From habits to harm: the effects of lifestyle, sleep, and fitness on injury risk in students using a structural equation modeling approach

. 2025 ; 13 () : 1664822. [epub] 20251118

Jazyk angličtina Země Švýcarsko Médium electronic-ecollection

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid41341447

BACKGROUND: University students often deal with a mix of challenges - from frequent sports and recreational injuries to habits like smoking, drinking alcohol, or consuming energy drinks, along with irregular sleep and different levels of physical activity. This study examines the links between lifestyle habits, sports participation, sleep quality, self-perceived fitness, and the likelihood of getting injured. METHODS: In a cross-sectional survey of 933 first-year students (mean age 20.1 ± 2.5), participants reported lifestyle indicators (cigarettes, alcoholic drinks, energy drinks), sports activity (training volume, athlete/competitive status, sport diversity), sleep quality, self-rated fitness, and the number of injuries causing class absence. Partial least squares structural equation modeling evaluated the measurement properties and the structural paths. RESULTS: Sports activity had a strong, positive association with perceived physical fitness. The interaction of lifestyle and sports activity is negatively associated with fitness, indicating that unhealthy habits attenuate sport-related fitness gains. Lifestyle was negatively associated with sleep quality, while better sleep quality positively predicted fitness. Physical fitness did not show a significant direct association with injury counts. Poorer sleep quality was associated with a higher number of injuries. CONCLUSION: In this large student sample, sleep quality emerged as a pivotal, modifiable protector-linked positively to fitness and negatively to injury risk-whereas sports participation improved fitness, but its benefits were undermined by unhealthy lifestyle behaviours. Injury prevention efforts in student populations should therefore combine promotion of healthy lifestyle choices, sleep hygiene interventions, and safe sport practices.

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Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, et al. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. (2016) 388:1311–24. doi: 10.1016/S0140-6736(16)30383-X, PMID: PubMed DOI

Basso JC, Suzuki WA. The effects of acute exercise on mood, cognition, neurophysiology and neurochemical pathways: a review. Brain Plast. (2017) 2:127–52. doi: 10.3233/BPL-160040, PMID: PubMed DOI PMC

Charest J, Grandner MA. Sleep and athletic performance: impacts on physical performance, mental performance, injury risk and recovery, and mental health: an update. Sleep Med Clin. (2022) 17:263–82. doi: 10.1016/j.jsmc.2022.03.006, PMID: PubMed DOI

Sarstedt M, Hair JJF, Cheah JH, Becker JM, Ringle CM. How to specify, estimate, and validate higher-order constructs in PLS-SEM. Australas Mark J. (2019) 27:197–211. doi: 10.1016/j.ausmj.2019.05.0 DOI

Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC, et al. 2023 International Olympic Committee’s (IOC) consensus statement on relative energy deficiency in sport (REDs). Br J Sports Med. (2024) 57:1073–97. doi: 10.1136/bjsports-2023-106994 PubMed DOI

Sumilo D, Stewart-Brown S. The causes and consequences of injury in students at UK institutes of higher education. Public Health. (2006) 120:125–31. doi: 10.1016/j.puhe.2005.01.018, PMID: PubMed DOI

Dietz P, Reichel JL, Werner AM, Letzel S. Study-related work and commuting accidents among students at the University of Mainz from 12/2012 to 12/2018: identification of potential risk groups and implications for prevention. Int J Environ Res Public Health. (2020) 17:3676. doi: 10.3390/ijerph17103676, PMID: PubMed DOI PMC

Faller G, Mikolajczyk RT, Akmatov MK, Meier S, Krämer A. Accidents in the context of study among university students--a multicentre cross-sectional study in North Rhine-Westphalia, Germany. Accid Anal Prev. (2010) 42:487–91. doi: 10.1016/j.aap.2009.09.012, PMID: PubMed DOI

Rajabali F, Zheng A, Turcotte K, Zhang LR, Kao D, Rasali D, et al. The association of material deprivation component measures with injury hospital separations in British Columbia, Canada. Inj Epidemiol. (2019) 6:20. doi: 10.1186/s40621-019-0198-7, PMID: PubMed DOI PMC

St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, et al. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. (2016) 134:e367–86. doi: 10.1161/CIR.0000000000000444 PubMed DOI PMC

Delahoyde MK, Tyack C, Kugarajah S, Joseph D. Insomnia and other sleep disorders in adolescence. BMJ Paediatr Open. (2024) 8:e001229. doi: 10.1136/bmjpo-2021-001229, PMID: PubMed DOI PMC

Kahn A, Van de Merckt C, Rebuffat E, Mozin MJ, Sottiaux M, Blum D, et al. Sleep problems in healthy preadolescents. Pediatrics. (1989) 84:542–6. doi: 10.1542/peds.84.3.542, PMID: PubMed DOI

Kock N, Mayfield M. PLS-based SEM algorithms: the good neighbor assumption, collinearity, and nonlinearity. Inf Manag Bus Rev. (2015) 7:113–30. doi: 10.22610/imbr.v7i2.1146 DOI

Kreider RB, Fry AC, O’Toole ML. Overtraining in sport. Champaign, IL: Human Kinetics; (1998).

Sanchez G. PLS path modeling with R. Berkeley: Trowchez Editions; (2013).

Ping T, Chenghong W. Correlation between sleep quality and health condition of college students. China J Health Psychol. (2010) 18:181–4. doi: 10.13342/j.cnki.cjhp.2010.02.056 DOI

Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet. (2012) 379:1056–67. doi: 10.1016/S0140-6736(11)60871-4, PMID: PubMed DOI PMC

Moussa-Chamari I, Farooq A, Romdhani M, Washif JA, Bakare U, Helmy M, et al. The relationship between quality of life, sleep quality, mental health, and physical activity in an international sample of college students: a structural equation modeling approach. Front Public Health. (2024) 12:1397924. doi: 10.3389/fpubh.2024.1397924, PMID: PubMed DOI PMC

Saefullah R, Hidayana RA, Cahyandari R. The role of physical activities in enhancing physical fitness among the community. Int J Health Med Sports. (2024) 2:66–70. doi: 10.46336/ijhms.v2i3.124 DOI

Skorga P, Young C. The “WHO safe communities” model for the prevention of injury in whole populations: a review summary. Public Health Nurs. (2010) 28:51–3. doi: 10.1111/j.1525-1446.2010.00919.x, PMID: PubMed DOI

Lunsford-Avery JR, Bidopia T, Jackson L, Sloan JS. Behavioral treatment of insomnia and sleep disturbances in school-aged children and adolescents. Child Adolesc Psychiatr Clin N Am. (2021) 30:101–16. doi: 10.1016/j.chc.2020.08.006, PMID: PubMed DOI PMC

Brivio F, Viganò A, Paterna A, Palena N, Greco A. Narrative Review and Analysis of the Use of “Lifestyle” in Health Psychology. Int J Environ Res Public Health. (2023) 20:4427. doi: 10.3390/ijerph20054427, PMID: PubMed DOI PMC

Kasović M, Štefan L, Zvonar M. Self-reported vs measured physical fitness in older women. Clin Interv Aging. (2020) 15:425–30. doi: 10.2147/CIA.S240156, PMID: PubMed DOI PMC

Evaristo S, Moreira C, Lopes L, Oliveira A, Abreu S, Agostinis-Sobrinho C, et al. Muscular fitness and cardiorespiratory fitness are associated with health-related quality of life: result from labmed physical activity study. J Exerc Sci Fit. (2019) 17:55–61. doi: 10.1016/j.jesf.2019.01.002, PMID: PubMed DOI PMC

Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc. (2011) 43:1334–59. doi: 10.1249/MSS.0b013e318213fefb, PMID: PubMed DOI

Kotarska K, Nowak MA, Nowak L, Król P, Sochacki A, Sygit K, et al. Physical activity and quality of life of University students, their parents, and grandparents in Poland-selected determinants. Int J Environ Res Public Health. (2021) 18:3871. doi: 10.3390/ijerph18083871, PMID: PubMed DOI PMC

Pinho CDF, Bagatini NC, Lisboa SDC, Mello JB, Cunha G d S. Effects of different supervised and structured physical exercise on the physical fitness trainability of children and adolescents: a meta-analysis and meta-regression. BMC Pediatr. (2024) 24:798. doi: 10.1186/s12887-024-04929-2 PubMed DOI PMC

Fernandes J, Arida RM, Gomez-Pinilla F. Physical exercise as an epigenetic modulator of brain plasticity and cognition. Neurosci Biobehav Rev. (2017) 80:443–56. doi: 10.1016/j.neubiorev.2017.06.012, PMID: PubMed DOI PMC

Li L, Wang YY, Wang SB, Li L, Lu L, Ng CH, et al. Sleep duration and sleep patterns in Chinese university students: a comprehensive meta-analysis. J Clin Sleep Med. (2017) 13:1153–62. doi: 10.5664/jcsm.6760, PMID: PubMed DOI PMC

Benson S, Verster JC, Verster JC, Scholey A. Consumption patterns of alcohol and alcohol mixed with energy drinks in Australian students and non-students. Nutrients. (2020) 12:149. doi: 10.3390/NU12010149, PMID: PubMed DOI PMC

De Giorgi A, Valeriani F, Gallè F, Ubaldi F, Bargellini A, Napoli C, et al. Alcohol mixed with energy drinks (AmED) use among university students: a systematic review and meta-analysis. Nutrients. (2022) 14:4985. doi: 10.3390/nu14234985, PMID: PubMed DOI PMC

Mindell JA, Owens JA, Carskadon MA. Developmental features of sleep. Child Adolesc Psychiatr Clin North Am. (1999) 8:695–725. doi: 10.1016/S1056-4993(18)30149-4 PubMed DOI

Paulozzi LJ, Ballesteros MF, Stevens JA. Recent trends in mortality from unintentional injury in the United States. J Saf Res. (2006) 37:277–83. doi: 10.1016/j.jsr.2006.02.004, PMID: PubMed DOI

Saltychev M, Saltychev M, Juhola J, Juhola J, Ervasti J, Kivimäki M, et al. Association of changes in lifestyle with changes in sleep difficulties: an analysis of 38 400 participants over a 16-year follow-up. BMJ Open. (2021) 11:e050046. doi: 10.1136/BMJOPEN-2021-050046 PubMed DOI PMC

Burkhalter TM, Hillman CH. A narrative review of physical activity, nutrition, and obesity to cognition and scholastic performance across the human lifespan. Adv Nutr. (2011) 2:201S–6S. doi: 10.3945/an.111.000331, PMID: PubMed DOI PMC

Sane J, Ylipaavalniemi P, Turtola L, Niemi T, Laaka V. Traumatic injuries among university students in Finland. J Am Coll Heal. (1997) 46:21–4. doi: 10.1080/07448489709595582, PMID: PubMed DOI

Grandner MA, Fernandez FX. The translational neuroscience of sleep: a contextual framework. Science. (2021) 374:568–73. doi: 10.1126/science.abj8188, PMID: PubMed DOI PMC

Mandolesi L, Polverino A, Montuori S, Foti F, Ferraioli G, Sorrentino P, et al. Effects of physical exercise on cognitive functioning and wellbeing: biological and psychological benefits. Front Psychol. (2018) 9:509. doi: 10.3389/fpsyg.2018.00509 PubMed DOI PMC

Jones MM, Nallamala S, Adams TM, Church B, Bryant LG. Perceived versus actual health related fitness among college students: 3645 board #92 June 3 8. Med Sci Sports Exerc. (2017) 49:1042. doi: 10.1249/01.MSS.0000519860.36630.BB DOI

McGranahan MJ, O’Connor PJ. Influence of regular physical activity on sleep In: Cisler JM, Crombie KM, Adams TG, editors. Exercise and mental health. Cham: Springer. (2024) doi: 10.1007/7854_2024_503 PubMed DOI

Grier T, Dinkeloo E, Reynolds M, Jones BH. Sleep duration and musculoskeletal injury incidence in physically active men and women: a study of U.S. army special operation forces soldiers. Sleep Health. (2020) 6:344–9. doi: 10.1016/j.sleh.2020.01.004 PubMed DOI

Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major noncommunicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. (2012) 380:219–29. doi: 10.1016/S0140-6736(12)61031-9, PMID: PubMed DOI PMC

Peterson C, Miller GF, Barnett SBL, Florence C. Economic cost of injury - United States, 2019. MMWR Morb Mortal Wkly Rep. (2021) 70:1655–9. doi: 10.15585/mmwr.mm7048a1, PMID: PubMed DOI PMC

Stickley A, Oh H, Sumiyoshi T, McKee M, Koyanagi A. Injury and depression among 212 039 individuals in 40 low- and middle-income countries. Epidemiol Psychiatr Sci. (2019) 29:e32. doi: 10.1017/S2045796019000210, PMID: PubMed DOI PMC

Kasović M, Štefan A, Štefan L. The associations between objectively measured gait speed and subjective sleep quality in first-year university students, according to gender. Nat Sci Sleep. (2021) 13:1663–8. doi: 10.2147/NSS.S328218, PMID: PubMed DOI PMC

Suris JC, Jeannin A, Michaud PA, Narring F, Diserens C, Smash Group . Unintentional injuries among 16 to 20 year old students in Switzerland. Int J Adolesc Med Health. (2004) 16:265–73. doi: 10.1515/ijamh.2004.16.3.265, PMID: PubMed DOI

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. (1989) 28:193–213. doi: 10.1016/0165-1781(89)90047-4, PMID: PubMed DOI

Jin Y, Ma H, Meng Y, Yin X, Gu S. Study on the relationship between physical activity level and physical fitness. Int J Phys Act Health. (2024) 3:95. doi: 10.18122/ijpah.3.3.95.boisestate DOI

Inigo A, Lestari H, Masloman N, Lolombulan J. Melatonin level and sleep disorders in adolescents. Paediatr Indones. (2015) 55:215–8. doi: 10.14238/pi55.4.2015.215-8 DOI

Peltzer K, Phaswana-Mafuya N, Arokiasamy P, Biritwum R, Yawson A, Minicuci N, et al. Prevalence, circumstances and consequences of non-fatal road traffic injuries and other bodily injuries among older people in China, Ghana, India, Mexico, Russia and South Africa. Afr Saf Promot A J Inj Violence Prev. (2015) 13:59–77.

Gerber M, Brand S, Holsboer-Trachsler E, Pühse U. Fitness and Exercise as Correlates of Sleep Complaints. Med Sci Sports Exerc. (2010) 42:893–901. doi: 10.1249/MSS.0b013e3181c0ea8c, PMID: PubMed DOI

Kansagra S. Sleep disorders in adolescents. Pediatrics. (2020) 145:S204–9. doi: 10.1542/peds.2019-2056I, PMID: PubMed DOI

Bonar EE, Green MR, Ashrafioun L. Characteristics of university students who mix alcohol and energy drinks. J Am Coll Heal. (2017) 65:288–93. doi: 10.1080/07448481.2017.1280799 PubMed DOI

Reiner M, Niermann C, Jekauc D, Woll A. Long-term health benefits of physical activity--a systematic review of longitudinal studies. BMC Public Health. (2013) 13:813. doi: 10.1186/1471-2458-13-813 PubMed DOI PMC

Hartwig TB, Gabbett TJ, Naughton G, Duncan CS, Harries SK, Perry NJ. Training and match volume and injury in adolescents playing multiple contact team sports: a prospective cohort study. Scand J Med Sci Sports. (2018) 29:469–75. doi: 10.1111/SMS.13343, PMID: PubMed DOI

Martin-Diener E, Foster S, Mohler-Kuo M, Martin BW. Physical activity, sensation seeking, and aggression as injury risk factors in young Swiss men: a population-based cohort study. J Phys Act Health. (2016) 13:1049–55. doi: 10.1123/jpah.2015-0602, PMID: PubMed DOI

Aira T, Salin K, Vasankari T, Korpelainen R, Parkkari J, Heinonen OJ, et al. Training volume and intensity of physical activity among young athletes: the health promoting sports club (HPSC) study. Adv Phys Educ. (2019) 9:270–87. doi: 10.4236/APE.2019.94019 DOI

Uehlia K, Mehta AJ, Miedinger D, Hug K, Schindler C, Holsboer-Trachsler E, et al. Sleep problems and work injuries: A systematic review and metaanalysis. Sleep Med Rev. (2014) 18:61–73. doi: 10.1016/j.smrv.2013.01.004, PMID: PubMed DOI

Hagum CN, Tønnessen E, Hisdal J, Shalfawi SAI. The effect of progressive and individualised sport-specific training on the prevalence of injury in football and handball student athletes: a randomised controlled trial. Front Sports Act Living. (2023) 5:1106404. doi: 10.3389/fspor.2023.1106404 PubMed DOI PMC

Hair JJF, Hult GTM, Ringle CM, Sarstedt M. A primer on partial least squares structural equation modeling (PLS-SEM). Second ed. Los Angeles: Sage publications; (2017).

Raikes AC, Athey A, Alfonso-Miller P, Killgore WDS, Grandner MA. Insomnia and daytime sleepiness: risk factors for sports-related concussion. Sleep Med. (2019) 58:66–74. doi: 10.1016/j.sleep.2019.03.008, PMID: PubMed DOI PMC

Dzierzewski JM, Sabet SM, Ghose SM, Perez E, Soto P, Ravyts SG, et al. Lifestyle factors and sleep health across the lifespan. Int J Environ Res Public Health. (2021) 18:6626. doi: 10.3390/IJERPH18126626, PMID: PubMed DOI PMC

Plante TG, Lantis A, Checa G. The influence of perceived versus aerobic fitness on psychological health and physiological stress responsitivity. Int J Stress Manage. (1998) 5:141–56. doi: 10.1023/A:1022936930992 DOI

Hsu CC, Hsu CC, Gu M, Lee TS, Lu CJ. The effects of daily sleep condition on performances of physical fitness among Taiwanese adults: a cross-sectional study. Int J Environ Res Public Health. (2020) 17:1907. doi: 10.3390/IJERPH17061907, PMID: PubMed DOI PMC

Mah CD, Kezirian EJ, Marcello BM, Dement WC. Poor sleep quality and insufficient sleep of a collegiate student-athlete population. Sleep Health. (2018) 4:251–7. doi: 10.1016/j.sleh.2018.02.005, PMID: PubMed DOI

International Olympic Committee Injury and Illness Epidemiology Consensus Group. Bahr R., Clarsen B., Derman W., Dvorak J., Emery C. A., Finch C. F., et al. (2020). International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS)). Orthopaedic journal of sports medicine, 8:2325967120902908. doi: 10.1177/2325967120902908 PubMed DOI PMC

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