Growing up in rural or urban settings: differences in physical activity, sexual attitude, and orthorexia. A cross-sectional study

Abstract Aim This study aimed to investigate how the living context (rural and urban) and physical activities (PA) levels influence SAS and I-DOS in university students, considering gender-related differences. A secondary aim of our study was to explore the correlation between the variables of interest by considering gender differences. Subject and methods In 562 university students (206 rural and 356 urban), PA levels using the Global Physical Activity Questionnaire (G-PAQ), attitudes to sexual expression using the Sexual Attitude Scale (SAS), and eating attitudes using the Orthorexia (I-DOS) questionnaire were assessed using a Google Form. Results Rural males (RM) were more conservative than urban males (UM) (27.0 vs 22.5). RM compared to rural females (RF) had significantly higher BMI (23.7 vs 21.5), PA levels (2350 vs 1320) and SAS scores (27 vs 19; all p < 0.01), suggesting that rural females are more liberal than males. Urban males compared to urban females (UF) showed significantly higher BMI (23.0 vs 22.0) and PA levels (2400 vs 1440; both p < 0.01). Correlation analysis showed that I-DOS was significantly and positively correlated with BMI (Rho = 0.132, p < 0.01), G-PAQ (Rho = 0.131, p < 0.01), and SAS (Rho = 0.240, p < 0.01) in females, irrespective of living context. Conclusion The living context (rural or urban) where males grew up may influence sexual attitudes. Irrespective of the living setting, males reported higher BMI and PA levels. These findings underscore the significant role of life contexts and sex differences in shaping health-related behaviors and attitudes, highlighting the need for further research to explore the underlying mechanisms and potential interventions.