Green, Indoor, or No Exercise? Health Outcomes of Physical Activity Settings Among Turkish Adults

Green exercise, or physical activity in natural environments, is believed to provide additional psychological and physical health benefits. However, little is known about how it compares with indoor exercise or no exercise in non-Western urban contexts.

A cross-sectional survey was conducted with 127 adults aged 18-64 in Aydın, Türkiye. Participants were categorized into green exercise (n = 59), indoor exercise (n = 54), and no exercise (n = 14) groups based on their reported activity. Mental health and general health were measured using the Depression Anxiety Stress Scale and the General Health Questionnaire. Generalized linear models were applied, adjusting for body mass index, sex, income, and other covariates.

Exercise setting was not a statistically significant predictor of either the Depression Anxiety Stress Scale or the General Health Questionnaire scores. Instead, sex, income, and body mass index were significant predictors: Underweight participants and females reported worse mental and general health, with gender-specific patterns in how weight status relates to health.

The findings suggest that in Türkiye, sociodemographic and psychosocial factors may outweigh the role of exercise setting in shaping health outcomes. Differences in green space quality, accessibility, and user cultural norms around physical activity-particularly for women-may partly explain why the expected benefits of green exercise were not observed. A multidimensional approach that considers social, cultural, and environmental factors is needed to promote physical activity and health equity in urban contexts.