Next Article in Journal
The Feasibility of an Online Lifestyle Intervention During the COVID-19 Pandemic on the BMI Z-Score of Mexican Schoolchildren: A Pilot Randomized Controlled Trial
Previous Article in Journal
Obesity Impacts Mortality After Cardiac Surgery
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Obesities
Volume 5
Issue 1
10.3390/obesities5010002
obesities-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Gender Differences in Physical Activity Levels Among Overweight and Obese Medical Students During and After the COVID-19 Pandemic: A Single-Center Cross-Sectional Study

by
Bartosz Bogusz Adamczak
1,
Aureliusz Andrzej Kosendiak
2,*,
Zofia Kuźnik
1,
Szymon Makles
1 and
Weronika Hariasz
3
1
Medical Faculty, Wroclaw Medical University, 50-345 Wrocław, Poland
2
College of Health Studies, University of Lower Silesia, 53-611 Wrocław, Poland
3
Medical Faculty, University of Opole, 45-040 Opole, Poland
*
Author to whom correspondence should be addressed.
Obesities 2025, 5(1), 2; https://doi.org/10.3390/obesities5010002
Submission received: 29 November 2024 / Revised: 26 December 2024 / Accepted: 9 January 2025 / Published: 9 January 2025
Browse Figure
Versions Notes

Abstract

:
The COVID-19 pandemic profoundly affected the physical activity (PA) patterns of various social groups, including medical students. This study aims to compare the levels of PA, expressed in metabolic equivalent of task minutes per week (MET-m/w), among overweight and obese medical students, during and after the pandemic. The pandemic period was defined as spanning from 2020 to 16 May 2022, while the post-pandemic period covered the second half of 2022 through the end of 2023. PA levels were assessed using the International Physical Activity Questionnaire (IPAQ), and Body Mass Index (BMI) was calculated based on self-reported weight and height. Only individuals with a BMI ≥ 25 kg/m2 were included. In total, 233 medical students from Wroclaw Medical University were assessed during the pandemic, and 217 post-pandemic. PA was categorized into walking, moderate, and vigorous with total MET-m/w calculated. During the pandemic, no significant gender differences were observed in walking, moderate, vigorous, or total PA. Post-pandemic, males demonstrated significantly higher levels of vigorous PA (p < 0.001) and total MET-m/w (p < 0.0001) compared to females. These findings underscore the necessity for targeted interventions promoting PA among overweight and obese medical students, especially among females.

1. Introduction

The COVID-19 pandemic, officially declared by the World Health Organization (WHO) in March 2020, had a profound global impact [1]. In Poland, the pandemic period formally ended with the issuance of the Minister of Health’s regulation on 16 May 2022 [2]. During this time, the Polish government implemented extensive nationwide lockdown measures aimed at controlling the spread of the virus [3]. The declaration of an epidemic emergency led to strict social isolation policies, including the prohibition of gatherings exceeding 50 people, the closure of cultural venues, restaurants, shopping centers, and the restriction of access to churches and gyms [4]. Educational institutions and workplaces were significantly affected with schools and universities transitioning to online learning and remote work becoming widespread across various sectors [5,6].
The restrictions imposed on access to sports facilities and the enforcement of stay-at-home measures during the COVID-19 pandemic significantly reduced opportunities for engaging in physical activity (PA) [7], including even solitary activities such as walking [8]. This phenomenon was observed globally with evidence consistently indicating a decline in PA levels during the pandemic [9]. Additionally, the pandemic period was marked by heightened levels of psychological distress, including increased anxiety and depression [10], which are known to negatively impact motivation and engagement in PA [11]. Research has highlighted the bidirectional relationship between PA and mental health, where lower PA levels can exacerbate stress and depressive symptoms, creating a reinforcing cycle of inactivity and declining mental well-being [12]. The adverse effects of the COVID-19 pandemic, including reduced PA and emotional distress, contributed to an increase in BMI within the general population. This trend is evidenced by a U.S. study of over 3.5 million adults, which reported significantly higher average BMI (+0.6%) and obesity prevalence rates (+3%) during the pandemic compared to the period from 2019 to early 2020 [13].
Overweight and obesity are associated with numerous adverse health outcomes, significantly increasing the risk of non-communicable diseases such as cardiovascular diseases [14], type 2 diabetes, certain cancers, and musculoskeletal disorders [15]. These conditions also contribute to reduced life expectancy and lower quality of life with obesity linked to systemic inflammation, insulin resistance, and metabolic dysregulation [16]. Additionally, the psychological burden of overweight and obesity, including heightened rates of anxiety, depression, and social stigma, further exacerbates their negative impact on overall well-being [17]. Therefore, effectively addressing and managing individuals with overweight and obesity represents a critical societal and educational priority.
Overweight and obesity are closely associated with insufficient PA [18], while anxiety or depression may further reduce PA motivation [19]. As highlighted, the pandemic’s restrictive measures and psychological stressors may have disproportionately impacted individuals with overweight or obesity. Furthermore, research indicates that households increased their daily caloric intake by approximately 280 calories per adult compared to pre-pandemic levels. These dietary changes were projected to raise the proportion of overweight adults by at least five percentage points within two years following the onset of the pandemic [20]. Reduced access to opportunities for regular exercise, combined with increased psychological strain, and increased caloric intake likely had a compounding effect on the overall health of the overweight and obese population [21]. Motivations and barriers to PA differ between genders; therefore, it is essential to examine PA patterns separately by gender in order to more accurately address their distinct needs and tailor interventions accordingly [22].
In Poland, a concerning trend of increasing BMI and body fat percentage has been observed among students over recent decades [23,24]. The COVID-19 pandemic further exacerbated this issue with a sharp rise in the prevalence of overweight and obesity recorded during this period [13]. This study specifically examines medical students, a young population of particular interest due to the demanding nature of their future professional roles, which will require substantial resilience to stress [25]. Additionally, they will be expected to serve as role models for healthy lifestyles both through their own behaviors and by encouraging their patients to adopt similar practices [26]. However, there is currently a lack of research specifically addressing overweight and obesity within this population.
This study aims to assess gender differences in PA levels among overweight and obese medical students in Wrocław, Poland, during and after the pandemic. Given their pivotal future social function, it is crucial to monitor the health-related behaviors and lifestyle choices of students pursuing medical degrees. Understanding these differences can provide valuable insights into the long-term consequences of the pandemic for this group and inform targeted interventions to address their unique health needs.

2. Materials and Methods

2.1. Study Design and Participants

This research was designed as a cross-sectional study involving medical students at Wroclaw Medical University. The primary aim was to examine changes in PA levels and BMI during and after the pandemic period, specifically focusing on medical students with overweight or obesity.
Data were collected over a four-year period from 2020 to 2023. The pandemic period was defined as spanning from 2020 to 16 May 2022, while the post-pandemic period covered the second half of 2022 through the end of 2023. During this time, all students attending mandatory physical education classes were invited to take part in an anonymous online survey, which was distributed via dedicated links. To achieve the broadest possible representation, invitations were sent to all students who might meet the inclusion criteria. The recruitment was carried out twice a year with invitations distributed at the beginning of each academic semester and remaining active until the following semester.
All students who met the criteria, specifically those with a BMI ≥ 25 kg/m2, were included in the research sample. This criterion was established to focus on individuals who may be at an increased risk for health complications associated with insufficient PA and excessive body mass. The weight and height of the students were self-reported. Inclusion criteria required participants to be students at Wroclaw Medical University, aged between 18 and 30 years, and identifying as either male or female. These criteria were carefully selected to reduce bias and enhance the reliability of the study. On the other hand, respondents were excluded if they had a BMI below 25 kg/m2, exhibited a low credibility level, as determined by verification questions, or if they did not complete the questionnaire fully. The inclusion and exclusion criteria were applied during surveys conducted both in the pandemic and post-pandemic period. A detailed overview of the data collection process, along with the inclusion and exclusion criteria, is provided in Figure 1.
Participation was entirely voluntary, with all eligible students encouraged to participate to ensure a diverse and representative sample, encompassing a range of experiences across both the pandemic and post-pandemic periods.
The study adhered to rigorous ethical standards. All participants were provided with detailed information regarding the study’s objectives, and their involvement was contingent upon obtaining informed consent.

2.2. International Physical Activity Questionnaire (IPAQ)

PA levels were assessed using the International Physical Activity Questionnaire (IPAQ), which is a validated self-reported tool designed to quantify the frequency and duration of various types of PA. The IPAQ includes questions regarding walking, moderate-intensity activities, vigorous-intensity activities, and sitting time with all activities assessed over the previous seven days. To minimize the risk of overreporting, participants were given clear and precise instructions on how to complete the questionnaire accurately [27].
PA data were processed by calculating the total metabolic equivalent of task (MET) minutes per week (MET-m/w) for each activity type. The corresponding MET values used were 3.3 for walking, 4.0 for moderate-intensity activity, and 8.0 for vigorous-intensity activity [28].
The IPAQ’s reliability and validity have been extensively verified, including within studies conducted on Polish populations [29,30,31]

2.3. Statistical Analysis

Data were processed using Microsoft Excel (version 16.77, Redmond, WA, USA), and statistical analyses were performed with Statistica 13 software (Statsoft, Kraków, Poland). The Shapiro–Wilk test was applied to assess the normality of the data, which revealed that the data did not follow a normal distribution. Descriptive statistics were calculated, including frequencies for categorical variables and medians with interquartile ranges (IQR) for continuous variables. To compare PA levels and BMI between the pandemic and post-pandemic periods, non-parametric tests, specifically the Kruskal–Wallis test, were employed. A significance level of p < 0.05 was applied for all analyses.

3. Results

3.1. Characteristics of Study Participants

Table 1 presents the general characteristics of the study participants during the pandemic and post-pandemic periods. In both periods, most participants were women; however, their proportion decreased from 72.5% during the pandemic to 60.4% in the post-pandemic period. Most participants resided in urban areas, especially the biggest cities, in both study periods. The mean BMI values slightly decreased in the latter study period.

3.2. Physical Activity Levels Between Genders and Study Periods

Table 2 displays the PA levels among participants, which were categorized by gender and study period. During the pandemic, approximately 20% of study participants met the HEPA criteria. This proportion increased post-pandemic with a slight rise among women and more than a twofold increase among men. The proportion of inactive individuals was consistently lower among men, when compared to women, in both periods. Most participants were classified as minimally active in both study periods.

3.3. Physical Activity MET-m/w Between Genders and Study Periods

Table 3 compares PA levels between genders and across study periods. Walking was the predominant form of PA for both men and women in both periods. No significant differences were observed between genders in walking or moderate PA during either study period. Men demonstrated significantly higher levels of vigorous PA compared to women in both periods; however, this difference reached statistical significance only in the post-pandemic period. The increase in vigorous activity in the latter period contributed to a significant rise in total PA for men. This relationship was not observed in women, as neither vigorous nor total PA significantly changed between the study periods, despite a significant increase in walking PA in the later period.

4. Discussion

This study aimed to assess gender differences in PA levels among overweight and obese medical students in Wrocław, Poland, during and after the pandemic. The respondents in our study were predominantly female, reflecting the higher enrollment of women in medical schools [32].
The majority of participants from both genders were either inactive or minimally active during both assessed periods. During the pandemic, most participants in both groups engaged in minimal levels of PA with only approximately one fifth achieving Health-Enhancing PA (HEPA) levels (21.9% of females and 18.8% of males). In the post-pandemic period, the proportion of inactive females decreased from 14.2% to 8%, but their HEPA achievement remained relatively stable, increasing slightly from 21.9% to 24.4%. In contrast, male participants demonstrated a substantial increase in PA with 47.7% reaching HEPA levels post-pandemic. Studies indicate that lockdowns during the COVID-19 pandemic were associated with significant weight gain [33], which was primarily due to reduced PA levels [34]. Consequently, it is plausible that the lifting of lockdown measures may have motivated individuals to restore their pre-pandemic levels of PA.
This increase in PA among males was further supported by a statistically significant rise in vigorous PA from an average of 713.3 MET-m/w during the pandemic to 1242.9 MET-m/w post-pandemic. This change also led to a significant increase in the total MET-m/w for the male group. Conversely, similar changes were not observed among females. For females, the only significant post-pandemic improvement was an increase in walking MET-m/w, which was insufficient to substantially raise their overall total MET-m/w. During the pandemic, there were no significant gender differences in any MET values. However, in the post-pandemic period, males demonstrated significantly higher vigorous MET-m/w, contributing to their higher overall total MET-m/w compared to females.
PA levels among medical students vary widely across studies, highlighting significant discrepancies. A pre-pandemic 2020 Bosnian study reported that 64.3% of medical students were physically inactive [35], whereas a 2008 study of U.S. medical students found a very high HEPA adherence rate of 61% [36]. During the pandemic lockdown, approximately 20% of our cohort of overweight and obese medical students were inactive, while a similar percentage achieved HEPA levels. These findings indicate relatively better outcomes compared to a Polish study conducted during the pandemic, which reported that 80.7% of medical students were physically inactive, and only 11% met HEPA recommendations [37]. This contrast suggests that despite the challenges posed by pandemic-related restrictions, our cohort demonstrated a comparatively favorable level of PA. These diverse findings, however, further underscore the need for the continuous monitoring of PA levels in the population of medical students, which is particularly susceptible to a sedentary lifestyle [38].
In the post-pandemic period, approximately 15% of our respondents were physically inactive. This result is notably more favorable than global trends from the last 20 years, where an estimated 31% of adults are physically inactive [39]. A 2023 Serbian study involving over 12,000 participants revealed only 3.3% adherence to HEPA guidelines with a negative association between HEPA adherence and BMI [40]. In contrast, our findings are more encouraging, with HEPA levels at 47.7% among males and 24.4% among females, despite our cohort being composed of overweight and obese individuals, which is a group typically associated with reduced PA levels [41].
The gender disparities in post-pandemic Total MET-m/w levels observed in our study align with broader trends. A 2024 Australian study found that after the pandemic, significantly more males returned to playing sport than females [42]. Women are consistently less active than men with global data indicating that 85% of adolescent girls and 78% of adolescent boys fail to meet WHO guidelines for HEPA [43]. Additionally, the aforementioned Serbian study found a positive association between HEPA adherence and male sex [40], further supporting the higher levels of Total MET-m/w and HEPA compliance observed among male participants in our study.
The post-pandemic increase in vigorous MET-m/w observed among males in our study may be attributed to the reopening of sports facilities, such as gyms and stadiums, which had been inaccessible during lockdowns and are conducive to engaging in vigorous forms of PA [44]. In contrast, the absence of a significant increase in Total MET-m/w among females post-pandemic is a concerning trend, which is consistent with existing research. A global study involving 707,616 adolescents reported higher levels of moderate-to-vigorous PA among boys compared to girls with the largest disparities observed in older adolescents [45]. Similarly, a Spanish study of 3060 university students demonstrated that men engaged in significantly greater levels of moderate-to-vigorous PA than their female counterparts [46]. Further support for these patterns is provided by a 2022 Irish study, which also identified higher MET-m/w levels among males compared to females [47].
The underlying reasons for this trend remain unclear; however, it is plausible that they arise from a combination of cultural and psychological gender differences. Research indicates that women report a greater number of perceived barriers to PA compared to men [48]. Among the most commonly cited obstacles for women are a lack of energy for exercise and insufficient willpower. Additionally, a survey of 2298 Australian adults revealed that a higher proportion of female respondents, compared to males, identified being “too fat” as a barrier to engaging in PA [49]. Women’s heightened self-consciousness about their body weight, driven by societal emphasis on externalized body image, may further discourage them from participating in PA, particularly in public settings such as sports facilities or gyms [50].
Interestingly, a 2021 study involving over 1500 students found that vigorous PA was significantly associated with subjective happiness in male students, while walking was more strongly linked to happiness in females [51]. This fact may explain why in our study, women demonstrated a significant post-pandemic increase in Walking MET-m/w, whereas men exhibited a significant increase in Vigorous MET-m/w. However, research also suggests that women experience greater reductions in mortality risk than men from moderate aerobic PA, vigorous PA, and strength training [52]. Thus, given these gender differences, it is crucial to understand and address the specific PA needs of overweight and obese individuals to promote their health and well-being.
Building upon the findings of this study, several targeted interventions can be developed to enhance PA participation among overweight and obese medical students with particular attention to gender-specific needs. Educational campaigns should emphasize the health benefits of both moderate and vigorous PA. Future research should aim to identify specific barriers and motivations for males and females within the overweight and obese population. For instance, initiatives aimed at women could focus on gradual increases in PA levels facilitated through social support networks. These interventions should seek to mitigate the self-consciousness, external pressure and stigma often associated with overweight women engaging in PA. Additionally, expanding access to on-campus sports facilities and offering flexible fitness programs could alleviate common barriers, such as limited time and energy, thereby fostering greater PA participation among students. It is also important to acknowledge that there are other factors at play among this specific group that may negatively influence PA levels, such as academic stress, which is positively associated with increased levels of anxiety and depression, both of which show a negative association with physical activity [53].
This study provides valuable insights, but several limitations must be considered. The primary limitations of this study include potential sampling bias, as the data were collected from a single medical school, Wroclaw Medical University, Poland, which may limit the generalizability of the findings. The impact of self-selection cannot be overlooked, as participation was voluntary, and students who opted to take part may differ in significant ways from those who did not, potentially influencing the results. Additionally, the predominance of female participants may further restrict the applicability of results to males. The use of an online survey introduces the potential for misinterpretation of questions despite efforts to clarify instructions. Moreover, reliance on self-reported data in questionnaire-based studies may introduce bias. Future research should include objective measures of PA for a more precise evaluation and explore the underlying reasons for the observed gender differences. This study was conducted among individuals who participated in physical education classes, making it less adequate to directly compare their baseline activity levels to those of other groups. Thus, these individuals may exhibit higher-than-average levels of PA. Additionally, expanding the participant pool to include a more diverse sample will improve the generalizability and depth of future findings.
Considering its strengths, this study addresses an important and timely issue by exploring the impact of the COVID-19 pandemic on PA patterns of overweight and obese medical students, which is a group particularly at risk for the health consequences of physical inactivity. The use of IPAQ, a well-validated tool for assessing PA, ensures the reliability of the data collected. By comparing PA levels during and after the pandemic, the study provides valuable insights into how the pandemic may have long-term effects on lifestyle behaviors in this population. Furthermore, the inclusion of gender-based comparisons reveals significant differences in PA patterns, emphasizing the need for targeted interventions, especially for female students. Focusing on a specific and understudied group—overweight and obese medical students—enhances the study’s relevance, as this population faces unique health challenges that could be mitigated through increased PA.

5. Conclusions

This study highlights significant gender differences in PA levels among medical students classified as overweight or obese in Wrocław, Poland, during and after the pandemic. While the overall PA levels were low, particularly during the pandemic, a notable post-pandemic increase in HEPA was observed among male students with a substantial rise in vigorous PA. Despite the cohort’s overweight and obese status, their PA levels were relatively favorable post-pandemic. In contrast, female students exhibited only modest improvements, primarily in walking, which did not significantly impact their overall PA levels.
These findings align with broader trends in gender disparities in PA, where males tend to engage in higher levels of vigorous activity than females. This phenomenon may be explained by the research suggesting that women, especially overweight or obese ones, face greater barriers to PA, including body image concerns, self-consciousness, and societal pressures, which may hinder their participation in more vigorous forms of PA. It further underscores the need for targeted interventions to address the specific barriers faced by female students, such as body image concerns and lack of motivation. Future research must look more closely at the psychological and environmental factors influencing PA, especially among women, to ensure that strategies promoting PA are both effective and equitable.

Author Contributions

Conceptualization, A.A.K. and B.B.A.; methodology, A.A.K. and B.B.A.; validation, A.A.K. and B.B.A.; formal analysis, B.B.A.; investigation, A.A.K. and B.B.A.; resources, A.A.K. and B.B.A.; writing—original draft preparation, S.M., Z.K. and W.H.; writing—review and editing, B.B.A. and W.H.; visualization, B.B.A. and W.H.; supervision, A.A.K., B.B.A. and W.H.; project administration, B.B.A. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was conducted in accordance with the Declaration of Helsinki and was approved by Ethics Committee of the Wroclaw Medical University (No. KB-251/2020, approval date: 17 March 2020).

Informed Consent Statement

Informed consent was obtained from all the subjects involved in this study.

Data Availability Statement

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. The data are not publicly available due to the inclusion of information that could compromise the privacy of the research participants in accordance with the decision of the Ethics Committee of the Wroclaw Medical University.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Jun, S.-P.; Yoo, H.S.; Lee, J.-S. The Impact of the Pandemic Declaration on Public Awareness and Behavior: Focusing on COVID-19 Google Searches. Technol. Forecast. Soc. Chang. 2021, 166, 120592. [Google Scholar] [CrossRef] [PubMed]
  2. Augustynowicz, E. Zniesienie Stanu Epidemii COVID-19. Pozostaje Stan Zagrożenia Epidemicznego. Available online: https://szczepienia.pzh.gov.pl/zniesienie-stanu-epidemii-covid-19-obowiazuje-stan-zagrozenia-epidemicznego/ (accessed on 24 November 2024).
  3. Jonski, K.; Rogowski, W. Evidence-Based Policymaking during the COVID-19 Crisis: Regulatory Impact Assessments and the Polish COVID-19 Restrictions. Eur. J. Risk Regul. 2023, 14, 65–77. [Google Scholar] [CrossRef]
  4. Rozporządzenie Ministra Zdrowia z Dnia 20 Marca 2020 r. w Sprawie Ogłoszenia Na Obszarze Rzeczypospolitej Polskiej Stanu Epidemii. Available online: https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20200000491 (accessed on 24 November 2024).
  5. Białek-Dratwa, A.; Szczepańska, E.; Grajek, M.; Całyniuk, B.; Staśkiewicz, W. Health Behaviors and Associated Feelings of Remote Workers During the COVID-19 Pandemic—Silesia (Poland). Front. Public Health 2022, 10, 774509. [Google Scholar] [CrossRef] [PubMed]
  6. Tomczyk, Ł.; Walker, C. The Emergency (Crisis) e-Learning as a Challenge for Teachers in Poland. Educ. Inf. Technol. 2021, 26, 6847–6877. [Google Scholar] [CrossRef]
  7. Piotrowski, D.; Piotrowska, A.I. Operation of Gyms and Fitness Clubs During the COVID-19 Pandemic—Financial, Legal, and Organisational Conditions. |EBSCOhost. Available online: https://openurl.ebsco.com/contentitem/doi:10.7752%2Fjpes.2021.s2127?sid=ebsco:plink:crawler&id=ebsco:doi:10.7752%2Fjpes.2021.s2127 (accessed on 24 November 2024).
  8. Strzelecki, A.; Azevedo, A.; Rizun, M.; Rutecka, P.; Zagała, K.; Cicha, K.; Albuquerque, A. Human Mobility Restrictions and COVID-19 Infection Rates: Analysis of Mobility Data and Coronavirus Spread in Poland and Portugal. Int. J. Environ. Res. Public Health 2022, 19, 14455. [Google Scholar] [CrossRef]
  9. Wilke, J.; Mohr, L.; Tenforde, A.S.; Edouard, P.; Fossati, C.; González-Gross, M.; Sánchez Ramírez, C.; Laiño, F.; Tan, B.; Pillay, J.D.; et al. A Pandemic within the Pandemic? Physical Activity Levels Substantially Decreased in Countries Affected by COVID-19. Int. J. Environ. Res. Public Health 2021, 18, 2235. [Google Scholar] [CrossRef]
  10. Chudzicka-Czupała, A.; Chiang, S.-K.; Grabowski, D.; Żywiołek-Szeja, M.; Quek, M.; Pudełek, B.; Teopiz, K.; Ho, R.; McIntyre, R.S. Predictors of Psychological Distress across Three Time Periods during the COVID-19 Pandemic in Poland. Int. J. Environ. Res. Public Health 2022, 19, 15405. [Google Scholar] [CrossRef]
  11. Yoon, E.S.; So, W.-Y.; Jang, S. Association between Perceived Psychological Stress and Exercise Behaviors: A Cross-Sectional Study Using the Survey of National Physical Fitness. Life 2023, 13, 2059. [Google Scholar] [CrossRef]
  12. White, R.L.; Babic, M.J.; Parker, P.D.; Lubans, D.R.; Astell-Burt, T.; Lonsdale, C. Domain-Specific Physical Activity and Mental Health: A Meta-Analysis. Am. J. Prev. Med. 2017, 52, 653–666. [Google Scholar] [CrossRef]
  13. Restrepo, B.J. Obesity Prevalence Among U.S. Adults During the COVID-19 Pandemic. Am. J. Prev. Med. 2022, 63, 102–106. [Google Scholar] [CrossRef]
  14. Ortega, F.B.; Lavie, C.J.; Blair, S.N. Obesity and Cardiovascular Disease. Circ. Res. 2016, 118, 1752–1770. [Google Scholar] [CrossRef] [PubMed]
  15. Mohajan, D.; Mohajan, H.K. Obesity and Its Related Diseases: A New Escalating Alarming in Global Health. J. Innov. Med. Res. 2023, 2, 12–23. [Google Scholar] [CrossRef]
  16. Lung, T.; Jan, S.; Tan, E.J.; Killedar, A.; Hayes, A. Impact of Overweight, Obesity and Severe Obesity on Life Expectancy of Australian Adults. Int. J. Obes. 2019, 43, 782–789. [Google Scholar] [CrossRef] [PubMed]
  17. Melamed, O.C.; Selby, P.; Taylor, V.H. Mental Health and Obesity During the COVID-19 Pandemic. Curr. Obes. Rep. 2022, 11, 23–31. [Google Scholar] [CrossRef]
  18. Kim, B.-Y.; Choi, D.-H.; Jung, C.-H.; Kang, S.-K.; Mok, J.-O.; Kim, C.-H. Obesity and Physical Activity. J. Obes. Metab. Syndr. 2017, 26, 15–22. [Google Scholar] [CrossRef]
  19. Marashi, M.Y.; Nicholson, E.; Ogrodnik, M.; Fenesi, B.; Heisz, J.J. A Mental Health Paradox: Mental Health Was Both a Motivator and Barrier to Physical Activity during the COVID-19 Pandemic. PLoS ONE 2021, 16, e0239244. [Google Scholar] [CrossRef]
  20. O’Connell, M.; Smith, K.; Stroud, R. The Dietary Impact of the COVID-19 Pandemic. J. Health Econ. 2022, 84, 102641. [Google Scholar] [CrossRef]
  21. Nour, T.Y.; ALTINTAŞ, K.H. Effect of the COVID-19 Pandemic on Obesity and Its Risk Factors: A Systematic Review. BMC Public Health 2023, 23, 1018. [Google Scholar] [CrossRef]
  22. Portela-Pino, I.; López-Castedo, A.; Martínez-Patiño, M.J.; Valverde-Esteve, T.; Domínguez-Alonso, J. Gender Differences in Motivation and Barriers for The Practice of Physical Exercise in Adolescence. Int. J. Environ. Res. Public Health 2020, 17, 168. [Google Scholar] [CrossRef]
  23. Podstawski, R.; Borysławski, K. 30 Years of Change: Declining Motor Fitness and Anthropometric Shifts in Polish University Students (1994–2024). Life 2024, 14, 1325. [Google Scholar] [CrossRef]
  24. Kalka, E.; Pastuszak, A.; Buśko, K. Secular Trends in Body Height, Body Weight, BMI and Fat Percentage in Polish University Students in a Period of 50 Years. PLoS ONE 2019, 14, e0220514. [Google Scholar] [CrossRef] [PubMed]
  25. Magnavita, N.; Soave, P.M.; Antonelli, M. Prolonged Stress Causes Depression in Frontline Workers Facing the COVID-19 Pandemic—A Repeated Cross-Sectional Study in a COVID-19 Hub-Hospital in Central Italy. Int. J. Environ. Res. Public Health 2021, 18, 7316. [Google Scholar] [CrossRef] [PubMed]
  26. Thomasson, C. Physicians’ Social Responsibility. AMA J. Ethics 2014, 16, 753–757. [Google Scholar] [CrossRef]
  27. Biernat, E.; Stupnicki, R.; Gajewski, A. International Physical Activity Questionnaire (IPAQ)—Polish Version. Phys. Educ. Sport 2007, 51, 47–54. [Google Scholar]
  28. Hagströmer, M.; Oja, P.; Sjöström, M. The International Physical Activity Questionnaire (IPAQ): A Study of Concurrent and Construct Validity. Public Health Nutr. 2006, 9, 755–762. [Google Scholar] [CrossRef]
  29. Adamczak, B.B.; Kuźnik, Z.; Makles, S.; Wasilewski, A.; Kosendiak, A.A. Physical Activity, Alcohol, and Cigarette Use in Urological Cancer Patients over Time since Diagnosis. Healthcare 2024, 12, 59. [Google Scholar] [CrossRef]
  30. Bergier, J.; Kapka-Skrzypczak, L.; Biliński, P.; Paprzycki, P.; Wojtyła, A. Physical Activity of Polish Adolescents and Young Adults According to IPAQ: A Population Based Study. Ann. Agric. Environ. Med. 2012, 19, 109–115. [Google Scholar]
  31. Craig, C.; Marshall, A.; Sjostrom, M.; Bauman, A.; Booth, M.; Ainsworth, B.; Pratt, M.; Ekelund, U.; Yngve, A.; Sallis, J.; et al. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med. Sci. Sports Exerc. 2003, 35, 1381–1395. [Google Scholar] [CrossRef]
  32. Moberly, T. Number of Women Entering Medical School Rises after Decade of Decline. BMJ 2018, 360, k254. [Google Scholar] [CrossRef]
  33. Drieskens, S.; Berger, N.; Vandevijvere, S.; Gisle, L.; Braekman, E.; Charafeddine, R.; De Ridder, K.; Demarest, S. Short-Term Impact of the COVID-19 Confinement Measures on Health Behaviours and Weight Gain among Adults in Belgium. Arch. Public Health 2021, 79, 22. [Google Scholar] [CrossRef]
  34. Brown, A.; Flint, S.W.; Kalea, A.Z.; O’Kane, M.; Williams, S.; Batterham, R.L. Negative Impact of the First COVID-19 Lockdown upon Health-Related Behaviours and Psychological Wellbeing in People Living with Severe and Complex Obesity in the UK. eClinicalMedicine 2021, 34, 100796. [Google Scholar] [CrossRef] [PubMed]
  35. Savić, S.; Gavran, L.; Tešanović, G. Assessment of Physical Activity and Body Weight among Medical Students in Banja Luka, Bosnia and Herzegovina. Med. Glas. 2019, 17, 188–193. [Google Scholar] [CrossRef] [PubMed]
  36. Frank, E.; Tong, E.; Lobelo, F.; Carrera, J.; Duperly, J. Physical Activity Levels and Counseling Practices of U.S. Medical Students. Med. Sci. Sports Exerc. 2008, 40, 413–421. [Google Scholar] [CrossRef] [PubMed]
  37. Kosendiak, A.A.; Adamczak, B.; Kontek, S.; Kuźnik, Z.; Roman, M.; Gostkowski, M.; Niedziółka, A. Level of Physical Activity, Sleep Quality and Use of Personal Protective Equipment of Students at Wroclaw Medical University during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2023, 20, 2406. [Google Scholar] [CrossRef]
  38. Alharbi, N.; Alshowibi, R.; Aljabri, N.; Alamri, F.; Alali, F.; Alajmi, N.; Almarshad, A.; Almasoudi, S. Comparative Study of Dietary Habits and Sedentary Lifestyle among the Female Medical and Non-Medical Students in a Saudi Arabia University. Adv. Hum. Biol. 2021, 11, S51. [Google Scholar] [CrossRef]
  39. Physical Activity. Available online: https://www.who.int/news-room/fact-sheets/detail/physical-activity (accessed on 28 November 2024).
  40. Djurdjevic, D.; Terzic-Supic, Z.; Todorovic, J.; Mikanovic, V.B.; Spurnic, A.R.; Laaser, U. Association between Health-Enhancing Physical Activity and the Social Factors, Lifestyle and Dietary Characteristics. PLoS ONE 2024, 19, e0311974. [Google Scholar] [CrossRef]
  41. D’Anna, C.; Forte, P.; Pugliese, E. Trends in Physical Activity and Motor Development in Young People—Decline or Improvement? A Review. Children 2024, 11, 298. [Google Scholar] [CrossRef]
  42. Eime, R.; Harvey, J.; Charity, M. Australian Sport and Physical Activity Behaviours Pre, during and Post-COVID-19. BMC Public Health 2024, 24, 834. [Google Scholar] [CrossRef]
  43. Guthold, R.; Stevens, G.A.; Riley, L.M.; Bull, F.C. Global Trends in Insufficient Physical Activity among Adolescents: A Pooled Analysis of 298 Population-Based Surveys with 1·6 Million Participants. Lancet Child Adolesc. Health 2020, 4, 23–35. [Google Scholar] [CrossRef]
  44. Sas-Nowosielski, K.; Szopa-Wiśnios, S. Usage Patterns, Exercise Motives, and Perceived Benefits and Limitations of Outdoor Gyms: A Case from a Provincial City in South Poland. New Educ. Rev. 2023, 73, 81–94. [Google Scholar] [CrossRef]
  45. Araujo, R.H.O.; Werneck, A.O.; Martins, C.L.; Barboza, L.L.; Tassitano, R.M.; Aguilar-Farias, N.; Jesus, G.M.; Ramírez-Vélez, R.; Tesler, R.; Oyeyemi, A.L.; et al. Global Prevalence and Gender Inequalities in at Least 60 Min of Self-Reported Moderate-to-Vigorous Physical Activity 1 or More Days per Week: An Analysis with 707,616 Adolescents. J. Sport Health Sci. 2024, 13, 709–716. [Google Scholar] [CrossRef] [PubMed]
  46. Espada, M.; Romero-Parra, N.; Bores-García, D.; Delfa-De La Morena, J.M. Gender Differences in University Students’ Levels of Physical Activity and Motivations to Engage in Physical Activity. Educ. Sci. 2023, 13, 340. [Google Scholar] [CrossRef]
  47. McCarthy, C.; Warne, J.P. Gender Differences in Physical Activity Status and Knowledge of Irish University Staff and Students. Sport Sci. Health 2022, 18, 1283–1291. [Google Scholar] [CrossRef]
  48. Rosselli, M.; Ermini, E.; Tosi, B.; Boddi, M.; Stefani, L.; Toncelli, L.; Modesti, P.A. Gender Differences in Barriers to Physical Activity among Adolescents. Nutr. Metab. Cardiovasc. Dis. 2020, 30, 1582–1589. [Google Scholar] [CrossRef]
  49. Ball, K.; Crawford, D.; Owen, N. Obesity as a Barrier to Physical Activity. Aust. N. Z. J. Public Health 2000, 24, 331–333. [Google Scholar] [CrossRef]
  50. Chao, H.-L. Body Image Change in Obese and Overweight Persons Enrolled in Weight Loss Intervention Programs: A Systematic Review and Meta-Analysis. PLoS ONE 2015, 10, e0124036. [Google Scholar] [CrossRef]
  51. Jiang, W.; Luo, J.; Guan, H. Gender Difference in the Relationship of Physical Activity and Subjective Happiness Among Chinese University Students. Front. Psychol. 2021, 12, 800515. [Google Scholar] [CrossRef]
  52. Ji, H.; Gulati, M.; Huang, T.Y.; Kwan, A.C.; Ouyang, D.; Ebinger, J.E.; Casaletto, K.; Moreau, K.L.; Skali, H.; Cheng, S. Sex Differences in Association of Physical Activity with All-Cause and Cardiovascular Mortality. J. Am. Coll. Cardiol. 2024, 83, 783–793. [Google Scholar] [CrossRef]
  53. Zhu, X.; Haegele, J.A.; Liu, H.; Yu, F. Academic Stress, Physical Activity, Sleep, and Mental Health among Chinese Adolescents. Int. J. Environ. Res. Public Health 2021, 18, 7257. [Google Scholar] [CrossRef]
Obesities 05 00002 g001
Figure 1. Study selection process.
Figure 1. Study selection process.
Obesities 05 00002 g001
Table 1. Characteristics of study participants.
Table 1. Characteristics of study participants.
VariablesPandemic Period
N = 233 [IQR] (%)		Post-Pandemic Period
N = 217 [IQR] (%)
Age mean20.5 [19.0–21.0]20.2 [19.0–20.0]
BMI mean27.6 [25.7–28.7]26.6 [25.7–28.3]
Gender
Male64 (27.5)86 (39.6)
Female169 (72.5)131 (60.4)
Place of residence
Rural area61 (26.2)58 (26.7)
City < 20,000 *19 (8.2)22 (10.1)
City 20,000–100,000 *42 (18.0)53 (24.2)
City 100,000+ *111 (47.6)84 (38.7)
Note: N is the number of observations; * number of inhabitants.
Table 2. Physical activity levels between genders and study periods.
Table 2. Physical activity levels between genders and study periods.
Physical Activity LevelN (%)
Pandemic PeriodPost-Pandemic Period
Females
Inactive24 (14.2)8 (6.1)
Minimally active108 (63.9)91 (69.5)
HEPA37 (21.9)32 (24.4)
Males
Inactive5 (7.8)8 (9.3)
Minimally active47 (73.4)37 (42.0)
HEPA12 (18.8)41 (47.7)
Note: N is the number of observations.
Table 3. Physical activity MET-m/w between genders and study periods.
Table 3. Physical activity MET-m/w between genders and study periods.
Pandemic Period
Female, N = 169Male, N = 64Female vs. Male
MeanMedianIQRMeanMedianIQRp-ValueZ
Walking MET-m/w1101.5792.0495.0–1386.01027.6924.0478.5–1386.00.091.792
Moderate MET-m/w429.8240.00.0–540.0335.7160.00.0–420.00.161.453
Vigorous MET-m/w492.80.00.0–720.0713.3320.00.0–1320.00.990.008
Total MET-m/w2024.21530.0891.0–2799.52076.51783.01215.75–2594.50.301.038
Post-Pandemic Period
Female, N = 131Male, N = 86Female vs. Male
MeanMedianIQRMeanMedianIQRp-ValueZ
Walking MET-m/w1271.31039.5693.0–1617.01292.81155.0594.0–1617.00.600.519
Moderate MET-m/w400.5240.00.0–540.0541.1360.00.0–720.00.390.856
Vigorous MET-m/w512.90.00.0–720.01242.9960.00.0–2160.00.00093.309
Total MET-m/w2184.71754.01188.0–2990.03076.82853.01626.0–4212.0<0.00014.963
Pandemic vs. Post-Pandemic
Female, N = 300Male, N = 150
p-ValueZp-ValueZ
Walking MET-m/w0.0042.8940.161.403
Moderate MET-m/w0.940.0650.061.916
Vigorous MET-m/w0.920.1070.0072.712
Total MET-m/w0.081.762<0.00013.302
Note: Numbers in bold are statistically significant (p < 0.05).
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Adamczak, B.B.; Kosendiak, A.A.; Kuźnik, Z.; Makles, S.; Hariasz, W. Gender Differences in Physical Activity Levels Among Overweight and Obese Medical Students During and After the COVID-19 Pandemic: A Single-Center Cross-Sectional Study. Obesities 2025, 5, 2. https://doi.org/10.3390/obesities5010002

AMA Style

Adamczak BB, Kosendiak AA, Kuźnik Z, Makles S, Hariasz W. Gender Differences in Physical Activity Levels Among Overweight and Obese Medical Students During and After the COVID-19 Pandemic: A Single-Center Cross-Sectional Study. Obesities. 2025; 5(1):2. https://doi.org/10.3390/obesities5010002

Chicago/Turabian Style

Adamczak, Bartosz Bogusz, Aureliusz Andrzej Kosendiak, Zofia Kuźnik, Szymon Makles, and Weronika Hariasz. 2025. "Gender Differences in Physical Activity Levels Among Overweight and Obese Medical Students During and After the COVID-19 Pandemic: A Single-Center Cross-Sectional Study" Obesities 5, no. 1: 2. https://doi.org/10.3390/obesities5010002

APA Style

Adamczak, B. B., Kosendiak, A. A., Kuźnik, Z., Makles, S., & Hariasz, W. (2025). Gender Differences in Physical Activity Levels Among Overweight and Obese Medical Students During and After the COVID-19 Pandemic: A Single-Center Cross-Sectional Study. Obesities, 5(1), 2. https://doi.org/10.3390/obesities5010002

Article Metrics

Back to TopTop