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Associations of sedentary behavior and physical activity with psychological distress: a cross-sectional study from Singapore

Robert A Sloan1*, Susumu S Sawada2, Daniel Girdano3, Yi Tong Liu1, Stuart JH Biddle4 and Steven N Blair5

Author Affiliations

1 Health Promotion Board, Physical Activity Centre of Excellence, Singapore, Singapore

2 Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan

3 Health Sciences Public Health, Walden University, Minneapolis, USA

4 School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire, UK

5 University of South Carolina, Departments of Exercise Science and Epidemiology /Biostatistics, Columbia, USA

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BMC Public Health 2013, 13:885  doi:10.1186/1471-2458-13-885

Published: 24 September 2013



Emerging evidence suggests the adverse association between sedentary behaviour (SB) with physical and mental health, but few studies have investigated the relationship between volume of physical activity and psychological distress. The present study examined the independent and interactive associations of daily SB and weekly level of moderate to vigorous physical activity (MVPA) with psychological distress in a multi-ethnic Asian population.


De-identified data of 4,337 adults (18–79 years old) on sedentary behaviors, physical activity patterns, psychological distresses, and other relevant variables were obtained from the Singapore Ministry of Health’s 2010 National Health Survey. Psychological distress was assessed using General Health Questionnaire-12 (GHQ-12), whereas total daily SB and total weekly volume (MET/minutes) of MVPA were estimated using the Global Physical Activity Questionnaire version 2 (GPAQ v2). Multivariate logistic regression analyses were carried out to estimate the odds ratios (95% confidence intervals) of the independent and interactive relationships of SB and MVPA with prevalence of psychological distress.


The category of high SB was positively associated with increased odds (OR = 1.29, 1.04-1.59) for psychological distress, whereas the category of active was inversely associated with lower odds (OR = 0.73, 0.62-0.86) for psychological distress. Multivariate analyses for psychological distress by combined daily SB and weekly MVPA levels showed inverse associations between middle SB and active categories (OR = 0.58, 0.45 - 0.74) along with low SB and active categories (OR = 0.61, 0.47-0.80).


The present population-based cross-sectional study indicated that in the multi-ethnic Asian society of Singapore, a high level of SB was independently associated with psychological distress and meeting the recommended guidelines for physical activity along with ≤ 5 h/day of SB was associated with the lowest odds of psychological distress.

Sedentary behavior; Volume; Physical activity; Psychological distress; Singapore; Cross-sectional