Table 3 Summary of the findings from the studies assessing mental health outcomes

Janssen [60]

Children (n = 20,122) from the Canadian Health Behavior in School-aged Children study, Canada; cross-sectional

Sedentary video games, active outdoor play, active video games – self report; sleep – not assessed

Mental health outcomes

Mekary et al. [12]/60 min

Sex, school grade, household structure, race, immigration status, socioeconomic status, smoking, frequency of drunkenness, active travel to school, participation in sport, and a diet composition factor score.

PR (95% CI)

High emotional problems

Sedentary video games → active outdoor play: 0.94 (0.91, 0.97)

Active outdoor play → active video games: 1.07 (1.03, 1.11)

Active video games → sedentary video games: 1.07 (1.03, 1.10)

Active video games → active outdoor play: 0.93 (0.90, 0.97)

Sedentary video games → active outdoor play: 0.88 (0.85, 0.90)

Active outdoor play → sedentary video games: 1.14 (1.11, 1.17)

High life satisfaction

Sedentary video games → active outdoor play: 1.04 (1.02, 1.07)

Active outdoor play → active video games: 0.97 (0.95, 0.99)

Active video games → sedentary video games: 0.96 (0.94, 0.98)

Active video games → active outdoor play: 1.04 (1.01, 1.06)

Sedentary video games → active outdoor play: 1.08 (1.06, 1.10)

Active outdoor play → sedentary video games: 0.92 (0.91, 0.94)

High prosocial behaviour

Sedentary video games → active outdoor play: 1.13 (1.09, 1.16)

Active outdoor play → active video games: 0.94(0.91, 0.98)

Active video games → sedentary video games: 0.89 (0.86, 0.92)

Active video games → active outdoor play: 1.06 (1.02, 1.10)

Sedentary video games → active outdoor play: 1.19 (1.16, 1.22)

Active outdoor play → sedentary video games: 0.84 (0.82, 0.86)

Mekary et al. [69]

Adult women (n = 32,900) from the Nurses’ Health Study, USA; prospective cohort

Television watching, easy walking pace, average walking pace, brisk/very brisk walking pace, jogging/running, other physical activities, total discretionary time – self report; sleep – not assessed

Risk of depression

Mekary et al. [12]/60 min

Age, weight, smoking, menopausal status, use of postmenopausal hormone therapy, previously diagnosed medical conditions, marital status, osteoarthritis, social or community group involvement, wealth and income, education, occupation, working status and educational level.

RR (95% CI)

TV watching → easy walking: 1.32 (0.73, 2.38)

TV watching → average walking: 0.88 (0.77, 1.00)

TV watching → brisk walking: 0.76 (0.68, 0.85)

TV watching → running: 0.76 (0.45, 1.29)

TV watching → other activities: 0.93 (0.85, 1.01)

TV watching → total discretionary time: 1.03 (1.02, 1.05)

Easy walking → TV watching: 0.73 (0.42, 1.26)

Easy walking → average walking: 0.65 (0.37, 1.12)

Easy walking → brisk walking: 0.56 (0.32, 0.96)

Easy walking → running: 0.56 (0.26, 1.19)

Easy walking → other activities: 0.68 (0.39, 1.18)

Easy walking → total discretionary time: 1.42 (0.82, 2.45)

Average walking → TV watching: 1.13 (0.99, 1.29)

Average walking → easy walking: 1.49 (0.82, 2.71)

Average walking → brisk walking: 0.86 (0.74, 0.99)

Average walking → running: 0.86 (0.50, 1.48)

Average walking → other activities: 1.05 (0.89, 1.24)

Average walking → total discretionary time: 0.91 (0.80, 1.04)

Brisk walking → TV watching: 1.32 (1.18, 1.47)

Brisk walking → easy walking: 1.73 (0.96, 3.13)

Brisk walking → average walking: 1.16 (1.00, 1.34)

Brisk walking → running: 1.00 (0.58, 1.72)

Brisk walking → other activities: 1.22 (1.05, 1.42)

Brisk walking → total activity: 0.79 (0.70, 0.88)

Running → TV watching: 1.19 (0.74, 1.91)

Running → easy walking: 1.56 (0.74, 3.32)

Running → average walking: 1.05 (0.64, 1.70)

Running → brisk walking: 0.90 (0.55, 1.46)

Running → other activities: 1.10 (0.68, 1.80)

Running → total discretionary time: 0.87 (0.54, 1.40)

Other activities → TV Watching: 1.08 (0.99, 1.17)

Other activities → easy walking: 1.42 (0.78, 2.56)

Other activities → average walking: 0.95 (0.80, 1.11)

Other activities → brisk walking: 0.81 (0.70, 0.95)

Other activities → running: 0.82 (0.48, 1.40)

Other activities → total discretionary time: 0.96 (0.88, 1.05)

Rethorst et al. [31]

Adults (n = 11,116) from the Hispanic Community Health Study/Study of Latinos, USA; cross-sectional

SB, LPA, MPA, VPA – waist-worn accelerometers; sleep – not assessed

Depressive symptoms

Mekary et al. [12]/60 min

Age, sex, Hispanic background group, BMI, household income level, and education level, recruitment site, physical health and acculturation.

β (95% CI)

SB ↔ LPA: − 0.003 (− 0.113, 0.107)

SB ↔ MPA: 0.285 (− 0.264, 0.834)

SB ↔ VPA: − 1.215 (− 2.250, − 0.180)

LPA ↔ MPA: 0.288 (− 0.304, 0.880)

LPA ↔ VPA: − 1.212 (− 2.244, − 0.179)

MPA ↔ VPA: − 1.5 (− 2.883, − 0.116)