A multi-behavioral assessment of physical activity, sedentary behavior, sleep, and weight status among iraqi undergraduate students
DOI:
https://doi.org/10.47197/retos.v76.118581Keywords:
motor activity, sedentary behavior, sleep, body mass index, college students, health behaviorAbstract
Background: University students in Iraq face rising obesity risk linked to physical inactivity, prolonged sedentary behavior, insufficient sleep, and academic stress. Longitudinal evidence examining the combined influence of these behaviors on weight status in Iraqi universities remains limited.
Objective: This study examined six-month longitudinal associations of physical activity, sedentary behavior, sleep duration, and perceived stress with body mass index and percentage body fat among Iraqi university students.
Methods: A prospective multi-behavioral study was conducted at six public universities in Iraq. Six hundred undergraduate students aged 18–25 years were followed monthly during one academic semester. Validated questionnaires and smartphone-based applications assessed health behaviors, while standardized procedures measured body mass index and body fat. Data were analyzed using descriptive statistics, correlations, regression models, and repeated-measures analysis.
Results: Overweight and obesity prevalence reached 63.7%. Most students met minimum physical activity recommendations, yet sedentary time was high and sleep duration was suboptimal. Sleep duration showed a small inverse association with body mass index and body fat and was the only behavior differing significantly across body mass index categories. Males exhibited higher body mass index, whereas females had higher body fat percentage.
Conclusions: Integrated context-sensitive health strategies addressing sleep habits, sedentary behavior, and academic lifestyle factors may support obesity prevention.
References
Al-Hazzaa, H. M., Abahussain, N. A., Al-Sobayel, H. I., Qahwaji, D. M., & Musaiger, A. O. (2011). Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 140. https://doi.org/10.1186/1479-5868-8-140
Alrubaiee, G. G., Alqalah, T. A., Alkubati, S. A., & Al-Rabeei, N. A. (2025). Overweight and obesity among Saudi university students and their relationships with various lifestyle habits: a cross-sectional study. BMC Public Health, 25(1), 2021. https://doi.org/10.1186/s12889-025-23164-7
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4
Carson, V., Tremblay, M. S., Chaput, J. P., & Chastin, S. F. M. (2016). Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses. Applied Physiology, Nutrition, and Metabolism, 41(6), S294–S302. https://doi.org/10.1139/apnm-2016-0026
Clark, B. K., Sugiyama, T., Healy, G. N., Salmon, J., Dunstan, D. W., & Owen, N. (2009). Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults: A review. In Obesity Reviews (Vol. 10, Issue 1, pp. 7–16). Wiley Online Library. https://doi.org/10.1111/j.1467-789X.2008.00508.x
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404
Cooper, C. B., Neufeld, E. V., Dolezal, B. A., & Martin, J. L. (2018). Sleep deprivation and obesity in adults: a brief narrative review. BMJ open sport & exercise medicine, 4(1). https://doi.org/10.1136/bmjsem-2018-000392
Corvetto-Castro, G., Villanueva Ruíz, M. A., Tejada Mendoza, M. A., Villacorta Huapaya, J. A., Núñez Lira , L. A. ., Grajeda Montalvo, A. T., Soto Zedano, F. A., & de la Cruz Pérez, V. N. (2025). Influence of achievement motivation on learning Physical Education and sedentary behavior outside school hours. Retos, 72, 239-250. https://doi.org/10.47197/retos.v72.115267
de Zambotti, M., Goldstone, A., Claudatos, S., Colrain, I. M., & Baker, F. C. (2018). A validation study of Fitbit Charge 2TM compared with polysomnography in adults. Chronobiology International, 35(4), 465–476. https://doi.org/10.1080/07420528.2017.1413578
Flores Paredes, A., Pino Vanegas, Y. M., Yupanqui Pino, E. H., Yupanqui Pino, A., Mamani Mamani, S., Coila Pancca, D. ., Atencio Ayma, L. J. ., Manzaneda Peña, M. A. ., & Lavalle Gonzales, A. K. . (2023). Lifestyles and body mass index in university students. Retos, 50, 950-957. https://doi.org/10.47197/retos.v50.99499
Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2018). Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys. The Lancet Global Health, 6(10), e1077–e1086. https://doi.org/10.1016/S2214-109X(18)30357-7
Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2020). Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. The Lancet Child & Adolescent Health, 4(1), 23–35. https://doi.org/10.1016/S2352-4642(19)30323-2
Herrmann, S. D., Heumann, K. J., Der Ananian, C. A., & Ainsworth, B. E. (2013). Validity and Reliability of the Global Physical Activity Questionnaire (GPAQ). Measurement in Physical Education and Exercise Science, 17(3), 221–235. https://doi.org/10.1080/1091367X.2013.805139
Itani, O., Jike, M., Watanabe, N., & Kaneita, Y. (2017). Short sleep duration and health outcomes: A systematic review, meta-analysis, and meta-regression. Sleep Medicine, 32, 246–256. https://doi.org/10.1016/j.sleep.2016.08.006
Jannah, M., Widohardhono, R., Purnomo, R. A. A., Santosa, R. P., Harita, A. N. W., Dewi, D. K., Nuryananda, T. F., Halida, A. N., & Maulidiyah, E. F. (2025). Physical activity as a key to happiness in university students: moderated by emotion regulation. Retos, 71, 805-817. https://doi.org/10.47197/retos.v71.117446
Keating, X. D., Guan, J., Piñero, J. C., & Bridges, D. M. (2005). A Meta-Analysis of College Students’ Physical Activity Behaviors. Journal of American College Health, 54(2), 116–126. https://doi.org/10.3200/JACH.54.2.116-126
Kyle, U. G., Bosaeus, I., De Lorenzo, A. D., Deurenberg, P., Elia, M., Gómez, J. M., Heitmann, B. L., Kent-Smith, L., Melchior, J. C., Pirlich, M., Scharfetter, H., Schols, A. M. W. J., & Pichard, C. (2004). Bioelectrical impedance analysis - Part I: Review of principles and methods. Clinical Nutrition, 23(5), 1226–1243. https://doi.org/10.1016/j.clnu.2004.06.004
Lee, K. X., Quek, K. F., & Ramadas, A. (2023). Dietary and Lifestyle Risk Factors of Obesity Among Young Adults: A Scoping Review of Observational Studies. Current Nutrition Reports, 12(4), 733–743. https://doi.org/10.1007/s13668-023-00513-9
López‐Gil, J. F., Tapia‐Serrano, M. A., Sevil‐Serrano, J., Sánchez‐Miguel, P. A., & García‐Hermoso, A. (2023). Are 24‐hour movement recommendations associated with obesity‐related indicators in the young population? A meta‐analysis. Obesity, 31(11), 2727–2739. https://doi.org/10.1002/oby.23848
Ñahui Rojas, H. F., & López Munguía, O. (2025). Relationship between obesity and working memory in students at a Peruvian university. Retos, 71, 441-450. https://doi.org/10.47197/retos.v71.114600
Owen, N., Healy, G. N., Matthews, C. E., & Dunstan, D. W. (2010). Too much sitting: The population health science of sedentary behavior. Exercise and Sport Sciences Reviews, 38(3), 105–113. https://doi.org/10.1097/JES.0b013e3181e373a2
Pengpid, S., & Peltzer, K. (2021). Overweight and Obesity among Adults in Iraq: Prevalence and Correlates from a National Survey in 2015. International Journal of Environmental Research and Public Health, 18(8), 4198. https://doi.org/10.3390/ijerph18084198
Romero-Carazas, R., Bazualdo-Fiorini, E. R., Pajares-Huaripata, E., Cabrera-Pimentel, H. R., Caro-Seminario, N. J., Jara-Ortega, C. E., Fernandez-Fernandez, R., & Panta-Medina, E. N. (2025). Impact of regular physical activity on the reduction of anxiety levels in university students. Retos, 68, 1121-1132. https://doi.org/10.47197/retos.v68.115331
Saunders, T. J., McIsaac, T., Douillette, K., Gaulton, N., Hunter, S., Rhodes, R. E., Prince, S. A., Carson, V., Chaput, J. P., Chastin, S., Giangregorio, L., Janssen, I., Katzmarzyk, P. T., Kho, M. E., Poitras, V. J., Powell, K. E., Ross, R., Ross-White, A., Tremblay, M. S., & Healy, G. N. (2020). Sedentary behaviour and health in adults: an overview of systematic reviews. In Applied Physiology, Nutrition and Metabolism (Vol. 45, Issue 10, pp. S197–S217). https://doi.org/10.1139/apnm-2020-0272
Severino Cardoso, D., do Nascimento, E. F., da Silva, T. M., Barbosa Feitosa, S., da Silva Rocha, K. B., Mijarra-Murillo, J.-J., Germano-Soares, A. H., Delfa-de-la-Morena, J. M., Wanderley Junior, R. de S., Gomes de Barros, M. V., Hardman, C. M., & Queiroz, D. da R. (2025). Association of physical activity, screen time, and sleep recommendations with excess weight in adolescents. Retos, 72, 990-998. https://doi.org/10.47197/retos.v72.113173
Stults-Kolehmainen, M. A., & Sinha, R. (2014). The effects of stress on physical activity and exercise. Sports medicine, 44(1), 81-121. https://doi.org/10.1007/s40279-013-0090-5
Tremblay, M. S., Chaput, J. P., Adamo, K. B., Aubert, S., Barnes, J. D., Choquette, L., Duggan, M., Faulkner, G., Goldfield, G. S., Gray, C. E., Gruber, R., Janson, K., Janssen, I., Janssen, X., Kho, M. E., Poitras, V. J., Prince, S. A., Saunders, T. J., & Carson, V. (2017). Canadian 24-hour movement guidelines for children and youth. Applied Physiology, Nutrition, and Metabolism, 42(6), S311–S327. https://doi.org/10.1139/apnm-2016-0151
Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Recommended amount of sleep for a healthy adult: A joint consensus statement. Sleep, 38(6), 843–844. https://doi.org/10.5665/sleep.4716
Wells, J. C. (2007). Sexual dimorphism of body composition. Best practice & research Clinical endocrinology & metabolism, 21(3), 415-430. https://doi.org/10.1016/j.beem.2007.04.007
Wilhite, K., Booker, B., Huang, B.-H., Antczak, D., Corbett, L., Parker, P., Noetel, M., Rissel, C., Lonsdale, C., del Pozo Cruz, B., & Sanders, T. (2023). Combinations of Physical Activity, Sedentary Behavior, and Sleep Duration and Their Associations With Physical, Psychological, and Educational Outcomes in Children and Adolescents: A Systematic Review. American Journal of Epidemiology, 192(4), 665–679. https://doi.org/10.1093/aje/kwac212
World Health Organization. (2000). Obesity: Preventing and managing the global epidemic (WHO Technical Report Series No. 894). WHO. https://iris.who.int/handle/10665/42330
World Health Organization. (2012). Global Physical Activity Questionnaire (GPAQ): Analysis guide. WHO
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Halah Sinan Atiyah, Denise Koh Choon Lian

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.