Assessing the Association Between Meeting New 24-h Movement Guidelines and Symptoms of Depression, Anxiety, and...

To investigate the associations between meeting the new Canadian 24-h movement guidelines and symptoms of depression, anxiety, and stress among Chinese medical students, thus providing empirical and theoretical support for targeted mental health interventions.

A total of 3679 medical students were recruited through multicenter convenience sampling in November 2022. A self-administered standardized questionnaire assessed three 24-h movement behaviors-moderate-to-vigorous physical activity (MVPA), sedentary time, and sleep-as well as symptoms of depression, anxiety, and stress. Logistic regression models were applied to analyze the association between meeting new 24-h movement guidelines and symptoms of depression, anxiety, and stress.

A total of 3228 valid responses were obtained. The proportions of students who met all 24-h movement behavior recommendations were low, at 4.01% among clinical students and 7.14% among nursing students. The overall prevalence of negative emotional symptoms was 60.9% in clinical students and 46.7% in nursing students. A clear dose-response relationship was evident between the number of recommendations met and a lower risk of depression, anxiety, and stress. Medical students who fully met all recommendations had a significantly lower risk of negative emotional symptoms compared with those who met none (stress odds ratio [OR] = 0.239, 95% confidence interval [CI]: 0.101-0.568, p = 0.001; anxiety OR = 0.601, 95% CI: 0.407-0.889, p = 0.011; depression OR = 0.450, 95% CI: 0.290-0.700, p  < 0.001). Similar protective associations were found in both clinical and nursing subgroups. All associations remained generally consistent after false discovery rate (FDR) correction, supporting the robustness of the results. A significant three-way interaction among MVPA, sedentary behavior, and sleep was observed for stress.

Adherence to the 24-h movement behavior recommendations was suboptimal among Chinese medical students. However, greater adherence was associated with a lower risk of symptoms of depression, anxiety, and stress, highlighting the need for integrated lifestyle interventions targeting physical activity, sedentary time, and sleep balance.