Joint Associations of Meditation and Physical Activity with Depression and Anxiety Symptoms in US Adults: NHIS 2022

Abstract Objectives Physical activity and meditation may each relate to mental health, but their joint associations in U.S. adults are unclear. We examined the separate and joint associations of any past-year meditation and meeting physical activity (PA) guidelines with depression and anxiety symptoms. Method We analyzed data from the 2022 National Health Interview Survey Sample Adult file ( n = 24,927). Exposures were meeting PA guidelines, any past-year meditation, and their four-level combination (Neither, PA only, Meditation only, Both). Outcomes were moderate-to-severe depressive and anxiety symptoms (PHQ-8/GAD-7 ≥ 10). Survey-weighted modified Poisson models estimated prevalence ratios (PRs), with interaction, sensitivity, and post hoc analyses. Results Versus Neither, adjusted PRs for depression were 0.49 (95% CI, 0.42–0.56) for PA only, 1.59 (1.38–1.85) for Meditation only, and 1.27 (1.08–1.50) for Both; corresponding anxiety PRs were 0.69 (0.60–0.80), 1.69 (1.44–1.99), and 1.26 (1.06–1.50). Associations varied by age for both outcomes and by income-to-poverty ratio for depression, but not by sex. In counseling-restricted analyses, the inverse PA-only association remained, whereas Meditation-only and Both estimates attenuated toward the null. Sensitivity analyses were similar. Conclusions Meeting PA guidelines was associated with lower depression and anxiety, whereas reporting any past-year meditation without sufficient PA was associated with higher prevalence, likely reflecting indication/help-seeking. Adults reporting both behaviors had a more favorable symptom profile than Meditation only, but this cross-sectional contrast should not be interpreted causally.