Analysis of the associations between moderate-to-vigorous physical activity and screen time on psychological symptoms among university students: a cross-sectional survey based on six geographic regions in China

Abstract Background Declining physical activity and increasing screen time (ST) among Chinese adolescents have become major concerns shared by scholars, while mental health issues are also on the rise. Previous studies have confirmed the association between physical activity and screen time and psychological symptoms, but it is unclear how their psychological symptoms, especially for Chinese university students who have a high proportion of psychological symptoms, and no research evidence has been found. Methods This study investigated physical activity, screen time, and psychological symptoms in 11,173 university students aged 19–22 years in six regions of China. A binary logistic regression analysis was used to analyze the association between moderate-to-vigorous physical activity (MVPA) and screen time and psychological symptoms. And the generalize linear model (GLM) analysis was used to further analyze the association between MVPA and screen time and psychological symptoms. Results The detection rate of psychological symptoms among Chinese university students was 16.3%, with a higher percentage of female students (17.5%) than male students (14.7%). The proportion of male students (8.2%) with MVPA > 60 min/d was higher than that of female students (2.3%), and the proportion of male students (33.8%) and female students (34.5%) with screen time > 2 h/d was basically the same. The generalize linear model (GLM) analysis showed that university students with MVPA 2 h/d (OR = 1.59, 95% CI: 1.10–2.31) had the highest risk of psychological symptoms (OR = 1.59, 95% CI: 1.10–2.31) compared to university students with MVPA > 60 min/d and screen time 2 h/d (OR = 1.59,95% CI: 1.10–2.31). In addition, university students with MVPA > 60 min/d and a screen time of 1–2 h/d (OR = 0.09, 95% CI: 0.03–0.25) had the lowest risk of psychological symptoms (P