This cross-sectional study was conducted in an urban area of Puducherry. The data was collected from 1^st February to 28^th February 2013. The study area with an approximate population of 12000 in the field practice area of Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.

A sample size of 522 was calculated assuming the 29% prevalence of physical activity with 15% relative precision, 95% confidence and 20% attrition rate based on ICMR-INDIAB study, Tamilnadu status [11]. As a field practice area of urban health training centre, in the routine surveillance from the list of households, 600 house hold selected by systematic random method and from each family one adult selected randomly. Totally 569 eligible participants were interviewed. Acutely ill patients, physically challenged and pregnant women were excluded from the study. Participant information sheet was provided. Informed written consent was obtained from the participants. This study was conducted as a part of WHO STEPS NCD risk factors surveillance. In this surveillance the NCD risk factors (physical activity, smoking, alcohol and diet) were screened using a standard pretested and validated questionnaire. Among those risk factors physical activity was captured using GPAQ is reflected in this study [12,13]. Data was collected by sixth semester MBBS student as a part of field training (Re-Orientation Medical Education posting) after training under supervision by faculty in charge and post graduates from community medicine. Ten percent of the proforma was randomly checked by faculty in charge for quality assurance.

Those who have ever consumed oral tobacco product or smoked any tobacco products for the past one year was considered as tobacco user and those who have consumed alcohol for the past one year was considered as alcohol user for operational definition [14]. For the analysis of GPAQ data, total number of minutes spend by a person on moderate and vigorous physical activity in a typical week were captured under three domains (during work, transport and leisure time) respectively using GPAQ questionnaire. Work includes activities such as paid or unpaid work, study/training, household chores, harvesting food/crops, fishing or hunting for food, seeking employment etc. Transport activities includes mode of travel around getting from place-to-place. Recreational activities include sports and exercises. This also called as leisure time activities [13]. WHO show card has been used to classify the type of work and intensity of work [15]. METs (Metabolic Equivalents) were used to calculate the intensity of physical activities. For calculation, four METS were multiplied with the number of minutes spend by a person on moderate intensity physical activity and eight METS for vigorous intensity physical activity in a typical week respectively because a person’s caloric consumption is four times higher when doing moderate activity, and eight times higher when doing vigorously active, when compared to a person sitting quietly [13]. As per WHO recommendation to consider a person as physically active, an adults should do at least 75 minutes of vigorous or 150 minutes of moderate physical activity or an equivalent combination of moderate and vigorous physical activity achieving at least 600 MET-minutes throughout a week, else he will be classified as physically inactive [13]. The detailed definitions and analysis plan has been described in WHO–GPAQ analysis guide [13].

Data analysis was done through SPSS 16. Association was analysed using Chi-Square. Adjusted odds ratio was calculated using logistic regression. Informed consent was obtained from all the participants after providing participants information sheet.

Overall prevalence of adults with physical inactivity in our study was 49.7% (CI: 45.6-53.8) (n=283) and the adults with adequate physical activity level was 50.3% (CI 46.16 - 54.37) (n=286). Contribution of physical activity by work was 77.4%, leisure time activity was 11.6% and transport time activity was 11%. Association of physical inactivity with other variables are shown in the [Table/Fig-1], METs score presented in [Table/Fig-2] and logistic regression for significant variables presented in [Table/Fig-3]. BMI, Hypertension, diabetes, Heart disease were not associated with level of physical inactivity in our study.

Puducherry is a coastal urban city in South India. This study has been conducted in the heart of the city (in our service area). Overall prevalence of physical inactivity in our study was 49.7%, which is higher than the global prevalence of physical inactivity 21.4% [16]. But is lower than the multicentric ICMR-INDIAB study done in India (physical inactivity among Indian urban population is 65% and in Tamilnadu 71%) [11].

This high level of physical inactivity is alarming in our study. India is the top in the world having highest number of diabetic patients and the number is also estimated to be increase very rapidly in near future [17]. Interventions need to be stepped up giving priority to physical activity and healthy life style.

The main contribution of total physical activity was from work (77.4%). The leisure time activities contribute only 11.6% and transport by 11%. Similar pattern was noted in other studies where the contribution of work was more when compared to leisure time and transport activities, but the proportion of contribution by work time was very high in our study when compared to leisure time and transport time physical activity. There is a hope to sensitize the general public during leisure time and transport time physical activity [11,18,19].

In our study, both men and women were equally inactive {women – 50% (44.1-55.9) and men - 49.5% (43.8-55.2)} and the prevalence of inactiveness was very high when comparing to the world wide estimate {women - 23.7% (CI: 20.4–27.1) and men - 18.9% (CI:16.2–1.7)} [16]. One of the study conducted among adult women in thiruvananthapuram city in India has shown 26.6% physical activity which is also lower than our study [20]. Prevalence of physical inactivity was increasing with increasing age group. Similar finding was also noticed in many other studies [10,21]. Non tobacco users were two times more active than tobacco users (Adjusted Odds Ratio - 2.183 (1.175-4.057)). This is a positive finding. Similar findings were noticed in other studies [22,23]. Studies have also shown that refraining from smoking and doing regular physical activity predict a long and healthy life [24].

In our study, those who are working were more active when comparing to retired (Adjusted OR: 0.412 (0.171-.991), students (Adjusted OR: 0.456 (0.196-1.060)), House wives (Adjusted OR: 0.757 (0.509-1.127)) and unemployed (Adjusted OR: 0.538 (0.271-1.068)). Leisure time activities and transport activities need to be promoted among house wives, retired people and school students. Studies have proven that physical activities in school environment have short term as well as long term benefits over health [25,26]. Encouraging physical activity from school days should be promoted in India, which will prevent the children from many risk factors including childhood obesity.

Non alcoholics were only 0.34 times as active as alcoholics. Limited number of studies were available to reason out this relationship between alcoholics and physical activity [11]. One reason may be the working population who were considered physically active, also consumed more alcohol due to peer pressure, work pressure and financial stability to afford. This leads to the concept of confounding which needs to be proved by research. One of the study have shown that the risk of losing mobility was positively associated with current smoking, not consuming alcohol [23].

This study has been done in an urban area of south India. Generalisation from our study should be done with caution, which is a limitation of this study.

Physical activity was insufficient among urban population both male and female in Puducherry. Only the working adult population was active, that too during their working time. Overall physical activity can be promoted by increasing leisure time and commuting activities. Special attention to promote physical activity is needed among elderly, unemployed, students and house wives.