From freshman to graduate: longitudinal analysis of student health status in sport and health sciences

Abstract Background University years are considered a critical period for the development of long-term health behaviors. However, evidence on longitudinal health trajectories in students is limited, particularly regarding objectively measured physiological outcomes. This study aimed to examine changes in cardiorespiratory fitness, anthropometrics, blood pressure, and cardiovascular risk factors during undergraduate studies, as well as the influence of physical activity, sex, and age. Methods This longitudinal observational study included 128 students (mean age at baseline 21.0 ± 2.1 years; 75% female) enrolled in sport science or health science programs at the Technical University of Munich. Participants underwent comprehensive physiological assessments at baseline and follow-up (mean interval 2.53 ± 0.60 years), including cardiopulmonary exercise testing, body composition analysis, blood pressure, and heart rate measurements, and a structured medical history interview supplemented with questions on smoking status, alcohol consumption, weekly training volume, and dietary patterns (omnivorous, vegetarian, or vegan). Paired-samples t-tests were used to compare baseline and follow-up measurements; additionally, linear mixed-effects models were used to evaluate longitudinal changes and predictors of individual trajectories. Results In the unadjusted paired analysis, VO₂peak increased significantly from baseline to follow-up ( p < .001, Cohen’s d = 0.434), accompanied by a reduction in resting heart rate ( p < .001, Cohen’s d = 0.378), whereas maximal power output remained unchanged. Body weight, BMI, and body fat percentage remained largely stable, whereas muscle mass increased significantly in the unadjusted paired analysis ( p = .006). However, after adjustment for sex, age, study program, and weekly training volume in the mixed-effects model, no statistically significant independent main effect of time on VO₂peak was observed. Higher weekly training volume was independently associated with higher VO₂peak, whereas sex, age, and study program did not moderate longitudinal trajectories. Conclusions In this cohort of students in sport and health science programs, several key health indicators remained stable or showed favorable changes during undergraduate studies. Although VO₂peak increased in the unadjusted within-subject comparison, this increase was not attributable to an independent effect of time after adjustment for relevant covariates. Higher weekly training volume was independently associated with higher cardiorespiratory fitness but did not significantly moderate changes in VO₂peak over time.