Physical activity levels among college students in Saudi Arabia

ABSTRACT

Objectives:

To synthesize the literature on Saudi college students physical activity (PA) levels, barriers, and facilitators, as well as the proportion of college students meeting WHO-recommended PA guidelines

Methods:

A comprehensive search strategy was developed, and the databases PubMed, CINAHL, and Scopus were searched for relevant studies. The systematic review protocol was registered in PROSPERO and the PRISMA reporting guidelines were followed. Studies that enrolled Saudi college students and reported PA levels, barriers to PA, facilitators of PA, or adherence to WHO PA recommendations were included. Reviews, animal studies, and conference proceedings were excluded. The quality of the studies was assessed with a relevant study quality assessment tools and data were extracted and synthesized from all the included studies.

Results:

A total of 44 studies were included, with a combined sample of 29,580 students. Most of these studies used cross-sectional designs and self-reported PA levels using various scales, with the International Physical Activity Questionnaire being the most common one. The results show that a substantial proportion of students exhibited low PA levels, with only 27% meeting WHO-recommended PA cutoffs. The barriers to engaging in PA included lack of time, motivation, and facilities, while the facilitators comprised health benefits, social support, and weight management.

Conclusion:

Physical activity levels among Saudi university students are concerningly low, with many failing to meet the WHO-recommended PA cutoffs. Barriers such as time constraints and limited resources must be addressed through culturally tailored interventions, improved infrastructure, and awareness campaigns. Future scholars should conduct longitudinal studies and employ objective measures of PA to further inform public-health policy.

PROSPERO Reg. No.: CRD42024542313

The World Health Organization (WHO) defines physical activity (PA) as “any bodily movement produced by skeletal muscles that requires energy expenditure”.¹ The WHO considers PA a fundamental aspect of maintaining and improving overall health.² It has been reported that regularly engaging in PA has considerable health benefits, including increased cardiovascular function, high bone density, and great muscle strength.² Furthermore, PA helps to prevent and manage common noncommunicable diseases, such as heart disease, stroke, diabetes, and some types of cancers.³ PA also enhances physical and mental health, and it improves the overall quality of life and well-being of individuals.⁴

According to the WHO’s guidelines, adults (individuals aged 18–65 years) should engage in at least 150–300 minutes of moderate aerobic PA, or at least 75–150 minutes of vigorous aerobic PA, per week.² One of the goals of the WHO is to achieve a “healthier world” by 2030 by increasing PA levels.⁵ However, despite this effort, young people, especially university students, are still below the recommended levels of PA.^6,7 As young adults transition from high schools to higher education institutions, they often live through significant changes in their lifestyles, academic demands, and social environments.^8,9 In Saudi Arabia, where cultural and environmental factors influence lifestyle choices, promoting PA among university students is essential.¹⁰

Saudi university students face unique challenges that can affect their PA patterns. These include busy academic schedules, limited access to recreational facilities, cultural norms, and environmental conditions. Still, regularly engaging in PA offers numerous benefits, such as improved physical health, enhanced mental well-being, better academic performance, and the development of lifelong healthy habits.¹¹ Recognizing the importance of PA, many Saudi universities are taking steps to promote active lifestyles among their students. Initiatives such as sport programs, fitness centers, and awareness campaigns that aim to promote PA and create supportive environments for it are becoming more common. In this context, understanding the facilitators of PA and addressing potential barriers to the achievement of the recommended PA levels can help Saudi universities develop strategies that foster a culture of health and fitness. This can contribute to the well-being and success of students, which will reflect positively on the higher education sector.

This systematic review synthesized the current evidence regarding PA levels among college students in Saudi Arabia by comprehensively examining available data. It also examined common barriers and facilitators pertaining to engagement in PA. Finally, the review reports the proportions of Saudi college students who meet the recommended weekly PA cutoffs.

Methods

A robust protocol was developed to outline the key terms and search strategy used to find relevant studies and databases, the screening processes for the potential studies, and the procedures for data extraction and synthesis for the included studies. Furthermore, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.¹²

Based on our inclusion criteria, we looked for 1) studies that enrolled Saudi college students and reported the following factors: i) PA levels (quantitative or qualitative data), ii) barriers and facilitators concerning PA, or iii) the proportion of Saudi college students who met the abovementioned WHO-recommended weekly PA cutoffs; and 2) studies written in English or Arabic. We excluded review studies (systematic, scoping, narrative, and so on), case studies (n=1), and abstracts, conference proceedings, editorials, commentaries, and animal studies. We searched 3 electronic databases—PubMed, CINAHL, and Scopus—on May 2024, using relevant keywords (Table 1).

Table 1.

- Key terms and search strategy used in the study.

Term 1	Term 2	Term 3
Physical activity OR physical activities OR exercise OR sedentary behavior OR activity OR physical activity levels OR Pattern OR participation	College students OR undergraduate students OR Saudi university OR female students OR male students OR female and male student OR medical students OR health colleges OR college students	Saudi Arabia OR Saudi OR Kingdom of Saudi Arabia, males, females, students

In addition to searching the electronic databases mentioned above, we hand searched the reference lists of the included studies to find other potential works that did not appear in the initial electronic search. Two authors (SSB and NZA) independently screened the studies’ titles and abstracts to determine their initial potential eligibility; then, a full-text review was carried out. The Covidence software (Veritas Health Innovation, Melbourne, Australia) was used to maintain consistency, track the screening process, and generate the PRISMA flowcharts. In the case of disagreement regarding the studies, a meeting was convened to solve the issue.

A predefined data extraction form (Microsoft word document) was used by each author to collect and extract the variables of interest from the included studies. These variables included i) the first author’s last name, ii) the study’s aims, iii) the sample’s demographic data, iv) the study’s design, v) reported PA levels, vi) barriers and facilitators, vii) patterns, and viii) data concerning the recommended weekly exercise levels. The 2 authors independently extracted the data from the included studies, met to discuss and revise the 2 forms, and resolved any disagreements between them. Afterward, a finalized data extraction form was used to synthesize the findings of the systematic review (Appendix A).

Study quality assessment

The methodological quality of the included studies was assessed using the relevant study quality assessment tools developed by the National Heart, Lung, and Blood Institute.¹³ These tools use text-based descriptions to classify observational and experimental studies as good, fair, or poor based on specific questions related to the internal validity of the included studies.¹³ The authors met to discuss the results of their quality assessments, and they reached a final decision regarding the quality of each included study (Appendix A).

Data synthesis

A robust summary was synthesized using data from the chosen studies. This included reporting and summarizing the studies’ results and designs as well as the findings of the quality assessment.

Results

A total of 291 studies were identified and screened for inclusion (database search, n=285; hand search, n=6). Of these studies, 53 were removed as duplicates; the remaining 238 were screened to check the relevance of their titles and abstracts. Of these 238 studies, 160 were irrelevant; hence, they were excluded. The remaining 78 underwent full-text review. Of these 78 studies, 34 were excluded for various reasons, including the absence of PA data (n=22), wrong settings (n=2), wrong outcomes (n=8), and the lack of full texts (n=2). The remaining 44 studies were chosen for the systematic review.^8-10,14-54

Overall descriptive summary

The 44 studies included in this systematic review were published from 2008 onward. Based on the quality assessment, 35 studies were categorized as good,^{8-10,14-18,20-40,44,49-52,54} and 9 studies were categorized as fair.^{19,41-43,45-48,53}

The included studies were published in 2008 and onward to 2024, with most publications done in 2023 (Table 2). The included studies were from different Saudi universities distributed among different regions (Figure 1) with the highest region that investigated physical activity among their college students in the central region of Saudi Arabia. The distribution of the included studies across Saudi universities were as follow: 13 studies from King Saud University,^{20,23,25,32-36,40,41,44,51} 5 studies from King Khaled University,^{9,29,30,38,39} and 2 studies from each of the following universities: Dammam University,^45,49 Majmaah University,^22,54 Jazan University,^14,50 Princess Nourah Bin Abdulrahman University,^28,37 and Umm Al-Qura University.^48,50 The remaining universities, which produced one study each, were King Faisal University,²⁶ Taif University,³¹ Imam Abdulrahman Bin Faisal University,²⁴ the Female Community College in Al-Quwayiyah,⁴² Kin Fahad University of Petroleum and Minerals,⁴³ Taibah University,⁵³ Al-Ahsa Medical College,⁴⁶ King Abdulaziz University,⁴⁷ Qassim University,¹⁰ and the University of Hafir Albatin.⁸ There was only one multisite study, which was conducted at Taif University, King Faisal University, and Imam Abdulrahman Bin Faisal University.¹⁸ The remaining 5 studies did not state where they were carried out.^15-17,19,21

Table 2.

- Distribution of published studies among Saudi Arabian regions.

Geographical region in Saudi Arabia	Studies (n)
Central region	18
Eastern region	8
Western region	5
Northern region	0
Southern region	7
Not Reported	5
Multi-cite study	1
Total	44

Figure 1.

- Year-Wise publication summary for included studies from 2008-2024.

Figure 2.

- Preferred reporting items for systematic reviews and meta-analyses flow chart.

The combined sample size from all the studies was 29,580 college students (women=16,019, 54%; men=9,594, 32%; not reported/unspecified=3,973, 14%). Most of the included studies used cross-sectional designs.^{8-10,14-16,18-23,26,28,30-51,53,54} One study utilized a 2×2 randomized trial design.¹⁷ One study employed an observational design.²⁴ One study used a mixed-methods design.²⁵ One study utilized a cohort design and another one employed an experimental design.^27,29

The studies used different scales to measure PA levels. The International Physical Activity Questionnaire (IPAQ) was used in 16 studies.^{8-10,17,20,22,31,42,44-48,51-53} The Global Physical Activity Questionnaire was used in 5 studies.^19,20,27-29 The Arab Teen Lifestyle Study questionnaire was utilized in 5 studies.^32,34,37-39 The following PA scales were employed in one study each: the Youth Risk Behavior Survey,¹⁴ the Active Questionnaire tool,¹⁵ the Sedentary Behavior Questionnaire,¹⁶ a mobile application,¹⁸ the WHO STEPwise questionnaire,²³ the Lifestyle behavior questionnaire,²⁴ the Health Promotion Lifestyle Profile II,³³ the adapted 4-level Saltin–Grimby Physical Activity Level Scale,³⁵ and an accelerometer device worn on the body.⁴⁹ Four studies used self-administered questionnaires.^36,40,43,54 Three studies did not report how PA levels were quantified.^26,30,50

PA levels

Of the 44 included studies, 26 reported the PA levels of college students and classified them as inactive or engaging in low, moderate, or vigorous PA.^{8-10,15,19,21,25,28,30,31,33-35,37-39,41,42,44-48,50,53,54} These 26 studies documented 752 inactive students, 5,402 students who engaged in low PA, 4,856 students who practiced moderate PA, and 3,501 who engaged in vigorous PA. Other studies reported the total number of minutes of PA per week.^{26,36,40,43,54} These results were as follows: 20 minutes or more, n=118;⁴⁰ 30 minutes, n=157;^36,43 more than 30 minutes, n=50;²⁶ more than 60 minutes, n=47;³⁶ 30-60 minutes, n=87;³⁶ 50-70 minutes, n=60;⁵⁴ 70-150 minutes, n=122;⁵⁴ and 150 minutes or more, n=60.^,43,5

Physical activity levels before and after the COVID-19 pandemic. Of the 44 selected studies, 6 [^{15,18,22,24,27,51}] examined PA levels before and after the COVID-19 pandemic. Four studies, ^15,22,24,51 which had a total sample of 2,630, reported that 319 (12%) participants were inactive, 816 (31%) were slightly active, 403 (15%) were moderately active, and 227 (8%) were highly active. Two studies^18,27 calculated the amount of time that college students spent being sedentary and the total number of steps they took before and after the pandemic. The results show that sedentary time increased²⁷ and that the number of steps per day of college students decreased in the first year after the pandemic; however, in the second year after the pandemic, the average number of steps per day returned to pre-COVID-19 levels.¹⁸

Saudi college students’ exercises

Of the 44 included studies, seven reported the types of exercises done by Saudi university students.^{20,23,32,36,37,44,54} Walking was the most common type of exercise (40%-70% of students). Of these 7 studies, 5 reported that 25%–40% of students engaged in weightlifting.^{20,23,36,37,44} Five also reported that 43%–48% of students went running/jogging.^{23,36,37,44,54} Furthermore, four of these 7 studies found that 6%–36% of students went swimming or played football (soccer).^23,37,44,54 Finally, 2 studies reported that about 15% of Saudi college students performed cycling exercises.^37,44

PA barriers and facilitators

Of the 44 selected studies, 10 reported barriers or facilitators pertaining to regular engagement in PA.^{8-10,25,36,37,39,40,46,51} The barriers included lack of time, motivation, encouragement, and access to exercise facilities, as well as body image issues and weather conditions. The facilitators comprised seeing health benefits after exercising (such as reduced stress, a good body shape, and an improved mood), being supported by family members, and having to manage one’s weight.

Meeting the WHO-recommended weekly moderate-to-vigorous PA cutoffs

Of the 44 included studies, only 3 reported the proportions of college students who met the weekly moderate-to-vigorous PA (MVPA) cutoffs recommended by the WHO (at least 150-300 minutes of moderate aerobic PA or at least 75-150 minutes of vigorous aerobic PA per week). In these three studies, approximately 27% of students met the cutoffs in question.

Discussion

In this systematic review, we comprehensively synthesized and summarized the PA of college students in Saudi Arabia with regard to patterns, barriers, and facilitators, as well as adherence to WHO guidelines. The findings show a significant prevalence of low PA levels among the study population, with a substantial proportion of students not meeting the weekly recommended exercise levels expressed as the total time spent engaging in MVPA.^34,36,37 These findings align with global trends indicating that university students often experience a decline in PA level/intensity due to the lifestyle changes associated with higher education, such as increased academic demands, social transitions, and new daily routines.^9,38

The low levels of PA among Saudi college students are particularly concerning given the well-documented benefits of regular engagement in PA, including the prevention of common noncommunicable diseases, improvements in mental health, and better quality of life.^1,55 Some of the reviewed studies reported reductions in the levels of PA after the COVID-19 pandemic.^{15,18,22,24,27,51} This has exacerbated a preexisting problem, and it indicates that the pandemic has produced a long-lasting negative effect on the PA habits of university students. This decline in PA levels may have resulted from the closure of recreational places, shifts toward online learning, and increased sedentary behavior due to periods of lockdown.

Barriers to PA, such as lack of time, motivation, and access to facilities, were consistently reported in the studies.^8,9,36 These barriers reflect broader societal and personal challenges concerning the promotion of active lifestyles at university. These challenges are particularly felt in Saudi Arabia, where cultural and environmental factors may considerably limit opportunities for regular PA. For example, unpleasant weather conditions and limited public spaces can significantly deter people from exercising frequently.⁷ The facilitators documented in this review, such as perceived health benefits, family support, and weight management goals, indicate potential areas and strategies for improvement.^37,40 By building on these facilitators, the PA levels of Saudi college students can be increased.

The relatively low proportion of students meeting WHO-recommended PA levels shows the need for targeted interventions in Saudi universities.^25,29,39 Physical education programs that address the identified barriers and strengthen the facilitators could play a crucial role in promoting PA among college students. Specifically, universities could implement more accessible and varied PA programs, improve their infrastructure, and run awareness campaigns that emphasize the importance of PA for physical and mental health. Our findings also highlight the importance of culturally tailored approaches to promoting PA. Given the unique cultural and environmental contexts of Saudi Arabia, interventions must be sensitive to the specific challenges faced by students in this country.¹⁰ For instance, offering indoor exercise options during periods of extreme weather or incorporating culturally relevant activities could enhance PA participation rates and eventually improve students’ health and quality of life.

Strengths and limitations

This systematic review has several strengths. First, it provides a comprehensive overview of PA in a large and diverse sample of college students across Saudi universities, drawing on studies conducted over several years. Second, the rigorous methodology, including the reliance on the PRISMA guidelines and quality assessment tools, ensures that our findings are reliable and applicable. Third, our systematic review highlights both quantitative and qualitative aspects of PA, thus offering a detailed understanding of the barriers and facilitators influencing college students’ exercise levels.

However, this systematic review also has limitations. The majority of the included studies relied on self-reported questionnaires, such as the IPAQ, to examine PA levels. The use of such questionnaires may lead to inaccurate PA data and reporting bias; for example, participants may overestimate or underestimate their exercise levels.⁵⁵ Moreover, the cross-sectional design that most of the included studies adopted makes it difficult to establish causal relationships between variables such as PA barriers and actual exercise levels. Another limitation is the lack of longitudinal data, which could provide great insights into how PA levels change over time, particularly during key transitional periods (such as the time spent at university).

Future research directions

This systematic review emphasizes the critical need for strategies that improve PA levels among college students in Saudi Arabia by removing the barriers and reinforcing the facilitators identified in this study to promote healthier, more active lifestyles. Future scholars should evaluate the effectiveness of specific interventions and explore innovative approaches that can overcome the challenges identified. By fostering an environment that supports regular PA, universities can significantly contribute to the long-term health and well-being of their students.^1,36,37

Future scholars should address the limitations of this review. Longitudinal studies are needed to monitor changes in PA levels over time, particularly in relation to major life events, such as the transition to university. Furthermore, researchers should employ objective measures of PA, such as accelerometers and pedometers, to complement self-reported data and reduce potential bias. Scholars should also explore the effectiveness of interventions designed to overcome the barriers identified in this review; interventions tailored to the cultural and environmental contexts of Saudi Arabia should be paid special attention. Finally, there is a need for studies that investigate the long-term health outcomes of different PA levels among college students. These studies could offer important evidence to guide public-health policies and university programs aimed at promoting PA among Saudi students.

In conclusions, the present systematic review highlights the concerningly low levels of PA among college students in Saudi Arabia, where a significant proportion of this population fails to meet the WHO-recommended guidelines for MVPA. The barriers to regularly engaging in PA identified in this review included lack of time, motivation, and access to facilities, while the facilitators comprised health benefits, social support, and weight management goals. Removing these barriers and enhancing these facilitators through culturally sensitive, targeted strategies is essential to promote PA and enhance the health of Saudi college students. Saudi universities can play a crucial role in creating environments that promote active lifestyles through infrastructure, awareness programs, and personalized interventions. Future scholars should evaluate the effectiveness of these interventions while considering the long-term health outcomes associated with increased PA in the population in question.

table 1.

- Data extraction sheet.

First author last name (year of publication)	Study design Study quality assessment Sample size (male [m], female [f]) Average age (years) Study region (University name)	Main findings
		Physical activity (PA) Data (Quantity, Descriptive)	Type of exercise	Barriers and Facilitators	Meeting PA cutoffs % (M, F), Based on WHO	Study limitations
Oraibi O et al, (2024)14	Cross-sectional PA tool: the Youth Risk Behavior Survey Good 474 (M=300, F=174) 22.15±3.64 years Jazan (Jazan University)	Participated in PA for at least 20 minutes that made you sweat= 0 days: n= 185 (39%) 1–3 days: n= 187 (39.5%) 4–6 days: n=77 (16.2%) 7 days: n=25 (5.3%) Participated in PA for at least 20 minutes that did not make you sweat: 0 days: n=245 (51.7%) 1–3 days: n=148 (31.2%) 4–6 days: n=52 (11%) 7 days: n=29 (6.1%)	-	-	-	Lack of other PA and PA contexts data
Mahfouz, HA et al, (2024)50	Cross-sectional PA tool: not reported Good 652 (M=196, 30% F=456, 70%) Mecca (Umm Al-Qura University, Colleges of Medicine, Dentistry, Pharmacy, Nursing, Applied Medical Sciences, Public Health, and Health Informatics)	23.0%, n=150 of the sample does not engage in physical activity regularly. 28.5%, n=186 reported engagement less than once a week. 34.7%, n=226 of the sample reported spending no time on exercise per day	-	-	-	No PA duration/intensity reported
Almeheyawi R et al, (2024)15	Cross-sectional PA tool: Active-Questionnaire Good 197 all females	Inactive (0 MET-min/week): n=2 (1.1%) Low (0–499 MET-min/week): n=20 (10.1%) Moderate (500–1000 MET-min/week): n=66 (33.5%) High (>1000 MET-min/week): n=109 (55.3%)	-	-	-	Lack of other PA and PA contexts data
Alahmadi MA et al, (2024)16	Cross-sectional PA tool: the Sedentary Behavior Questionnaire Good 6,975 (M=3,553, F=3,422) 21.03±1.99	Males: SB= 521.73±236.53 (mins/day), 64.1% Females: SB=467.38±255.28 (min/day), 52.3% Total sample: SB=495.09±247.38 (min/day), 58.4%	-	-	-	Lack of PA contexts data
Saquib J et al, (2023)17	2 × 2 randomized trial design group 1: intervention: WhatsApp (12-weeks duration), and group 2: control PA tool: IPAQ Good 181 all females 22.6±1.35	Baseline measures: Intervention group=4813±2430 (steps/day) Control=4392±2000 (steps/day)	-	-	-	Lack of other PA and PA contexts data
Aly M et al, (2023)18	Cross-sectional PA tool: mobile app Good 628 (M=299, F=329) 20.4±2.9 years Mecca (Taif University) Eastern (Prince Sultan Military College for Health Sciences, King Faisal University, and Imam AbdulRahman Bin Faisal University)	Averaged daily steps: Pre-pandemic =3793.68±1733.281 (steps/day) First pandemic year =2873.360±1593.725 Second pandemic year =3598.070±1915.334	-	-	-	Lack of other PA and PA contexts data
Alrushud, A et al, (2023)51	Cross-sectional PA tool: IPAQ-SF Good 396 (M=143, F=253) 21.1±1.6 years Riyadh (King Saud University) - Riyad (King Saud University)	(n=22)	-	47% of students agreed that the lockdown and the transition to online learning impacted their compliance to exercise. Students perceived that online learning did not help them to increase their PA levels	-	Lack of other PA and PA contexts data
Alnofaiey, YH et al, (2023)19	Cross-sectional PA tool: the Global Physical Activity Questionnaire Fair 2,819 (M=944, F=1,875) 22.17±2.28 years	44.3% low activity 41.5 moderate activity 14.2 high activity	-	-	-	Lack of other PA and PA contexts data
Alhammad SA et al, (2023)20	Cross-sectional PA tool: Global Physical Activity Questionnaire Good 377 (M=223, F=154) 19.3±1.3 years Riyadh (College of Applied Medical Sciences, King Saud University) - Riyadh (College of Applied Medical Sciences, King Saud University)	-	Walking was the most popular physical activity for about 42.7% of students, followed by gym or bodybuilding (37.8%), and football (11.6%). The majority of the students engaged in VIA for an average of 1.5 hours per day, followed by 1.4 hours of vigorous-intensity sports, fitness, or leisure activities (VISFRA). The average amount of time spent performing VIA and MIA at work on a normal day was 1.5 (SD=0.91) and 0.98 (SD=0.59), respectively. Additionally, more than half of the students (52.4%, n = 108) engaged in moderate-intensity sports, fitness, or recreational activities (MISFRA) for an average of 1.03 (SD=0.63) hours each day, which resulted in significant increases in breathing or heart rate for at least 10 minutes continuously. y activities (MIA), VIA, MISFRA, and VISFRA, respectively. Walking or bicycling for at least 10 minutes continuously to get to and from places was done by 21.9% (n=25) of students for 5 days a week	-	-	Lack of PA contexts data
Alghamdi IK et al, (2023)21	Cross-sectional PA tool= IPAQ Good 241 males (mean not reported), range=20-28 years Male medical students from the same college	Low: n=144 (59.8%) Moderate: n=48 (19.9%) High: n=49 (20.3%)
Sirajudeen MS et al, (2022)22	Cross-sectional PA tool= IPAQ-SF Good 313 (M=143, F=170) 22.6±4.08 years Riyadh (College of Applied Medical Sciences, Majmaah University)	Light: n=143 (45.70%) Moderate: n=123 (39.29%) Vigorous: n=47 (15.01%)	-	-	-	Lack of other PA and PA contexts data
Samarkandi, OA et al, (2022)23	Cross-sectional PA tool= the WHO stepwise questionnaire Good 176, all males Not reported (range=18-30 years) Riyadh (Prince Sultan College for Emergency Medical Services, King Saud University)	Any type of PA on weekly basis Yes=123 (69.9%) No=53 (30.1%)	-Walking=91 (51.7%) -Gym/bodybuilding= 44 (25%) -Running 43 (24.4%) -Swimming 12 (6.8%) -Football 39 (22.2%) -I’m not active physically=43 (24.4%)	-	-	Lack of PA contexts data
Rafique N et al, (2022)24	Observational PA tool= lifestyle behavior Questionnaire Good 1724 (sex did not reported) 18 ± 2 years Eastern (Imam Abdulrahman Bin Faisal University, Dammam)	1-Month before COVID, based on IPAQ: Low=390 (22.6%) Moderate=288 (16.7%) High=69 (4.0) 2-years after COVID: Low=653 (37.9%) Moderate=157 (9.1) High=49 (2.8)	-	-	-	Lack of PA contexts data
Aljehani N et al, (2022)25	Mixed methods (cross-sectional) PA tool: IPAQ Good 375 females 19.9±1.7 years (range 18–28 years) Riyadh (King Saud University)		-	Barriers: Themes: 1) Unsuitability of environment (Subtheme: Extreme climate conditions Road’s design and safety concerns) 2) Difficulties in accessing facilities (Subtheme: Limited female facilities High gym fees) 3) Personal barriers (Subthemes: Academic workload Not seeing physical activity as a priority) 4) Social contextual factors (Subthemes: Soia-cultural expectations regarding a socially acceptable body image Restrictive gender role Pressure to adhere to cultural and religious standards) Motivators: 1) Personal motivators (Subtheme: Noticing positive results from physical activity Having a company to workout with General health concerns Having a high level of self-determination) 2) Family support (Subthemes: Mothers as the main source of support Being influenced by active family members)	Meeting Moderate, 150–299 mins/day: n=42 (11.2%) Meeting 300 or more mins/day: n=69 (18.4%). Meeting Vigorous, 75–149 mins/day: n=40 (10.7%), 150 or more mins: n=104 (27.7%).	Lack of PA contexts data
Jouhar R et al, (2021)26	Cross-sectional PA tool= not reported Good 185 males 22.29 ± 2.13 years Eastern (male dental students and interns at King Faisal University, Al-Ahsa)	Physical Activity on weekdays: None=39 (38%) <30 min=50 (22%) >30 min=98 (40%) Physical Activity on weekends: None=24 (12%) <30 min=42 (35%) >30 min=119 (53%)	-	-	-	Lack of other PA and PA contexts data
Jalal, S. M. et al., (2021)27	Cohort research (Good) before lockdown (March 2020) and another once during lockdown (June 2020) PA tool: global physical activity questionnaire 628 (M=183, F=445) Not reported (Range=18 and above years) King Faisal University, Alisha	Before Lockdown: SB=448.7± 73.6 minsday During Lockdown: SB=517.8 ± 83.03 minsday	-	-	-	Lack of other PA and PA contexts data
Alsulaiman, SH et al, (2021)28	Cross-sectional PA tool: Global Physical Activity Questionnaire Good 713 females 20.59±5.30 years Riyadh (Princess Nourah Bint Abdulrahman University)	IPAQ: High: n=173 (27.2%) Moderate: n=138 (21.7%) Low: n=326 (51.2%)	-	-	-	Lack of other PA and PA contexts data
Alshahrani A et al, (2021)29	Experimental Study PA tool:Global Physical Activity Questionnaire (GPAQ) Good 103 females Not reported Aseer (King Khalid University)	-	-	-	36% met the WHO PA guidelines	Lack of PA contexts data
Alhazmi A et al, (2021)30	Cross-sectional PA tool: not reported Good 379 females Not reported Aseer (King Khalid University)	Extremely inactive: n=39 (10.3%) Inactive: n=193 (50.9%) Active: n=130 (34.3%) Extremely active: n=17 (4.5%)	-	-	-	Lack of other PA and PA contexts data
Mahfouz MS et al, (2020)52	Cross-sectional PA tool= IPAQ Good 440 (M=215, F=225 Not reported Jazan (Jazan University)	Physically Inactive: n=276 (62.7%) Moderate Active: n=134 (30.5%) High Active: n=30 (6.8%)	-	-	-	Lack of other PA and PA contexts data
Hendi OM et al, (2019)31	Cross-sectional PA tool= IPAQ SF Good 392 (M=183, F=209) 21.83±2.9 Mecca (Taif University)	Low: n=194 (49.5%) Moderate: n=133 (33.9%) High: n=65 (16.6%)	-	-	-	Lack of other PA and PA contexts data
Alzamil HA et al, (2019)32	Cross-sectional PA tool= The Arab Teen Lifestyle Study questionnaire Good 456 females 20.3 ± 1.5 (range= 18–28 years) Riyadh (Health science colleges in King Saud University)	-	- Walking (min/week)=71.0 - Stair stepping (min/week)=9.9 - Jogging (min/week)=15.2 - Cycling (min/week)=4.5 -Swimming (min/week)=2.1 - Martial arts (min/week)=2.1 -Resistance training (min/week)=13.0 -Household chores (min/week)=84.2 - Dancing (min/week)=49.2 Moderate–intensity sports (min/week)=7.1 -Vigorous intensity sports (min/week)=6.4	-	-	Lack of PA contexts data
Almutairi et al,(2018)33	Cross-sectional PA tool: Health Promotion Lifestyle Profile II (HPLP-II) Good 1656 (M=491; F=1165 LESS THAN 20=950 21-30=662 MORE THAN 31=44 Riyadh (King Saud University)	Exercise vigorously for 20 minutes or more at least 3 times per week: Non-health student Never=167 Sometimes=267 Often=125 Routinely= 112 Health- student Never= 252 Sometimes=360 Often=199 Routinely =174 Take part in light to moderate physical activity (such as sustained walking 30–40 min 5 or more times a week Non-health student Never=184 Sometimes=276 Often=116 Routinely= 95 health student Never=289 Sometimes=377 Often=170 Routinely= 149	-	-	-	Lack of PA contexts data
Alhakbany et al, (2018)34	Cross-sectional PA tool: Arab Teen Lifestyle Study Good 454 females (Nonoverweight/nonobese, n=320; Overweight/obese, n=134) 20.3 ± 1.5 Riyadh (King Saud University)	PA: Total activity energy expenditure (METs-min/week) Non-overweight/non-obese=964.1 ± 70.9 Obese/overweight 1320.5 ± 324.8 Sum of moderate-intensity activity (METs-min/week) Non-overweight/non-obese = 573.6 ± 54.1 Obese/overweight 875.6 ± 271.6 0.277 Sum of vigorous-intensity activity (METs-min/week) Non-overweight/non-obese 390.5 ± 38.0 Obese/overweight 444.8 ± 73.7 Inactive (600METS-min/week) Non-overweight=51.6 Overweight/obese=47.8 Active (600+min/week) overweight=48.8 Overweight/obese=52.2	-	-	-	Lack of other PA and PA contexts data
Torchyan et al, (2016)35	Cross-sectional PA Tool: adapted 4-level Saltin-Grimby Physical Activity Level Scale Good 406 students (208 boys, 198 girls) 19-22 years=241 23-26 years =150 Riyadh (King Saud University)	Physically inactive or some light physical activity Total=293 (76.5%) Moderate or vigorous physical activity Total=90 (23.5%)	-	-	-	Lack of other PA and PA contexts data
Al drees et al, (2016)36	Cross-sectional PA Tool: Self questionnaire Good 409 (205 males, 204 female) 21.33 ±1.52 Riyadh (King Saud University	Number of subject >60 min/day=47 >30-60= 87 30 min=59 0 (no exercise) =216	Exercise modalities (N=193)n (%) Walking 135 (69.9) Jogging 94 (48.7) Weight lifting 59 (30.6) Football playing 56 (29.0) Swimming 35 (18.1)Others 52 (26.9)	Motivation factors (N=193) n (%) To stay in shape 115 (59.6) To improve mood 119 (61.7) Body building 112 (58.0) To reduce stress 82 (42.5) Obstacles factors (N=216) n (%) Laziness 112 (51.9%) Lack of time 94 (43.5%) Studying 84 (38.9%) No interest 18 (8.3%) Others 9 (4.2%)	-	Lack of PA contexts data
Samara et al,(2015)37	· Cross-sectional · PA tool: Arab Teens Lifestyle (ATLS) questionnaire · Good · 94 females · 20.0±0.7 · Riyadh (Princess Nourah Bint Abdulrahman University, first year)	Total minutes of physical activity (n=68) · Moderate (min/week) 267±269 · High (min/week) 47±53	Exercise Benefits/Barriers Scale (EBBS). Walk (min/week) 101±114 Stairs (min/week) 13±12 Run/jog (min/week) 16±26 Cycle (min/week) 6±24 Swim (min/week) 14±40 Moderate intensity sports (min/week) 68±175 Self-defense (min/week) 0±1.8 Weight training/bodybuilding (min/week) 12±25 Household work (min/week) 90±150	Regarding barriers, there were shared responses for most items. The students considered one important barrier to be that locations for exercise were too far away (52% agreed) and that there were too few places to exercise (75% agreed). They mostly disagreed that family members (66% disagreed) or feeling embarrassed to exercise were barriers to physical activity (71% disagreed).	-	Lack of PA contexts data
Khalaf et al, (2015)38	· Cross-sectional · PA Tool: Arab Teens Lifestyle Study (ATLS) physical activity questionnaire · Good 600 males · 20.4±1·5 · Aseer (University centre for female studies in south-western of KSA, King Khalid university)	Underweight (N=127) Light active (n=58) (45·7%) Moderately active(n=3) (26·8%) High active(n=35) (27·6%) Normal weight(=376) Low active (n=119) (31·6%) Moderate (n=130) (34·6%) High (n=127)(33·8%)	-	-	-	Lack of other PA and PA contexts data
Awadalla et al, (2014)9	Cross-sectional PA Tool: IPAQ Good 1257 students (426 males and 831 females) 20.1 (SD 1.4) Aseer (King Khalid University)	Physical activity level High Male= 60 = (14.1 %) Female=102 (12.3%) Total= 162 (12.9%) Moderate Male= 126 (29.6%) Female= 240 (28.9%) Total= 366 (29.1%) Low Male= 240 (56.3%) Female= 489 (58.8%) Total= 729 (58.0%) Vigorous activities ≥ 10 min/week Male= 114 (26.8%) Female= 148 (17.8%) Total 262 (20.8%) ≥75 min/week male=83 (19.5 %) Female=85 (10.2 %) Total= 168 (13.4%) Moderate activities ≥ 10 min/weekMale= 124 (29.1 %) Female= 264 (31.8%) Total= 388 (30.9%) ≥150 min/week male=64 (15.0%) Female= 122 (14.7%) Total= 186 (14.8%) Walking ≥60 min/week male= 194 (45.5%) female= 419 (50.4%) total= 613 (48.8 %) 150 min/week Male= 109 (25.6%) Female= 267 (32.1%) Total= 376 (29.9%)	-	Barriers: time limitations (51.3%); lack of accessible and suitable sports places (31.1%); have other important priorities (28.1%); lack of friends to encourage (27.8%); lack of support and encouragement from others (23.2%); lack of safe sporting places (22.8%); lack of motivation (19.6%); high cost (17.7%); not being interested in sports (18.5%); lack of sports skills (17.8%); feeling tired on physical activity (15.8%) and ignorance about the benefits of sports (9.3%)	-	Lack of PA contexts data
Khalaf et al., (2013)39	Cross-sectional PA tool:Arab Teens Life Style questionnaire (ATLS) Good 663 females 20.4+_1.5 Aseer (King Khalid University)	Meeting WHO recommendation: moderate-intensity PA (150 minutes/week) total = 412 of 660 (68%) vigorous-intensity PA (75 minutes/week) total= 99 of 660 (15%)	-	Facilitator:To have fun -for health - to lose weight Barriers: Time - Lack of suitable places -no one exercising with me	With regard to the WHO recommendations for maintaining a moderate-intensity PA level, only 43% of the participants in the middle tertile met these guidelines, while 14% of the same group met the recommendations for vigorous-intensity activity Among the highly active females, only 1% failed to meet the WHO guidelines for moderate-intensity activity and 24% did not fulfill the requirements for vigorous-intensity PA.	Lack of PA contexts data
Gawwad (2008)40	Cross-sectional PA tool: Self questionnaire Good 302 (150 males, 102 females) 21.38 + 1.84 years Riyadh (King Saud University)	Time to exercise per week (no. of subject) DON’T exercise=114 1-2 time=114 3-4 times= 50 Everyday= 24 Time spend when exercising(no. of subject): 0<5 minutes=85 5 minutes= 39 10 minutes= 28 15 minutes= 32 20 minutes or more= 118	-	Most of the students had low level of perceived body- and socially-related barriers. However, a considerable proportion had moderate to high levels of perceived barriers with regard to time, weather, resources and skill.	-	Lack of PA contexts data
Alhurishi (2023)41	Cross-sectional PA tool: International Physical Activity Questionnaire Short Form (IPAQ-SF) Fair 429 (m=324, f= 103) 18-19 years=105 20-21 years=182 22 or more=140 Riyadh (King Saud University)	PA Low =240 Moderate =131 High=56	-	-	-	Lack of other PA and PA contexts data
Farhan et al, (2021)54	Cross-sectional PA tool: Self questionnaire Good 150 22.56±4.31 years Riyadh (Majmaah University)	<70 minutes per week(inactive)=53 70-150 minutes per week (insufficiently active) =60 >150 (active & high active) =37	Football=47 Table tennis=20 Brisk wall=2 Swimming= 4 Housework=2 Jogging=2 Cricket=1 None=25	-	-	Lack of PA contexts data
Alarifi (2023)42	Cross-sectional PA tool: IPAQ Fair 161 females NA Riyadh (Female Community Colleges, Al-Quwayiyah city)	According to IPAQ Low activity = 13 Moderate=32 High=116	-	-	-	Lack of PA contexts data
Antony & Aseem (2019)43	Cross-sectional PA tool: IPAQ Good 376 21.7 years Riyadh (King Saud University)	PA per Week (in minutes) 60 minutes -Underweight= 17 -Normal= 2 -Obese=19 -Obese III= 17 Total= 55 90 minutes -Underweight= 11 -Normal= 8 -Obese=8 obese III= 8 total= 35 120 minutes -Underweight= 4 -Normal= 9 Obese=6 obese III= 8 total = 27 150 minutes -Underweight= 5 -Normal= 12 -Obese=4 obese III= 2 total=23	-	-	-	Lack of PA contexts data
Alsabih et al, (2018)44	Cross-sectional PA tool: IPAQ Good 376 21.7 years Riyadh (King Saud University)	(IPAQ) Descriptive: (56.6% reported doing PA 24.4% (n=52) reported doing vigorous PA (n=75)35.2% reported doing moderate PA (n=86) 40.4% reported doing light PA ≤ 30 mins 24.9% 31-60 mins 38.5% >60 mins 36.6%	50.7% reported walking Running 43.2% Weight lifting 40.8% Football 36.2% Swimming 30% Bicycling 15% Jogging/brisk Walking 14% Tennis 6.1%	-	-	Lack of PA contexts data
Jalloun & Surrati, (2020)53	Cross-sectional Tool: IPAQ Fair 658 females 18-2 Almadinah Almonawarah (Taibah university)	(IPAQ) Vigorous=247 Moderate=296 Vigorous-	-	-	-	Lack of PA contexts data
Zafar Mubashir et al, (2020)45	Cross-sectional Tool: IPAQ Fair 285 21.2±1.49 Eastern (Damman University)	Mild physical activity MET(Min/week) 160.47±150.09 Moderate physical activity (Min/week) 190.88±170.97 Vigorous physical activity (Min/week) 193.07±140.76	-	-	-	Lack of other PA and PA contexts data
El-Gilany & El-Masry, (2011)46	Cross-sectional PA tool: IPAQ Fair 297 Saudi students 20.8±1.6 Eastern (Al-Hassa Medical College)	(IPAQ) Low=122 (41.1%) moderate=143 (48.1%) high= 32 (10.8%)	-	Time limitation=267(89.9%), having other priorities 239(80.5), unsuitable weather1 53 (51.5), fear of injuries 114 (38.4) and previous bad experience with sport PA 87(29.3)	-	Lack of PA contexts data
Kokandi et al, (2018)47	Cross-sectional PA tool: IPAQ Fair 1026 Females were 767 and males were 250 18-20 years (61%), followed by the age group of 21-30 years (31.2%) Mecca (King Abdulaziz University)	Low= 200 (19.5%) Moderate= 318 (31.00%) High= 508 (49.5%)	-	-	-	Lack of PA contexts data
Bardisi et al, (2020)48	Cross-sectional PA tool: IPAQ Fair 505 (M=270, F=235) NA Mecca (Umm Al-Qura University)	Low activity level =237 (46.9%) Moderate activity level =130 (25.7%) High activity level =138 (27.3%)	-	-	-	Lack of PA contexts data
Alkahtani &Awad (2016)49	Cross-sectional PA tool: Accelerometers Good 46 (M=23, F=23) Age of female 19-20 years Eastern (University of Dammam)	Male and female students respectively spent 66.4% and 65.8% of their daily waking time sedentary, 30.1% and 32.1% in LPA, and 3.5% and 2.1% in MVPA. Nearly all, 95.7%, female students and 52.2% of male students did not engage in 30 minutes of MVPA. Analysis of MVPA for a minimum of 10 minutes, independent of a 30-minute threshold, showed that 22% of male students and 13% of female students spent a minimum of 10 minutes on MVPA more than once, and 56% of male students and 26% of female students spent a minimum of 10 minutes on MVPA at least once.	-	-	-	Lack of PA contexts data
Aldukhayel et al, (2020)10	Cross sectional PA tool: IPAQ Good 174 NA Qassim (Unayzah College- Qassim University)	Physical activity High=40% (70), Moderate=32% (55) Low= 28% (49)	-	Barriers: -study pressure 76%. - lack of time 72%.	-	Lack of PA contexts data
Alsalim (2023)8	Cross-sectional PA Tool: IPAQ-SF Good 608 (M=263, F=245) Eastern (Hafr Albatin University)	Low 204 (33.6%) Moderate 254 (41.8% High 150 (24.75) For males (No. subject) Low =78 Moderate =106 High =79 For females (no. of subject) Low =126 Moderate =148 High =71	-	Barriers:lack of resources, social influence, lack of willpower, lack of energy, lack of time, and lack of skill	-	Lack of PA contexts data