# ABSTRACT

In this study the objective was to establish the association between physical activity barriers and adiposity markers in university students. A cross sectional descriptive study was executed. Anthropometric assessment, sociodemographic data survey and physical activity barrier perception questionnaire were applied to 211 students. The most frequent barriers were lack of time, energy and free will. It was found greater value in indicators of adiposity in men and association between the barriers lack of time, skills and fear of injury, with a higher body mass index. It was found a relationship between barriers to physical activity and adiposity markers, relevant aspects in the strategies of promotion of physical activity and weight control.

Keywords:
Anthropometry; Motivation; Overweight; Physical activity

Palabras-clave:

# RESUMO

Palavras-chave:
Antropometria; Motivação; Excesso de peso; Actividade física

# INTRODUCTION

The university context can be strategic for learning and consolidating personal attitudes, promoting healthy behaviour patterns that determine the future condition of the young adults preparing for university (Peltzer et al., 2017Peltzer K, Pengpid S, Sodi T, Mantilla Toloza S. Happiness and health behaviours among university students from 24 low, middle and high income countries. J Psychol Afr. 2017;27(1):61-8. http://dx.doi.org/10.1080/14330237.2016.1219556.
http://dx.doi.org/10.1080/14330237.2016....
). However, at the university stage, many students cite the lack of time, the inability to create an effective schedule, rules or lack of motivation (Mantilla et al., 2015Mantilla S, Mogollón O, Villamizar C. Physical health from the belief model in students of the University of Pamplona. J Phys Act Hum Dev. 2015;7(1):78-89.), as obstacles to the practice of physical activity (Marques et al., 2018Marques A, Peralta M, Naia A, Loureiro N, de Matos MG. Prevalence of adult overweight and obesity in20 European countries, 2014. Eur J Public Health. 2018;28(2):295-300. http://dx.doi.org/10.1093/eurpub/ckx143. PMid:29036436.
http://dx.doi.org/10.1093/eurpub/ckx143...
) and an unsuitable environment for healthy eating (Mantilla et al., 2014Mantilla SC, Carvajal L, Villamizar C. Nutritional status by anthropometry and eating behaviour in undergraduate students at the University of Pamplona. Alimentech. 2014;12(1):55-62.); situations leading to a high prevalence of overweight and obesity (Peltzer et al., 2017Peltzer K, Pengpid S, Sodi T, Mantilla Toloza S. Happiness and health behaviours among university students from 24 low, middle and high income countries. J Psychol Afr. 2017;27(1):61-8. http://dx.doi.org/10.1080/14330237.2016.1219556.
http://dx.doi.org/10.1080/14330237.2016....
; Sánchez-Ojeda and De Luna-Bertos, 2015Sánchez-Ojeda M, De Luna-Bertos E. Healthy lifestyle habits in the university population. Nutr Hosp. 2015;31(5):1910-9.; Morales et al., 2016Morales M, Pacheco V, Morales J. Influence of physical activity and nutritional habits on the risk of metabolic syndrome. Global Nursing [Internet]. 2016 [cited 2021 May 7];15(44):209-21. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412016000400009&lng=es&tlng=es
http://scielo.isciii.es/scielo.php?scrip...
). The increasing trend in the transition from overweight to obesity often occurs between 18 and 29 years (Herrán et al., 2016Herrán OF, Patiño GA, Del Castillo SE. Food transition and overweight in adults evaluated based on the Nutritional Situation Survey in Colombia, 2010. Biomedica. 2016;36(1):109-20.). Obesity is a major public health concern, as it is accompanied by numerous physical and psychological problems including coronary disease, diabetes and various types of cancer (Kearns et al., 2014Kearns K, Dee A, Fitzgerald AP, Doherty E, Perry IJ. Chronic disease burden associated with overweight and obesity in Ireland: the effects of a small BMI reduction at population level. BMC Public Health. 2014;14(1):143. http://dx.doi.org/10.1186/1471-2458-14-143. PMid:24512151.
http://dx.doi.org/10.1186/1471-2458-14-1...
), morbidities that make the health system more expensive (Torres and Rojas, 2018Torres F, Rojas A. Obesidad y salud pública en México: transformation of the hegemonic pattern of food supply and demand. Development Challenges. 2018;49(193):145-69. http://dx.doi.org/10.22201/iiec.20078951e.2018.193.63185.
https://doi.org/10.22201/iiec.20078951e....
).

The occurrence of obesity is determined among other behavioural factors by the low level of physical activity, which, in turn, can be explained by self-perceived barriers that seem to be more closely linked to aspects of the individual situation that the person lives in his/her daily life (Capdevila Ortís et al., 2014Capdevila Ortís L, Niñerola J, Pintanel M. Motivation and physical activity: the self-report of reasons for the practice of physical activity (AMPEF). Rev Psicol Deporte. 2014;13(1):55-74.). However, there are few studies that show the perception of barriers that prevent the physical activity in university students. This research aims to establish the association between barriers to the practice of physical activity and adiposity markers in a group of university students in the rehabilitation area. The results obtained, in addition to identifying possible risk situations, will facilitate the generation of strategies to reverse the tendencies of sedentarism or weight gain and obesity among students.

# MATERIALS AND METHODS

Cross-sectional descriptive study in 2018. The population corresponded to students enrolled in rehabilitation programs (Physiotherapy and Occupational Therapy) of the Faculty of Health in a public university. A final sample of 211 undergraduate students was obtained. For the calculation of the sample, the formula for finite population was used with a margin of error of 5%, a confidence level of 95%, and an expected proportion of 50%. Independent samples were calculated for each of the programs, the population in Occupational Therapy were 130 students and in Physiotherapy 162. With these assumptions the final sample in Occupational Therapy were 97 and in Physiotherapy of 114 (Figure 1). A stratified sampling was performed with proportional fixation per academic semester and each program. None participant refused to take part in the study and no one left the study.

Figure 1
Population and sample size.

## Instruments

A sociodemographic data survey and the “Barriers to Being Active Quiz-21 Items” Questionnaire (Barriers to Being Active Quiz-21 items) (Rubio et al., 2015Rubio F, Correa-Bautta JE, Ramírez-Vélez R. Psychometric Properties of the Spanish Version of the “Barriers To Being Active Quiz” Questionnaire in Colombian University Students. Nutr Hosp. 2015;31:1714-22.) were applied to identify behaviours that prevent the regular practice of physical activity. It has 21 questions, with the option to answer items in categories: very likely with a value of 3, probably with a value of 2, which is unlikely with a value of 1 and very unlikely with a value of 0. In the questionnaire, each barrier was evaluated by three items. To estimate the score of each one, the sum of the three items was performed. P A score of 5 or more in any barrier shows that it is an important barrier to defeat, which is classified as lack of time, social influence, lack of energy, lack of free will, and fear of getting hurt, lack of skills and lack of resources.

Anthropometric assessment: Height, weight and waist circumference were measured, with reference to the anatomical points and protocols described by Norton and Olds (2000)Norton K, Olds T. Anthropometric: a reference book on human body measurements for education in sports and health. Rosario: BIOSYSTEM Servicio Educativo; 2000..

The height was recorded in a biped position with a portable measuring rod, reference 500KL brand Health or meter ®. Weight was measured with digital balance, reference 500KL, mark Health or meter®. The waist circumference was taken with metric tape (SECA 203 ®). This measurement was performed at the narrowest point level between the last coastal arc and the iliac crest, taking as a cut-off point abdominal obesity ≥ 90 cm for men and ≥ 80 cm for women (Colombia, 2016Colombia. Ministry of Health and Social Protection. Resolution 2465. 14 of 06 of 2016. Anthropometric indicators, reference patterns and cut-off points for anthropometric classification of the nutritional status of children and adolescents under 18 years of age, adults 18 to 64 years of age and adult pregnant women [Internet]. 2016 [cited 2018 November 8]. Available from: https://www.who.int/childgrowth/publications/physical_status/es/
https://www.who.int/childgrowth/publicat...
).

In a single meeting and with prior citation in groups of 20, the students who accepted and signed the consent for participation in the research, answered the survey of sociodemographic data and the questionnaire of barriers to the practice of physical activity, in a room designed for this purpose, with the aim of providing privacy to answer questions. Then they were measured size, weight and waist circumference.

The following aspects were considered for the anthropometric measures: The exploration was carried out during the morning hours, two hours after breakfast, in a large place with a comfortable temperature. Each subject was asked to be barefoot and with the least possible and appropriate clothing.

No measurements were taken in those participants. No measurements were taken in those who performed physical activity 24 hours before the evaluation. Two non-consecutive measurements were made for each anthropometric parameter, using the mean in subsequent calculations. Two attendees were responsible for taking the measures, and a third assistant was responsible for writing the values and standardizing the measurement technique.

The Body Mass Index with normal cut-off points ≤ 24.99 kg/m2 and overweight ≥ 25 kg/m2 (Browning et al., 2010Browning L, Hsieh S, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary valuee. Nutr Res Rev. 2010;23(2):247-69. http://dx.doi.org/10.1017/S0954422410000144. PMid:20819243.
http://dx.doi.org/10.1017/S0954422410000...
) was used to determine nutritional status. The height waist index was calculated to weigh intra-abdominal fat with cut-off point ≥ 0.50 for central obesity (Browning et al., 2010Browning L, Hsieh S, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary valuee. Nutr Res Rev. 2010;23(2):247-69. http://dx.doi.org/10.1017/S0954422410000144. PMid:20819243.
http://dx.doi.org/10.1017/S0954422410000...
).

This research was approved by the Ethics and Environmental Impact Committee of the University of Pamplona through act 002 of April 16, 2018, it complies with the ethical standards recognized by the Helsinki Declaration and the current Colombian legal regulations governing research in humans (Colombia, 1993Colombia. Ministry of Health. Resolution 8430 laying down the scientific, technical and administrative standards for health research [Internet]. 1993 [cited 2019 December 21]. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF
https://www.minsalud.gov.co/sites/rid/Li...
).

## Statistical analysis

From an exploratory analysis, absolute and percentage frequencies were calculated for the qualitative variables, for the quantitative variables with a symmetric dispersion mean and standard deviation were expressed, in the case of the asymmetric, a description was performed by median and quartile 1 and 3.

In order to evaluate the association between the barriers to physical activity and adiposity, linear model was applied (Coutinho et al., 2008Coutinho L, Scazufca M, Menezes P. Methods for estimating prevalence ratios in cross-sectional studies. Rev Saude Publica. 2008;42(6):992-8. http://dx.doi.org/10.1590/S0034-89102008000600003. PMid:19009156.
http://dx.doi.org/10.1590/S0034-89102008...
). For adjusted models, biological plausibility criteria and statistical criterion were taken into account Akaike (AIC) record. After adjusting the model by plausibility, the candidate variables to enter were selected, using the Hosmer-Lemeshow criteria and the AIC criterion for the order and addition of new variables was taken into account. The models that were performed were explanatory. The parameter estimates were developed with a confidence level of 95% and a nominal significance of p = 0.05 was considered. The analyses were performed in IBM ® SPSS® STATISTICS. Version 21.

# RESULTS

Data collected from a total of 211 undergraduate students who were from the rehabilitation area of a Faculty of Health were analyzed. The age range was 18 to 30 years ($x¯$: 22,0 SD: 2,1), 13.3% were male and 86.7% were female. The most frequent barriers to physical activity perceived by participants are lack of time (67.8 per cent), lack of energy (63 per cent) and lack of will (69.2 per cent). Other data are shown in Table 1.

Table 1
Description of socio-demographic data and barriers to physical activity among university students in the field of rehabilitation.

Table 2 shows the description of adiposity markers based on the socio-demographic characteristics described and the barriers to physical activity practice. Men had a tendency to have higher values in the three adiposity indicators, those who claimed to be single tend to have lower values in the three independent adiposity indicators, and in general those who accused not presenting each of the different barriers tend to have lower values in the adiposity indicators, these data are shown in Table 2.

Table 2
Description of adiposity markers by sex. socio-demographic characteristics and barriers to physical activity in university students in the field of rehabilitation.

University students who have the time barrier showed higher values in the body mass index, waist index and waist circumference compared to those who do not. However, only the association with body mass index was maintained in the multivariate analysis. Those university students who accused of being afraid of injury or lack of skills showed a higher body mass index (p < 0.05). The barriers of social influence, lack of energy, lack of will and lack of resources, showed no association with the indicators of adiposity. Data for generalized linear models are shown in Table 3.

Table 3
Association between adiposity markers. socio-demographic characteristics and barriers to physical activity in university students in the field of rehabilitation.

# DISCUSSION

The objective of this study was to establish the association between barriers to the practice of physical activity and adiposity markers, in a group of undergraduate university students who were in the rehabilitation area of a health faculty.

The main barrier to physical activity reported by the students surveyed was lack of time. This finding is consistent with previous research (Ramírez-Vélez et al., 2016Ramírez-Vélez R, Triana-Reina HR, Carrillo HA, Ramos-Sepúlveda JA. Percepción de barreras para la práctica de la actividad física y obesidad abdominal en universitarios de Colombia. Nutr Hosp. 2016;33(6):1317-23. http://dx.doi.org/10.20960/nh.777. PMid:28000459.
http://dx.doi.org/10.20960/nh.777...
; Ramírez-Velez et al.,2015; Rubio Henao and Varela Arevalo , 2016Rubio Henao RF, Varela Arevalo MT. Perceived barriers in young university students to perform physical activity. Cuban Public Health Mag. 2016;42(1):61-9.) suggesting that the perception of time management in university students is a highly personal and relative aspect, through which they determine their priorities (Castañeda et al., 2018Castañeda C, Zagalaz M, Arufe V, Campos M. Reasons for the physical activity of Sevillan university students. Iberoam J Psychol Exercise Sport. 2018;13(1):79-89.). Other important barriers identified were lack of energy and lack of will (Navas and Soriano, 2016Navas L, Soriano J. Análisis de los motivos para practicar o no actividades físicas extracurriculares y su relación con el autoconcepto físico en estudiantes chilenos. Iberoam J Psychol Exercise Sport. 2016;11(1):69-76.; Hurley et al., 2018Hurley K, Flippin K, Blom L, Bolin J, Hoover D, Judge L. Practices, perceived benefits, and barriers to resistance training among women enrolled in College. Int J Exerc Sci. 2018;11(5):226-38. PMid:29795737.). Usually, university students say they do not practice physical activity because they take time off study, or because they are tired of the study, work and/or class (Cambronero et al.,2015Cambronero M, Blasco J, Chiner E, Lucas-Cuevas A. Reasons for the participation of university students in physical-sports activities. Iberoam J Psychol Exercise Sport. 2015;10(2):179-86.). In contrast, other studies have reported that social support during leisure could be considered as an aspect that could positively or negatively influence the practice of exercise and that family or friends’ activities should include physical activity (Martínez et al., 2016Martínez Y, Harmon B, Nigg C, Bantum E, Strayhorn S. Diet and physical activity intervention strategies for college students. Health Behav Policy Rev. 2016;3(4):336-47. http://dx.doi.org/10.14485/HBPR.3.4.5. PMid:28480225.
http://dx.doi.org/10.14485/HBPR.3.4.5...
).

Regarding adiposity markers, in this paper it was found that male university students show overweight and central obesity according to their body mass index and height waist index. Without differentiating by gender, other studies carried out on university students argue overweight and central obesity (Corvos et al., 2014Corvos CA, Corvos A, Salazar A. Índices antropométricos y salud en estudiantes de ingeniería de la Universidad de Carabobo. Clinical Nutrition and Hospital Dietetics. 2014;34(2):45-51. http://dx.doi.org/10.12873/342carabobocorvos.
http://dx.doi.org/10.12873/342caraboboco...
; Salazar et al., 2013Salazar CCM, Feu S, Vizuete Carrizosa M, de la Cruz-Sánchez E. IMC y actividad física de los estudiantes de la Universidad de Colima. Rev Int Med Cienc Act Fís Deporte. 2013;13(51):569-84.); probably due to genetic conditions or their interaction with various situations specific to university life such as moving away from the family core, taking responsibility for their food, night social life, academic occupations, economic aspects and emotional changes; which may favour negative and unassertive nutritional behaviors that alter anthropometric parameters. On the other hand, women are probably due to aesthetic aspects, as they are more concerned about their image and more aware of their body weight (Peltzer et al., 2014Peltzer K, Pengpid S, Samuels TA, Özcan NK, Mantilla C, Rahamefy OH, et al. Prevalence of overweight/obesity and its associated factors among university students from 22 countries. Int J Environ Res Public Health. 2014;11(7):7425-41. http://dx.doi.org/10.3390/ijerph110707425. PMid:25050651.
http://dx.doi.org/10.3390/ijerph11070742...
; Villaquiran et al., 2020Villaquiran AF, Cuero P, Ceron GM, Ordoñez A, Jácome S. Características antropométricas, hábitos nutricionales, actividad física y consumo de alcohol en estudiantes universitarios. Salud UIS. 2020;52(2):111-20. http://dx.doi.org/10.18273/revsal.v52n2-2020005.
http://dx.doi.org/10.18273/revsal.v52n2-...
).

The marital status of students in married status regardless of sex presents a statistically significant association with increased values in waist circumference and body mass index both in univariate and multivariate analysis. A study conducted with young adults from Brazil concluded that marital status was strongly associated with overweight and obesity. Weight gain may be influenced by changes in social behaviour, depending on the living conditions where a married person is developing (Cavalcante et al., 2015Cavalcante S., Magalhães T., Sampaio F. Association between overweight and characteristics of young school adults: contribution for nursing care. Rev. Latino-Am. Enfermagem. 2015;23(2):250-258. DOI: 10.1590/0104-1169.0174.2549.
https://doi.org/DOI: 10.1590/0104-1169.0...
).

In addition, students of occupational therapy had overweight and central obesity according to their body mass index and waist circumference. This difference may be due to the way this group of students assumes psychological, social, economic and academic situations that can affect their habits and in some way produce important changes in abdominal adiposity. By contrast, Martínez and others (2014)Martínez M, Navarrete E, García M, Gimenez D, Gonzalez S, Valera D, et al. Association between hours of television, physical activity, hours of sleep and overweight in young adult population. Health Gaceta. 2014;28(3):203-8. found less prevalence of overweight in university students in the health sciences possibly because they have a greater awareness of their health and healthier habits compared to students in other areas (Martínez et al., 2014Martínez M, Navarrete E, García M, Gimenez D, Gonzalez S, Valera D, et al. Association between hours of television, physical activity, hours of sleep and overweight in young adult population. Health Gaceta. 2014;28(3):203-8.). Perhaps this conviction has failed to develop in the previously mentioned group of students.

Despite the fact that in the multivariate analysis only the barriers lack of time, fear of injury and lack of skills maintained the association with the body mass index, it was found that male students who showed high values of body mass index, waist index and waist circumference were those who expressed social influence as a barrier (Ashton et al., 2015Ashton L, Hutchesson M, Rollo M, Morgan P, Thompson M, Collins C. Young adult males’ motivators and perceived barriers towards eating healthily and being active: a qualitative study. Int J Behav Nutr Phys Act. 2015;12(1):93-100. http://dx.doi.org/10.1186/s12966-015-0257-6. PMid:26169503.
http://dx.doi.org/10.1186/s12966-015-025...
), while women who manifest as barriers to the practice of physical activity lack of time, social influence, lack of energy, lack of will, fear of injury, lack of skills and lack of resources presented central obesity according to the waist circumference (Hurley et al., 2018Hurley K, Flippin K, Blom L, Bolin J, Hoover D, Judge L. Practices, perceived benefits, and barriers to resistance training among women enrolled in College. Int J Exerc Sci. 2018;11(5):226-38. PMid:29795737.). In addition, a significant relationship was found between sociodemographic variables, adiposity markers and barriers to the practice of physical activity; and the older the body mass index and waist circumference increase regardless of sex, suggesting that overweight and obesity could be related to the aging of the organism.

The results of this research show that there is a close relationship between the reasons for not performing physical activity and the increase of waist circumference, waist index and body mass index as adiposity markers in university students in the rehabilitation area of a health faculty. Similarly, Saghafi and other authors (2020) examined factors that affect the behavioral intent of weight control and body mass index, finding that overweight students showed higher scores on the scale of perceived barriers to adopting healthy eating habits and physical activity. Participants who considered lack of time, ignorance, lack of motivation and the cost of physical activity as barriers had a higher body mass index (Saghafi-Asl et al., 2020Saghafi-Asl M, Aliasgharzadeh S, Asghari-Jafarabadi M. Factors influencing weight management behavior among college students: an application of the Health Belief Model. PLoS One. 2020;15(2):e0228058. http://dx.doi.org/10.1371/journal.pone.0228058. PMid:32032376.
http://dx.doi.org/10.1371/journal.pone.0...
).

The results of this study suggest that higher education institutions have as a challenge to find strategies to positively influence and facilitate conditions for students to acquire the habit of moving, overcome barriers to initiate and achieve adherence to the practice of physical activity. Although paradoxical, it is a challenge to raise awareness among teachers about healthy lifestyles and the varied possibilities they have to perform physical activity on a regular basis, without forgetting to impact the importance of self-care in students who belong to the health area, since as future professionals they will be directly responsible for influencing weight control and related problems. The adiposity markers and the removal of barriers to the practice of physical activity play an important role in the success of the maintenance and weight loss programs (Lazzeretti et al 2015Lazzeretti L, Rotella F, Pala L, Rotella CM. Assessment of psychological predictors of weight loss: how and what for? World J Psychiatry. 2015;5(1):56-67. http://dx.doi.org/10.5498/wjp.v5.i1.56. PMid:25815255.
http://dx.doi.org/10.5498/wjp.v5.i1.56...
; Faghri et al., 2016Faghri P, Simon J, Huedo-Medina T, Gorin A. Effects of self-efficacy on health behavior and body weight. J Obes Weight Loss Ther. 2016;6:329.), being the most common weight control methods among students, exercise practice and healthy eating (Senekal et al.., 2016Senekal M, Lasker GL, van Velden L, Laubscher R, Temple NJ. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters. BMC Public Health. 2016;16(1):918. http://dx.doi.org/10.1186/s12889-016-3576-x. PMid:27586376.
http://dx.doi.org/10.1186/s12889-016-357...
). Educational strategies in the university context for the prevention of overweight, obesity and the promotion of the regular practice of physical activity, should have considering that many students say they try to control their weight to improve their appearance, moreover, that individuals make changes if they perceive that their current state could have serious health complications (Saghafi-Asl et al., 2020Saghafi-Asl M, Aliasgharzadeh S, Asghari-Jafarabadi M. Factors influencing weight management behavior among college students: an application of the Health Belief Model. PLoS One. 2020;15(2):e0228058. http://dx.doi.org/10.1371/journal.pone.0228058. PMid:32032376.
http://dx.doi.org/10.1371/journal.pone.0...
). If university students know the benefits of managing their weight through diet and exercise and if they also have the facilities of time, schedules, access and free training, provision of infrastructure, proximity to facilities and easy access, they could join the programs.

The present is one of the few studies on the subject. It suggests the generation of others that identify the barriers to the adoption of healthy food and its relationship with the level of physical activity and demographic factors that could influence the perception of barriers to physical activity.

## Limitations

Within the limitations of this report, the cross-sectional design is highlighted, which does not allow to identify causal relationships between the variables. In addition, the fact that the barriers were self-informed and therefore aspects to be considered as true motives could have been confused with possible “excuses” related to barriers to PA. The sociocultural and economic profiles of the students who participated in this study may be different from those of the students attending other universities in Colombia. Another limitation was that the level of physical activity of the participants was not objectively measured.

# CONCLUSION

A close relationship was found between the barriers to physical activity, mainly lack of time, with the increase of waist circumference, waist index and body mass index as adiposity markers in university students. This result represents a relevant and useful input for health, sports and university professionals in the construction of strategies to promote physical activity and weight control as strategies of public health.

• ### FUNDING

The autors declare not there was financial support.

# REFERENCES

• Ashton L, Hutchesson M, Rollo M, Morgan P, Thompson M, Collins C. Young adult males’ motivators and perceived barriers towards eating healthily and being active: a qualitative study. Int J Behav Nutr Phys Act. 2015;12(1):93-100. http://dx.doi.org/10.1186/s12966-015-0257-6 PMid:26169503.
» http://dx.doi.org/10.1186/s12966-015-0257-6
• Browning L, Hsieh S, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary valuee. Nutr Res Rev. 2010;23(2):247-69. http://dx.doi.org/10.1017/S0954422410000144 PMid:20819243.
» http://dx.doi.org/10.1017/S0954422410000144
• Cambronero M, Blasco J, Chiner E, Lucas-Cuevas A. Reasons for the participation of university students in physical-sports activities. Iberoam J Psychol Exercise Sport. 2015;10(2):179-86.
• Capdevila Ortís L, Niñerola J, Pintanel M. Motivation and physical activity: the self-report of reasons for the practice of physical activity (AMPEF). Rev Psicol Deporte. 2014;13(1):55-74.
• Castañeda C, Zagalaz M, Arufe V, Campos M. Reasons for the physical activity of Sevillan university students. Iberoam J Psychol Exercise Sport. 2018;13(1):79-89.
• Cavalcante S., Magalhães T., Sampaio F. Association between overweight and characteristics of young school adults: contribution for nursing care. Rev. Latino-Am. Enfermagem. 2015;23(2):250-258. DOI: 10.1590/0104-1169.0174.2549.
» https://doi.org/DOI: 10.1590/0104-1169.0174.2549
• Colombia. Ministry of Health and Social Protection. Resolution 2465. 14 of 06 of 2016. Anthropometric indicators, reference patterns and cut-off points for anthropometric classification of the nutritional status of children and adolescents under 18 years of age, adults 18 to 64 years of age and adult pregnant women [Internet]. 2016 [cited 2018 November 8]. Available from: https://www.who.int/childgrowth/publications/physical_status/es/
» https://www.who.int/childgrowth/publications/physical_status/es/
• Colombia. Ministry of Health. Resolution 8430 laying down the scientific, technical and administrative standards for health research [Internet]. 1993 [cited 2019 December 21]. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF
• Corvos CA, Corvos A, Salazar A. Índices antropométricos y salud en estudiantes de ingeniería de la Universidad de Carabobo. Clinical Nutrition and Hospital Dietetics. 2014;34(2):45-51. http://dx.doi.org/10.12873/342carabobocorvos
» http://dx.doi.org/10.12873/342carabobocorvos
• Coutinho L, Scazufca M, Menezes P. Methods for estimating prevalence ratios in cross-sectional studies. Rev Saude Publica. 2008;42(6):992-8. http://dx.doi.org/10.1590/S0034-89102008000600003 PMid:19009156.
» http://dx.doi.org/10.1590/S0034-89102008000600003
• Faghri P, Simon J, Huedo-Medina T, Gorin A. Effects of self-efficacy on health behavior and body weight. J Obes Weight Loss Ther. 2016;6:329.
• Herrán OF, Patiño GA, Del Castillo SE. Food transition and overweight in adults evaluated based on the Nutritional Situation Survey in Colombia, 2010. Biomedica. 2016;36(1):109-20.
• Hurley K, Flippin K, Blom L, Bolin J, Hoover D, Judge L. Practices, perceived benefits, and barriers to resistance training among women enrolled in College. Int J Exerc Sci. 2018;11(5):226-38. PMid:29795737.
• Kearns K, Dee A, Fitzgerald AP, Doherty E, Perry IJ. Chronic disease burden associated with overweight and obesity in Ireland: the effects of a small BMI reduction at population level. BMC Public Health. 2014;14(1):143. http://dx.doi.org/10.1186/1471-2458-14-143 PMid:24512151.
» http://dx.doi.org/10.1186/1471-2458-14-143
• Lazzeretti L, Rotella F, Pala L, Rotella CM. Assessment of psychological predictors of weight loss: how and what for? World J Psychiatry. 2015;5(1):56-67. http://dx.doi.org/10.5498/wjp.v5.i1.56 PMid:25815255.
» http://dx.doi.org/10.5498/wjp.v5.i1.56
• Mantilla S, Mogollón O, Villamizar C. Physical health from the belief model in students of the University of Pamplona. J Phys Act Hum Dev. 2015;7(1):78-89.
• Mantilla SC, Carvajal L, Villamizar C. Nutritional status by anthropometry and eating behaviour in undergraduate students at the University of Pamplona. Alimentech. 2014;12(1):55-62.
• Marques A, Peralta M, Naia A, Loureiro N, de Matos MG. Prevalence of adult overweight and obesity in20 European countries, 2014. Eur J Public Health. 2018;28(2):295-300. http://dx.doi.org/10.1093/eurpub/ckx143 PMid:29036436.
» http://dx.doi.org/10.1093/eurpub/ckx143
• Martínez M, Navarrete E, García M, Gimenez D, Gonzalez S, Valera D, et al. Association between hours of television, physical activity, hours of sleep and overweight in young adult population. Health Gaceta. 2014;28(3):203-8.
• Martínez Y, Harmon B, Nigg C, Bantum E, Strayhorn S. Diet and physical activity intervention strategies for college students. Health Behav Policy Rev. 2016;3(4):336-47. http://dx.doi.org/10.14485/HBPR.3.4.5 PMid:28480225.
» http://dx.doi.org/10.14485/HBPR.3.4.5
• Morales M, Pacheco V, Morales J. Influence of physical activity and nutritional habits on the risk of metabolic syndrome. Global Nursing [Internet]. 2016 [cited 2021 May 7];15(44):209-21. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412016000400009&lng=es&tlng=es
» http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412016000400009&lng=es&tlng=es
• Navas L, Soriano J. Análisis de los motivos para practicar o no actividades físicas extracurriculares y su relación con el autoconcepto físico en estudiantes chilenos. Iberoam J Psychol Exercise Sport. 2016;11(1):69-76.
• Norton K, Olds T. Anthropometric: a reference book on human body measurements for education in sports and health. Rosario: BIOSYSTEM Servicio Educativo; 2000.
• Peltzer K, Pengpid S, Samuels TA, Özcan NK, Mantilla C, Rahamefy OH, et al. Prevalence of overweight/obesity and its associated factors among university students from 22 countries. Int J Environ Res Public Health. 2014;11(7):7425-41. http://dx.doi.org/10.3390/ijerph110707425 PMid:25050651.
» http://dx.doi.org/10.3390/ijerph110707425
• Peltzer K, Pengpid S, Sodi T, Mantilla Toloza S. Happiness and health behaviours among university students from 24 low, middle and high income countries. J Psychol Afr. 2017;27(1):61-8. http://dx.doi.org/10.1080/14330237.2016.1219556
» http://dx.doi.org/10.1080/14330237.2016.1219556
• Ramírez-Vélez R, Tordecilla-Sanders A, Laverde D, Hernández-Novoa JG, Ríos M, Rubio F, et al. The prevalence of barriers for Colombian college students engaging in physical activity. Nutr Hosp. 2014;31(2):858-65. http://dx.doi.org/10.3305/nh.2015.31.2.7737 PMid:25617574.
» http://dx.doi.org/10.3305/nh.2015.31.2.7737
• Ramírez-Vélez R, Triana-Reina HR, Carrillo HA, Ramos-Sepúlveda JA. Percepción de barreras para la práctica de la actividad física y obesidad abdominal en universitarios de Colombia. Nutr Hosp. 2016;33(6):1317-23. http://dx.doi.org/10.20960/nh.777 PMid:28000459.
» http://dx.doi.org/10.20960/nh.777
• Rubio F, Correa-Bautta JE, Ramírez-Vélez R. Psychometric Properties of the Spanish Version of the “Barriers To Being Active Quiz” Questionnaire in Colombian University Students. Nutr Hosp. 2015;31:1714-22.
• Rubio Henao RF, Varela Arevalo MT. Perceived barriers in young university students to perform physical activity. Cuban Public Health Mag. 2016;42(1):61-9.
• Saghafi-Asl M, Aliasgharzadeh S, Asghari-Jafarabadi M. Factors influencing weight management behavior among college students: an application of the Health Belief Model. PLoS One. 2020;15(2):e0228058. http://dx.doi.org/10.1371/journal.pone.0228058 PMid:32032376.
» http://dx.doi.org/10.1371/journal.pone.0228058
• Salazar CCM, Feu S, Vizuete Carrizosa M, de la Cruz-Sánchez E. IMC y actividad física de los estudiantes de la Universidad de Colima. Rev Int Med Cienc Act Fís Deporte. 2013;13(51):569-84.
• Sánchez-Ojeda M, De Luna-Bertos E. Healthy lifestyle habits in the university population. Nutr Hosp. 2015;31(5):1910-9.
• Senekal M, Lasker GL, van Velden L, Laubscher R, Temple NJ. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters. BMC Public Health. 2016;16(1):918. http://dx.doi.org/10.1186/s12889-016-3576-x PMid:27586376.
» http://dx.doi.org/10.1186/s12889-016-3576-x
• Torres F, Rojas A. Obesidad y salud pública en México: transformation of the hegemonic pattern of food supply and demand. Development Challenges. 2018;49(193):145-69. http://dx.doi.org/10.22201/iiec.20078951e.2018.193.63185.
» https://doi.org/10.22201/iiec.20078951e.2018.193.63185
• Villaquiran AF, Cuero P, Ceron GM, Ordoñez A, Jácome S. Características antropométricas, hábitos nutricionales, actividad física y consumo de alcohol en estudiantes universitarios. Salud UIS. 2020;52(2):111-20. http://dx.doi.org/10.18273/revsal.v52n2-2020005
» http://dx.doi.org/10.18273/revsal.v52n2-2020005

# Publication Dates

• Publication in this collection
04 Apr 2022
• Date of issue
2022