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Effects of Physical Activity Level on the Moderated Mediation Model Linking BMI VO₂max and Endurance Performance in Male University Students Under High Altitude Hypoxia

Yue Zhai, Manqing Li, Jia Li
Vol. 6, No. 10, pp. 240-252, 2026 DOI: 10.54691/q8k91340 October 19, 2026
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Abstract.This study investigated the mediating mechanism linking body mass index (BMI), maximal oxygen uptake (VO₂max), and endurance performance in the 1000 m run among male university students living at an altitude of 3650 m. It examined whether physical activity level moderated the BMI → VO₂max → 1000 m run performance pathway and whether this moderation changed over time with high-altitude exposure and accumulated training. Following the National Student Physical Fitness Standard, 300 male students aged 18–22 years from two universities at 3650 m were followed over two academic years. BMI and 1000 m run time were measured, and VO₂max was estimated. A supplementary questionnaire assessed self-directed extracurricular exercise to provide a multidimensional assessment of physical activity. Participants were compared in high- and low-physical-activity groups, and a moderated mediation model was fitted. The associations of physical activity with aerobic capacity and endurance performance showed marked time dependence. In the first year, the high-physical-activity (HPA) group had lower VO₂max and poorer 1000 m run performance than the low-physical-activity (LPA) group, with no significant difference in BMI. In the second year, the HPA group showed significant improvements in aerobic capacity and endurance performance and outperformed the LPA group. VO₂max consistently mediated the association between BMI and endurance performance. Physical activity moderated this pathway, with moderation emerging progressively during adaptation to high altitude; higher physical activity attenuated the indirect adverse association of BMI with endurance performance through VO₂max. Sustained high physical activity may improve aerobic capacity and endurance performance, modify the associations among BMI, VO₂max, and endurance performance, and facilitate adaptation to high-altitude hypoxia. These effects were time dependent. The findings provide a scientific basis for physical education, physical fitness interventions, and fitness management at universities in high-altitude regions.
Keywords. High-altitude hypoxia; Physical activity differences; Cardiorespiratory endurance; Aerobic performance; Longitudinal study.
APA Citation Yue Zhai, Manqing Li, Jia Li (2026). Effects of Physical Activity Level on the Moderated Mediation Model Linking BMI VO₂max and Endurance Performance in Male University Students Under High Altitude Hypoxia. Frontiers in Humanities and Social Sciences, 6(10), 240-252. https://doi.org/10.54691/q8k91340

References

  1. Wang, S., Niu, Z., Xiong, J., et al. (2024). The relationship between physical activity and psychological sub-health among high altitude region Tibetan college students. Frontiers in Psychology, 15, 1465845.
  2. Ministry of Education of the People's Republic of China. (2014, July 8). Notice of the Ministry of Education on issuing the National Student Physical Fitness Standard (2014 revision). http://www.moe.gov.cn/srcsite/A17/moe_938/moe_792/s3273/201407/t20140708_171692.html
  3. Beidleman, B. A., Fulco, C. S., Staab, J. E., et al. (2014). Cycling performance decrement is greater in hypobaric versus normobaric hypoxia. Extrem Physiol Med, 3, 8.
  4. Takezawa, T., Dobashi, S., Koyama, K. (2021). Cardiorespiratory response and power output during submaximal exercise in normobaric versus hypobaric hypoxia: A pilot study using a specific chamber that controls environmental factors. High Altitude Medicine & Biology, 22(2), 201–208.
  5. Zhang, Y., Su, F., Song, Y., et al. (2022). Associations between physical fitness index and body mass index in Tibetan children and adolescents in different high-altitude areas: Based on a study in Tibet, China. International Journal of Environmental Research and Public Health, 19(16), 10155.
  6. Kettunen, O., Leppävuori, A., Mikkonen, R., et al. (2023). Hemoglobin mass and performance responses during 4 weeks of normobaric “live high–train low and high”. Scandinavian Journal of Medicine & Science in Sports, 33(8), 1335–1344.
  7. Daussin, F. N., Ponsot, E., Dufour, S. P., et al. (2007). Improvement of by cardiac output and oxygen extraction adaptation during intermittent versus continuous endurance training. European Journal of Applied Physiology, 101(3), 377–383.
  8. Nima-Ouzhu, Yang, J. Y., Ren, Y. Y., et al. (2025). A longitudinal comparative study on the effects of different physical activity levels on physical fitness in male college students under high-altitude hypoxic conditions. Plateau Science Research, 9(02), 52–61.
  9. Tian, X. Q., Mo, J. F., Huang, Y., et al. (2024). Physical activity status and influencing factors among 1090 college students. Chinese Journal of School Doctor, 38(7), 499–504.
  10. Dong, Y., Chen, M., Song, Y., et al. (2021). Geographical variation in physical fitness among Chinese children and adolescents from 2005 to 2014. Frontiers in Public Health, 9, 694070.
  11. Husu, P., Suni, J., Vähä-Ypyä, H., et al. (2016). Objectively measured sedentary behavior and physical activity in a sample of Finnish adults: A cross-sectional study. BMC Public Health, 16(1), 920.
  12. Zhang, F., Bi, C., Yin, X., et al. (2022). Roles of age, sex, and weight status in the muscular fitness of Chinese Tibetan children and adolescents living at altitudes over 3600 m: A cross‐sectional study. American Journal of Human Biology, 34(2), e23624.
  13. Li, D. (2025). Importance, current situation and optimization strategies of physical exercise for college students. Contemporary Sports Technology, 15(26), 161–164.
  14. Cai, X., Liu, Y., Li, Y., et al. (2025). Physical education exercise improves physical fitness and working memory function: A randomized controlled trial study of Uyghur adolescents in Xinjiang, China. BMC Pediatrics, 25(1), 122.
  15. Weatherwax, R., Harris, N., Kilding, A. E., et al. (2019). Time course changes in confirmed ‘true’ VO2max after individualized and standardized training. Sports Medicine International Open, 3(02), E32–E39.
  16. Wang, W., Xie, Y. Z., Yin, Z. Y., et al. (2002). The changes of oxygen consumption and blood oxygen saturation during physical activities at 5 380 m altitude. Chinese Journal of Aerospace Medicine, 13(2), 91–93.
  17. Zubieta-Calleja, G. R., Paulev, P., Zubieta-Calleja, L., et al. (2007). Altitude adaptation through hematocrit changes. Journal of Physiology and Pharmacology, 58(5), 811–818.
  18. Dyrstad, S. M., Anderssen, S. A., Edvardsen, E., et al. (2016). Cardiorespiratory fitness in groups with different physical activity levels. Scandinavian Journal of Medicine & Science in Sports, 26(3), 291–298.
  19. Furian, M., Tannheimer, M., Burtscher, M. (2022). Effects of acute exposure and acclimatization to high-altitude on oxygen saturation and related cardiorespiratory fitness in health and disease. Journal of Clinical Medicine, 11(22), 6699.
  20. Watz, H., Pitta, F., Rochester, C. L., et al. (2014). An official European Respiratory Society statement on physical activity in COPD. European Respiratory Journal, 44(6), 1521–1537.
  21. Kessler, H. S., Sisson, S. B., Short, K. R. (2012). The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Medicine, 42(6), 489–509.
  22. Ross, R., de Lannoy, L., Stotz, P. J. (2015). Separate effects of intensity and amount of exercise on interindividual cardiorespiratory fitness response. Mayo Clinic Proceedings, 90(11), 1506–1514.
  23. Campbell, W. W., Kraus, W. E., Powell, K. E., et al. (2019). High-intensity interval training for cardiometabolic disease prevention. Medicine & Science in Sports & Exercise, 51(6), 1220–1226.
  24. Filopoulos, D., Cormack, S. J., Whyte, D. G. (2017). Normobaric hypoxia increases the growth hormone response to maximal resistance exercise in trained men. European Journal of Sport Science, 17(10), 1234–1242.