Risk factors for cardiovascular disease among Saudi students: Association with BMI, current smoking, level of physical activity, and dietary habits

Cardiovascular disease (CVD) risk factors, including poor diet, lack of physical activity (PA), smoking, and obesity, are associated with unhealthy lifestyle choices and contribute significantly to the global disease burden. This study aims to investigate the prevalence of behavioral risk factors associated with overweight/obesity, PA, smoking, and eating habits among Saudi students and explores how these vary by region, age, gender, relationship status, and income. A total of 968 participants (285 males and 681 females), aged 18-50, were recruited from bachelor's, master's, doctoral, and other university programs across the Eastern, Riyadh, and Western provinces. Each participant completed the Saudi Food Frequency Questionnaire (SFFQ). The risk of CVD was assessed by summing individual risk factors related to BMI, tobacco use, PA level, glycemic load (GL) of ingested foods, and consumption of saturated fats (SF), processed meats, oily fish, nuts, and cereal fiber (CF). Participants were classified into minimal, medium, or high-risk categories based on their total scores. A high prevalence of CVD risk factors was observed, with 93.6% of participants having three or more risk factors. After adjusting for demographic variables, living in Riyadh was associated with a 12% lower probability of CVD risk. Conversely, students aged 46-50 showed a five- to nine-fold increase in CVD risk. Significant factors influencing CVD risk included BMI (Exp(β) = 11.70), smoking status (Exp(β) = 6.54), PA (Exp(β) = 7.61), SF intake (Exp(β) = 4.79), GL (Exp(β) = 7.00), CF intake (Exp(β) = 24.58), and oily fish consumption (Exp(β) = 2.99). Low CF intake and high BMI were the most prominent risk factors. Lifestyle interventions targeting overweight/obesity, physical inactivity, smoking, high GL and SF intake, and promoting CF and oily fish consumption could improve CV health among participants. Addressing these modifiable risk factors is essential for effective prevention.