Frontiers in Public Health · Oct 30, 2026
Combined Healthy Behaviors and Cardiometabolic Risk in University Students: A Biomarker-Based Cross-Sectional Study
By Jacksaint Saintila, Norma Del Carmen Gálvez-Díaz, Luz Antonia Barreto-Espinoza et al.
Background: Unfavorable lifestyle behaviors commonly cluster during university life, yet their combined association with continuous cardiometabolic risk (CMR) remains insufficiently characterized in university populations. Objective: To evaluate the association between the accumulation of healthy behaviors and CMR in university students. Methods: A cross-sectional study using convenience sampling was conducted among 307 students at a private university in Chiclayo, northern Peru. Five self-reported behaviors were assessed: regular breakfast consumption, physical activity ≥3 times/week, fruit intake ≥2 servings/day, vegetable intake ≥2 servings/day, and sleep duration of 7–9 hours. A Healthy Lifestyle Behavior Index (0–100) was constructed by rescaling each of the five behaviors from 0 to 1. The component scores were averaged and multiplied by 100; a separate favorable behavior count (0–5) was also calculated. The CMR score integrated waist circumference (WC), mean arterial pressure, glucose, ln-triglycerides, and HDL-cholesterol, standardized by sex. Associations were estimated using linear regression models with HC3 robust standard errors and adjusted for sociodemographic variables. Results: Overall, 25.7% of participants exhibited 0–1 favorable behaviors, 51.1% exhibited 2–3, and 23.1% exhibited 4–5. Each 10-point increase in the healthy behavior index was associated with a reduction of 0.127 standard deviations (SD) in the CMR score (𝛽= −0.127; 95% CI: −0.179 to −0.075; 𝑝< 0.001). Compared to the group with 4–5 behaviors, the groups with 2–3 and 0–1 behaviors had higher risk scores (𝛽= 0.267; 95% CI: 0.017 to 0.516; and 𝛽= 0.682; 95% CI: 0.395 to 0.968, respectively). Conclusion: A greater accumulation of healthy lifestyle behaviors was associated with a more favorable cardiometabolic profile in university students; given the cross-sectional design, these findings should not be interpreted causally.