Abstract
The objective of this study was to analyze the isolated and combined linkage of insufficient physical activity and excessive sitting time on negatively self-rated health in university students. This is a cross-sectional study conducted with 418 students from a community university in western Santa Catarina, Brazil. Self-rated health was the dependent variable. Self-reported information on moderate to vigorous physical activity and sitting time was collected through a questionnaire. University students were classified as insufficiently active or with excessive sitting time if they did not meet the recommended guidelines. For the analysis, models were developed that considered physical activity and sitting time in isolation and in combination, using those who did meet the guidelines as a reference. The data was analyzed using Poisson regression, with adjustment for sociodemographic variables and characteristics related to the participants' degree. Results show that most of the participants were women (73.4%) and the average age was 22.9 years (SD = 5.3). Three out of every 10 university students had a negatively self-rated health. In addition, individually, insufficiently active university students and those with excessive sitting time were 1.73 (95% CI = 1.25-2.40) and 1.40 (95% CI = 1.05-1.87) times more likely to report a negatively self-rated health. In the combined analysis, when presenting both risk factors simultaneously, the probability of presenting negatively self-rated health was 2.76 (95% CI = 1.62 – 4.71). College students with insufficient physical activity and excessive sitting time are at a higher risk of negatively self-rated health, particularly when both behaviors are present simultaneously.
References
Abrantes, L. C. S., de Souza de Morais, N., Gonçalves, V. S. S., Ribeiro, S. A. V., de Oliveira Sediyama, C. M. N., do Carmo Castro Franceschini, S., dos Santos Amorim, P.R., & Priore, S. E. (2022). Physical activity and quality of life among college students without comorbidities for cardiometabolic diseases: systematic review and meta-analysis. Quality of Life Research, 31, 1933-1962. https://doi.org/10.1007/s11136-021-03035-5
Andrade, G. F., Loch, M. R., & Silva, A. M. R. (2019). Changes in health-related behaviors as predictors of changes in health self-perception: longitudinal study (2011-2015). Cad Saude Publica, 35(4), e00151418. https://doi.org/10.1590/0102-311x00151418
Booth, F. W., Roberts, C. K., Thyfault, J. P., Ruegsegger, G. N., & Toedebusch, R. G. (2017). Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms. Physiological Reviews, 97(4), 1351-1402. https://doi.org/10.1152/physrev.00019.2016
Brandão, M. P., Pimentel, F. L., & Cardoso, M. F. (2011). Impact of academic exposure on health status of university students. Revista Saúde Publica, 45(1), 49-58. https://doi.org/10.1590/s0034-89102011000100006
Campos, L., Isensse, D. C., Rucker, T. C., & Bottan, E. R. (2016). Health behaviors of freshmen and senior undergraduate students of a health-related fields. Revista Brasileira de Pesquisa em saúde, 18(2), 17-25. https://periodicos.ufes.br/rbps/article/view/15080
Cena, H., Porri, D., De Giuseppe, R., Kalmpourtzidou, A., Salvatore, F. P., El Ghoch, M., Itani, L., Kreidieh, D., Brytek-Matera, A., Pocol, C., Arteta, S., Utan, G., & Kolčić, I. (2021). How Healthy Are Health-Related Behaviors in University Students: The HOLISTic Study. Nutrients, 13(2). https://doi.org/10.3390/nu13020675
De Marco, J. C. P., Martins, R., Bim, M. A., Pelegrini, A., & Antes, D. L. (2023). Autopercepção de saúde negativa e fatores associados em estudantes de uma universidade do oeste catarinense. Saúde, 49(2), e74481-e74481. https://periodicos.ufsm.br/revistasaude/article/view/74481
de Sousa, T. F., José, H. P., & Barbosa, A. R. (2013). Condutas negativas à saúde em estudantes universitários brasileiros. Cien Saude Colet, 18(12), 3563-3575. https://doi.org/10.1590/s1413-81232013001200013
dos Santos, A. L., Prati, S. R. A., & de Souza Santos, A. (2021). University students’ lifestyle of students in diferent shifts. Research, Society and Developmen, 10(5), e54810515442-e54810515442. https://doi.org/http://dx.doi.org/10.33448/rsd-v10i5.15442
Dunstan, D. W., Dogra, S., Carter, S. E., & Owen, N. (2021). Sit less and move more for cardiovascular health: emerging insights and opportunities. Nature Reviews Cardiology, 18(9), 637-648. https://doi.org/10.1038/s41569-021-00547-y
Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., Bauman, A., & Lee, I. M. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302-1310. https://doi.org/https://doi.org/10.1016/S0140-6736(16)30370-1
Ferreira, M. d. S., Farias, G. S., Nunes, S. A. N., Papini, C. B., & de Sousa, T. F. (2021). Self-rated health in university students: a systematic review. Saúde em Revista, 21(1), 195-213. https://www.researchgate.net/publication/358487954_Self-rated_health_in_university_students_a_systematic_review
Ferreira, M. d. S., Nunes, S. A. N., Papini, C. B., & Sousa, T. F. d. (2022a). Prevalence of negative self-rated health in university students and its relationship with the co-occurrence of risk behaviors. Journal of Physical Education, 33(1), e3321. https://doi.org/https://doi.org/10.4025/jphyseduc.v33i1.3321
Ferreira, M. d. S., Nunes, S. A. N., Papini, C. B., & Sousa, T. F. d.. (2022b). Análise da realocação do tempo sentado, sono e em atividades físicas sob a autoavaliação de saúde negativa de universitários. Mundo Saúde, 46, 1-11. https://doi.org/10.15343/0104-7809.202246142152
Ganna, A., & Ingelsson, E. (2015). 5 year mortality predictors in 498 103 UK Biobank participants: a prospective population-based study. The Lancet, 386(9993), 533-540. https://doi.org/https://doi.org/10.1016/S0140-6736(15)60175-1
Hwang, C.-L., Chen, S.-H., Chou, C.-H., Grigoriadis, G., Liao, T.-C., Fancher, I. S., Arena, R., & Phillips, S. A. (2022). The physiological benefits of sitting less and moving more: Opportunities for future research. Progress in Cardiovascular Diseases, 73, 61-66. https://doi.org/https://doi.org/10.1016/j.pcad.2020.12.010
Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira [Inep]. (2022a). Censo da Educação Superior 2020: notas estatísticas. https://download.inep.gov.br/publicacoes/institucionais/estatisticas_e_indicadores/notas_estatisticas_censo_da_educacao_superior_2020.pdf
Jones, S. A., Wen, F., Herring, A. H., & Evenson, K. R. (2016). Correlates of US adult physical activity and sedentary behavior patterns. Journal of Science and Medicine in Sport, 19(12), 1020-1027. https://doi.org/https://doi.org/10.1016/j.jsams.2016.03.009
Loch, M. R., de Souza, R. K., Mesas, A. E., González, A. D., & Rodriguez-Artalejo, F. (2015). Association between social capital and self-perception of health in Brazilian adults. Rev Saúde Publica, 49, 53. https://doi.org/10.1590/s0034-8910.2015049005116
Luiz, R. R., & Magnanini, M. M. J. C. s. c. (2000). A lógica da determinaçäo do tamanho da amostra em investigaçöes epidemiológicas. Cad. health colet, 8(2), 9-28. https://pesquisa.bvsalud.org/portal/resource/pt/lil-326604
Ma, C., Zhou, L., Xu, W., Ma, S., & Wang, Y. (2020). Associations of physical activity and screen time with suboptimal health status and sleep quality among Chinese college freshmen: A cross-sectional study. PLoS One, 15(9), e0239429. https://doi.org/10.1371/journal.pone.0239429
Mansoubi, M., Pearson, N., Biddle, S. J. H., & Clemes, S. (2014). The relationship between sedentary behaviour and physical activity in adults: A systematic review. Preventive Medicine, 69, 28-35. https://doi.org/https://doi.org/10.1016/j.ypmed.2014.08.028
Marco, J. C. P., Souza, F. U., Pinto, A. A., Bim, M. A., Barbosa, R., Nahas, M. V., & Pelegrini, A. (2023). Isolated and combined association of excessive screen time and physical inactivity with negative self-rated health in adolescents. Rev Paul Pediatr, 41, e2022077. https://doi.org/10.1590/1984-0462/2023/41/2022077
Matsudo, S., Araújo, T., Marsudo, V., Andrade, D., Andrade, E., & Braggion, G. (2001). Questinário internacional de atividade física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Revista Brasileira de Atividade Física e Saúde, 6(2), 5-18. https://rbafs.org.br/rbafs/article/view/931
Mavaddat, N., Valderas, J. M., van der Linde, R., Khaw, K. T., & Kinmonth, A. L. (2014). Association of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional study. BMC Family Practice, 15(1), 185. https://doi.org/10.1186/s12875-014-0185-6
Ministério da saúde do Brazil. (2022b). Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico: estimativas sobre frequência e distribuição sócio-demográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 Estados brasileiros e no Distrito Federal em 2021. https://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2021.pdf
Nguyen, P., Le, L. K.-D., Ananthapavan, J., Gao, L., Dunstan, D. W., & Moodie, M. (2022). Economics of sedentary behaviour: A systematic review of cost of illness, cost-effectiveness, and return on investment studies. Preventive Medicine, 156, 106964. https://doi.org/https://doi.org/10.1016/j.ypmed.2022.106964
Pavão, A. L., Werneck, G. L., & Campos, M. R. (2013). Autoavaliação do estado de saúde e a associação com fatores sociodemográficos, hábitos de vida e morbidade na população: um inquérito nacional [Self-rated health and the association with social and demographic factors, health behavior, and morbidity: a national health survey]. Cadernos de saude publica, 29(4), 723–734. https://pubmed.ncbi.nlm.nih.gov/23568302/
Peersman, W., Cambier, D., De Maeseneer, J., & Willems, S. (2012). Gender, educational and age differences in meanings that underlie global self-rated health. International Journal of Public Health, 57, 513-523. https://doi.org/10.1007/s00038-011-0320-2
Pengpid, S., & Peltzer, K. (2019). Sedentary Behaviour, Physical Activity and Life Satisfaction, Happiness and Perceived Health Status in University Students from 24 Countries. International Journal of Environmental Research and Public Health, 16(12). https://doi.org/10.3390/ijerph16122084
Pinto, A. J., Bergouignan, A., Dempsey, P. C., Roschel, H., Owen, N., Gualano, B., & Dunstan, D. W. (2023). Physiology of sedentary behavior. Physiological Reviews, 103(4), 2561-2622. https://doi.org/10.1152/physrev.00022.2022
Posadzki, P., Pieper, D., Bajpai, R., Makaruk, H., Könsgen, N., Neuhaus, A. L., & Semwal, M. (2020). Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health, 20, 1724. https://doi.org/10.1186/s12889-020-09855-3
Raffin, J., de Souto Barreto, P., Le Traon, A. P., Vellas, B., Aubertin-Leheudre, M., & Rolland, Y. (2023). Sedentary behavior and the biological hallmarks of aging. Ageing Research Reviews, 83, 101807. https://doi.org/10.1016/j.arr.2022.101807
Reichert, F. F., Loch, M. R., & Capilheira, M. F. (2012). Autopercepção de saúde em adolescentes, adultos e idosos [Self-reported health status in adolescents, adults and the elderly]. Ciencia & saude coletiva, 17(12), 3353–3362. https://doi.org/10.1590/s1413-81232012001200020
Robards, J., Evandrou, M., Falkingham, J., & Vlachantoni, A. (2012). Marital status, health and mortality. Maturitas, 73(4), 295-299. https://doi.org/https://doi.org/10.1016/j.maturitas.2012.08.007
Rodriguez-Ayllon, M., Cadenas-Sánchez, C., Estévez-López, F., Muñoz, N. E., Mora-Gonzalez, J., Migueles, J. H., Molina-García, P., Henriksson, H., Mena-Molina, A., Martínez-Vizcaíno, V., Catena, A., Löf, M., Erickson, K. I., Lubans, D.R., Ortega, F.B y Esteban-Cornejo, I. (2019). Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Medicine, 49(9), 1383-1410. https://doi.org/https://doi.org/10.1007/s40279-019-01099-5
Ross, R., Chaput, J. P., Giangregorio, L. M., Janssen, I., Saunders, T. J., Kho, M. E., Poitras, V.J., Tomasone, J.R., El-Kotob, R., McLaughlin, E.C., Duggan, M., Carrier, J., Carson, V., Chastin, S.F., Latimer-Cheung, A.E., Chulak-Bozzer, T., Faulkner, G., Flood, S.M., Gazendam, M.K. . . . Tremblay, M. S. (2020). Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Applied Physiology Nutrition and Metabolism, 45(10 (Suppl. 2)), S57-s102. https://doi.org/10.1139/apnm-2020-0467
Sampasa-Kanyinga, H., Lien, A., Hamilton, H. A., & Chaput, J.P. (2022). The Canadian 24-hour movement guidelines and self-rated physical and mental health among adolescents. Canadian Journal of Public Health, 113(2), 312-321. https://doi.org/10.17269/s41997-021-00568-7
Santos, A. C., Willumsen, J., Meheus, F., Ilbawi, A., & Bull, F. C. (2023). The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis. The Lancet Glob Health, 11(1), e32-e39. https://doi.org/10.1016/s2214-109x(22)00464-8
Sousa, T. F., Loch, M. R., Lima, A. J. O., Franco, D. C., & Barbosa, A. R. (2021). Coocorrência de fatores de risco à saúde em universitários de uma instituição de ensino superior brasileira [Co-occurrence of risk factors to health among university students of a Brazilian tertiary education institution]. Ciencia & saude coletiva, 26(2), 729–738. https://doi.org/10.1590/1413-81232021262.07062019
Tavenier, J., Rasmussen, L. J. H., Tolstrup, J., Petersen, J., Sobocki, J., Pisinger, C., Eugen-Olsen, J., & Gamst-Jensen, H. (2022). Self-rated health and chronic inflammation are related and independently associated with hospitalization and long-term mortality in the general population. Scientific Reports, 12(1), 19761. https://doi.org/10.1038/s41598-022-24422-z
Tebar, W. R., Werneck, A. O., Silva, D. R. P., de Souza, J. M., Stubbs, B., da Silva, C. C. M., Ritti-Dias, R. M. & Christofaro, D. G. D. (2021). Poor self-rated health is associated with sedentary behavior regardless of physical activity in adolescents - PeNSE study. Mental Health and Physical Activity, 20, 100384. https://doi.org/https://doi.org/10.1016/j.mhpa.2021.100384
Uddin, R., Lee, E.Y., Khan, S. R., Tremblay, M. S., & Khan, A. (2020). Clustering of lifestyle risk factors for non-communicable diseases in 304,779 adolescents from 89 countries: A global perspective. Preventive Medicine, 131, 105955. https://doi.org/https://doi.org/10.1016/j.ypmed.2019.105955
Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J.J. & Egger, M. (2014). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. International Journal of Surgery, 12(12), 1500-1524. https://doi.org/10.1016/j.ijsu.2014.07.014
Warburton, D. E. R., & Bredin, S. S. D. (2019). Health Benefits of Physical Activity: A Strengths-Based Approach. Journal of Clinical Medicine, 8(12). https://doi.org/10.3390/jcm8122044
WHO. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications-detail-redirect/9789240015128
Xiong, S., Wang, Z., Lee, B., Guo, Q., Peoples, N., Jin, X., Gong, E., Li, Y., Chen, X., He, Z., Zhang, X., & Yan, L. L. (2022). The association between self-rated health and all-cause mortality and explanatory factors in China's oldest-old population. Journal of Global Health, 12, 11005. https://doi.org/10.7189/jogh.12.11005
Zhang, Y.B., Pan, X.F., Chen, J., Cao, A., Xia, L., Zhang, Y., Wang, J., Li, H., & Pan, A. (2021). Combined lifestyle factors, all-cause mortality and cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. Journal of Epidemiology and Community Health, 75(1), 92. https://doi.org/10.1136/jech-2020-214050
##plugins.facebook.comentarios##
![Creative Commons License](http://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2024 Jean Carlos Parmigiani De Marco, Andreia Pelegrini, Danielle Ledur Antes