Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study

Overview

Journal J Prev Med Public Health

Specialty Public Health

Date 2023 Nov 17

PMID 37974058

Authors

Hyo-Jung Lee

Jeong Pil Choi

Kunhee Oh

Jin-Young Min

Kyoung-Bok Min

Affiliations

Soon will be listed here.

Abstract

Objectives: Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.

Methods: This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).

Results: The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.

Conclusions: These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.

References

McKenzie M, Jorm A, Romaniuk H, Olsson C, Patton G . Association of adolescent symptoms of depression and anxiety with alcohol use disorders in young adulthood: findings from the Victorian Adolescent Health Cohort Study. Med J Aust. 2011; 195(3):S27-30. DOI: 10.5694/j.1326-5377.2011.tb03262.x. View

Johnson J, Cohen P, Pine D, Klein D, Kasen S, Brook J . Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. JAMA. 2000; 284(18):2348-51. DOI: 10.1001/jama.284.18.2348. View

Gilpin N, Karanikas C, Richardson H . Adolescent binge drinking leads to changes in alcohol drinking, anxiety, and amygdalar corticotropin releasing factor cells in adulthood in male rats. PLoS One. 2012; 7(2):e31466. PMC: 3275622. DOI: 10.1371/journal.pone.0031466. View

Scully D, Kremer J, Meade M, Graham R, Dudgeon K . Physical exercise and psychological well being: a critical review. Br J Sports Med. 1998; 32(2):111-20. PMC: 1756084. DOI: 10.1136/bjsm.32.2.111. View

Paluska S, Schwenk T . Physical activity and mental health: current concepts. Sports Med. 2000; 29(3):167-80. DOI: 10.2165/00007256-200029030-00003. View

Kushner M, Abrams K, Borchardt C . The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clin Psychol Rev. 2000; 20(2):149-71. DOI: 10.1016/s0272-7358(99)00027-6. View

Esser M, Guy Jr G, Zhang K, Brewer R . Binge Drinking and Prescription Opioid Misuse in the U.S., 2012-2014. Am J Prev Med. 2019; 57(2):197-208. PMC: 6642832. DOI: 10.1016/j.amepre.2019.02.025. View

Kalina O, Geckova A, Klein D, Jarcuska P, Orosova O, van Dijk J . Psychosocial factors associated with sexual behaviour in early adolescence. Eur J Contracept Reprod Health Care. 2011; 16(4):298-306. DOI: 10.3109/13625187.2011.586076. View

Wang T, Gentzke A, Sharapova S, Cullen K, Ambrose B, Jamal A . Tobacco Product Use Among Middle and High School Students - United States, 2011-2017. MMWR Morb Mortal Wkly Rep. 2018; 67(22):629-633. PMC: 5991815. DOI: 10.15585/mmwr.mm6722a3. View

10.

Hoots B, Li J, Hertz M, Esser M, Rico A, Zavala E . Alcohol and Other Substance Use Before and During the COVID-19 Pandemic Among High School Students - Youth Risk Behavior Survey, United States, 2021. MMWR Suppl. 2023; 72(1):84-92. PMC: 10156154. DOI: 10.15585/mmwr.su7201a10. View

11.

Kim Y, Choi S, Chun C, Park S, Khang Y, Oh K . Data Resource Profile: The Korea Youth Risk Behavior Web-based Survey (KYRBS). Int J Epidemiol. 2016; 45(4):1076-1076e. DOI: 10.1093/ije/dyw070. View

12.

Anderson E, Shivakumar G . Effects of exercise and physical activity on anxiety. Front Psychiatry. 2013; 4:27. PMC: 3632802. DOI: 10.3389/fpsyt.2013.00027. View

13.

Ju Y, Kim W, Oh S, Park E . Solitary drinking and the risk of depressive symptoms and suicidal ideation in college students: Findings from a nationwide survey in Korea. J Affect Disord. 2019; 257:710-715. DOI: 10.1016/j.jad.2019.07.080. View

14.

Ho S, Chen J, Leung L, Mok H, Wang L, Wang M . Adolescent Smoking in Hong Kong: Prevalence, Psychosocial Correlates, and Prevention. J Adolesc Health. 2019; 64(6S):S19-S27. DOI: 10.1016/j.jadohealth.2019.01.003. View

15.

Droste S, Gesing A, Ulbricht S, Muller M, Linthorst A, Reul J . Effects of long-term voluntary exercise on the mouse hypothalamic-pituitary-adrenocortical axis. Endocrinology. 2003; 144(7):3012-23. DOI: 10.1210/en.2003-0097. View

16.

Park S . Smoking and adolescent health. Korean J Pediatr. 2012; 54(10):401-4. PMC: 3250592. DOI: 10.3345/kjp.2011.54.10.401. View

17.

Teychenne M, Costigan S, Parker K . The association between sedentary behaviour and risk of anxiety: a systematic review. BMC Public Health. 2015; 15:513. PMC: 4474345. DOI: 10.1186/s12889-015-1843-x. View

18.

Ussher M, Taylor A, West R, McEwen A . Does exercise aid smoking cessation? A systematic review. Addiction. 2000; 95(2):199-208. DOI: 10.1046/j.1360-0443.2000.9521996.x. View

19.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

20.

Hallgren M, Vancampfort D, Giesen E, Lundin A, Stubbs B . Exercise as treatment for alcohol use disorders: systematic review and meta-analysis. Br J Sports Med. 2017; 51(14):1058-1064. DOI: 10.1136/bjsports-2016-096814. View