Introduction:
The association between levels of physical activity and depression is not well understood. However, depressive symptoms are common in patients with metabolic dysfunction associated fatty liver disease (MAFLD). This study aimed to investigate whether there is a correlation between MAFLD patients’ levels of moderate to vigorous recreational exercise and depression.

Material and methods:
From the National Health and Nutrition Examination Survey (NHANES) database, 2656 individuals with MAFLD were included in this investigation. Depressive symptoms were examined in relation to varying degrees of recreational activity using a generalized linear model that was weighted on numerous factors.

Results:
After accounting for all potential confounding factors, the weighted generalized linear model revealed a negative correlation between moderate recreational activity and depression (OR = 0.599, 95% CI: 0.475–0.755; p < 0.001). This correlation persisted even after controlling for other variables. In spite of this, after controlling for all potential confounding variables, there was still no correlation between the intensity of recreational activity and depression. Females who engage in moderate amounts of amusement are less likely to suffer from depression, according to subgroup analysis (OR = 0.657, 95% CI: 0.440–0.983; p = 0.036).

Conclusions:
This association persists after controlling for other variables; patients with MAFLD are more prone to depression, whereas those with higher levels of moderate recreational activity are less likely to suffer from depression. Their depressive symptoms may be treatable by modest recreational activity, according to these results.