Assessing the Association Between Meeting New 24‐h Movement Guidelines and Symptoms of Depression, Anxiety, and Stress Among Chinese Medical Students: A Multicenter Study

Objective To investigate the associations between meeting the new Canadian 24‐h movement guidelines and symptoms of depression, anxiety, and stress among Chinese medical students, thus providing empirical and theoretical support for targeted mental health interventions. Methods A total of 3679 medical students were recruited through multicenter convenience sampling in November 2022. A self‐administered standardized questionnaire assessed three 24‐h movement behaviors—moderate‐to‐vigorous physical activity (MVPA), sedentary time, and sleep—as well as symptoms of depression, anxiety, and stress. Logistic regression models were applied to analyze the association between meeting new 24‐h movement guidelines and symptoms of depression, anxiety, and stress. Results A total of 3228 valid responses were obtained. The proportions of students who met all 24‐h movement behavior recommendations were low, at 4.01% among clinical students and 7.14% among nursing students. The overall prevalence of negative emotional symptoms was 60.9% in clinical students and 46.7% in nursing students. A clear dose–response relationship was evident between the number of recommendations met and a lower risk of depression, anxiety, and stress. Medical students who fully met all recommendations had a significantly lower risk of negative emotional symptoms compared with those who met none (stress odds ratio [OR] = 0.239, 95% confidence interval [CI]: 0.101–0.568, p = 0.001; anxiety OR = 0.601, 95% CI: 0.407–0.889, p = 0.011; depression OR = 0.450, 95% CI: 0.290–0.700, p < 0.001). Similar protective associations were found in both clinical and nursing subgroups. All associations remained generally consistent after false discovery rate (FDR) correction, supporting the robustness of the results. A significant three‐way interaction among MVPA, sedentary behavior, and sleep was observed for stress. Conclusion Adherence to the 24‐h movement behavior recommendations was suboptimal among Chinese medical students. However, greater adherence was associated with a lower risk of symptoms of depression, anxiety, and stress, highlighting the need for integrated lifestyle interventions targeting physical activity, sedentary time, and sleep balance.