Joint associations of sedentary behavior and physical activity with psychological distress: A population-based study

Background: Low physical activity and high sedentary behavior are independently associated with poorer mental health, however, studies examining their combined associations are scarce.
Purpose: To examine the joint association of sedentary behavior and leisure-time physical activity (LTPA) on psychological distress in Finnish adult population from two cross-sectional studies before (2017) and after (2023) COVID-19 pandemic.
Methods: Random sample of Finnish adults were asked to fill in questionnaire of the FinHealth 2017 (n=10 300) and Healthy Finland 2023 (n= 10 000) surveys. Analytical samples in 2017 (n=4400) and in 2023 (n=2900) were restricted to working age population. LTPA was classified into: inactive, moderately active, and active and non-work sedentary time into: low sedentary and high sedentary (>5 hours/day) yielding a six-category variable for the joint analyses. Psychological distress was measured with Mental Health Inventory-5 (MHI-5) dichotomized using clinically significant symptoms (≤ 52 points) as a cut-point. Logistic regression analysis was used adjusting for key covariates with SPSS 29.
Results: The prevalence of psychological distress increased from 8% to 14% between 2017 and 2023. Compared with the active low sedentary group, the inactive high sedentary group in 2017 (OR 3.46 CI 95% 2.08-5.77) and in 2023 (OR 3.42 CI 95% 2.27-5.16) as well as, the moderate active high sedentary groups and the inactive low sedentary groups had increased likelihood of psychological distress. In 2017, the active high sedentary group also showed a similar association (OR 2.36, 95% CI 1.32-4.23), and in 2023 moderate active low sedentary group (OR 1.69, 95% CI 1.15-2.48) .
Conclusions: The study emphasize that both lack of LTPA and high sedentary time associate with psychological distress in adults.
Practical implications: Promoting LTPA and reduce sedentariness among the working-age population may prove useful to reduce psychological distress.
Funding: Juho Vainio Foundation