Field-assessed functional exercise capacity and selected NCD-related health markers among students at Kuwait University: a cross-sectional study using the incremental shuttle walk test

Abstract

Background Functional exercise capacity, assessed as observed distance on the Incremental Shuttle Walk Test (ISWT), is a field-based indicator relevant to cardiometabolic health, yet it remains poorly characterised among university students in Gulf Cooperation Council (GCC) countries. This cross-sectional study characterised field-assessed functional exercise capacity and selected NCD-related health markers among students at Kuwait University. Methods A pragmatic convenience sample of 389 Kuwait University students (76.3% female; mean age 20.2 ± 2.3 years) completed the ISWT between 28 July and 4 December 2025, alongside assessments of physical activity (IPAQ-SF), depressive symptoms (PHQ-9), anthropometric measurements, and resting clinical indicators. The primary outcome was observed ISWT distance (metres). Physical-activity volume was expressed as log₁₀-transformed total MET-min/week. Hierarchical multiple linear regression was used to identify independent correlates of observed ISWT distance; equation-derived percentage-predicted outcomes were examined only as exploratory supplementary analyses restricted to participants aged ≥21 years. Results Mean observed ISWT distance was 439.1 ± 306.0 m (median 360 m, IQR 230–550 m). Males walked significantly further than females (596.7 ± 388.1 m vs. 390.3 ± 257.5 m, p < 0.001). In the fully adjusted primary model, male sex (β = 0.283, p < 0.001), lower body mass index (β = −0.162, p < 0.001), higher physical-activity volume (log₁₀ MET-min/week; β = 0.113, p = 0.023), and Kuwaiti nationality (β = −0.099, p = 0.040) were independently associated with observed ISWT distance, explaining 13.3% of variance (adjusted R2 = 0.120). Depressive symptoms were not independently associated with observed ISWT distance (β = −0.079, p = 0.104). An exploratory sex×physical-activity interaction was observed (p = 0.010), with the positive activity association evident among females but not the smaller male subgroup. Conclusion Observed ISWT distance was independently associated with male sex, lower BMI, higher physical-activity volume, and nationality among students at Kuwait University. Although the single-university cross-sectional design precludes policy-level inference, these findings identify physical-activity volume and body composition as potentially modifiable correlates and support the development and evaluation of campus-based physical-activity and early NCD-prevention initiatives in Kuwaiti higher-education settings.