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

Abstract

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.

Prospective Health Outcomes of Sugar-Sweetened Beverage Consumption Patterns Associated with Sociodemographic and Ethnic Factors among Chinese Adults

“…Similarly, increased consumption of SSBs has been linked to depression and mood disorders in a cognate study in London, UK. Research on SSB consumption maintained that a lower intake of raw sugar and nonnutritive sweeteners (NNS) such as aspartame, saccharin, sucralose, neotame, acesulfame-K, and stevia may be associated with better psychological and physical health outcomes [14][15][16][17][18][19].…”

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

“…SSBs such as carbonated beverages and sugar-sweetened fruit juice beverages, were suggested to have an association with an increased risk of children’s physical health problems, including dental caries, obesity(s) and other metabolic diseases ( 4 , 5 ). Some previous studies suggested that SSB consumption was linked with mental problems, such as impaired cognitive function ( 6 , 7 ), executive function (EF) ( 8 ), as well as behavioral problems, including hyperactivity problems and emotional symptoms ( 9 , 10 ).…”

How Diet Impacts the Relationship between Intimate Partner Aggression and Child Conduct Problems

“…The way in which dietary patterns are derived and assessed by questionnaires is also crucial, such as the frequency of food intake and the assessment of portion size. A clear gap in the literature on diet and child behaviour is that most of the research has only focused on frequency of food intake, rather than the actual portion (quantity) of food consumed (Ajmal et al, 2022;Zhang et al, 2021). For example, one study asked, "How many times do you eat takeaways each week", the answers ranged from "never" to "high frequency" (Zhang et al, 2021).…”

“…A clear gap in the literature on diet and child behaviour is that most of the research has only focused on frequency of food intake, rather than the actual portion (quantity) of food consumed (Ajmal et al, 2022;Zhang et al, 2021). For example, one study asked, "How many times do you eat takeaways each week", the answers ranged from "never" to "high frequency" (Zhang et al, 2021). However, the portion of the food consumed was not included within the questionnaire.…”

“…Children who are exposed to an 'unhealthy' diet antenatally by mothers and postnatally by their own food consumption may be at a higher risk for behavioural problems. Whereas a healthier diet may be a protective factor for children's behaviour (Ajmal et al, 2022;Dou et al, 2023;Gete et al, 2022;Hammersley et al, 2022;Jacka, 2019;Jackson et al, 2016;Miyake et al, 2020;Oh et al, 2014;Zhang et al, 2021;Zhu et al, 2023). It asks the question on whether diet is important to consider when investigating potential preventative measures to combat negative child outcomes, such as CP.…”