Associations of healthy lifestyles and physical education enjoyment with physical fitness among Chinese medical students: a cross-sectional study.

Background: Physical fitness is a key indicator for assessing individuals' current health status and predicting future health outcomes. However, relatively little attention has been paid to the physical fitness of medical students, who will serve as the main workforce in the healthcare industry in the future. This cross-sectional study aimed to explore the current status of physical fitness and to examine the associations of healthy lifestyles and physical education (PE) enjoyment with physical fitness among Chinese medical students. Methods: A total of 12,840 students from three medical universities in Jiangsu Province were enrolled. Validated questionnaires were used to assess healthy lifestyles and PE enjoyment, while physical fitness indicators were measured according to national standards. Multiple regression was used to determine the relationship between independent variables (participants' basic information, health-related lifestyle and enjoyment of PE) and dependent variables (participants' physical fitness performance). Results: The results showed that medical students exhibited a moderate level of physical fitness (70.85 ± 0.33), which was influenced by demographic factors including gender, major type, academic system, grade and monthly living expenses. Moreover, medical students constituted a highly sedentary population, with daily screen time of 6.56 ± 3.20 h and daily non-screen sedentary time of 4.56 ± 3.10 h. Their physical fitness was positively correlated with exercise frequency, sleep duration, non-screen sedentary time, and PE enjoyment, and negatively correlated with screen time and smoking behavior. Furthermore, after incorporating PE enjoyment, the negative correlation between smoking and physical health was not significant ( Conclusion: Although relatively uncontrollable factors (e.g., gender, major, academic system, grade, and monthly living expenses) show significant correlations with physical fitness, relatively self-controllable factors (healthy lifestyle habits) and interactions with the external environment (PE enjoyment) also exhibit strong associations with physical fitness. The results suggest that fostering healthy lifestyle behaviors through individuals' internal motivation and improving the quality of physical education classes may be of great significance for medical students to achieve superior physical fitness levels.