PHYSICAL ACTIVITY LEVELS AND BODY MASS INDEX AMONG MIDDLE SCHOOL STUDENTS: A CROSS-SECTIONAL STUDY

Abstract

Adolescence is a critical period for establishing healthy lifestyle behaviors; yet physical inactivity and overweight are rising globally, posing significant public health challenges. This cross-sectional study aimed to assess physical activity (PA) levels and Body Mass Index (BMI) among middle school students in District Bajaur, Khyber Pakhtunkhwa, Pakistan and to examine the relationship between these variables. A total of 220 students aged 11–14 years were selected using multistage random sampling from government middle schools. Physical activity was measured using the Physical Activity Questionnaire for Adolescents (PAQ-A) and BMI was calculated from direct measurements of height and weight, classified according to WHO age and sex-specific cut-offs. Descriptive statistics indicated a mean PAQ-A score of 2.85 ± 0.65, with 27.3% of students classified as low active, 54.5% as moderately active and 18.2% as highly active. The mean BMI was 19.8 ± 2.9 kg/m², with 13.6% underweight, 63.6% normal weight, 15.9% overweight and 6.8% obese. Pearson correlation revealed a significant negative relationship between PAQ-A scores and BMI (r = –0.42, p < .001), indicating that higher physical activity is associated with lower BMI. Chi-square analysis further confirmed a significant association between PA categories and BMI classification (χ² = 18.67, df = 6, p = .005). Age-wise comparisons showed no statistically significant differences in PA or BMI. The findings underscore that a considerable proportion of adolescents in District Bajaur are insufficiently active, with a notable prevalence of overweight and obesity. These results highlight the need for school-based interventions, structured physical activity programs and health promotion strategies to improve adolescent health and provide baseline data for regional policymakers.