24-h movement behavior priorities differ by mental health outcome among Chinese college students, with reducing sedentary behavior and maintaining minimal MVPA most relevant for depression, sleep optimization central for anxiety, and stress benefiting from adequate sleep combined with less sedentary behavior and preserved MVPA, with sedentary and sleep targets more pronounced in women.
Key Findings
Results
Higher moderate-to-vigorous physical activity (MVPA) was associated with lower depression and stress among Chinese college students.
Sample size: 5888 college students in Southwest China
MVPA was associated with lower depression (β = -0.105, P < 0.001)
MVPA was associated with lower stress (β = -0.068, P < 0.001)
Physical activity was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF)
Mental health was measured via the Depression Anxiety and Stress Scale (DASS-21)
Results
Higher sedentary behavior (SED) was associated with higher depression and stress.
SED was associated with higher depression (β = 0.306, P < 0.001)
SED was associated with higher stress (β = 0.615, P < 0.001)
Compositional data analysis (CoDA) was used to investigate these associations
The association between SED and both depression and stress was more pronounced in women than men
Results
Higher sleep duration/quality (SLP) was associated with lower anxiety and stress.
SLP was associated with lower anxiety (β = -0.187, P = 0.003)
SLP was associated with lower stress (β = -0.419, P < 0.001)
Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI)
The association between SLP and anxiety and stress was more pronounced in women
Results
In proportional substitution analyses, sleep had the largest effect on mental health outcomes, with a 10% increase in sleep linked to lower anxiety and stress.
A 10% increase in sleep was associated with lower anxiety (-0.031, 95% CI: -0.051, -0.011)
A 10% increase in sleep was associated with lower stress (-0.069, 95% CI: -0.091, -0.046)
Sleep showed the largest effect size among all movement behaviors in the proportional substitution model
Dose-response analyses indicated asymmetric relationships between MVPA, SED, SLP, and mental health
Results
Sex-stratified models revealed that associations between sedentary behavior and sleep with mental health were more pronounced in women, while MVPA showed broadly similar protective patterns across sexes.
SED associations with depression and stress were more pronounced in women than men
SLP associations with anxiety and stress were more pronounced in women
MVPA showed broadly similar protective patterns across both sexes
Sex stratification was incorporated into compositional regression models
Conclusions
The study found that 24-h movement behavior priorities differ by mental health outcome, with distinct behavioral targets for depression, anxiety, and stress.
Reducing SED and maintaining minimal MVPA appeared most relevant for depression
SLP optimization was identified as central for anxiety
Stress benefited from adequate SLP combined with less prolonged SED and preserved MVPA
Compositional data analysis was used to account for the co-dependent, time-constrained nature of 24-h movement behaviors
The study recruited students from Southwest China, which may limit generalizability
What This Means
This research suggests that how college students spend their 24 hours — across physical activity, sitting, and sleep — is meaningfully linked to their mental health, but in different ways depending on whether the concern is depression, anxiety, or stress. Using data from nearly 6,000 college students in Southwest China, the researchers found that spending more time in moderate-to-vigorous physical activity and less time sitting was most strongly linked to lower depression and stress, while getting better or more sleep was most strongly linked to lower anxiety. Stress appeared to benefit from a combination of good sleep, less sitting, and some physical activity. Among all the behaviors studied, improving sleep had the largest single effect — a 10% increase in sleep time was associated with meaningful reductions in both anxiety and stress.
The study also found notable differences between men and women. Women showed stronger associations between both sitting behavior and sleep quality with their mental health outcomes, while the protective effect of physical activity was similarly beneficial across both sexes. This suggests that interventions aimed at reducing prolonged sitting and improving sleep may be especially impactful for female college students.
This research suggests that mental health promotion strategies for college students should not focus on a single behavior in isolation, but instead consider the full 24-hour day. Rather than a one-size-fits-all approach, targeting sedentary behavior reduction may be most useful for depression, sleep improvement for anxiety, and a combination of both along with physical activity for stress — with particular attention to women who may be more sensitive to changes in sitting and sleep patterns.
Li C, Yang B, Yang X, Qiu Y, Zhang M, Luo J. (2026). Association between 24-h movement behavior and mental health among Chinese college students: A compositional data analysis.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2025.121109