The relationship between exercise behavior, body composition, and cardiovascular risk in adults: A transtheoretical model approach

Cardiovascular diseases are among the leading causes of mortality worldwide. The growing aging population, the widespread prevalence of physical inactivity, and related health problems underscore the importance of fostering healthy lifestyle habits. This study aimed to investigate the relationship between exercise behavior change stages, body composition, cardiovascular risk levels, and Transtheoretical Model (TTM) variables in adults. The study was conducted with 118 healthy adults (59 females and 59 males), aged 30–60 years, residing in the Melikgazi district of Kayseri province. Participants had a mean height of 168.49 ± 10.00 cm, a mean body weight of 74.45 ± 12.10 kg, and a mean Body Mass Index (BMI) of 26.29 ± 4.15 kg/m². After collecting demographic information, body composition was assessed using dual-energy X-ray absorptiometry (DEXA). Blood parameters, including HDL, LDL, total cholesterol, and triglycerides, were measured. Exercise behavior change stages were evaluated using the Exercise Stages of Change Scale (ESCS), Exercise Processes of Change Scale (EPCS), Exercise Decisional Balance Scale (EDBS), and Exercise Self-Efficacy Scale (ESES). Data distribution was assessed with skewness and kurtosis, confirming normality. Accordingly, independent t-tests were used for binary group comparisons, one-way analysis of variance (ANOVA) was applied for multiple group comparisons, and the LSD test was performed to identify the source of differences. Correlation analyses were also conducted. The results revealed that as individuals progressed through the stages of exercise behavior, body fat percentage decreased, while lean mass and bone mineral content significantly increased (p<0.01). Cardiovascular risk scores were lower among those who exercised, with significant differences between groups (p<0.05). Exercising groups also had significantly higher EPCS and ESES scores (p<0.01), while perceived barriers were lower (p<0.01). Moreover, with advancing age, unfavorable changes in body composition and cardiovascular risk indicators were observed, which were more pronounced in females. This study emphasizes the influence of exercise behavior on morphological and cardiorespiratory fitness, as well as on physiological and psychosocial health indicators. The findings further highlight the potential of TTM-based interventions as effective tools for guiding individualized public health strategies. Keywords: Body Composition, Cardiovascular Risk, Exercise Behavior, Transtheoretical Model