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BackgroundSugar consumption has increased dramatically around the world, and at the same time, the prevalence of mental illnesses such as depression and anxiety continues to increase. While previous research has explored the impact of various dietary factors on mental health, the specific impact of dietary sugar consumption on the risk of depression and anxiety disorders remains elusive. This study aimed to comprehensively assess this relationship through a systematic review and meta-analysis.MethodsPubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Network (CNKI), and WangFang were systematically searched for studies of the association between total dietary sugar intake and risk of depression and/or anxiety. The articles that meet the criteria are screened and included in the systematic review, and the data are extracted after assessing their quality. Stata 18.0 software was used for the meta-analysis.ResultsForty studies with 1,212,107 participants were included in the analysis. Results showed that sugar intake increased the risk of depression by 21% (OR = 1.21, 95% CI: 1.14, 1.27), while the overall association between sugar intake and anxiety risk was not statistically significant (OR = 1.11, 95% CI: 0.93, 1.28). Despite high heterogeneity (I2 = 99.7%), the results were statistically significant (p < 0.000). Subgroup analyses showed that the association between sugar consumption and depression risk remains consistent across different study designs (cross-sectional, cohort, and case–control studies) and different sample sizes (<5,000, 5,000–10,000, >10,000). Women have a higher risk of depression than men (OR = 1.19, 95% CI: 1.04, 1.35). Among the different exposure measures, the Food Frequency Questionnaire (FFQ) showed the most significant effect (OR = 1.32, 95% CI: 1.08, 1.67, I2 = 99.7%, p < 0.000). The measuring tool of subgroup analysis showed that there was a significant correlation between sugar intake and risk of depression, PHQ-9 (OR = 1.29, 95% CI: 1.17, 1.42, I2 = 86.5%, p < 0.000), and CES-D (OR = 1.28, 95% CI: 1.14, 1.44, I2 = 71.3%, p < 0.000). High-quality cross-sectional and cohort studies showed a significant association between sugar intake and depression risk, with most results being robust. While the overall analysis of sugar intake and anxiety risk was not significant, some subgroups approached significance, particularly in studies with a sample size of <5,000 (OR = 1.14, 95% CI: 0.89, 1.46) and studies using the FFQ questionnaire (OR = 1.31, 95% CI: 0.90, 1.89).ConclusionTotal dietary sugar consumption was significantly associated with increased risk of depression in the general population, whereas the association with risk of anxiety was not significant. Further high-quality studies are needed to verify these associations and ensure their reliability. This study highlights the impact of dietary sugar intake on mental health, identifies potentially high-risk groups through subgroup analysis, and provides new insights into the prevention of depression and anxiety.Systematic review registrationCRD42024540548.
BackgroundSugar consumption has increased dramatically around the world, and at the same time, the prevalence of mental illnesses such as depression and anxiety continues to increase. While previous research has explored the impact of various dietary factors on mental health, the specific impact of dietary sugar consumption on the risk of depression and anxiety disorders remains elusive. This study aimed to comprehensively assess this relationship through a systematic review and meta-analysis.MethodsPubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Network (CNKI), and WangFang were systematically searched for studies of the association between total dietary sugar intake and risk of depression and/or anxiety. The articles that meet the criteria are screened and included in the systematic review, and the data are extracted after assessing their quality. Stata 18.0 software was used for the meta-analysis.ResultsForty studies with 1,212,107 participants were included in the analysis. Results showed that sugar intake increased the risk of depression by 21% (OR = 1.21, 95% CI: 1.14, 1.27), while the overall association between sugar intake and anxiety risk was not statistically significant (OR = 1.11, 95% CI: 0.93, 1.28). Despite high heterogeneity (I2 = 99.7%), the results were statistically significant (p < 0.000). Subgroup analyses showed that the association between sugar consumption and depression risk remains consistent across different study designs (cross-sectional, cohort, and case–control studies) and different sample sizes (<5,000, 5,000–10,000, >10,000). Women have a higher risk of depression than men (OR = 1.19, 95% CI: 1.04, 1.35). Among the different exposure measures, the Food Frequency Questionnaire (FFQ) showed the most significant effect (OR = 1.32, 95% CI: 1.08, 1.67, I2 = 99.7%, p < 0.000). The measuring tool of subgroup analysis showed that there was a significant correlation between sugar intake and risk of depression, PHQ-9 (OR = 1.29, 95% CI: 1.17, 1.42, I2 = 86.5%, p < 0.000), and CES-D (OR = 1.28, 95% CI: 1.14, 1.44, I2 = 71.3%, p < 0.000). High-quality cross-sectional and cohort studies showed a significant association between sugar intake and depression risk, with most results being robust. While the overall analysis of sugar intake and anxiety risk was not significant, some subgroups approached significance, particularly in studies with a sample size of <5,000 (OR = 1.14, 95% CI: 0.89, 1.46) and studies using the FFQ questionnaire (OR = 1.31, 95% CI: 0.90, 1.89).ConclusionTotal dietary sugar consumption was significantly associated with increased risk of depression in the general population, whereas the association with risk of anxiety was not significant. Further high-quality studies are needed to verify these associations and ensure their reliability. This study highlights the impact of dietary sugar intake on mental health, identifies potentially high-risk groups through subgroup analysis, and provides new insights into the prevention of depression and anxiety.Systematic review registrationCRD42024540548.
ObjectiveInternet addiction and depressive symptoms are common mental health problems in adolescents. Due to the comorbidity of Internet addiction and depressive symptoms, their mutual relationship influences their developmental trajectories over time. Thus, this study aimed to identify the joint trajectories of Internet addiction and depressive symptoms, and examined the individual, family, and school antecedents of these trajectories among Chinese adolescents.MethodsUsing a battery of self-report scales, three waves of data collection were conducted in a Chinese adolescent sample (N = 1,301). The co-developmental trajectories of Internet addiction and depressive symptoms were extracted by adopting parallel-process latent class growth modeling (PPLCGM). Multinomial logistic regression was performed to assess predictive factors.ResultsFour unique joint trajectory classes were detected: the Health Group (n = 912, 70.1%), Comorbidity-Worsening Group (n = 85, 6.5%), Asymptomatic-Comorbid Risk Group (n = 148, 11.4%), and Prominent Depressive Symptoms-Remission Group (n = 156, 12.0%). Individual, family, and school factors (e.g., gender, positive youth development, family function, academic performance) significantly predicted the membership in these distinct co-developmental trajectories.ConclusionOur findings illustrate that the joint development of Internet addiction and depressive symptoms among adolescents presents a heterogeneous distribution, which could better inform prevention and intervention strategies since each co-developmental trajectory may represent unique experience for adolescents who need targeted treatment. Various individual, family, and school factors are important predictors that play different roles in distinguishing the joint trajectories of Internet addiction and depressive symptoms during this critical developmental transition period.
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