Association between early childhood outdoor activity and anxiety symptoms in preschoolers

Abstract Background Recently, there has been a decreasing trend in the frequency and duration of outdoor activity among children, which has garnered concern regarding the potential impacts of this decline during mental health in early childhood. Currently, the association between outdoor activity in early childhood and the symptoms of anxiety disorders in preschoolers remains unclear. The purpose of this study was to investigated the association between the frequency and duration of outdoor activities in children aged 0-3 yearsand anxiety symptoms in preschoolers. Methods A cross-sectional study was conducted in 2021 using questionnaires, included 69,571 preschoolersresiding in Longhua District, Shenzhen. Data on family social demographics, outdoor activity frequency and duration in children aged 0-3 years, and the anxiety symptoms of preschoolerswere collected through parent-completed questionnaires. The association between early childhood outdoor activity and anxiety symptoms in preschoolerswas analyzed using a binary logistic regression model. Results Children 0–1 years of age who were outdoors < 1 times/week had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥7 times/week (OR = 2.55, 95% confidence interval(CI): 2.22–2.94). Children in this age group who were outdoors <30 min/session had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥120 min/ session (OR = 1.62, 95%CI: 1.38–1.90). Children 1–3 years of age, who were outdoors < 1 time/week had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥7 times/week, (OR = 3.10, 95%CI: 2.72–3.54). Children in this age group who were outdoors for < 30 min/sessionhad a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors time ≥120 min/ session (OR = 2.07, 95%CI: 1.73–2.48). Conclusion Lower-frequency and shorter-duration outdoor activity during infancy was associated with a higher risk of anxiety symptoms in preschoolers. A frequency of ≥7 outdoor activity per week and a duration of ≥120 min/session during infancy were associated with lower levels of anxiety symptoms in preschoolers.