Sugar-sweetened beverages consumption are associated with behavioral problems among preschoolers: A population based cross-sectional study in China

The association between junk foods consumption and attention deficit hyperactivity disorder in children and adolescents: a systematic review and meta-analysis of observational studies

The adverse effects of junk foods on the risk of attention deficit hyperactivity disorder (ADHD) symptoms were reported in several studies. In this meta-analysis, the association between junk food consumption and the risk of ADHD was investigated in children and adolescents. A comprehensive systematic search was conducted to find all relevant literature via four databases, including PubMed, Web of Science, Scopus, and Google scholar, up to September 2022. Two independent authors screened all documents based on inclusion criteria. The overall effect sizes and related 95% confidence interval (CI) were pooled with the random effect approach. Subgroup analysis was done to measure potential sources of heterogeneity between studies. The quality of the included studies was evaluated with The Newcastle-Ottawa scale (NOS). Nine observational studies with 58,296 children /adolescents were eligible to be include in the meta-analysis. According to the random effect model, there was a positive relation between the consumption of junk foods and ADHD symptoms (odds ratio (OR): 1.24, 95%CI 1.15-1.34, P < 0.001, I2: 37.4%, P = 0.085). A similar significant positive association was shown in the subgroups analysis by different junk foods (sweetened beverages/soft drinks, sweets/candies, and other types of junk foods). This meta-analysis finding demonstrated that consuming junk foods, especially sweetened beverages/soft drinks, and sweets/candies is associated with ADHD symptoms.

Beverage Consumption and Factors Influencing the Choice of Beverages among Polish Children Aged 11-13 Years in 2018-2023

Adequate hydration is essential for good health, and an individual's hydration status is determined by the quantity and type of ingested fluids. The aim of the present study was to determine the hydration status of school-age children and evaluate changes in the type and quantity of consumed beverages between 2018 and 2023. The study was conducted in two stages between 2018 and 2023, and a total of 1030 fully completed questionnaires were returned by the children and their parents. A comparison of the parents' responses regarding factors that affect beverage choices revealed that beverage composition was more significant for the parents in 2023 than in 2018, whereas health-promoting properties were significant for only less than 30% of the respondents. Taste preferences were important for both the parents and the children, and they were the main criterion in the choice of beverages in both 2018 and 2023. In turn, advertising was an important factor for children, and the percentage of children who were guided by advertising in their choice of beverages increased from 52.1% in 2018 to 58.5% in 2023 (p < 0.05). Daily fluid intake from beverages in children aged 11-13 years generally does not meet recommended intakes. Low fluid intake can negatively affect children's hydration status and bodily functions. Taste preferences and advertising were correlated with a higher intake of carbonated and non-carbonated sugar-sweetened beverages (SSBs) and dairy beverages. The percentage of children who bought drinks independently and had access to SSBs increased significantly during the analyzed period. Obtain results indicate that nutrition education programs are needed to teach adolescents to make healthy drink choices, limit their consumption of SSBs and EDs, and promote regular intake of natural mineral water and non-sweetened dairy beverages.

Interaction effect of screen time and sugar-sweetened beverages with depressive symptoms in adolescents: evidence from a large sample-based survey in China

Excessive screen time and the consumption of sugar-sweetened beverages are found to be independent predictors of depressive symptoms. However, the potential interaction effect of screen time and sugar-sweetened beverages, that is, whether one exposure factor strengthens the association of another with depressive symptoms, remains unclear. A large-scale adolescent health surveillance survey was conducted in 27 schools in eight regions across China. A total of 22,868 students were recruited to complete an eligible questionnaire to provide details of their screen time and sugar-sweetened beverage consumption. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Multiplicative and additive interaction models were performed to estimate the interaction effects of screen time and sugar-sweetened beverages on depressive symptoms, and whether the relationship varied by age group was also examined. The multivariate logistic regression model showed that even if the confounding factors were controlled, screen time and sugar-sweetened beverages were still risk factors for depressive symptoms in adolescents. Interaction models indicated that screen time and sugar-sweetened beverages in combination were related to greater odds of depressive symptoms. Compared with late adolescents, early adolescents had a higher probability of depressive symptoms when exposed to the joint effects. Our study may hopefully deepen the understanding of the association between screen time and sugar-sweetened beverages and depressive symptoms. Future research should further explore how and why screen time and sugar-sweetened beverages affect individuals more profoundly in early adolescence than in late adolescence and how to mitigate this.

Association between Hyperactivity and SSB Consumption in Schoolchildren: A Cross-Sectional Study in China

Sugar-sweetened beverages (SSBs) consumption has risen significantly, which may lead to various health problems. Studies about the association between SSBs and attention-deficit/hyperactivity disorder (ADHD) in children are rare and inconsistent. We have used the two-stage cluster sampling method to select 6541 students aged 6-12. We further investigated their basic information and SSB intake. Teachers' questionnaires and parents' questionnaires were used to evaluating the hyperactive behaviors in children. We examined the associations between SSB consumption and hyperactivity index (HI) by adopting the censored least absolute deviation (CLAD) estimator. Then, we further evaluated the impacts of sex and age on the association between SSB intake and hyperactivity. Children who weekly drank SSB two or more times were associated with 0.05 (0.04, 0.07) and 0.04 (0.02, 0.06) higher scores of ln (HI+1) reported by teachers and parents, respectively, compared to non-consumers children (p for trend < 0.05). A stronger association between SSB intake and hyperactivity occurred in girls and old children. (p for interaction < 0.05). SSB intake has a positive correlation with the risk of hyperactivity in children, and the frequency of SSB consumption and hyperactivity have a dose-response relationship.

Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood: a prospective register linkage study of the HUNT survey and health registries

BACKGROUND

There is increasing need for prospective investigations in the preventing role of health-related behaviours on mental health problems. The aim of this study is to identify patterns of health-related behaviours in adolescence, and the association between the behavioural patterns and the subsequent diagnoses and/or drug treatment for anxiety and/or depression in adulthood.

METHODS

This prospective study consisted of 13-19-year-old participants in the Trøndelag Health Study (Young-HUNT3) in 2006-2008 (n = 2061, 1205 females and 856 males) in Norway, who also participated in HUNT4 (2017-2019). Survey data on health-related behaviours in adolescence, including low level of physical activity, low consumption of wholegrain bread, fish, fruit, vegetables and high consumption of sugar-sweetened beverages and insomnia were linked on an individual level to prospective information on drug use and diagnosis in national health registries. The different patterns of health-related behaviours were identified through latent class analysis. Subsequent anxiety or depression was defined as at least one recording in either of three registries covering recorded diagnosis in primary and specialist healthcare, or dispensed prescription drugs during 2008-2019. Additionally, self-reported psychological distress measured in young adulthood was applied as a supplemental outcome measure.

RESULTS

Four patterns of health-related behaviours were identified: high risk behaviours (class 1), moderate to high risk behaviours (class 2), low to moderate risk behaviours (class 3) and low risk behaviours (class 4). Adolescents in class 3 showed higher odds of subsequent diagnoses for anxiety and/or depression in primary and specialist healthcare compared to class 4 participants. In addition, both class 1 and class 4 participants had higher odds for self-reported psychological distress than those class 4 (OR = 1.56 and OR = 1.86, respectively).

CONCLUSIONS

Our findings suggest that health-related behaviours are clustered among Norwegian adolescents. The patterns of unhealthy behaviours during adolescence only partly increased the risk of anxiety and depression in adulthood. Promoting healthy behaviours during adolescence may potentially reduce the burden of mental illness in adulthood, but further research is needed to clarify the nature of the relationships.

The association between sugar-sweetened beverages and milk intake with emotional and behavioral problems in children with autism spectrum disorder

Background

Emotional and behavioral problems are common in children with autism spectrum disorder (ASD). It's still unclear whether children with ASD have abnormal sugar-sweetened beverages (SSBs) and milk intake and whether this abnormality will affect their emotions and behavior remains unclear. The current study aims to investigate the association of SSBs and milk intake with emotional and behavioral problems in children with autism spectrum disorder (ASD).

Methods

107 children with ASD and 207 typical developing (TD) children aged 6-12 years old were recruited for the study. The frequency of SSBs and milk intake was assessed by a self-designed questionnaire. Emotional and behavioral problems were assessed by Strength and Difficulties Questionnaire (SDQ). Then, the linear regression model was produced to evaluate the association of SSBs and milk intake with emotional and behavioral problems.

Results

In the current study, there was no difference in frequency of SSBs intake between children with ASD and TD children (p > 0.05), and children with ASD consumed less milk compared to TD children (p < 0.05). After adjusting sex, age, maternal and paternal education, and monthly family income, we found a significant difference in each subscale score of SDQ in the two groups (p < 0.05). In children with ASD, higher frequent SSBs intake was positively associated with the scores of the emotional problem (p for trend <0.05), and lower frequent milk intake was inversely associated with the scores of prosocial behavior (p for trend <0.05). No interactive effects were found on SSBs and milk intake with emotional and behavioral problems (p for trend > 0.05).

Conclusion

In children with ASD, frequency of SSBs and milk intake was associated with the emotional problem and prosocial behavior, respectively. Children with ASD should increase the frequency of milk intake and decrease the frequency of SSBs intake.

Association of sugar-sweetened beverages with executive function in autistic children

The association between sugar-sweetened beverages (SSBs) consumption and executive function (EF) among typically developing (TD) children has been investigated in previous studies but with inconsistent results. Furthermore, this relationship has been less investigated among autistic children who perform worse in EF compared with TD children. In this study, we aimed to investigate the association between SSB consumption and EF in autistic children, and whether the association between SSB and EF in autistic children is different from that in TD children. We recruited 106 autistic children and 207 TD children aged 6–12 years in Guangzhou, China. Children’s EF was assessed by using the Chinese version of parent-reported Behavior Rating Inventory of Executive Function, Stroop Color–Word Test, and working memory subscales of the Chinese version of Wechsler Intelligence Scale for children, Fourth edition. Meanwhile, we assessed children’s dietary intake and SSB consumption with a validated Food Frequency Questionnaire. In this study, 70 (66.0%) autistic children consumed SSB and 20 (18.9%) of them consumed more than two servings SSB a week. Among autistic children, over two servings per week SSB consumption was associated with poorer performance in emotional control [β = 7.20, 95% confidence interval (CI): 0.94–13.46] and plan/Organize (β = 6.45, 95% CI: 0.27–12.63). The association between over two servings/week SSB consumption and emotional control among autistic children was significantly different from that among TD children (β_ASD = 7.20; β_TD = −3.09, Z = 2.72, p = 0.006). Results of this study show that SSB consumption was associated with an impairment in some subscales of EF in autistic children. Furthermore, the association between SSB and EF in autistic children might be different from that in TD children.

Impact of Obesogenic Environments on Sugar-Sweetened Beverage Consumption among Preschoolers: Findings from a Cross-Sectional Survey in Beijing

The excessive consumption of sugar-sweetened beverages (SSBs) has been proven to be critical for obesity among preschoolers. This study aimed to describe the SSB consumption rates among preschoolers in the Dongcheng District of Beijing, China, and to explore the association between obesogenic environmental determinants and consumption. We applied a stratified cluster sampling method and recruited 3057 primary caregivers of preschoolers in June 2019 to participate in the survey. The caregivers reported their children’s consumption rates of six categories of SSBs and their exposure rates to SSB-related obesogenic environments. The associations between them were tested using multivariate logistic regression models. The mean (SD) age of the children was 5.6 (0.6) years and nearly half (48.3%) were girls. About 84.5% of the children had consumed SSBs over the past three months, and sugar-sweetened milk beverages had the highest consumption rate. Higher exposure to advertisements for the corresponding SSB categories in children, higher frequency rates of consuming SSBs and of taking children to fast-food restaurants in caregivers, and lower frequency rates of reading the Nutrition Facts Panels by caregivers were associated with higher SSB consumption rates among children (p < 0.05 in all of the SSB categories investigated, except for the Nutrition Facts Panel reading behaviors for the sports and energy beverages). SSB consumption among preschoolers is of concern, and comprehensive policy actions and education are urgently needed.

A Scoping Literature Review of the Relation between Nutrition and ASD Symptoms in Children

Autism spectrum disorder (ASD) is characterized by impairments in social interaction, communication skills, and repetitive and restrictive behaviors and interests. Even though there is a biological basis for an effect of specific nutrition factors on ASD symptoms and there is scientific literature available on this relationship, whether nutrition factors could play a role in ASD treatment is unclear. The goal of the current literature review was to summarize the available scientific literature on the relation between nutrition and autism spectrum disorder (ASD) symptoms in childhood, and to formulate practical dietary guidelines. A comprehensive search strategy including terms for ASD, nutrition factors (therapeutic diets, dietary patterns, specific food products, fatty acids and micronutrients) and childhood was developed and executed in six literature databases (Cinahl, Cochrane, Ovid Embase, PsycInfo, PubMed and Web of Science). Data from meta-analyses, systematic reviews and original studies were qualitatively summarized. A total of 5 meta-analyses, 29 systematic reviews and 27 original studies were retrieved that focused on therapeutic diets, specific food products, fatty acids and micronutrients and ASD symptoms during childhood. Results of the available studies were sparse and inconclusive, and hence, no firm conclusions could be drawn. There is currently insufficient evidence for a relation between nutrition and ASD symptoms in childhood, making it impossible to provide practical nutrition guidelines; more methodological sound research is needed.

Physical activity, sugar-sweetened beverages, whole grain bread and insomnia among adolescents and psychological distress in adulthood: prospective data from the population-based HUNT study

Background

In this study, we examined the relationship between low levels of physical activity, high consumption of sugar-sweetened beverages and low consumption of whole grain bread and experiencing insomnia in adolescence and psychological distress in young adults.

Methods

This prospective study was based on information retrieved from the Trøndelag Health Study (HUNT) in Norway and included adolescents (age 13–19) participating in Young-HUNT3 (2006–2008) and in HUNT4 (2017–2019) 11 years later (age 23–31). The study sample consisted of 2,230 participants (1,287 females and 943 males). The exposure variables collected in adolescence included self-reported physical activity, consumption of sugar-sweetened beverages and whole grain bread and insomnia, and psychological distress in young adulthood was used as an outcome variable. The relationship between lifestyle behaviours in adolescence and psychological distress in young adulthood was examined using multivariable logistic regression, adjusted for gender, age and psychological distress in adolescence and educational level in young adulthood.

Results

An increased odds of psychological distress was shown among young adults who reported low levels of physical activity (OR: 1.44, 95 % CI: 1.10–2.89), high consumption of sugar-sweetened beverages (OR: 1.49, 95 % CI: 1.12–1.98), low consumption of whole grain bread (OR: 1.35, 95 % CI: 1.04–1.77) and insomnia (OR: 1.69, 95 % CI: 1.23–2.33) in adolescence. In terms of absolute differences, unhealthy lifestyle behaviours increased the risk of psychological distress in young adulthood between 3.18 (95 % CI: 0.29–6.07) (low whole grain bread consumption) and 6.01 (95 % CI: 1.95–10.07) (insomnia) percentage points.

Conclusions

Low levels of physical activity, high consumption of sugar-sweetened beverages and low consumption of whole grain bread and insomnia during adolescence were associated with psychological distress in young adulthood.

Health behavior patterns of sugar-sweetened beverage consumption among Brazilian adolescents in a nationally representative school-based study

Studies on sugar-sweetened beverage consumption patterns can help in the individual and population level management of chronic non-communicable diseases and other conditions. This study aimed to identify the association between health behavior patterns and the consumption of sugar-sweetened beverages among Brazilian adolescents from a nationally representative school-based study. A cross-sectional study analyzed data from 71,553 adolescents aged 12-17 years who attended public and private schools in Brazilian cities, from the Study of Cardiovascular Risk in Adolescents. Principal component analysis was performed to identify health behavior patterns, and ordered logistic regression was performed to identify the association between health behavior patterns and sugar-sweetened beverage consumption. Sugar-sweetened beverage consumption (mL/day) was used as the dependent variable. The analyses were performed using Stata software version 14.0 with a significance level of 0.05. Patterns 2 (alcoholic beverage and smoking habit) and 3 (ultra-processed food and screen time) of health behaviors and regularly purchasing snacks in the school cafeteria increased the odds of sugar-sweetened beverage consumption, while pattern 1 (water, unprocessed and minimally processed food and physical activity) decreased these odds. The adoption of healthy habits can indirectly stimulate the adoption of other habits beneficial to health. These results indicate the importance of adopting a set of regulatory measures to reduce sugar-sweetened beverage consumption.

The Relationship Between Sugar-Sweetened Beverages, Takeaway Dietary Pattern, and Psychological and Behavioral Problems Among Children and Adolescents in China

Background and Aim: The association of sugar-sweetened beverage (SSB) consumption and takeaway dietary pattern with psychological problems in Chinese children and adolescents has not been concretely reported. Our study aimed to investigate the association between SSB consumption, takeaway dietary pattern, and psychological and behavioral problems (PBPs). Methods: Cluster sampling method has been adopted from April to May 2019 to conduct a questionnaire survey among 30,188 children and adolescents in grades 1 to 12 from 14 schools in six streets in Bao'an District of Shenzhen. This cross-sectional study investigated the association of consumption of SSBs and takeaway patterns with PBPs, and PBPs were measured by the Strengths and Difficulties Questionnaire (SDQ) in primary, junior, and senior high school students. Results: A total of 33,801 primary, junior, and senior high school students (mean age = 12.44, SD = 3.47) ranging from 6 to 18 years old were recruited in this study using a health survey of children and adolescents in junior and senior high schools (grades 1-12), and 30,188 students with no missing data were finally analyzed (questionnaires with missing value >5% were excluded). The top three SSBs in the intake frequency were milk beverage drinks (not milk), vegetable protein drinks, and fruit and vegetable juice drinks. Adjusted for demographic factors, the higher the frequency of students consuming SSBs who have significantly higher PBPs, the higher the frequency of students with takeaway dietary patterns who also have significantly higher PBPs. More frequent intake of SSBs [odds ratio (OR) = 2.23, 95%CI = 2.0-2.47, p < 0.01] and higher takeaway dietary patterns (OR = 2.34, 95%CI = 1.81-3.03, p < 0.01) were associated with higher SDQ total difficulties scores. When low and medium consumption of SSB was compared, children and adolescents who have high SSB intake were more associated with total difficulties score (OR = 3.10, 95%CI = 2.67-3.59, p < 0.01), and when low and medium takeaway dietary patterns were compared, children and adolescents who have high takeaway dietary patterns were more associated with total difficulties score. The joint associations of SSBs and takeaway pattern with SDQ were stronger than the associations individually. Conclusions: Students consuming higher SSBs and having takeaway dietary pattern are associated with increased levels of PBPs individually and interactively. These results may have implications for mental health prevention in adolescents.