Associations of physical activity type and frequency with perceived stress among adolescents: a secondary analysis

BACKGROUND: Adolescents are highly vulnerable to stress, which is closely associated with adverse psychological outcomes. Although physical activity has been linked to lower levels of perceived stress, evidence regarding how these associations vary by activity type and frequency remains limited. METHODS: The present study investigated this relationship by conducting a secondary analysis of the 2009–2024 Korea Youth Risk Behavior Survey, including 995,518 adolescents aged 12–18 years. Perceived stress was treated as the outcome (high vs. low), and physical activity was assessed as the exposure in three domains: moderate-intensity physical activity (MIPA), vigorous-intensity physical activity (VIPA), and muscle-strengthening exercise (MSE), each categorized by weekly frequency. Multivariable logistic regression models were applied, adjusting for sociodemographic and behavioral covariates. RESULTS: In adjusted analyses, associations between physical activity and high perceived stress differed by activity type and weekly frequency, with the strongest inverse associations generally observed at moderate frequencies. Patterns varied across activity types and subgroups, and higher-frequency categories showed attenuated or positive associations for some activities. CONCLUSIONS: In this nationally representative adolescent sample, perceived stress was differentially associated with the type and frequency of physical activity. These findings should be interpreted as associations rather than causal effects, as perceived stress represents one dimension of adolescent mental well-being and the data are cross-sectional. Nevertheless, the findings may inform public health initiatives and school-based programs addressing adolescent stress and well-being.