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An international research team has investigated the physical activity behaviour of study participants from Berlin’s inner-city areas and Singapore. Their analyses included measured and self-reported information from participants in the German National Cohort (NAKO) and the Singapore Population Health Studies. The result: the participants in Singapore were more physically active than those in Berlin. The study helps to better recognise risk groups and supports the development of strategies to encourage physical activity in cities.
Physical activity has been shown to reduce the risk of disease. Nevertheless, around a third of adults worldwide do not reach the minimum daily physical activity levels recommended by the World Health Organisation (WHO). A recent study compared the activity levels of 1,195 people in Singapore and 2,060 people from Berlin city centre districts.
Measured data on physical activity was provided by an accelerometer. The participants wore the movement sensor on a hip belt for a week. The activity was divided into different categories: inactive, light and moderate to intensive. "Inactivity usually involves sitting or resting positions, but no sleeping times; light exercise occurs during everyday activities and moderate to intense exercise describes activities that make you sweat, such as jogging," explains Dr Lilian Krist from the Institute of Social Medicine, Epidemiology and Health Economics at Charité – University Medicine Berlin and head of NAKO Study Centre Berlin-Mitte. The researchers also considered further information from the study participants on lifestyle, body measurements, age, education and chronic diseases.
People in Singapore are more active
The analysis showed that the participants from Singapore were moderately to intensively active for 14 minutes more per day and were lightly physically active for over 60 minutes more than the participants in Berlin. When comparing the inactive times, the participants in Singapore were 80 minutes less inactive than the Berliners. Even when socio-demographic factors such as age, gender, level of education or body mass index were taken into account, the differences between the cities remained for the three activity levels.
The researchers also focussed on individual socio-demographic factors. “Men in Singapore were more active than women in all three levels of physical activity, while there was no such difference between the sexes among the Berlin participants. Among the Berlin participants, moderate to vigorous activity was associated with lower age, occupation, normal weight and non-smoking,” says Lilian Krist. “We also identified various risk groups with lower levels of activity in both cities. For example, overweight and adipose people, the unemployed and older people tended to be less active. In Berlin, the level of education was also linked to a lower level of activity and the youngest age group between 20-34 years showed the lowest light activity.”
Impulse for health policy
The higher activity levels in Singapore could possibly be linked to a more targeted health policy, the researchers discuss. In addition, the climatic conditions and urban planning concepts of the two cities differ.
"Physical activity is one of the most important factors for a healthy population. An effective health policy should therefore also include measures to increase physical activity. The example of Singapore shows that programmes such as the National Steps Challenge, which has been running since 2015, can help to motivate the population to be more active. Long-term and comprehensive planning of parks and green spaces has also helped to improve the infrastructure for physical activity in Singapore," says Professor Dr Falk Müller-Riemenschneider from the Saw Swee Hock School of Public Health at the National University of Singapore.
The current study also has limitations, including differences in the accelerometer wearing protocol between the two studies. In addition, the correlations described are not suitable for identifying causal relationships. Nevertheless, the study results provide an important basis for further studies and show the way to approaches in other countries for supporting physical activity.
Priv.-Doz. Dr. med. Lilian Krist, MPH
Kittner, P., Bürgel, T., Lin, C.M.G.J. et al. Patterns and associated factors of accelerometer-measured physical activity in the metropolitan areas of Singapore and Berlin – comparative analysis of the Singapore population health studies and the German National Cohort (NAKO). BMC Public Health 25, 1872 (2025). https://doi.org/10.1186/s12889-025-22922-x
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