Study finds no link between physical activity and quality of life in Riyadh university

Among 353 students, faculty members, and administrative staff at Alfaisal University in Riyadh, the amount of physical activity people reported showed no statistically significant association with how they rated their own health-related quality of life. What was associated, consistently, was underlying health status: participants with a pre-existing mental health condition reported markedly lower quality-of-life scores, and those with pre-existing physical conditions also scored lower on one of the two measures. The cross-sectional study, published in Frontiers in Public Health, examined physical activity, health-related quality of life, and perceived barriers to activity within a single academic community at a moment when Saudi Arabia’s Vision 2030 agenda has made active lifestyles and population well-being national priorities.

The research team surveyed the university community between October 2024 and April 2025, with questionnaire data collected in January 2025. Participants completed three validated instruments in a single standardized questionnaire. Physical activity during the preceding week was assessed with the International Physical Activity Questionnaire Short Form, which captures walking, moderate-intensity activity, vigorous-intensity activity, and sitting time, and converts reported durations into metabolic equivalent of task minutes per week, with walking weighted at 3.3 METs, moderate activity at 4.0, and vigorous activity at 8.0. Quality of life was measured with the EQ-5D-5L, which rates mobility, self-care, usual activities, pain and discomfort, and anxiety and depression across five severity levels, alongside the EuroQol Visual Analog Scale, on which participants score their overall health from 0 to 100. Perceived barriers were assessed with the 21-item Barriers to Being Active Quiz, covering seven domains from lack of time to fear of injury.

The sample skewed young and heavily academic. Of the 353 participants analyzed, 288 were students, 40 were faculty, and 25 were administrative staff. Most were aged 18 to 24 years, and 57.2 percent were female. Pre-existing physical conditions were reported by 15.3 percent and pre-existing mental health conditions by 8.5 percent. Moderate physical activity was the most frequently reported category, at 43.6 percent, followed by high activity at 28.6 percent and low activity at 27.8 percent. The median weekly volume was 1,618.5 MET-minutes, though the range stretched from zero to 15,750, and 47 participants reported no activity at all. Among the 217 participants who provided sitting-time data, the mean was 423.2 minutes per day, roughly seven hours, with a median of 360 minutes and reported values reaching 1,200 minutes per day.

In multivariable regression models adjusted for age, gender, nationality, education level, university role, marital status, monthly income, and pre-existing physical and mental health conditions, physical activity level was not significantly associated with either quality-of-life outcome. Compared with low activity, high physical activity was associated with an EQ-VAS coefficient of 4.055 points, but the bias-corrected and accelerated 95 percent confidence interval spanned from −2.082 to 10.426, with a p-value of 0.197. For the EQ-5D-5L index score, the coefficient for high versus low activity was −0.005, with a confidence interval from −0.035 to 0.028 and a p-value of 0.824. Moderate activity showed no significant association either. Sitting time, analyzed separately, was also not significantly associated with either outcome, and analyses of the five individual EQ-5D-5L dimensions showed no significant links to activity level. A fractional logistic sensitivity analysis, conducted because the index score is bounded at 1.0 and concentrated there, produced the same qualitative conclusion.

What the models did detect was the association of underlying health status with perceived health. A pre-existing mental health condition was associated with an EQ-VAS score lower by 11.891 points, with a confidence interval from −22.157 to −2.653 and a p-value of 0.010, and with an index score lower by 0.088, p = 0.001. Pre-existing physical conditions were associated with lower index scores by 0.042, p = 0.013. In a population where 39.1 percent of participants reported the full-health state and held the maximum index score of 1.000, these conditions stood out as the clearest correlates of how people perceived their own health. The authors note that this pattern aligns with conceptual models in which physical functioning, psychological health, symptoms, and everyday functioning interact to shape an individual’s overall perception of well-being, rather than lifestyle behavior operating in isolation.

The activity data revealed demographic patterns. In the adjusted ordinal logistic regression, female participants had higher odds of being in a lower physical activity category than males, with an adjusted odds ratio of 1.897 and a confidence interval from 1.267 to 2.840, p = 0.002. Saudi participants, by contrast, had lower odds of being in a lower activity category than non-Saudi participants, with an adjusted odds ratio of 0.589, p = 0.009. A supplementary analysis of whether participants achieved at least 150 minutes of weekly activity found that women had lower odds than men of reaching the threshold, with an adjusted odds ratio of 0.452, and participants aged 35 to 44 had lower odds than those aged 18 to 24, with an adjusted odds ratio of 0.050. Age, education, role, income, and health conditions were not significantly associated with activity category after adjustment.

The barriers data may be the study’s most immediately applicable contribution. Lack of willpower was reported by 67 percent of participants, lack of energy by 66 percent, and lack of time by 65 percent, with lack of resources at 43 percent and social influence at 42 percent, while lack of skill at 24 percent and fear of injury at 16 percent trailed behind. Each one-category increase in physical activity level was associated with lower lack-of-willpower scores, with a coefficient of −0.711, and lower lack-of-time scores, with a coefficient of −0.608, both with p-values below 0.001 after adjustment for age, gender, and university role. The authors are careful about direction here: fewer perceived barriers may facilitate greater activity, or regularly active people may simply perceive and manage such barriers differently. Either way, the pattern flags potentially modifiable factors for university wellness programs.

Why did physical activity fail to show the association often reported elsewhere? The authors point to several features of the sample. Participants were largely young, reported generally favorable quality of life, with a mean EQ-VAS of 78.9 and a mean index score of 0.928, and most were moderately or highly active. The substantial ceiling effect, with nearly four in ten participants at the maximum index score, may have limited the instrument’s ability to distinguish differences among healthier participants. The cross-sectional design, self-reported activity measures vulnerable to recall and social desirability bias, convenience sampling that precluded calculating a response rate, and an English-only questionnaire all constrain interpretation. The authors also stress that the absence of a statistically significant association should not be read as evidence that physical activity is unrelated to quality of life; the confidence intervals do not rule out potentially relevant associations, and the established benefits of regular activity in the broader literature remain intact.

The implications reach beyond one campus. The authors suggest that university health promotion strategies may benefit from integrating physical activity initiatives with mental health support and interventions targeting the behavioral barriers of time, energy, and motivation, rather than assuming that activity programs alone will lift perceived well-being. Such an approach aligns with Saudi Arabia’s objectives under Vision 2030, which emphasize active lifestyles, prevention of noncommunicable diseases, and population well-being. The team calls for longitudinal designs to clarify the temporal relationship between activity and quality of life, objective assessment with accelerometers or wearable devices to complement self-reports, and multicenter studies across more diverse university populations. Until such evidence accumulates, the findings from Riyadh suggest that in a young academic community, perceived health may reflect a combination of psychological, physical, and behavioral influences rather than physical activity level alone.

Subject of Research: Physical activity, health-related quality of life, 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

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1999364

Keywords: physical activity, health-related quality of life, EQ-5D-5L, IPAQ-SF, perceived barriers, mental health, university population, Saudi Arabia, cross-sectional study, public health, Physical, activity