Abstract
BACKGROUND: While substantial evidence links single lifestyle factors to mental health, research on how multiple co-occurring healthy lifestyle behaviors relate to mental health, particularly among college students, remains limited. This study aimed to identify distinct profiles of healthy lifestyle behaviors and examine their associations with mental health among college students. METHOD: This cross-sectional study included 1340 college students (mean age = 19.4 years; SD = 1.2). Self-reported data were collected on diet, sleep, physical activity (PA), screen time, and sedentary behavior. Mental health was assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Latent profile analysis was used to identify groups with similar lifestyle characteristics. Multiple linear regression was applied to examine associations between lifestyle profiles and mental health. RESULT: Three lifestyle profiles were identified: "Active Engagement" (n = 520, 38.8%), "Moderate Engagement" (n = 478, 35.7%), and "Negative Engagement" (n = 342, 25.5%). These groups showed significant differences in anxiety, depression and stress levels (p < 0.001). Monthly family income and sex predicted profile membership. Compared with the "Active Engagement" group, the "Moderate Engagement" and "Negative Engagement" groups showed a higher risk of mental health problems. CONCLUSIONS: Our findings suggest that interventions specifically targeting the active lifestyle pattern (characterized by the higher PA, low sedentary behavior and screen time) may be particularly effective for improving mental health in college students, moving beyond simply promoting single health behaviors.