A Nationwide Cross-Sectional Survey of the Prevalence of and Association of Physical Activity With Suicidal, Psychosocial and Health-Risk Indicators Among Adolescents in Bangladesh

Purpose: This study investigated the associations between physical activity (PA) and suicidal behaviours, psychosocial outcomes and indicators of health risks. Methods: This was a secondary analysis of data from the Global School-Based Student Health Survey (GSHS) database. A total of 2058 adolescents aged 11–17 years in Grades 7–10 completed a self-administered questionnaire. Sex-stratified logistic regression was used to evaluate the associations between PA and suicidal behaviours, psychosocial outcomes and indicators of health risks. We used the least absolute shrinkage and selection operator (LASSO) regression to test whether PA-related factors predicted suicidal, psychological and lifestyle-related behaviours. A generalized linear mixed model (GLMM) examined the contributions of PA to these factors. Findings: Half of the adolescents (18.9% boys and 30.3% girls) indicated satisfactory PA per the World Health Organization guidelines. The most active group in terms of frequency of activity and walking or bicycling to school was positively associated with suicidal behaviour. Isolated adolescents reported anxiety despite frequent PA. Reduced frequency of PA was significantly associated with sexual activity, smoking, tobacco product use (girls), alcohol abuse (boys) and other drug use (boys and girls). The LASSO revealed that different PA-related factors predicted suicidal, psychological and lifestyle-related behaviour among girls and boys. The GLMM showed a significant contribution of PA to selected predictors. Conclusion: Increased PA may lower suicidal behaviour among adolescents. The most physically active groups were associated with predictors that varied by sex; boys were bullied, whereas girls experienced physical abuse.