Estimation of the Attributable Fraction of Noncommunicable Diseases Related to Physical Inactivity, Morocco

Introduction: Physical inactivity is a major risk factor for noncommunicable diseases (NCDs). With the growing prevalence of NCDs, quantifying the effects of physical inactivity is essential for informing public health policies. This study estimates the attributable fraction of NCDs related to physical inactivity in Morocco and examines differences by sex and physical activity level. Methods: We applied a population attributable fraction approach to estimate preventable cases of breast cancer, colorectal cancer, type 2 diabetes, ischemic heart disease, and ischemic stroke through increased physical activity. The analysis focused on adults aged 18 years or older, with a focus on ischemic conditions among those aged 35 or older. Data sources included the national World Health Organization (WHO) STEPwise approach to NCD risk factor surveillance (STEPS) survey (for inactivity prevalence), meta-analyses (for relative risks), the national cancer registry (for cancer incidence), and published studies (for disease prevalence). Results: For breast cancer in women, physical inactivity accounted for 0.88% to 3.95% of cases. For colorectal cancer, the attributable fraction ranged from 2.72% (women) and 1.69% (men) at low activity levels to 6.49% (women) and 4.13% (men) at high activity levels. For type 2 diabetes, it ranged from 4.16% (women) and 2.60% (men) to 9.10% (women) and 5.84% (men). Among adults aged 35 years or older, physical inactivity accounted for up to 6.49% of ischemic heart disease cases and 7.08% of ischemic stroke cases in women and up to 5.16% and 5.64%, respectively, in men. Conclusions: Higher physical activity levels could significantly reduce NCD incidence. These findings underscore the preventive potential of physical activity and the need for sex-sensitive public health strategies to reduce NCD burden.