Associations between physical activity intensity, frequency, and anxiety symptoms among South Korean adolescents: a sociodemographic subgroup analysis.
Song J & Choi W • Frontiers in public health • 2026
All types/intensities of physical activity for 3 or more days per week were generally associated with lower anxiety among South Korean adolescents, but these associations varied significantly by gender, school level, and socioeconomic status, with high-frequency moderate-to-vigorous PA unexpectedly associated with higher anxiety in females and high-SES adolescents.
Key Findings
Results
In the overall sample, all types and intensities of physical activity performed 3 or more days per week were generally associated with lower anxiety symptoms compared to 0–2 days per week.
Sample consisted of 54,653 South Korean adolescents from the 20th Korea Youth Risk Behavior Web-Based Survey
Single-group structural equation modeling (SEM) was used for the overall analysis
Beta coefficients ranged from -0.021 to -0.057 across PA types and intensities
All associations were statistically significant at p < 0.01
PA types examined included vigorous PA, moderate-to-vigorous PA (MVPA), and muscle-strengthening activities
Results
Vigorous physical activity was the most consistently associated with lower anxiety across multiple sociodemographic subgroups.
Multi-group SEM analyses tested differences across gender, school level, and socioeconomic status
Vigorous PA showed protective associations more consistently than other PA types across subgroups
This pattern held across gender, school level, and SES categories
The consistency of vigorous PA's association contrasted with the more variable patterns seen for MVPA and muscle-strengthening activities
Results
Muscle-strengthening activities were significantly associated with lower anxiety primarily at high frequency (≥5 days/week) among high school students and low-SES adolescents.
The protective association of muscle-strengthening activities was not consistently observed at lower frequencies (3–4 days/week)
The protective effect was specific to high school students and low-SES adolescents rather than being broadly observed
This subgroup-specific pattern was identified through multi-group SEM analysis
Low-SES adolescents represented a group for whom high-frequency muscle-strengthening was particularly associated with anxiety reduction
Results
Moderate-to-vigorous physical activity at ≥5 days/week was unexpectedly associated with higher anxiety levels among females and high-SES adolescents.
Among females, MVPA at ≥5 days/week was associated with higher anxiety (β = 0.055, p = 0.033)
Among high-SES adolescents, MVPA at ≥5 days/week was associated with higher anxiety (β = 0.111, p = 0.011)
These positive associations between high-frequency MVPA and anxiety were contrary to the general pattern observed in the overall sample
The high-SES association (β = 0.111) was numerically larger than the female association (β = 0.055)
Results
Associations between physical activity frequency and anxiety symptoms varied significantly across sociodemographic factors including gender, school level, and socioeconomic status.
Multi-group SEM analyses were conducted to test moderation by gender, school level, and SES
The overall pattern of more frequent PA being associated with fewer anxiety symptoms did not hold uniformly across all subgroups
Effect sizes were described as small across all associations
The sociodemographic variation indicates that assuming uniform benefits of PA for anxiety reduction is not supported by the data
What This Means
This research suggests that exercise is generally linked to lower anxiety in South Korean teenagers, but the relationship is more complicated than a simple 'more exercise equals less anxiety.' Using data from over 54,000 adolescents, the study found that doing any type of physical activity at least 3 days per week was associated with somewhat lower anxiety symptoms overall. However, when researchers looked more closely at different groups of teenagers—separated by gender, grade level (middle vs. high school), and family income level—the picture became much more nuanced.
One of the most striking findings was that doing moderate-to-vigorous exercise very frequently (5 or more days per week) was actually linked to higher anxiety in two specific groups: girls and teenagers from higher-income families. This unexpected result suggests that very high exercise loads may not benefit everyone equally, and in some cases could be connected to greater anxiety, possibly due to pressure, overtraining, or the kinds of competitive or performance-driven exercise contexts that some adolescents face. On the other hand, vigorous physical activity showed the most consistent anxiety-reducing associations across nearly all groups, and muscle-strengthening exercises (like weightlifting or bodyweight exercises) appeared most beneficial for high school students and lower-income adolescents when done at high frequency.
This research suggests that public health programs promoting exercise for teen mental health should not apply a one-size-fits-all approach. The type, amount, and social context of physical activity all matter, and what works for one group of teenagers may not work—or could even backfire—for another. Schools and community programs may need to tailor their approaches based on students' gender, age, and socioeconomic background, and focus on making enjoyable and age-appropriate activities accessible to all teens rather than simply pushing for maximum exercise volume.
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Song J, Choi W. (2026). Associations between physical activity intensity, frequency, and anxiety symptoms among South Korean adolescents: a sociodemographic subgroup analysis.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1934776