Abstract
BACKGROUND: The COVID-19 pandemic caused significant disruptions to daily life, affecting regular physical activity (PA) and health behaviors worldwide. This study investigates the associations between PA domains and changes in health behaviors and mental health outcomes among middle-aged and old Chinese adults. METHODS: Using wave 5 cross-sectional data from the 2020 China Health and Retirement Longitudinal Study, we analyzed 17,180 adults aged 45 and above, focusing on health behavior changes such as smoking, alcohol consumption, dietary adjustments, and panic purchasing, as well as mental health outcomes like anxiety and fear. PA was classified by intensity levels-light, moderate, and vigorous-and by activity purposes-total, leisure, and occupational. RESULTS: The findings indicate that leisure PA is associated with healthier behaviors, including lower odds of increased smoking (OR = 0.71, 95% CI: 0.57-0.90) and alcohol consumption (OR = 0.70, 95% CI: 0.54-0.90), whereas occupational PA is linked to adverse behavioral outcomes, such as higher odds of smoking (OR = 1.45, 95% CI: 1.15-1.83) and alcohol use (OR = 1.43, 95% CI: 1.10-1.86). Additionally, participants engaged in all domains of PA were more likely to experience anxiety and fear compared to those who were physically inactive. CONCLUSIONS: Our limited understanding of the role PA has on behavioral and mental health during public health crises highlights the importance of having tailored strategies to enhance resilience in similar future scenarios.