Enter your details:
Thank you for subscribing.
Subscribe to our newsletter!

Christian Alvin Purwanto1, Nelson Sudiyono1, Nawanto Agung Prastowo1, Ignatio Rika Haryono1

1Atma Jaya Catholic University of Indonesia, Department of Physiology, School of Medicine and Health Sciences, Jakarta, Indonesia

The Association between Regular Sports Participation and Immune Status in College Students Using Immune Status Questionnaire

Sport Mont 2024, 22(1), 109-114 | DOI: 10.26773/smj.240215


College students may lack physical activity due to academic burden. This puts them at a higher risk of decreased immunity. This study aimed to investigate the association between sports participation and immune status. This was a cross-sectional retrospective study. Participants were 170 Atma Jaya Medicine and Health Science School students consisting of 59 boys (34.7%) and 111 girls (65.3%). Seventy-nine (46.5%) students participated in the Sports Students Club from December 2021 - December 2022, and 91 did not (53.5%). There were four sports, i.e., badminton, basketball, futsal, and volleyball. Data was taken from July-August 2023. Immune status was assessed using the Indonesian Immune Status Questionnaire (ISQ) version. The amounts of boys engaged in sports activity was significantly greater than girls [45(76.3%) vs 34(30.6%), p=0.001]. One hundred eleven students (65.3%) had good immune status, consisting of 65 girls (58.6%) and 46 boys (78%); 59 students (74.7%) participated in sports, and 52 students (57.1%) did not. Sex and sports participation were associated with immune status (p=0.000 and p=0.017, respectively). Students with good immune status had higher final ISQ scores than those with poor immune status (8.37±1.4 vs 3.84±1.4, p=0.000). Skin problems, headache, and muscle joint pain (MJP) were the three most common illnesses. Sports participation was a protective factor for skin problems, headache, and MJP (OR 0.27, 0.34, 0.41; 95%CI 0.14-0.53, 0.17-0.67, 0.20- 0.84; p=0.000, 0.002, 0.013, respectively). Regular sports participation is associated with favorable immune status. Sport participation could be a protective factor for some symptoms.


physical activity, immune system, immune assessment, low immune symptoms, young people

View full article
(PDF – 103KB)


Abd El-Kader, S. M., &Al-Jiffri, O. H. (2020). Aerobic exercise affects sleep, psychological well-being, and immune system parameters among subjects with chronic primary insomnia. African Health Sciences, 20(4), 1761-1769. https://doi.org/10.4314/ahs.v20i4.29.

Ahmadinejad, Z., Alijani, N., Mansori, S., & Ziaee, V. (2014). Common sports-related infections: a review on clinical pictures, management and time to return to sports. Asian Journal of Sports Medicine, 5(1), 1-9. https://doi.org/10.5812/asjsm.34174

Alharbi, A. S., Altwaim, S. A., Alharbi, A. S., & Alsulami, S. (2023). The interplay between sociodemographic variables, physical activity, sleep, dietary habits, and immune health status: a cross-sectional study from Saudi Arabia's Western Province. Cureus, 15(1), e33211. https://doi.org/10.7759/cureus.33211

Alonso, J. M., Edouard, P., Fischetto, G., Adams, B., Depiesse, F., & Mountjoy, M. (2012). Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. British Journal of Sports Medicine, 46, 505–514.

Azhar, Y., Erdiansyah, Z., & Rudiman, R. (2022). Validation of Immune Status Questionnaire (ISQ) in Indonesian bahasa language as a simple assessment of perceived immune status. Asian Pacific Journal of Cancer Prevention, 23(10), 3261-3263.

Bains, J. S., & Sharkey, K. A. (2022). Stress and immunity — the circuit makes the difference. Nature Immunology, 23, 1137–1139. doi.org/10.1038/s41590-022-01276-1.

Barrett, B., Hayney, M. S., Muller, D., Rakel, D., Brown, R., & Zgierska, A. E. (2018). Meditation or exercise for preventing acute respiratory infection (MEPARI-2): a randomized controlled trial. PLoS One, 13(6), e0197778. https://doi.org/10.1371/journal.pone.0197778.

Barrett, B., Hayney, M.S ., Muller, D., Rakel, D., Ward, A., & Obasi, C. N. (2012). Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Annals of Family Medicine, 10, 337–346.

Bray, S. R, & Born, H. A. (2004). Transition to university and vigorous physical activity: implications for health and psychological well-being. Journal of American College Health, 52(4), 181-188.

Cena, H., Porri, D., De Giuseppe, R., Kalmpourtzidou, A., Salvatore, F. P., El Ghoch, M., & Kolčić, I. (2021). How healthy are health-related behaviors in university students: The HOLISTic study. Nutrients, 13(2), 675. https://doi.org/10.3390/nu13020675.

Forte, P., Branquinho, L., & Ferraz, R. (2022). The Relationships between physical activity, exercise, and sport on the immune system. International Journal of Environment Research and Public Health, 19(11), 6777. https://doi.org/10.3390/ijerph19116777

Harber, V. J., & Sutton, J. R. (1984). Endorphins and exercise. Sports Medicine, 1(2), 154-171. https://doi.org/10.2165/00007256-198401020-00004

Hossen, M. S., Karmakar, P., Das, A., Rahman, A., & Chakma, M. (2020). Association of sport and exercise with health condition and academic performance: a cross sectional study among university students in Bangladesh. Turkish Journal of Sports Medicine, 55(4), 290-299. 10.5152/tjsm.2020.187

Institute of Medicine (US) Committee on Military Nutrition Research. (1999). Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington (DC): National Academies Press (US). Overview of Immune Assessment Tests. Available from: https://www.ncbi.nlm.nih.gov/books/NBK230966/

Isaev, A. P., Erlikh, V. V., Zalyapin, V. I., Bakhareva, A. S., Nenasheva, A. V., Romanov., & Yu, B. (2018). The immune system of athletes of different sports. Pedagogy of Physical Culture and Sports, 22(6), 280–286. https://doi.org/10.15561/18189172.2018.0601

Jaworski, C. A., & Rygiel, V. (2019). Acute illness in the athlete. Clinics in Sports Medicine, 38(4), 577–595.

Kelly, S., Pollock, N., Polglass, G., & Clarsen, B. (2022). Injury and illness in elite athletics: a prospective cohort study over three seasons. International Journal of Sports Physical Therapy, 17(3), 420-433. https://doi.org/10.26603/001c.32589.

Klein, S., & Flanagan, K. (2016). Sex differences in immune responses. Nature Reviews Immunology, 16, 626–638. https://doi.org/10.1038/nri.2016.90

Kwan, M. Y., Cairney, J., Faulkner, G. E., & Pullaneyagum, E. E. (2012). Physical activity and other health-risk behaviors during the transition into early adulthood: a longitudinal cohort study. American Journal of Preventive Medicine, 42(1), 14-20.

Lee, D. J., So, W. Y., & Lee, S. M. (2021). The relationship between Korean adolescents’ sports participation, internal health locus of control, and wellness during COVID-19. International Journal of Environmental Research and Public Health, 18(6), 2950. https://doi.org/10.3390/ijerph18062950

Liu, C., Chu, D., Kalantar-Zadeh, K., George, J., Young, H. A., & Liu, G. (2021). Cytokines: from clinical significance to quantification. Advanced Science (Weinheim), 8(15), e2004433. https://doi.org/10.1002/advs.202004433

Mellman, M. F., & Podesta, L. (1997). Common medical problems in sports. Clinics in Sports Medicine, 16(4), 635-62. https://doi.org/10.1016/s0278-5919(05)70046-6

Mofatteh, M. (2020). Risk factors associated with stress, anxiety, and depression among university undergraduate students. AIMS Public Health, 8(1), 36-65. https://doi.org/10.3934/public health

Morey, J. N., Boggero, I. A., Scott, A. B., & Segerstrom, S. C. (2015). Current directions in stress and human immune function. Current Opinion in Psychology, 5, 13-17. https://doi.org/10.1016/j.copsyc.2015.03.007

Nieman, D. C., Henson, D. A., Gusewitch, G., Warren, B. J., Dotson, R. C., & Butterworth, D. E. (1993). Physical activity and immune function in elderly women. Medicine and Science in Sports & Exercise, 25, 823–831.

Nieman, D. C., & Wentz, L. M. (2019). The compelling link between physical activity and the body’s defense system. Journal of Sport and Health Science, 8(3), 201–217. https://doi.org/10.1016/j.jshs.2018.09.009

Prien, A., Mountjoy, M., Miller, J., Boyd, K., van den Hoogenband C., & Gerrard, D. (2017). Injury and illness in aquatic sport: how high is the risk? A comparison of results from three FINA World Championships. British Journal of Sports Medicine, 51, 277–282

Reed, P., Vile, R., Osborne, L. A., Romano, M., & Truzoli, R. (2015). Problematic internet usage and immune function. PLoS ONE, 10, e0140692

Sciarra, F., Campolo, F., Franceschini, E., Carlomagno, F., & Venneri, M.A. (20230. Gender-specific impact of sex hormones on the immune system. International Journal of Molecular Sciences, 24(7), 6302. https://doi.org/10.3390/ijms24076302

Sigmundová, D., Chmelík, F., Sigmund, E., Feltlová, D., & Frömel, K. (2013). Physical activity in the lifestyle of Czech university students: meeting health recommendations. European Journal of Sport Science, 13(6), 744-50

Timpka, T., Jacobsson, J., Bargoria, V., Périard, J. D., Racinais, S., & Ronsen, O. (2017). Preparticipation predictors for championship injury and illness: cohort study at the Beijing 2015 International Association of Athletics Federations World Championships. British Journal of Sports Medicine, 51, 271–276.

Versprille, L. J. W. F., van de Loo, A. J., Mackus, M., Arnoldy, L., Sulzer, T. A., Vermeulen, S. A., & Scholey, A. (2019). Development and validation of the Immune Status Questionnaire (ISQ). International Journal of Environment Research and Public Health, 16(23), 4743. https://doi.org/10.3390/ijerph16234743.

Wilkinson, N. M., Chen, H. C., Lechner, M. G., & Su, M. A. (2022). Sex differences in immunity. Annual Review of Immunology, 40, 75–94

Worsley, J. D., Harrison, P., & Corcoran, R. (2021). Bridging the gap: exploring the unique transition from home, school or college into university. Frontiers in Public Health, 17(9), 634285. https://doi.org/10.3389/fpubh.2021.634285