Cardiorespiratory Fitness, Physical Activity Level, Body Mass Index and Blood Pressure Among University Students in Negeri Sembilan

Background

The transition to university life represents a critical period for health behaviour change. Students often experience reduced physical activity, altered dietary patterns, increased sedentary behaviour, and psychological stress — a combination that can lead to weight gain and declining cardiovascular fitness. In Malaysia, where the prevalence of overweight and obesity among adults exceeds 50%, understanding the fitness and metabolic profiles of university students is essential for early intervention.

Cardiorespiratory fitness (CRF) — the ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity — is one of the strongest predictors of cardiovascular disease risk and all-cause mortality, independent of body mass index. This study examined the relationships between CRF, habitual physical activity levels, body mass index, and resting blood pressure among university students in Negeri Sembilan, Malaysia.

Study Population and Methods

The study recruited university students in Negeri Sembilan state, employing standardised assessments of cardiorespiratory fitness, anthropometric measurements (height, weight, BMI), and resting blood pressure. Physical activity levels were assessed using validated questionnaire instruments. CRF was measured through established exercise testing protocols that estimate maximal oxygen uptake (VO2max).

Physical Activity and Fitness Levels

The study revealed concerning patterns of low physical activity and poor cardiovascular fitness among the student population. A substantial proportion of students did not meet the WHO recommendation of at least 150 minutes of moderate-intensity physical activity per week. CRF levels, as estimated by VO2max, were generally low by international standards, with female students showing particular deficits.

These findings are consistent with broader trends observed among university students globally. A study of 490 Indonesian university students found that only 37.75% achieved high physical activity levels, while 18.98% were classified in the light activity category. The sedentary nature of academic life — long hours of sitting in lectures, library study, and screen-based learning — contributes to these patterns.

BMI and Cardiovascular Risk Factors

A significant proportion of students were classified as overweight or obese using Asian BMI cut-offs (overweight: 23–24.9 kg/m²; obese: ≥25 kg/m²). BMI showed a negative correlation with CRF — students with higher BMI tended to have lower cardiovascular fitness. This inverse relationship, well-established in the literature, reflects the combined effects of excess adiposity on exercise capacity and the tendency for less fit individuals to be less physically active.

Blood pressure was also correlated with BMI status. Overweight and obese students demonstrated higher mean systolic and diastolic blood pressure compared with their normal-weight peers. While most blood pressure values remained within the normotensive range, the presence of elevated readings in young adults is concerning, as hypertension in young adulthood is a strong predictor of cardiovascular disease in middle age.

Public Health Implications

The findings have important implications for Malaysian universities and public health policy. Campus-based physical activity promotion programmes should be a priority, integrating opportunities for regular exercise into the university environment. This could include enhanced sports facilities, subsidised fitness programmes, active transportation infrastructure, and integration of physical activity breaks into the academic schedule.

The study also supports the broader public health case for CRF assessment as a routine component of young adult health screening. Unlike BMI alone — which does not distinguish between fat mass and lean mass — CRF provides a direct measure of cardiovascular function and is a more precise predictor of health outcomes. Establishing CRF baselines during university years could enable longitudinal tracking and early identification of students at elevated cardiovascular risk.

Limitations

The cross-sectional design precludes causal inferences about the directionality of observed associations. The study population was drawn from a single state and may not fully represent the diversity of Malaysian university students. Self-reported physical activity data are subject to recall and social desirability biases. Direct measurement of body composition (e.g., using dual-energy X-ray absorptiometry) would have provided more precise information than BMI alone.

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