Exploring the associations between daily sedentary behavior, physical activity, sleep, and risk of depressive symptoms in Chinese adolescents

BACKGROUNDS: To investigate the relationship between depressive symptoms and daily behaviors, including sedentary behavior, walk, moderate-to-vigorous physical activity (VMPA) and sleep in Chinese adolescents. METHODS: 11,152 adolescents (51.5% boys; mean age 14.3 ± 0.7 years) were included from the city-wide school physical examination. Depressive symptoms and daily movement data were collected with questionnaires. RESULTS: 37.9% (32.2% boys and 44.0% girls; P < 0.001) of participants were considered at risk for depressive symptoms. Replacing 30-minute of sedentary behavior with equivalent duration of sleep was associated with a decrease risk of depressive symptoms with ORs of 0.93 (95% CI: 0.91, 0.95; P < 0.001) in boys and 0.91 (95% CI: 0.88, 0.93; P < 0.001) in girls. In participants who did not meet 1-hour VMPA recommendation, replacing 30-minute of sedentary behavior with VMPA was associated with lower risk of depressive symptoms, with Ors of 0.67 (95% CI: 0.53, 0.83; P < 0.001) in boys and 0.93 (95% CI: 0.76, 1.14; P = 0.475) in girls. CONCLUSION: Significant associations between depressive symptoms and daily movement were found in Chinese adolescents. Maintaining adequate sleep duration is associated with a lower likelihood of depressive symptoms, while reallocating sedentary time to VMPA represents an option for adolescents, particularly boys, not meeting physical activity guidelines. Future school-based randomized controlled trials and lifestyle-focused mHealth interventions are warranted to evaluate the efficacy of these behavioral modifications.