COVID-19 has caused mental health issues among adolescents. This study aimed to explore the related factors of nutrition, physical activity (PA), and symptoms of insomnia, depression and anxiety, and to investigate associations between the two lifestyle behaviors (insolated or combined) with symptoms of insomnia, depression and anxiety. Cross-sectional data of 1,756 middle school students from a survey conducted in May 2020 was used. The t-tests or c2 tests were used to determine the related factors of nutrition, PA, and symptoms of insomnia, depression and anxiety across the subgroups when appropriate. Logistic regression analysis was used to explore the relationships between nutrition and PA, and symptoms of insomnia, depression and anxiety. Girls, rural students, left-behind, sibling, students with low family income or excessive fear had worse lifestyle or mental status. Both poor nutrition and inactive PA were related to higher odds of reporting symptoms of insomnia, depression and anxiety. Students with both poor nutrition and inactive PA tended to report insomnia symptoms (OR = 2.16) and depressive symptoms (OR = 2.57) than those with only one behavior or neither of them after controlling for confounding factors. The present study indicates the importance of helping adolescents to pursue a healthier lifestyle.
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