Sex differences in physical activity patterns and cardiometabolic risk among Moroccan adults: a cross-sectional study

Abstract Aim The prevalence of general and central obesity has increased worldwide, alongside urbanization and sedentary lifestyles. This study aimed to investigate the associations between obesity, sociodemographic characteristics, and physical activity among Moroccan adults living in the Casablanca-Settat region. Subjects and methods This cross-sectional study included 300 adults aged ≥ 18 years recruited through convenience sampling. Anthropometric measurements were collected directly and used to derive cardiometabolic risk indicators, including waist-to-height ratio (WHtR), waist-to-hip ratio, relative fat mass (RFM), and National Institute for Health and Care Excellence (NICE) obesity risk. Physical activity was self-reported using the validated General Practice Physical Activity Questionnaire. Multivariate models examined associations between adiposity indicators and sociodemographic and lifestyle factors. Results Women showed higher levels of general and central adiposity and were more frequently classified in very high-risk categories than men ( p < 0.05). Sedentary work predominated in both sexes. Men reported higher levels of leisure-time exercise, whereas women reported greater involvement in housework and childcare and had about twice the prevalence of physical inactivity. Multivariate analyses revealed significant associations between sociodemographic factors, physical activity, and cardiometabolic risk indicators ( p < 0.001). In men, age and inactivity were the main determinants of higher WHtR, NICE risk, and RFM. In women, cardiometabolic risk was mainly influenced by reproductive and sociodemographic factors, with the number of children independently associated with higher WHtR and RFM. Conclusion Marked sex differences in adiposity patterns, physical activity, and cardiometabolic risk indicators were observed among Moroccan adults. These findings suggest that measures of central adiposity, including WHtR and RFM, may complement body mass index (BMI) in cardiometabolic risk assessment and support the development of sex-sensitive public health strategies. However, the cross-sectional design, convenience sampling, and reliance on self-reported physical activity limit causal inference and the generalizability of the findings. Prospective studies are needed to confirm their predictive value.