Lifestyle factors associated with physical activity and cardiorespiratory fitness among adults with overweight and obesity a cross sectional analysis

The global rise in obesity has prompted the implementation of healthy lifestyle medicine (HLM) initiatives. Although associations between individual lifestyle factors, physical activity and cardiorespiratory fitness, in overweight and obese populations have been investigated, the combined influence of these factors on overall lifestyle and physical activity remains unclear.

A cross-sectional convenience sample of 100 adults (18–40 years) with a BMI of 25.0–34.9 kg/m² was recruited; individuals with a BMI ≥ 35 kg/m² or with systemic/acute conditions were excluded. Demographics and body composition data were recorded. Cardiorespiratory fitness (CRF) measured as VO₂ peak was estimated via the YMCA cycle ergometer test. The participants completed questionnaires: the Global Physical Activity Questionnaire (GPAQ), Sedentary Behavior Questionnaire, Pittsburgh Sleep Quality Index, RM-4FM (motivation), self-efficacy and social support for exercise scales, and the Physical Activity Neighbourhood Environment Scale. Multiple linear regression analyses were used to assess predictors of physical activity and related outcomes, and binomial regression was used to examine determinants of CRF.

The mean participant age was 23.28 ± 3.38 years; 73% were female. The mean BMI was 29.03 ± 2.80 kg/m². Higher GPAQ scores were significantly associated with greater estimated VO₂ peak, greater bone mass, and increased positive social support. Weight (OR = 1.104, 95% CI = 1.031–1.18, p = 0.005), perceived stress scale (PSS) score (OR = 1.089, 95% CI = 1.021–1.16, p = 0.01), and socioeconomic level (OR = 6.08, 95% CI = 1.164–31.75, p = 0.032) were significant predictors of poor CRF according to binomial regression analysis. These findings highlight the complex interplay between lifestyle factors and fitness in young adults with obesity. Sedentary behaviour, sleep quality, diet, motivation and self-efficacy for stress, perceived environment, and socioeconomic status were not significant predictors of physical activity in the multivariable models.

In this sample of young overweight adults and adults with class I obesity, self-reported physical activity was positively associated with CRF, bone mass, and social support, whereas other examined lifestyle and contextual factors did not independently predict physical activity. Limitations inherent to the cross-sectional, convenience-sampled design may have reduced the power to detect additional associations. Targeted, multifactorial interventions that tailor physical activity promotion to individual circumstances and preferences and that address social support may increase engagement in physical activity in this population.