Changes in Aerobic and Muscle-Strengthening Physical Activity and Self-Reported Morbidity Among University Students During the COVID-19 Pandemic: A Cross-Sectional Study

The COVID-19 pandemic substantially affected lifestyle behaviors among university students, potentially increasing their vulnerability to chronic noncommunicable diseases (NCDs). This cross-sectional study investigated associations between self-reported changes in the frequency of moderate-intensity aerobic physical activity (MPA) and muscle-strengthening physical activity (MSPA) and self-reported morbidity among university students. Data were collected through an online questionnaire from 1150 students at a private university in Rio de Janeiro, Brazil, between August 2021 and April 2022. Morbidity was defined as a self-reported medical diagnosis of hypertension, type 2 diabetes mellitus, and/or cardiovascular disease. Separate and mutually adjusted binary logistic regression models were controlled for sex, age, smoking, sugar consumption, and fat consumption. Morbidity prevalence was 9.4%. In separate adjusted models, MPA (global p = 0.046) and MSPA (global p = 0.016) were associated with morbidity. Compared with no engagement, all MPA engagement categories were linked to lower odds of morbidity (ORs = 0.41–0.42), as were increased (OR = 0.41; 95% CI: 0.22–0.75) and maintained MSPA (OR = 0.44; 95% CI: 0.24–0.81). In the mutually adjusted model, the overall associations were attenuated for MPA (p = 0.442) and MSPA (p = 0.127), although increased MSPA remained individually associated with lower odds of morbidity (OR = 0.42; 95% CI: 0.19–0.93; p = 0.032). These findings should be interpreted cautiously, as the cross-sectional design precludes establishing temporal direction and reverse causality is possible.