.3), November–December 2013 (Special Eurobarometer 412; wave 80.2), December 2017 (Special Eurobarometer 472; wave 88.4) and April–May 2022 (Special Eurobarometer 525; wave 97.3). The surveys used multistage random sampling and collectively included 112 811 individuals aged ≥15 years living in European Union member states. However, we restricted our analyses to participants aged 18+ years, because temporal trends in different types of physical activity and factors that shape them may substantially differ between adolescents and adults.24 25 For example, it can be assumed that opportunities for engagement in physical education and school sports are more likely to shape trends in sports and exercise participation among 15–17 year olds, compared with 18+ year old adults. Data were collected through interviews in national languages. The participants provided informed consent prior to the start of the interviews, and their data were anonymised.
Equity, diversity and inclusion
The research team comprised women and men with diverse ethnicities, professional backgrounds, seniority levels and geographic origins. At the time of the study, four members of the author team were residing in Croatia, a high-income European Union member state. One author had previous working/living experience in Austria, a high-income European Union member state, and the author author had such experience in Bosnia and Herzegovina, a European Union candidate country. Three authors were citizens of countries outside Europe; one of Pakistan, a lower-middle-income country; and two of Australia, a high-income country. Three members of the author team were involved in large sport-related projects, involving partner organisations from 17 European countries. This enabled the author team to consider diverse perspectives when interpreting study findings, especially in relation to geographic patterns. The study was also inclusive in terms of sampling, as it involved a population representative sample of adults from 26 European Union member states, covering various population groups and enabling stratified analyses by country and key sociodemographic characteristics.
Patient and public involvement
No involvement.
Measures
The question ‘How often do you exercise or play sport?’ was used to assess the frequency of sports and exercise participation. The responses to the question were categorised as: ‘never’, ‘less than once a month’, ‘monthly’ (ie, one to three times per month) and ‘weekly’ (ie, at least once a week). Although the questions on vigorous-intensity physical activity used in the Eurobarometer surveys have shown acceptable validity and test–retest reliability,26 no such data are available specifically for the question on sports and exercise participation. Sociodemographic variables including gender (female and male), age (18–39 years, 40–64 years and 65+years), marital status (not married and married), employment status (unemployed and employed), place of residence (rural area, small/mid-sized town and large town), the number of household members (one, two, three and four or more) and country (Austria, Belgium, Bulgaria, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden) were included in the analyses because they were consistent across all four surveys.
Data analysis
For all categories of sociodemographic variables, we calculated absolute frequencies (unweighted) and percentages (weighted). For all categories of sports and exercise participation frequency, we calculated weighted percentages and their 95% confidence intervals (CI) in each survey year. This was done for the overall sample and for each of the sociodemographic categories separately. Temporal trends in sports and exercise participation were established using a multilevel ordinal logistic regression analysis with survey year (categorical) as fixed effect, country as a random intercept and sports and exercise participation (ordinal variable) as the dependent variable in the model. This was performed via the cumulative link mixed model (clmm function), using the Laplace approximation. In addition to the overall model, we conducted stratified analyses for each sociodemographic category. Temporal trends were also established for each country separately via the ordinal logistic regression analysis using the cumulative link model (clm function) and maximum likelihood estimation method. The trends analyses were adjusted for gender, age, marital status, employment status, place of residence and number of household members. Survey year was treated as a categorical variable (with 2009 as the reference category) to calculate the odds of higher sports and exercise frequencies in the given survey year, relative to the reference year. We then used polynomial contrasts to test for linear, quadratic and cubic trends for the odds ratios (OR) across survey years, with p value less than 0.05 indicating statistical significance. In the ordinal logistic regression models, OR>1.0 indicated a shift towards more frequent participation, that is, from the lowest (ie, ‘never’) towards the highest (ie, ‘weekly’) category, while OR<1.0 indicated a shift towards less frequent participation. The proportional odds assumption was evaluated by conducting a separate binary logistic regression analysis for each category boundary of the outcome variable (eg, ‘never’ vs remaining categories, ‘never’ and ‘less than once a month’ vs remaining categories). ORs from the binary logistic regressions were then compared with the OR from the ordinal logistic regression analysis. Consistency of estimates across the models supported the proportional odds assumption. In order to improve the generalisability of estimates, we applied sampling weights calculated based on sex, age, region and the size of locality as auxiliary variables. In the ordinal regression analyses, sample weighting was applied using the weights argument, as part of the clmm and clm functions. To identify which sociodemographic groups had the most concerning trends in sports and exercise participation, we applied the following criteria: (1) the linear or inverted U-shaped trends were significant; and (2) for OR in 2022, the upper limit of 95% CI in the given group (eg, females) does not overlap with the lower limit of 95% CI in the comparison group (eg, for males). To identify which countries had the most concerning trends in sports and exercise frequency, we applied the following criteria: (1) the linear or inverted U-shaped trends were significant; (2) for countries with linear trend, the upper limit of 95% CI for OR in 2022 does not overlap with 1 (ie, the OR in the reference year); and (3) for countries with inverted U-shaped trend, the upper limit of 95% CI for OR in 2022 does not overlap with the lower limit of 95% CI for the year with the highest OR (ie, the ‘peak’ year). The analysis was performed in R software (R Foundation for Statistical Computing, Vienna, Austria). The packages used for statistical analysis included survey,27 srvyr28 and ordinal package.29
Results
Participant characteristics
Overall, 52.1% of participants in the study sample were females (table 1). The most represented sociodemographic groups were middle-aged adults (41.2%), the married (73.4%), the employed (52.6%), residents of small/mid-sized towns (42.6%) and those sharing their household with one other person (36.1%).
Table 1. Participant characteristics.
| Category | Participants, n, (weighted percentage) | ||||
|---|---|---|---|---|---|
| 2009 | 2013 | 2017 | 2022 | Total | |
| Overall | 22 082 (100.0) | 24 884 (100.0) | 25 078 (100.0) | 24 904 (100.0) | 96 948 (100.0) |
| Gender | |||||
| Female | 12 333 (52.1) | 13 626 (51.9) | 13 799 (51.9) | 13 307 (52.4) | 53 065 (52.1) |
| Male | 9749 (47.9) | 11 258 (48.1) | 11 279 (48.1) | 11 597 (47.6) | 43 883 (47.9) |
| Age (years) | |||||
| 18–39 | 6881 (35.7) | 7566 (36.8) | 6746 (33.8) | 6780 (31.6) | 27 973 (34.5) |
| 40–64 | 9542 (41.2) | 11 312 (41.7) | 11 054 (41.0) | 10 875 (40.9) | 42 783 (41.2) |
| 65+ | 5659 (23.1) | 6006 (21.5) | 7278 (25.2) | 7249 (27.5) | 26 192 (24.3) |
| Marital status | |||||
| Not married | 7957 (34.7) | 4743 (15.5) | 4852 (16.2) | 9102 (40.1) | 26 654 (26.6) |
| Married | 14 125 (65.3) | 20 141 (84.5) | 20 226 (83.8) | 15 802 (59.9) | 70 294 (73.4) |
| Employment status | |||||
| Unemployed | 11 304 (48.1) | 12 481 (49.1) | 12 054 (46.7) | 11 203 (45.6) | 47 042 (47.4) |
| Employed | 10 778 (51.9) | 12 403 (50.9) | 13 024 (53.3) | 13 701 (54.4) | 49 906 (52.6) |
| Place of residence | |||||
| Rural area | 7876 (34.7) | 8572 (33.5) | 7148 (29.9) | 8270 (29.5) | 31 866 (31.9) |
| Small/mid-sized town | 7784 (40.7) | 9299 (41.7) | 11 016 (45.4) | 9028 (42.6) | 37 127 (42.6) |
| Large town | 6422 (24.6) | 7013 (24.8) | 6914 (24.7) | 7606 (27.9) | 27 955 (25.5) |
| Number of household members | |||||
| One | 5429 (21.5) | 5593 (19.1) | 5804 (20.4) | 5837 (25.1) | 22 663 (21.5) |
| Two | 8414 (37.8) | 8985 (34.9) | 9230 (34.8) | 9399 (36.9) | 36 028 (36.1) |
| Three | 4290 (20.8) | 4391 (19.5) | 4045 (18.0) | 4137 (16.1) | 16 863 (18.6) |
| Four or more | 3949 (19.9) | 5915 (26.5) | 5999 (26.9) | 5531 (21.9) | 21 394 (23.8) |
| Country | |||||
| Austria | 928 (2.1) | 1006 (2.0) | 1010 (2.0) | 981 (2.0) | 3925 (2.0) |
| Belgium | 864 (2.4) | 1045 (2.5) | 985 (2.6) | 1048 (2.5) | 3942 (2.5) |
| Bulgaria | 845 (1.8) | 990 (1.8) | 986 (1.7) | 1011 (1.6) | 3832 (1.7) |
| Cyprus | 398 (0.2) | 482 (0.2) | 486 (0.2) | 494 (0.2) | 1860 (0.2) |
| The Czech Republic | 960 (2.6) | 998 (2.5) | 1009 (2.5) | 1041 (2.3) | 4008 (2.5) |
| Denmark | 952 (1.3) | 991 (1.3) | 996 (1.3) | 992 (1.3) | 3931 (1.3) |
| Estonia | 887 (0.3) | 980 (0.3) | 983 (0.3) | 991 (0.3) | 3841 (0.3) |
| Finland | 941 (1.3) | 951 (1.2) | 1004 (1.3) | 988 (1.2) | 3884 (1.3) |
| France | 903 (13.7) | 1000 (13.5) | 988 (14.4) | 992 (14.8) | 3883 (14.1) |
| Germany | 1433 (18.4) | 1560 (17.9) | 1563 (18.8) | 1487 (19.2) | 6043 (18.6) |
| Greece | 917 (2.6) | 975 (2.4) | 979 (2.6) | 991 (2.5) | 3862 (2.5) |
| Hungary | 935 (2.3) | 995 (2.4) | 1031 (2.4) | 1005 (2.2) | 3966 (2.3) |
| Ireland | 771 (0.8) | 974 (1.0) | 984 (1.0) | 1002 (1.1) | 3731 (1.0) |
| Italy | 908 (14.6) | 1006 (14.8) | 1017 (14.2) | 969 (13.7) | 3900 (14.3) |
| Latvia | 783 (0.4) | 974 (0.4) | 964 (0.5) | 987 (0.4) | 3708 (0.4) |
| Lithuania | 894 (0.8) | 977 (0.8) | 997 (0.7) | 981 (0.6) | 3849 (0.7) |
| Luxembourg | 429 (0.1) | 488 (0.1) | 482 (0.1) | 481 (0.1) | 1880 (0.1) |
| Malta | 421 (0.1) | 494 (0.1) | 499 (0.1) | 490 (0.1) | 1904 (0.1) |
| The Netherlands | 865 (3.7) | 1002 (3.7) | 1001 (3.5) | 1015 (3.9) | 3883 (3.7) |
| Poland | 848 (8.8) | 954 (8.9) | 956 (8.7) | 989 (8.4) | 3747 (8.7) |
| Portugal | 908 (2.3) | 1025 (2.4) | 1063 (2.3) | 974 (2.3) | 3970 (2.3) |
| Romania | 838 (4.8) | 981 (5.0) | 967 (4.4) | 1013 (4.3) | 3799 (4.6) |
| Slovakia | 799 (1.1) | 977 (1.3) | 1080 (1.2) | 984 (1.2) | 3840 (1.2) |
| Slovenia | 852 (0.5) | 1083 (0.5) | 1013 (0.5) | 994 (0.5) | 3942 (0.5) |
| Spain | 877 (11.0) | 985 (11.0) | 1001 (10.6) | 975 (10.9) | 3838 (10.9) |
| Sweden | 926 (2.2) | 991 (2.1) | 1034 (2.2) | 1029 (2.3) | 3980 (2.2) |
Prevalence of sports and exercise participation
The prevalence of no participation in sports and exercise increased from 41.7% (95% CI 40.6% to 42.7%) in 2009 to 48.0% (95% CI 47.0% to 49.0%) in 2017, before decreasing to 45.8% (95% CI 44.8% to 46.8%) in 2022 (online supplemental table 1). Furthermore, the prevalence of participating in sports and exercise less than once a month decreased from 14.6% (95% CI 13.9% to 15.4%) in 2009 to 9.3% (95% CI 8.7% to 9.8%) in 2017, before increasing to 11.2% (95% CI 10.6% to 11.9%) in 2022. Similarly, the prevalence of participating in sports and exercise monthly decreased from 6.3% (95% CI 5.8% to 6.8%) in 2009 to 4.7% (95% CI 4.3% to 5.2%) in 2017, before increasing to 5.5% (95% CI 5.1% to 6.0%) in 2022. Weekly participation in sports and exercise increased from 37.4% (95% CI 36.4% to 38.5%) in 2009 to 39.0% (95% CI 38.1% to 40.0%) in 2013, before decreasing to 37.5% (95% CI 36.5% to 38.5%) in 2022. Similar patterns were found in most sociodemographic groups.
Across all survey years, countries in Northern Europe generally had the highest frequency of sports and exercise participation. The participation rates were generally the lowest in Southern and Central/Eastern European countries. The highest prevalence of no sports and exercise participation was found in Greece in 2009, in Bulgaria from 2013 to 2017, and in Portugal in 2022. The countries with the highest increase in the prevalence of no sports and exercise participation between 2009 and 2022 were Portugal (from 58.3% to 75.5%), followed by Poland (from 50.4% to 66.2%) and Romania (from 53.0% to 63.9%). The highest prevalence of weekly sports and exercise participation was found in Sweden from 2009 to 2013 and in Finland from 2017 to 2022. The countries with the highest increase in the prevalence of weekly sports and exercise participation from 2009 to 2022 were Latvia (from 20.0% to 37.7%), followed by the Czech Republic (from 26.8% to 43.0%) and Luxembourg (from 47.3% to 60.5%).
Trends in sports and exercise participation
The frequency of sports and exercise participation decreased from 2009 to 2017 (adjusted OR for 2013=0.96; 95% CI 0.92 to 0.99; OR for 2017=0.87; 95% CI 0.84 to 0.91) and then increased in 2022 (OR=0.92; 95% CI 0.89 to 0.95), suggesting a quadratic, U-shaped trend (p<0.001; table 2). Similar U-shaped trends in sports and exercise participation frequency were found among females, middle-aged adults, the unmarried, the unemployed, the employed, residents of small/mid-sized and large towns and those living alone (p<0.001 for all). A cubic trend (specifically, an increase, followed by a decrease and a subsequent increase) in sports and exercise participation frequency was found among older adults (p=0.048), the married (p<0.001) and those sharing their household with one other person (p<0.001).
Table 2. Trends in sports participation in the European Union: results of ordinal logistic regression analyses*.
| Category | 2009 | Adjusted odds ratio† (95% confidence interval) | P for linear trend | P for quadratic trend | P for cubic trend | ||
|---|---|---|---|---|---|---|---|
| 2013 | 2017 | 2022 | |||||
| Overall | Ref | 0.96 (0.92 to 0.99) | 0.87 (0.84 to 0.91) | 0.92 (0.89 to 0.95) | <0.001 | <0.001 | <0.001 |
| Gender | |||||||
| Male | Ref | 0.99 (0.93 to 1.04) | 0.94 (0.89 to 0.99) | 0.97 (0.92 to 1.03) | 0.115 | 0.098 | 0.079 |
| Female | Ref | 0.92 (0.88 to 0.97) | 0.81 (0.78 to 0.86) | 0.88 (0.83 to 0.92) | <0.001 | <0.001 | <0.001 |
| Age (years) | |||||||
| 18–39 | Ref | 1.06 (0.99 to 1.13) | 0.99 (0.92 to 1.06) | 1.03 (0.97 to 1.10) | 0.852 | 0.956 | 0.142 |
| 40–64 | Ref | 0.86 (0.82 to 0.91) | 0.78 (0.74 to 0.83) | 0.79 (0.75 to 0.84) | <0.001 | <0.001 | <0.001 |
| 65+ | Ref | 1.05 (0.97 to 1.14) | 0.94 (0.87 to 1.02) | 0.99 (0.92 to 1.07) | 0.295 | 0.552 | 0.048 |
| Marital status | |||||||
| Not married | Ref | 0.84 (0.77 to 0.91) | 0.77 (0.71 to 0.83) | 0.89 (0.84 to 0.94) | <0.001 | <0.001 | <0.001 |
| Married | Ref | 1.02 (0.98 to 1.06) | 0.93 (0.89 to 0.97) | 0.93 (0.89 to 0.98) | <0.001 | <0.001 | <0.001 |
| Employment status | |||||||
| Unemployed | Ref | 0.96 (0.91 to 1.02) | 0.89 (0.84 to 0.94) | 1.00 (0.94 to 1.05) | <0.001 | <0.001 | <0.001 |
| Employed | Ref | 0.96 (0.91 to 1.01) | 0.88 (0.83 to 0.93) | 0.92 (0.87 to 0.97) | <0.001 | <0.001 | <0.001 |
| Place of residence | |||||||
| Rural area | Ref | 0.99 (0.93 to 1.05) | 0.95 (0.89 to 1.01) | 0.95 (0.90 to 1.01) | 0.067 | 0.183 | 0.271 |
| Small/mid-sized town | Ref | 0.92 (0.86 to 0.97) | 0.86 (0.81 to 0.92) | 0.90 (0.85 to 0.96) | <0.001 | <0.001 | <0.001 |
| Large town | Ref | 0.99 (0.92 to 1.06) | 0.82 (0.77 to 0.88) | 0.93 (0.87 to 0.99) | <0.001 | <0.001 | <0.001 |
| Number of household members | |||||||
| One | Ref | 0.87 (0.80 to 0.95) | 0.78 (0.72 to 0.85) | 0.83 (0.77 to 0.89) | <0.001 | <0.001 | <0.001 |
| Two | Ref | 1.02 (0.97 to 1.09) | 0.86 (0.81 to 0.91) | 0.95 (0.90 to 1.01) | 0.001 | <0.001 | <0.001 |
| Three | Ref | 0.96 (0.88 to 1.04) | 0.98 (0.90 to 1.06) | 0.94 (0.87 to 1.03) | 0.244 | 0.490 | 0.526 |
| Four or more | Ref | 0.96 (0.89 to 1.04) | 0.93 (0.86 to 1.01) | 0.96 (0.89 to 1.04) | 0.223 | 0.208 | 0.339 |
| Country | |||||||
| Austria | Ref | 1.25 (1.06 to 1.49) | 0.84 (0.70 to 0.99) | 0.96 (0.81 to 1.14) | 0.055 | 0.121 | <0.001 |
| Belgium | Ref | 0.86 (0.72 to 1.02) | 1.03 (0.86 to 1.22) | 0.92 (0.77 to 1.09) | 0.826 | 0.943 | 0.121 |
| Bulgaria | Ref | 0.39 (0.31 to 0.48) | 0.84 (0.68 to 1.03) | 1.36 (1.12 to 1.66) | <0.001 | <0.001 | <0.001 |
| Cyprus | Ref | 0.72 (0.54 to 0.95) | 1.10 (0.84 to 1.44) | 1.03 (0.78 to 1.34) | 0.173 | 0.195 | 0.005 |
| The Czech Republic | Ref | 1.17 (0.99 to 1.38) | 1.07 (0.90 to 1.26) | 2.23 (1.89 to 2.65) | <0.001 | <0.001 | <0.001 |
| Denmark | Ref | 1.30 (1.08 to 1.58) | 0.94 (0.78 to 1.13) | 0.87 (0.72 to 1.04) | 0.006 | 0.001 | <0.001 |
| Estonia | Ref | 1.25 (1.04 to 1.50) | 0.85 (0.71 to 1.02) | 1.83 (1.53 to 2.19) | <0.001 | <0.001 | <0.001 |
| Finland | Ref | 0.72 (0.59 to 0.87) | 0.84 (0.69 to 1.02) | 1.04 (0.86 to 1.27) | 0.281 | <0.001 | <0.001 |
| France | Ref | 0.73 (0.61 to 0.88) | 0.69 (0.57 to 0.82) | 0.73 (0.61 to 0.87) | <0.001 | <0.001 | <0.001 |
| Germany | Ref | 1.04 (0.90 to 1.20) | 0.91 (0.79 to 1.05) | 0.98 (0.86 to 1.13) | 0.385 | 0.643 | 0.258 |
| Greece | Ref | 1.64 (1.33 to 2.02) | 1.19 (0.96 to 1.47) | 1.35 (1.09 to 1.66) | 0.088 | 0.016 | <0.001 |
| Hungary | Ref | 1.73 (1.45 to 2.07) | 1.35 (1.13 to 1.62) | 0.99 (0.82 to 1.19) | 0.414 | <0.001 | <0.001 |
| Ireland | Ref | 0.71 (0.58 to 0.87) | 0.77 (0.63 to 0.94) | 0.80 (0.66 to 0.96) | 0.111 | 0.010 | 0.008 |
| Italy | Ref | 0.95 (0.78 to 1.15) | 0.96 (0.79 to 1.17) | 1.25 (1.03 to 1.52) | 0.028 | 0.008 | 0.019 |
| Latvia | Ref | 1.42 (1.18 to 1.71) | 1.01 (0.84 to 1.22) | 2.64 (2.19 to 3.18) | <0.001 | <0.001 | <0.001 |
| Lithuania | Ref | 1.06 (0.90 to 1.26) | 0.90 (0.76 to 1.08) | 0.86 (0.72 to 1.03) | 0.038 | 0.076 | 0.084 |
| Luxembourg | Ref | 1.18 (0.91 to 1.53) | 1.29 (0.99 to 1.68) | 1.82 (1.41 to 2.37) | <0.001 | <0.001 | <0.001 |
| Malta | Ref | 0.17 (0.13 to 0.23) | 0.43 (0.33 to 0.57) | 0.84 (0.65 to 1.08) | 0.027 | <0.001 | <0.001 |
| The Netherlands | Ref | 1.05 (0.88 to 1.27) | 0.94 (0.78 to 1.13) | 1.26 (1.05 to 1.50) | 0.036 | 0.024 | 0.009 |
| Poland | Ref | 0.98 (0.81 to 1.18) | 0.97 (0.80 to 1.18) | 0.70 (0.58 to 0.85) | <0.001 | <0.001 | <0.001 |
| Portugal | Ref | 0.83 (0.68 to 1.00) | 0.66 (0.54 to 0.80) | 0.54 (0.44 to 0.66) | <0.001 | <0.001 | <0.001 |
| Romania | Ref | 0.77 (0.64 to 0.92) | 0.73 (0.60 to 0.89) | 0.80 (0.66 to 0.96) | 0.013 | 0.002 | 0.006 |
| Slovakia | Ref | 0.90 (0.76 to 1.07) | 0.71 (0.59 to 0.85) | 1.08 (0.90 to 1.29) | 0.975 | <0.001 | <0.001 |
| Slovenia | Ref | 1.05 (0.88 to 1.25) | 0.99 (0.83 to 1.18) | 1.16 (0.97 to 1.38) | 0.172 | 0.272 | 0.247 |
| Spain | Ref | 1.11 (0.93 to 1.33) | 1.04 (0.87 to 1.25) | 0.99 (0.83 to 1.18) | 0.733 | 0.464 | 0.589 |
| Sweden | Ref | 0.75 (0.62 to 0.92) | 0.72 (0.59 to 0.88) | 0.56 (0.47 to 0.68) | <0.001 | <0.001 | <0.001 |
Multilevel model with country as a random intercept, except for analyses stratified by country.
Adjusted for all the remaining variables.
The only country showing a linear increase in the sports and exercise participation frequency over time was Luxembourg (p<0.001). A downward linear trend was found in Lithuania (p=0.038), Poland (p<0.001), Portugal (p<0.001) and Sweden (p<0.001). A U-shaped trend was found in Bulgaria (p<0.001), Finland (p<0.001), France (p<0.001), Ireland (p=0.010), Italy (p=0.008), Malta (p<0.001), Romania (p=0.002) and Slovakia (p<0.001). An inverted U-shaped trend was found in Denmark (p=0.001) and Hungary (p<0.001). A cubic trend (specifically, an increase, followed by a decrease and a subsequent increase) was found in Austria (p<0.001), the Czech Republic (p<0.001), Estonia (p<0.001), Greece (p<0.001), Latvia (p<0.001) and the Netherlands (p=0.009). We did not find significant trends in Belgium, Germany, Slovenia and Spain (p>0.050 for all).
Discussion
Key findings
Our analyses resulted in several important findings related to the frequency of sports and exercise participation among adults in the European Union. First, the percentage of adults who never participate in sports and exercise was persistently high, with a slight overall increase from 2009 to 2022. Second, across all survey years the highest frequency of sports and exercise participation was generally found in Northern Europe and the lowest in Southern and Central/Eastern European countries. Third, the overall trend in sports and exercise participation frequency among European Union adults between 2009 and 2022 was U-shaped and mainly due to temporal changes in the prevalence of those who never, rarely or occasionally participate in sports. Fourth, trends in sports and exercise participation frequency differed across European Union member states and population groups, with the most concerning trends found for females, middle-aged adults, those living alone, Denmark, Hungary, Poland, Portugal and Sweden.
Persistently high and increasing prevalence of no sports participation
Across the European Union, the percentage of adults who never participated in sports and exercise remained persistently high from 2009 to 2022, with a slight overall increase over time. While there has been a slight decline in the prevalence of no sports and exercise participation between 2017 and 2022, it did not fully counterbalance the upward trend observed from 2009 to 2017. In contrast, notable increases in sports and exercise participation were found in countries in other world regions. For example, a study from Brazil showed that the percentage of adults who did not participate in sports and exercise declined from 55.9% to 43.0% between 2006 and 2019.30 Similarly, in Japan, the percentage for adults who did not participate in any sports or physical activities declined from 49.3% in 1992 to 27.1% in 2022.31 Furthermore, we found that only one-third of the European Union adults participated in sports and exercise weekly, with slight variations between 2009 and 2022. Relatively stable weekly sports participation rates were also observed in Australia, varying between 43% and 40% in the period from 2016 to 2023.13 However, different trends were found in other countries. For example, weekly participation in sports and activities rose from 15.8% in 2002 to 29.3% in 2014 among Mexican adults.11 Similarly, among adults in Russia, the prevalence of weekly participation in any vigorous sports activity increased from 17.0% in 2010 to 25.0% in 2017.32 33
The WHO Regional Office for Europe reported that European Union member states have significantly improved their physical activity policy implementation in the past 10 years, reflecting their commitment to Health-Enhancing Physical Activity Monitoring Framework.34 While the European Union makes large investments in the sports sector and physical activity promotion, from our findings it seems that this has not increased sports and exercise participation rates. Nevertheless, it is important to acknowledge that these efforts may have actually prevented what would otherwise potentially be a significant decline in sports and exercise participation rates.
Persistent geographic divide in sports and exercise participation
The persistent geographic divide in sports and exercise participation found in our study is in accordance with previous findings for non-type-specific physical activity.35 36 For example, Martínez-González et al35 found the highest levels of physical activity in Nordic countries in 1997, and 20 years later Nikitara et al36 have shown the same geographic pattern. The geographic divide in sports and exercise participation could partially be due to differences in economic development and policy orientation between European regions, systems of sports governance and sports associations, financial investments in the sports sector, accessibility and quality of sports and exercise facilities, sport promoting initiatives and volunteering in sports clubs.17 18 37–39
Trends in sports and exercise participation
Although sports and exercise participation frequency in Europe decreased from 2009 to 2017 and then increased in 2022 (forming a U-shaped trend), overall, it declined. Our finding is in accordance with declining trends in weekly sports participation in Australia.13 It is also aligned with global trends in the prevalence of meeting WHO’s physical activity guidelines.24 However, the guideline-compliance study used a composite measure of moderate-to-vigorous physical activity across all physical activity domains (ie, work, household, leisure and transport), whereas we only analysed the frequency of sports and exercise participation; a specific type of physical activity that may not necessarily follow the same trends as the overall physical activity. Hence, the comparison of our findings with the trends in meeting physical activity guidelines should be taken with caution.
The overall U-shaped trend seems to be mainly driven by temporal changes in the prevalence of those who never, rarely (ie, less than once) or occasionally (ie, monthly) participate in sports and exercise. The WHO physical activity guidelines state that some physical activity is better than no activity.40 Hence, the trends established in our study can be considered as relevant from a public health perspective, despite no clear temporal changes in the crude (ie, unadjusted) prevalence of regular (ie, weekly) sports and exercise participation. compared with never engaging in sports and exercise, rare or occasional participation may create a more favourable starting point for individuals to transition into regular sports participation over time. It can also contribute to the overall physical activity level, although probably not as much as regular participation.
It may be that the overall increase in sports and exercise participation frequency in 2022 was due to the influence of COVID-19 restrictions on the lifestyle of European adults. This rising trend could be partially explained by increased awareness of the importance of physical activity in the population, thanks to intensified public health messaging during the COVID-19 pandemic.41 It seems that COVID-19 restrictions generally led to a decrease in physical activity levels in the population,42 partly because of closure of facilities, the shift to remote work and the displacement of active routines by sedentary behaviours including higher screen time.43 44 However, in some studies the restrictions were associated with increases in recreational activity.45 46 Physical activity levels may have reduced due to lower engagement in active transport and manual work, leaving more time and ‘energy’ for participation in sports and exercise. It is also possible that there was a shift in expected outcomes and behavioural intention related to sports and exercise participation, with an increased number of individuals perceiving sports and exercise participation as the most viable way to stay sufficiently physically active during the COVID-19 restrictions. Furthermore, the trends in sports and exercise participation from 2017 to 2022 (ie, from the pre-COVID-19 to COVID-19 period surveys) varied across the European Union member states, with particularly high increases observed in the Czech Republic, Estonia and Latvia. The variation in trends across the European Union member states could be explained by differences in national COVID-19 policies, especially in how restrictive they were on activities contributing to physical activity levels in the population. Future studies could explore which specific public health measures introduced during the COVID-19 pandemic were most impactful in relation to sports and exercise participation. The variation could also be partially explained by cross-country differences in data collection methods in the Eurobarometer 2022 survey. Due to the COVID-19 restrictions, in this survey year, face-to-face interviews were supplemented by online interviews in 10 member states, including the three above-mentioned countries. It could be that overestimation of sports and exercise participation frequency was more likely in the online surveys, compared with the face-to-face interviews, at least in some European Union member states.
The overall decline in sports participation frequency was particularly pronounced among females (compared with males), middle-aged adults (compared with young and older adults) and those living alone (compared with those living in a shared household), suggesting that these population groups should be targeted in future sport promoting initiatives in the European Union. It is possible that the current policies and sports-promoting interventions at the European Union and national levels are not equitably tailored to these three sociodemographic groups, compared with the rest of the population. The need to focus on these population groups is further amplified by their persistently higher prevalence of no sports and exercise participation and lower prevalence of weekly sports and exercise participation, compared with males, young adults and those living in shared households.
A previous study found a decline in physical activity levels among Hungarian, Polish and Portuguese adults.24 The concerning decline in sports and exercise frequency in Hungary, Poland and Portugal observed in our study could be a reflection of the general decrease in physical activity in their populations. The governments of these countries should make increased efforts to promote physical activity, including sports and exercise, as the prevalence of insufficient physical activity and no sports and exercise participation in their adult populations is already very high. A relatively steep decline in sports and exercise participation frequency among Danish and Swedish adults is somewhat less concerning than in Hungary, Poland and Portugal, primarily because their physical activity levels seem to be on the rise24 and the prevalence of their weekly participation in sports and exercise is still relatively high. The discord between the trends in physical activity participation and the trends in sports and exercise participation in Denmark and Sweden might be due to changes in physical activity preferences, that is, a decrease in popularity of sports and exercise compared with other types of physical activity. However, this assumption would need to be confirmed in future studies.
Implications for policy and practice
The persistently high and increasing prevalence of no sports and exercise participation among adults in the European Union between 2009 and 2022 highlights the need to strengthen the promotion of sports and exercise at the European Union level. This could be achieved by refining policies related to sports and physical activity and implementing large-scale interventions and initiatives by European umbrella sports organisations, such as the European Olympic Committee, European Federation for Company Sport and European Non-Governmental Sports Organisation. This could also be facilitated by supporting the work of large European networks engaged in the promotion of sports-for-all, such as the European Network for the Promotion of Health-Enhancing Physical Activity and Sports Club for Health Consortium.
Gender disparities in sports and exercise participation trends in the European Union call for campaigns addressing relevant factors that affect females more than males, such as gender roles and sports-related sex stereotypes.47 Age-specific strategies should be applied to promote lifelong participation in sports and exercise, with particular attention to middle-aged adults, as the trends among them seem to be most concerning. Community-based initiatives that draw on social support may be needed to revert the decreasing trend in sports and exercise participation among individuals who live alone.
Our findings also suggest that specific actions need to be taken in different countries, as the prevalence and trends in sports and exercise participation vary across Europe. It is particularly important to strengthen sports and exercise promotion in the countries that experienced large declines in sports and exercise participation frequency over time and whose prevalence of weekly sports participation is already relatively low, including Hungary, Poland and Portugal. It is also important to prevent further fast decline in sports and exercise participation frequency in Denmark and Sweden. Examples of good practice in sports and exercise promotion can be found across Europe,14 but, at the country level, it seems that Luxembourg has performed best in this regard, as it was the only European Union country in which the sports and exercise participation frequency increased continuously from 2009 to 2022. However, given that Luxembourg has the highest gross domestic product per capita and the second smallest population size and area in the European Union, its sport promotion strategies may not necessarily be applicable to other European Union member states. Some lessons could potentially also be learnt from other countries where positive trends in sports and exercise participation have been observed, such as Brazil and Japan. There seems to be a mismatch between the availability and implementation of physical activity policies; at the national level such policies are often well developed but poorly implemented, while at the local level it is commonly the other way around.48 Therefore, to facilitate sports and exercise promotion, it may be needed to improve the implementation of relevant policies at the national level, while developing more local-level policies and community-based initiatives. This could be facilitated via national sports associations and local sports clubs, as they have shown to be suitable settings for the promotion of health-enhancing sports activities and other healthy behaviours.49 50 While such initiatives are already in place across the European Union, further efforts are needed for their widespread implementation.14
Strengths and limitations
The key strengths of our study include: (1) a population-representative sample from four consecutive Eurobarometer surveys, allowing us to make inferences about the trends in sports and exercise participation in the whole European Union and in each of its member states separately and (2) data collected using standardised questionnaires across 26 countries in all four Eurobarometer surveys, which enabled us to make direct comparisons between countries and survey years.
This study also had several limitations. First, self-reports were used to collect data on sports and exercise participation. Although this is a standard way of assessing sports and exercise participation in large-scale surveys, it may be subject to reporting and recall bias. Second, the Eurobarometer surveys did not collect data on other important temporal dimensions of sports and exercise participation, such as duration, intensity, timing, sequencing and regularity23; hence, we could not include these important variables in our analyses. Additionally, some relevant sociodemographic variables (eg, socioeconomic status, education) could not be included in this study because of inconsistencies in the respective questions and response options across the Eurobarometer surveys. Due to the impact of COVID-19 and subsequent health safety measures, face-to-face interviews were supplemented by online interviews in 10 member states (ie, Belgium, the Czech Republic, Denmark, Estonia, Latvia, Malta, the Netherlands, Slovenia, Finland and Sweden), which might have impacted some of the findings.
Conclusions
The prevalence of no sports and exercise participation among adults in the European Union was persistently high between 2009 and 2022, with a slight overall increase over time. Throughout this period the highest frequency of sports and exercise participation was generally found in Northern Europe and the lowest in Southern and Central/Eastern European countries. In the overall adult population, a decrease in sports and exercise participation frequency from 2009 to 2017 was followed by an increase in 2022, indicating a U-shaped trend. When considering specific population groups and countries, the most concerning trends in sports and exercise participation were found among females, middle-aged adults and those living alone, as well as in Denmark, Hungary, Poland, Portugal and Sweden. These findings highlight the need to strengthen the promotion of sports and exercise in the European Union.
The trends in sports and exercise participation frequency in the European Union should continue to be observed, to determine whether its increase will continue beyond COVID-19 restrictions period and over the coming years. Future studies should aim to include additional sociodemographic variables, such as socioeconomic status and level of education, and consider not only the frequency but also other temporal dimensions of sports and exercise participation.
Supplementary material
Footnotes
Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Provenance and peer review: Not commissioned; externally peer reviewed.
Patient consent for publication: Not applicable.
Ethics approval: This study involves human participants. This study uses secondary data. Participants gave informed consent to participate in the study before taking part. The survey was approved by the European Commission, Directorate-General for Education, Youth, Sport and Culture and co-ordinated by the Directorate-General for Communication (Rreference from 2009 onwards: ZA No. 4977, ZA No. 5877, ZA No. 6939, ZA No. 7888). The analyses in this study included a total of 96 948 adults aged 18+ years from 26 European Union member countries. We did not include Croatian participants in the analysis, because Croatia was not a member of the European Union until 2013. We also did not include the United Kingdom in the analysis, because its membership in the European Union ceased in 2020.
Data availability free text: The raw data are available on https://search.gesis.org/research_data/ZA4977, https://search.gesis.org/research_data/ZA5877, https://search.gesis.org/research_data/ZA6939 and https://search.gesis.org/research_data/ZA7888 and can be accessed freely for research purposes.
Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Data availability statement
Data are available in a public, open access repository.
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Supplementary Materials
Data Availability Statement
Data are available in a public, open access repository.