Lear and colleagues1 observed much stronger relationships between the ownership 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 relatively uncommon among participants from low-income countries, ownership may increase with rapid economic development. This transition may have dire consequences for the health systems of low-income countries, which are already struggling with a high prevalence 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 associated with greater engagement in sedentary 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 promoting an active lifestyle in low-income countries. The United Nations’ political declaration on noncommunicable diseases8 is a good step in the right direction, but there remains a clear need for raising the political priority for developing and implementing effective and culturally relevant interventions to prevent noncommunicable diseases in low-income countries.9