Prevalence and correlates of meeting 24-hour movement guidelines and its associations with physical fitness and depressive symptoms among adults: a provincial surveillance in China

Background: 24-hour movement behaviors integrating physical activity (PA), sedentary behavior (SB), and sleep are important components influencing adults’ health. Canadian 24-hour movement guidelines for adults were launched in 2020. However, there is little evidence on the prevalence and correlates of guideline compliance and its associations with health outcomes among Chinese adults. The purposes of this study were to investigate the prevalence and correlates of meeting 24-hour movement guidelines and examine its association with physical fitness and depressive symptoms among Chinese adults.

Methods: A total of 7059 adults (45.73 ± 14.56 years, age range: 20–79 years, 52% female) were recruited by stratified cluster random sampling from health surveillance of Hubei, China, between 25-Jul and 19-Nov 2020 during the COVID-19 pandemic. Participants completed a self-reported questionnaire including movement behaviors (PA, SB, and sleep), depressive symptoms, and demographic information. In addition, eight objectively measured physical fitness tests (body mass index, waist-hip ratio, body fat percentage, vital capacity, handgrip strength, flexibility, balance, and choice reaction time) were conducted. SPSS 28.0 was used to perform Generalized Linear Mixed Models analysis to examine the correlates of movement guidelines and its association with fitness and depressive symptoms.

Results: 25.54% of participants met all three movement guidelines, while 48.62% met only two, 23.10% met one, and 2.75% met none. Participants who were older adults (OR = 2.24; P =.017), unmarried (OR = 0.21; P <.001), and living near PA facilities (OR = 1.58; P =.017) were more likely to meet all three movement guidelines. Meeting more movement recommendations was associated with less likelihood of depressive symptoms (OR = 0.41; P <.001), while no significant associations were observed between meeting 24-hour movement guidelines and physical fitness indicators (P >.05). 

Conclusions: The findings of this study indicate the need to promote adherence to all movement guidelines among Chinese adults. Future promoting strategies to meet movement guidelines should emphasize the demographic differences of the targeting population, especially age, marital status, and accessibility of PA facilities. Future interventions should be applied to affirm the effects of compliance with overall 24-hour movement guidelines to mitigate depressive symptoms among adults.