Sedentary Behaviour In Relation To Depressive And Anxiety Symptoms Among Adolescents In Low-and Middle-income Countries

Background: Anxiety and depression are burdensome and popular in adolescents.Taking an active part in physical activity is protective of anxiety and depressive symptoms.But,evidence is insufficient on the relationship between sedentary behaviour and the risk of anxiety and depressive symptoms.Therefore,we aimed to investigate the association among adolescents in 24 low-and middle-income countries(LMICs).Methods: Data from the Global School-based Student Health Survey(GSHS)were analyzed in 59587 youth aged 12-15 years.Most of the country-wide data were nationally representative.Anxiety and depression symptoms were self-reported.Time spent on physical activity and sedentary behavior was self-reported.Multivariable logistic regression and meta-analyses of country-wise estimates were conducted.Results: The prevalence of anxiety and depressive symptoms was 8.2% and27.0%.A countrywide meta-analysis demonstrated that sedentary behaviour of >2h/day(vs.≤2 h/day)was associated with an increased risk of anxiety symptoms(OR=1.22;95% CI=1.10-1.37).Sedentary behaviour of >2 h/day(vs.≤2 h/day)was associated with an increased risk of depressive symptoms(OR = 1.13;95% CI =1.07-1.20).Subgroup analyses indicate that high sedentary time was significantly associated with an increased risk of anxiety and depressive symptoms in both males and females.Nevertheless,there was no significant difference in the association between sedentary behaviour and anxiety symptoms in Africa.High vs.low sedentary time was associated with a higher risk of depressive symptoms among those in Africa and East and Southeast Asia but not among those in other regions.Conclusions: The study provided multi-national evidence of the dangerous effect of sedentary behaviour against anxiety and depressive symptoms among adolescents in LMICs,Decreasing the level of sedentary behaviour during adolescence could be an important strategy for reducing the prevalence of anxiety and depressive symptoms.