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A study of 353 students, teachers, and administrative staff at Alfaisal University in Riyadh found no statistically significant link between how much physical activity people reported and how they rated their own health and quality of life. However, a person's existing health problems were linked to their scores. Participants with mental health conditions reported much lower quality-of-life scores. Those with physical health conditions also had lower scores on one of the two measures used. The study was published in Frontiers in Public Health. It examined physical activity, quality of life related to health, and the obstacles people felt stopped them from being active. The research took place in one university community at a time when Saudi Arabia's Vision 2030 plan was making active living and public well-being important national goals.
The research team surveyed people in the university community between October 2024 and April 2025. Questionnaire data were collected in January 2025. Participants answered one standard questionnaire containing three tested measurement tools. The International Physical Activity Questionnaire Short Form measured physical activity during the previous week. It asked about walking, moderate activity, vigorous activity, and time spent sitting. It then used the reported time to calculate weekly activity in metabolic equivalent of task minutes, or MET-minutes. Walking was given a value of 3.3 METs, moderate activity 4.0, and vigorous activity 8.0. The EQ-5D-5L measured quality of life across five areas: moving around, personal care, usual activities, pain and discomfort, and anxiety and depression. Each area had five levels of severity. Participants also completed the EuroQol Visual Analog Scale, which asks people to rate their overall health from 0 to 100. A third tool, the 21-item Barriers to Being Active Quiz, measured obstacles to exercise across seven areas, including lack of time and fear of injury.
Most participants were young and part of the university's academic community. Of the 353 people included in the analysis, 288 were students, 40 were faculty members, and 25 were administrative staff. Most were between 18 and 24 years old, and 57.2 percent were female. A total of 15.3 percent reported existing physical health conditions, while 8.5 percent reported existing mental health conditions. Moderate activity was the most common level, reported by 43.6 percent of participants. Another 28.6 percent reported high activity, and 27.8 percent reported low activity. The middle value for weekly activity was 1,618.5 MET-minutes. Individual values ranged from zero to 15,750, and 47 people reported doing no physical activity at all. Among the 217 participants who reported how long they sat, the average was 423.2 minutes a day, or about seven hours. The middle value was 360 minutes, and some people reported sitting for as long as 1,200 minutes per day.
The researchers used statistical models that accounted for age, gender, nationality, education, university role, marital status, monthly income, and existing physical and mental health conditions. After making these adjustments, they found no statistically significant link between physical activity level and either quality-of-life measure. Compared with people who had low activity levels, those with high activity levels had an EQ-VAS score that was 4.055 points higher on average. However, the bias-corrected and accelerated 95 percent confidence interval ranged from −2.082 to 10.426, and the p-value was 0.197. This means the results did not provide strong enough evidence to establish a link. For the EQ-5D-5L index score, the estimated difference between people with high and low activity was −0.005. The confidence interval ranged from −0.035 to 0.028, and the p-value was 0.824. Moderate activity also showed no significant link with either measure. Time spent sitting, examined separately, was not significantly linked to either outcome. The researchers also found no significant links between activity level and any of the five individual EQ-5D-5L areas. A further analysis using a fractional logistic model reached the same general conclusion. This extra analysis was used because the index score cannot exceed 1.0 and many participants had the maximum score.
The models did find links between existing health conditions and how people rated their health. Participants with an existing mental health condition had EQ-VAS scores that were 11.891 points lower. The confidence interval ranged from −22.157 to −2.653, and the p-value was 0.010. Their EQ-5D-5L index scores were also lower by 0.088, with a p-value of 0.001. Participants with existing physical health conditions had index scores that were lower by 0.042, with a p-value of 0.013. In total, 39.1 percent of participants reported being in full health and received the highest possible index score of 1.000. These health conditions were the clearest factors linked to how participants rated their own health. The authors explain that this fits with ideas about how physical ability, mental health, symptoms, and daily activities work together to shape overall well-being. In other words, lifestyle habits may not explain a person's sense of well-being on their own.
The activity results also showed differences between groups of people. In an adjusted statistical analysis, female participants were more likely than male participants to fall into a lower physical activity category. The adjusted odds ratio was 1.897, with a confidence interval from 1.267 to 2.840 and a p-value of 0.002. Saudi participants, on the other hand, were less likely than non-Saudi participants to fall into a lower activity category. Their adjusted odds ratio was 0.589, with a p-value of 0.009. An additional analysis examined whether people met the target of at least 150 minutes of physical activity each week. Women had lower odds than men of meeting this target, with an adjusted odds ratio of 0.452. Participants aged 35 to 44 also had lower odds of meeting it than those aged 18 to 24, with an adjusted odds ratio of 0.050. After the researchers accounted for other factors, age, education, university role, income, and existing health conditions were not significantly linked to activity category.
The findings about barriers to exercise may be especially useful for university health programs. Lack of willpower was reported as a barrier by 67 percent of participants, lack of energy by 66 percent, and lack of time by 65 percent. Lack of resources was reported by 43 percent, and social influence by 42 percent. Fewer people reported lack of skill, at 24 percent, or fear of injury, at 16 percent. The statistical analysis found that moving up one activity category was linked to a lower lack-of-willpower score, with a coefficient of −0.711, and a lower lack-of-time score, with a coefficient of −0.608. Both results had p-values below 0.001 after accounting for age, gender, and university role. The authors warn that these findings do not show which factor causes the other. People who feel fewer barriers may find it easier to be active, or people who exercise regularly may see and manage these barriers differently. Either way, the results point to factors that university wellness programs may be able to change.
Why did this study fail to find a link between physical activity and quality of life when other studies often have? The authors point to several features of the group they studied. Most participants were young and reported generally good quality of life. Their average EQ-VAS score was 78.9, and their average EQ-5D-5L index score was 0.928. Most also reported moderate or high levels of activity. Nearly four in ten participants received the highest possible index score, creating what researchers call a ceiling effect. When many people score at the top, a measurement tool may struggle to show differences between people who are already in good health. The study also has other limits. It collected information at one point in time, so it cannot show how activity and quality of life may influence each other over time. Activity levels were self-reported, which means answers may have been affected by memory errors or by a desire to give socially acceptable answers. The researchers used convenience sampling, which meant they could not calculate a response rate. The questionnaire was also available only in English. The authors stress that failing to find a statistically significant link does not prove that physical activity has no relationship with quality of life. The confidence intervals still allow for potentially important links, and the wider body of research supporting the benefits of regular physical activity remains valid.
The findings may be useful beyond this one university. The authors suggest that university health programs could combine physical activity activities with mental health support and help for common barriers such as lack of time, energy, and motivation. This may work better than assuming that exercise programs alone will improve how people feel about their health and well-being. Such an approach fits Saudi Arabia's Vision 2030 goals, which include encouraging active lifestyles, preventing noncommunicable diseases, and improving public well-being. The research team calls for future studies that follow people over time to better understand how physical activity and quality of life are related. They also recommend measuring activity more directly with accelerometers or wearable devices, alongside self-reported information, and conducting studies at several universities with more varied groups of people. Until more evidence is available, the findings from Riyadh suggest that in a young university community, how people feel about their health may depend on a mix of mental, physical, and behavioral factors, not just how active they are.
Subject of Research: Physical activity, quality of life related to health, and perceived barriers among a Saudi university community
Article Title: Physical activity, health-related quality of life, and perceived barriers among the Alfaisal University Community in Riyadh, Saudi Arabia: a cross-sectional study
Article References: Alsouss, Y. O., Ameer, O. Z., Alfaraj, G. A., Cahusac, P. M. B., Al Sharif, A. I., & Alhusseini, N. (2026). Physical activity, health-related quality of life, and perceived barriers among the Alfaisal University Community in Riyadh, Saudi Arabia: a cross-sectional study. Frontiers in Public Health, 14, Article 1999364. [https://doi.org/10.3389/fpubh.2026.1999364](https://doi.org/10.3389/fpubh.2026.1999364)
Image Credits: AI Generated
DOI: 10.3389/fpubh.2026.1999364
Keywords: physical activity, quality of life related to health, EQ-5D-5L, IPAQ-SF, perceived barriers, mental health, university population, Saudi Arabia, cross-sectional study, public health, physical activity