Associations between takeaway food consumption, physical activity levels, and their joint effect with comorbid depression and anxiety symptoms among Chinese university students.

Background: The prevalence of depression and anxiety symptoms, and their comorbid among Chinese university students is rising. Psychological symptoms are strongly associated with lifestyle choices, such as takeaway food consumption and physical activity. While the association between takeaway food consumption, physical activity level, and their joint effect on the psychological symptoms of university students are still unclear. In this study, we explore the associations between them.

Methods: Using stratified cluster sampling, 14,340 students aged 18-22 from four provinces in China were selected as participants. A self-survey takeaway food consumption behavior questionnaire; the International Physical Activity Questionnaire Chinese Short Form; and the Depression, Anxiety, and Stress Scales-21 Short Version were used in this survey. Chi-square tests and binary logistic regression analyses were used to analyze the association.

Results: The incidence rates of depression symptoms, anxiety symptoms, and CDAS were 26.26%, 34.58%, and 23.75%, respectively. Higher takeaway food consumption was positively associated with CDAS rates. Furthermore, compared with female students, the CDAS rates of male students were more likely to be influenced by different takeaway food consumption and physical activity. As for joint effect of takeaway food consumption and physical activity, overall, participants who engaged in light physical activity had a higher risk of CDAS with the increase in takeaway food consumption (OR = 1.279-2.661, 95% CI = 1.119-3.194, all p < 0.001). Moreover, participants with combination of moderate or vigorous physical activity and frequent takeaway food consumption (4-6 or ≥ 7 times/week) were more likely to suffer from CDAS (moderate: 4-6 times/week OR = 1.568, 95% CI: 1.206-2.039; ≥7 times/weeks: OR = 1.802, 95% CI: 1.202-2.700; vigorous: 4-6 times/week OR = 2.075, 95% CI: 1.623-2.653; ≥7 times/weeks: OR = 2.272, 95% CI: 1.567-3.295; all p < 0.05). In general, light to moderate physical activity levels and higher frequency of takeaway food consumption were associated with a higher risk of CDAS in male students than in female students.

Conclusion: High consumption of takeaway food and lower physical activity levels may be risk factors for depression and anxiety in university students. In general, the psychological symptoms of male students are more likely to be influenced by these factors than those of female students.