Keywords
College students; exercise; Kuwait; physical activity; sedentary behaviors; sleep.
Abstract
Objectives: To determine the prevalence of physical activity (PA), sedentary behaviors (SB) and sleep duration and the associations between those variables among Kuwaiti Physical Education (PE) College students.
Methods: A total of 418 participants (220 females) were randomly selected from the Basic Education College in the Public Authority for Applied Education and Training in Kuwait. Body weight and height were measured, and body mass index (BMI) was calculated. A validated questionnaire was used to assess lifestyle behaviors.
Results: Based on BMI classification, the prevalence of overweight or obesity among males (34.9%) was significantly higher than that of females (16.7%). However, the mean (SD) of body fat percentage using bioelectrical impedance analysis was 21.3 (9.0) for males and 32.3 (7.7) for females. The proportions of highly active (>1200 METs-min/week) males (85.9%) and females (64.3%) were significantly (p<0.005) different. The participants exceeding 3 hours of screen viewing time/day and insufficient sleep duration (<7 hours/night) were 76.8% and 65.1%, respectively, with no gender differences. Logistic regression, adjusted for confounders, showed that highly active PE students had a higher proportion of SB. However, neither sleep duration nor body fat percentage exhibited any significant difference relative to PA.
Conclusions: Despite having high PA, Kuwaiti PE College students had a high prevalence of SB and insufficient sleep. Gender differences were found in PA but not in screen time or sleep duration. Efforts toward reducing SB and insufficient sleep among Kuwaiti PE College students are needed to reduce unhealthy lifestyle behaviors and promote health and well‑being.
References
References
1- Behbehani K. Kuwait National Programme for Healthy Living: first 5-year plan (2013-2017). Med Princ Pract 2014; 23 Suppl 1: 32-42. doi:10.1159/000358884.
2- Loef M, Walach H. The combined effects of healthy lifestyle behaviors on all-cause mortality: a systematic review and meta-analysis. Prev Med 2012; 55 (3): 163-170. doi:10.1016/j.ypmed.2012.06.017.
3- Karageorgi S, Alsmadi O, Behbehani K. A review of adult obesity prevalence, trends, risk factors, and epidemiologic methods in Kuwait. J Obes 2013: 378650. doi:10.1155/2013/378650.
4- Moussa MA, Alsaeid M, Abdella N, Refai TM, Al-Sheikh N, Gomez J.E. Prevalence of type 2 diabetes mellitus among Kuwaiti children and adolescents. Med Princ Pract 2008; 17 (4): 270-275. doi:10.1159/000129604.
5- World Health Organization (WHO). Global Recommendations on Physical Activity for Health. Geneva, Switzerland, WHO, 2010.
6- Al-Haifi AR, Al-Fayez MA, Al-Athari BI, Al-Ajmi FA, Allafi AR, Al-Hazzaa, HM, Musaiger AO. Relative contribution of physical activity, sedentary behaviors, and dietary habits to the prevalence of obesity among Kuwaiti adolescents. Food Nutr Bull 2013; 34 (1), 6-13. doi:10.1177/156482651303400102.
7- Bronikowski M, Bronikowska M, Laudanska-Krzeminska I, Kantanista A, Morina B, Vehapi S. PE Teacher and Classmate Support in Level of Physical Activity: The Role of Sex and BMI Status in Adolescents from Kosovo. Biomed Res Int 2015; 290349. doi:10.1155/2015/290349.
8- Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010; 7: 40. doi: 10.1186/1479-5868-7-40.
9- Peterson NE, Sirard JR, Kulbok PA, DeBoer MD, Erickson JM. Sedentary behavior and physical activity of young adult university students. Res Nurs Health 2018; 41: 30-38.
10- Huang TT, Harris KJ, Lee RE, Nazir N, Born W, Kaur H. Assessing overweight, obesity, diet, and physical activity in college students. J Am Coll Health 2003; 52: 83-86.
11- Grasdalsmoen M, Eriksen HR, Lønning KJ, Sivertsen B. Physical Exercise and Body-Mass Index in Young Adults: A National Survey of Norwegian University Students. BMC Public Health 2019; 19 (1): 1354. doi: 10.1186/s12889-019-7650-z.
12- Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas 1970; 30: 607-610.
13- Al-Hazzaa HM, Musaiger AO, ATLS Research Group. Arab Teens Lifestyle Study (ATLS): Objectives, design, methodology and implications. Diabetes Metab Syndr Obes 2011; 4: 417-26. doi:10.2147/DMSO.S26676
14- Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO. Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act 2011; 8: 140. doi:10.1186/1479-5868-8-140.
15- Al-Hazzaa H, Al-Ahmadi MA. Self-reported questionnaire for the assessment of physical activity in youth 15–25 years: Development, reliability and construct validity. Arab J of Food & Nutrition 2003; 4 (8): 279-291.
16- Al-Hazzaa HM, Al-Sobayel HI, Musaiger AO. Convergent validity of the Arab Teens Lifestyle Study (ATLS) physical activity questionnaire. Int J Environ Res Public Health 2011-a; 8 (9): 3810-3820. doi: 10.3390/ijerph8093810.
17- Hirshkowitz M, Whiton K, Albert S, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1: 40-50. http://www.sleephealthjournal.org/article/S2352-7218%2815%2900015-7/fulltext
18- Khalaf A, Ekblom O, Kowalski J, Berggren V, Westergren A, Al-Hazzaa H. Female university students' physical activity levels and associated factors--a cross-sectional study in southwestern Saudi Arabia. Int J Environ Res Public Health 2013; 10 (8): 3502-3517. doi:10.3390/ijerph10083502.
19- Tayyem RF, Al-Hazzaa HM, Abu-Mweis SS, Bawadi HA, Hammad SS, Musaiger AO. Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools. East Mediterr Health J 2014; 20 (7): 416-423.
20- Hamrani A, Mehdad S, El Kari K, El Hamdouchi A, El Menchawy I, Belghiti H, et al. Physical activity and dietary habits among Moroccan adolescents. Public Health Nutr 2015; 18 (10): 1793-1800. doi:10.1017/S1368980014002274.
21- Alzamil HA, Alhakbany MA, Alfadda NA, Almusallam SM, Al-Hazzaa HM. A Profile of Physical Activity, Sedentary Behaviors, Sleep, and Dietary Habits of Saudi College Female Students. J Family Community Med 2018; 26 (1): 1-8. doi:10.4103/jfcm.JFCM_58_18.
22- Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non‑communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet 2012; 380: 219‑29.
23- Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health 2018; 6: e1077-e1086.
24- Kragelund C, Omland TA. Farewell to body-mass index? Lancet 2005; 366 (9497): 1589-1591. doi:10.1016/S0140-6736(05)67642-8.
25- Prentice AM, Jebb SA. Beyond body mass index. Obes Rev 2001; 2 (3): 141-147.
26- Alissa EM, Alsawadi H, Zedan A, Alqarni D, Bakry M, Bin Hli N. Knowledge, attitude and practice of dietary and lifestyle habits among medical students in King Abdulaziz University, Saudi Arabia. Int J Nutr Food Sci 2015; 4: 650‑5.
27- Al-Hazzaa HM. Physical inactivity in Saudi Arabia revisited: A systematic review of inactivity prevalence and perceived barriers to active living. Int J Health Sci (Qassim) 2018; 12 (6): 50-64.
28- Samara A, Nistrup A, Al-Rammah TY, Aro AR. Lack of facilities rather than sociocultural factors as the primary barrier to physical activity among female Saudi university students. Int J Womens Health 2015; 7: 279-286.
29- Alkhateeb SA, Alkhameesi N, Lamfon GN, Khawandanh SZ, Kurdi LK, Faran MY, et al. Pattern of physical exercise practice among university students in the Kingdom of Saudi Arabia (before beginning and during college): a cross-sectional study. BMC Public Health 2019; 19 (1): 1716. doi: 10.1186/s12889-019-8093-2.
30- Tremblay MS, Colley RC, Saunders TJ, Healy, GN, Owen N. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 2010; 35 (6): 725-740. doi:10.1139/H10-079.
31- Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, et al. TV viewing and physical activity are independently associated with metabolic risk in children: the European Youth Heart Study. PLoS Med 2006; 3 (12): e488.
32- Al‑Hazzaa HM, Al‑Sobayel HI, Abahussain NA, Qahwaji DM, Alahmadi MA, Musaiger AO. Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. J Hum Nutr Diet 2014; 27 Suppl 2: 204-13.
33- Ge Y, Xin S, Luan D, Zou Z, Bai X, Liu M, Gao Q. Independent and combined associations between screen time and physical activity and perceived stress among college students. Addict Behav 2020; 103: 106224. doi: 10.1016/j.addbeh.2019.106224.
34- Wasenius N, Venojärvi M, Manderoos S, Surakka J, Lindholm H, Heinonen OJ, et al. Unfavorable influence of structured exercise program on total leisure-time physical activity. Scand J Med Sci Sports 2014; 24: 404-13. doi: 10.1111/sms.12015.
35- Lund HG, Reider BD, Whiting AB, Prichard J. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 2010; 46: 124-32. doi: 10.1016/j.jadohealth.2009.06.016.
36- Cahuas A, He Z, Zhang Z, Chen W. Relationship of physical activity and sleep with depression in college students. J Am Coll Health 2019; 1-8. doi: 10.1080/07448481.2019.1583653.
37- Ge Y, Xin S, Luan D, Zou Z, Liu M, Bai X, Gao Q. Association of physical activity, sedentary time, and sleep duration on the health-related quality of life of college students in Northeast China. Health Qual Life Outcomes 2019; 17: 124. doi: 10.1186/s12955-019-1194-x.
38- Al‑Otaibi HH. Associations between sleep quality and different measures of obesity in Saudi Adults. Glob J Health Sci 2016; 9: 57770.
1- Behbehani K. Kuwait National Programme for Healthy Living: first 5-year plan (2013-2017). Med Princ Pract 2014; 23 Suppl 1: 32-42. doi:10.1159/000358884.
2- Loef M, Walach H. The combined effects of healthy lifestyle behaviors on all-cause mortality: a systematic review and meta-analysis. Prev Med 2012; 55 (3): 163-170. doi:10.1016/j.ypmed.2012.06.017.
3- Karageorgi S, Alsmadi O, Behbehani K. A review of adult obesity prevalence, trends, risk factors, and epidemiologic methods in Kuwait. J Obes 2013: 378650. doi:10.1155/2013/378650.
4- Moussa MA, Alsaeid M, Abdella N, Refai TM, Al-Sheikh N, Gomez J.E. Prevalence of type 2 diabetes mellitus among Kuwaiti children and adolescents. Med Princ Pract 2008; 17 (4): 270-275. doi:10.1159/000129604.
5- World Health Organization (WHO). Global Recommendations on Physical Activity for Health. Geneva, Switzerland, WHO, 2010.
6- Al-Haifi AR, Al-Fayez MA, Al-Athari BI, Al-Ajmi FA, Allafi AR, Al-Hazzaa, HM, Musaiger AO. Relative contribution of physical activity, sedentary behaviors, and dietary habits to the prevalence of obesity among Kuwaiti adolescents. Food Nutr Bull 2013; 34 (1), 6-13. doi:10.1177/156482651303400102.
7- Bronikowski M, Bronikowska M, Laudanska-Krzeminska I, Kantanista A, Morina B, Vehapi S. PE Teacher and Classmate Support in Level of Physical Activity: The Role of Sex and BMI Status in Adolescents from Kosovo. Biomed Res Int 2015; 290349. doi:10.1155/2015/290349.
8- Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010; 7: 40. doi: 10.1186/1479-5868-7-40.
9- Peterson NE, Sirard JR, Kulbok PA, DeBoer MD, Erickson JM. Sedentary behavior and physical activity of young adult university students. Res Nurs Health 2018; 41: 30-38.
10- Huang TT, Harris KJ, Lee RE, Nazir N, Born W, Kaur H. Assessing overweight, obesity, diet, and physical activity in college students. J Am Coll Health 2003; 52: 83-86.
11- Grasdalsmoen M, Eriksen HR, Lønning KJ, Sivertsen B. Physical Exercise and Body-Mass Index in Young Adults: A National Survey of Norwegian University Students. BMC Public Health 2019; 19 (1): 1354. doi: 10.1186/s12889-019-7650-z.
12- Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas 1970; 30: 607-610.
13- Al-Hazzaa HM, Musaiger AO, ATLS Research Group. Arab Teens Lifestyle Study (ATLS): Objectives, design, methodology and implications. Diabetes Metab Syndr Obes 2011; 4: 417-26. doi:10.2147/DMSO.S26676
14- Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO. Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act 2011; 8: 140. doi:10.1186/1479-5868-8-140.
15- Al-Hazzaa H, Al-Ahmadi MA. Self-reported questionnaire for the assessment of physical activity in youth 15–25 years: Development, reliability and construct validity. Arab J of Food & Nutrition 2003; 4 (8): 279-291.
16- Al-Hazzaa HM, Al-Sobayel HI, Musaiger AO. Convergent validity of the Arab Teens Lifestyle Study (ATLS) physical activity questionnaire. Int J Environ Res Public Health 2011-a; 8 (9): 3810-3820. doi: 10.3390/ijerph8093810.
17- Hirshkowitz M, Whiton K, Albert S, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1: 40-50. http://www.sleephealthjournal.org/article/S2352-7218%2815%2900015-7/fulltext
18- Khalaf A, Ekblom O, Kowalski J, Berggren V, Westergren A, Al-Hazzaa H. Female university students' physical activity levels and associated factors--a cross-sectional study in southwestern Saudi Arabia. Int J Environ Res Public Health 2013; 10 (8): 3502-3517. doi:10.3390/ijerph10083502.
19- Tayyem RF, Al-Hazzaa HM, Abu-Mweis SS, Bawadi HA, Hammad SS, Musaiger AO. Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools. East Mediterr Health J 2014; 20 (7): 416-423.
20- Hamrani A, Mehdad S, El Kari K, El Hamdouchi A, El Menchawy I, Belghiti H, et al. Physical activity and dietary habits among Moroccan adolescents. Public Health Nutr 2015; 18 (10): 1793-1800. doi:10.1017/S1368980014002274.
21- Alzamil HA, Alhakbany MA, Alfadda NA, Almusallam SM, Al-Hazzaa HM. A Profile of Physical Activity, Sedentary Behaviors, Sleep, and Dietary Habits of Saudi College Female Students. J Family Community Med 2018; 26 (1): 1-8. doi:10.4103/jfcm.JFCM_58_18.
22- Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non‑communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet 2012; 380: 219‑29.
23- Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health 2018; 6: e1077-e1086.
24- Kragelund C, Omland TA. Farewell to body-mass index? Lancet 2005; 366 (9497): 1589-1591. doi:10.1016/S0140-6736(05)67642-8.
25- Prentice AM, Jebb SA. Beyond body mass index. Obes Rev 2001; 2 (3): 141-147.
26- Alissa EM, Alsawadi H, Zedan A, Alqarni D, Bakry M, Bin Hli N. Knowledge, attitude and practice of dietary and lifestyle habits among medical students in King Abdulaziz University, Saudi Arabia. Int J Nutr Food Sci 2015; 4: 650‑5.
27- Al-Hazzaa HM. Physical inactivity in Saudi Arabia revisited: A systematic review of inactivity prevalence and perceived barriers to active living. Int J Health Sci (Qassim) 2018; 12 (6): 50-64.
28- Samara A, Nistrup A, Al-Rammah TY, Aro AR. Lack of facilities rather than sociocultural factors as the primary barrier to physical activity among female Saudi university students. Int J Womens Health 2015; 7: 279-286.
29- Alkhateeb SA, Alkhameesi N, Lamfon GN, Khawandanh SZ, Kurdi LK, Faran MY, et al. Pattern of physical exercise practice among university students in the Kingdom of Saudi Arabia (before beginning and during college): a cross-sectional study. BMC Public Health 2019; 19 (1): 1716. doi: 10.1186/s12889-019-8093-2.
30- Tremblay MS, Colley RC, Saunders TJ, Healy, GN, Owen N. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 2010; 35 (6): 725-740. doi:10.1139/H10-079.
31- Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, et al. TV viewing and physical activity are independently associated with metabolic risk in children: the European Youth Heart Study. PLoS Med 2006; 3 (12): e488.
32- Al‑Hazzaa HM, Al‑Sobayel HI, Abahussain NA, Qahwaji DM, Alahmadi MA, Musaiger AO. Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. J Hum Nutr Diet 2014; 27 Suppl 2: 204-13.
33- Ge Y, Xin S, Luan D, Zou Z, Bai X, Liu M, Gao Q. Independent and combined associations between screen time and physical activity and perceived stress among college students. Addict Behav 2020; 103: 106224. doi: 10.1016/j.addbeh.2019.106224.
34- Wasenius N, Venojärvi M, Manderoos S, Surakka J, Lindholm H, Heinonen OJ, et al. Unfavorable influence of structured exercise program on total leisure-time physical activity. Scand J Med Sci Sports 2014; 24: 404-13. doi: 10.1111/sms.12015.
35- Lund HG, Reider BD, Whiting AB, Prichard J. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 2010; 46: 124-32. doi: 10.1016/j.jadohealth.2009.06.016.
36- Cahuas A, He Z, Zhang Z, Chen W. Relationship of physical activity and sleep with depression in college students. J Am Coll Health 2019; 1-8. doi: 10.1080/07448481.2019.1583653.
37- Ge Y, Xin S, Luan D, Zou Z, Liu M, Bai X, Gao Q. Association of physical activity, sedentary time, and sleep duration on the health-related quality of life of college students in Northeast China. Health Qual Life Outcomes 2019; 17: 124. doi: 10.1186/s12955-019-1194-x.
38- Al‑Otaibi HH. Associations between sleep quality and different measures of obesity in Saudi Adults. Glob J Health Sci 2016; 9: 57770.