Sugar-sweetened beverages consumption and the risk of depression: A meta-analysis of observational studies

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.

Diet Quality and Sociodemographic, Lifestyle, and Health-Related Determinants among People with Depression in Spain: New Evidence from a Cross-Sectional Population-Based Study (2011-2017)

The role of diet quality in depression is an emerging research area and it appears that diet quality could be an important modifying factor. The aims of this study were to report the prevalence of diet quality among individuals with and without a self-reported diagnosis of depression aged from 16 to 64 years old in Spain, to analyze the time trends of the frequency of food consumption and diet quality from 2011 to 2017 in individuals with a self-reported diagnosis of depression, and to explore the associations between poor/improvable diet quality and sociodemographic, lifestyle, and health-related factors. A nationwide cross-sectional study was conducted in 42,280 participants with and without a self-reported diagnosis of depression who had participated in the 2011/2012 and 2017 Spanish National Health Surveys and the 2014 European Health Survey in Spain. A logistic regression analysis was performed to identify the variables associated with diet quality. The overall prevalence of diet quality among depressive and non-depressive individuals revealed 65.71% and 70.27% were in need of improvement, respectively. Moreover, having a poor or improvable diet quality is associated with male gender, people aged 16-24 years old and 25-44 years old, separated or divorced, and also in smokers.

Dose-response association between sugar- and artificially sweetened beverage consumption and the risk of metabolic syndrome: a meta-analysis of population-based epidemiological studies

OBJECTIVE

The associations between sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption and the risk of metabolic syndrome (MetS) remain controversial. A quantitative assessment of dose-response associations has not been reported. This study aims to assess the associations between the risk of MetS and SSB, ASB, and total sweetened beverage (TSB, the combination of SSB and ASB) consumption by reviewing population-based epidemiological studies.

DESIGN

Meta-analysis.

SETTING

We searched PubMed, Embase and Web of Science databases prior to 4 November 2019, for relevant studies investigating the SSB-MetS and ASB-MetS associations. A random effects model was used to estimate pooled relative risks (RR) and 95 % CI. Dose-response association was assessed using a restricted cubic splines model.

PARTICIPANTS

We identified seventeen articles (twenty-four studies, including 93 095 participants and 20 749 MetS patients).

RESULTS

The pooled RR for the risk of MetS were 1·51 (95 % CI 1·34, 1·69), 1·56 (1·32, 1·83) and 1·44 (1·19, 1·75) in high consumption group of TSB, SSB and ASB, respectively; and 1·20 (1·13, 1·28), 1·19 (1·11, 1·28) and 1·31 (1·05, 1·65) per 250 ml/d increase in TSB, SSB and ASB consumption, respectively. Additionally, we found evidence of non-linear, TSB-MetS and SSB-MetS dose-response associations and a linear ASB-MetS dose-response association.

CONCLUSIONS

TSB, SSB and ASB consumption was associated with the risk of MetS. The present findings provide evidence that supports reducing intake of these beverages to lower the TSB-, SSB- and ASB-related risk of MetS.

Associations of Non-Alcoholic Beverages with Major Depressive Disorder History and Depressive Symptoms Clusters in a Sample of Overweight Adults

BACKGROUND

Meta-analysis of observational studies concluded that soft drinks may increase the risk of depression, while high consumption of coffee and tea may reduce the risk. Objectives were to explore the associations between the consumption of soft drinks, coffee or tea and: (1) a history of major depressive disorder (MDD) and (2) the severity of depressive symptoms clusters (mood, cognitive and somatic/vegetative symptoms).

METHODS

Cross-sectional and longitudinal analysis based on baseline and 12-month-follow-up data collected from four countries participating in the European MooDFOOD prevention trial. In total, 941 overweight adults with subsyndromal depressive symptoms aged 18 to 75 years were analyzed. History of MDD, depressive symptoms and beverages intake were assessed.

RESULTS

Sugar-sweetened soft drinks were positively related to MDD history rates whereas soft drinks with non-nutritive sweeteners were inversely related for the high vs. low categories of intake. Longitudinal analysis showed no significant associations between beverages and mood, cognitive and somatic/vegetative clusters.

CONCLUSION

Our findings point toward a relationship between soft drinks and past MDD diagnoses depending on how they are sweetened while we found no association with coffee and tea. No significant effects were found between any studied beverages and the depressive symptoms clusters in a sample of overweight adults.

A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

There is increasing academic and clinical interest in how "lifestyle factors" traditionally associated with physical health may also relate to mental health and psychological well-being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta-review of the top-tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta-analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta-reviews, and two meta-analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress-related disorders, schizophrenia, bipolar disorder, and attention-deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non-pharmacological sleep-focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.

Association between sucrose and fiber intake and symptoms of depression in older people

Objectives: This study aimed to analyze the relationship between sucrose and fiber intake and symptoms of depression in older people.Material and Methods: The research group consisted of 813 community-dwelling subjects (221 males and 592 females, median age 75). The symptoms of depression were assessed using the Geriatric Depression Scale (GDS). Participants were divided into two subgroups according to the GDS scale. Group A: 0-5 points - no symptoms of depression (612, M:167, W:445), and group B: 6-15 points - with symptoms of depression (201, M:54, W:147). The level of nutrient consumption was assessed with a 24 h Recall Questionnaire and the software 'Dieta 5.0'.Results: In males, consumption of sucrose (A: 30 g (18.1-53.3), B: 62.8 g (43.2-92.6)) (median (25%-75% quartile) and % of energy from sucrose (A: 7.3% (4.8-11.9), B: 13.5% (7.8-18.6)) were significantly higher in the group with symptoms of depression. Kilocalories per 1 g of fiber intake ratios were higher in depressive groups of both males (A: 89.1 kcal/g (68.1-109), B: 103.9 kcal/g (86.1-134.1)) and females (A: 78.6 kcal/g (62.1-99.9), B: 93 kcal/g (67.1-118.3)). Females without symptoms of depression consumed significantly more fiber (17.2 g (12.9-23.1)) than females with symptoms of depression (16.1 g (11.3-20)).Conclusions: This analysis shows increased kilocalories per 1 g of fiber intake in patients with symptoms of depression. In males, symptoms of depression were connected with higher consumption of sucrose and higher % of energy intake from sucrose. In females, greater fiber consumption was related to less frequent symptoms of depression.

An In-Depth Exploration of Knowledge and Beliefs Associated with Soda and Diet Soda Consumption

The need to reduce sugar-sweetened beverage (SSB) consumption is widely accepted, but whether artificially sweetened beverages (ASBs) are a recommended alternative is a growing policy issue because of emerging evidence of potential health effects associated with excess consumption. This study aimed to establish the extent of the Australian population's knowledge of the risks associated with consuming SSBs (e.g., soda) and ASBs (e.g., diet soda), which is essential for identifying which facets of knowledge to target with public health interventions. A national computer-assisted telephone survey of 3430 Australian adults was conducted in 2017. The survey included a range of measures to test associations between SSB and ASB knowledge and beliefs, demographic characteristics, and soda and diet soda consumption. Participants had an overall awareness that there were health risks associated with SSB and ASB consumption, but they lacked more detailed knowledge of health effects and nutritional composition of these drinks. These knowledge gaps are concerning given that SSBs and ASBs are consumed in large quantities in Australia. Public health interventions targeting consumers' limited knowledge and perceptions of health risks associated with excess sugar, calorie intake and artificial sweeteners are essential in reducing the health burden of obesity.

Varying levels of depressive symptoms and lifestyle health behaviors in a low income, urban population

This study examined the relationships between varying levels of depressive symptoms and key dietary indicators of chronic disease risk, sugar-sweetened beverage (SSB) and fruit and vegetable (F + V) consumption, among a racially/ethnically diverse urban population in Los Angeles County (LAC). Analyses were carried out using data from a 2012 cross-sectional health survey of 1401 low-income public health center clients. Participants with a high level of depressive symptoms consumed 30% more SSBs (IRR = 1.30, 95% CI = 1.08, 1.55) than participants with a lower level of these symptoms. Other predictors of higher SSB consumption included being African American/Black (IRR = 1.65, 95% CI = 1.32, 2.05), male (IRR = 1.20, 95% CI = 1.06, 1.35), U.S. born (IRR = 1.32, 95% CI = 1.11, 1.57), and using tobacco (IRR = 1.26, 95% CI = 1.11, 1.43). Similar associations with F + V consumption were not found. Findings suggest that depressive symptoms may influence certain health behaviors in certain groups under certain situations. Policy and practice implications are discussed within this context.

Soft drink consumption and mental health problems: Longitudinal relations in children and adolescents

BACKGROUND

Increased soft drink consumption has been proposed as both predictor and result of mental health problems. Although possible mechanisms for both directions have been suggested, understanding of the association is limited. Most previous research has been cross-sectional and could not assess directionality.

METHOD

This study investigated the directionality of the association between soft drink consumption and mental health using longitudinal panel data of 5882 children and adolescents from the nationally representative German KiGGS baseline study (2003-2006) and KiGGS Wave 1 (2009-2012). Soft drink consumption and mental health problems were assessed by standardized questionnaire (baseline) and telephone interview (Wave 1). Four cross-lagged panel models were specified and compared regarding their fit indices. Specific paths were tested for significance.

RESULTS

Positive cross-sectional associations between soft drink consumption and mental health problems were found at both measurement points (ps < .01), even after controlling for third variables (including age, gender, and socioeconomic status). Only the lagged effect of mental health problems on soft drink consumption reached statistical significance (β = 0.031, p = .020), but not the effect in the opposite direction. The corresponding model also showed the best model fit overall.

CONCLUSIONS

Mental health problems predicted soft drink consumption over an average of six years, but not vice versa. These findings suggest that consuming soft drinks might be a dysfunctional strategy of coping with mental health problems for children and adolescents and highlight the importance of considering mental health problems in the prevention of soft drink overconsumption and obesity.

Prospective association of soft drink consumption with depressive symptoms

OBJECTIVE

Consumption of soft drinks has become a serious public health issue worldwide. However, prospective evidence is limited regarding the relationship between soft drink consumption and depression, especially in Asia. The aim of this study was to investigate the prospective association between soft drink consumption and the development of depressive symptoms.

METHODS

We evaluated an occupational cohort of 935 adults in Japan (2012-2016), who were free from depressive symptoms at baseline and attended a 3-y follow-up assessment. Soft drink consumption was assessed using a self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multivariate logistic regression analysis controlling for sociodemographic, lifestyle, dietary, and occupational covariates.

RESULTS

Over the 3-y study period, 16.9% (158 cases) of the study participants reported depressive symptoms. Higher soft drink consumption was associated with higher odds of depressive symptoms. The multivariable-adjusted OR was 1.91 (95% CI, 1.11-3.29; P_trend = 0.015) when comparing soft drink consumption of ≥4 cups/wk with consumption of <1 cup/wk.

CONCLUSION

The present results suggested that greater consumption of soft drinks would increase the likelihood of exhibiting depressive symptoms.

Consumption of Sugar-Sweetened Beverages, Juice, Artificially-Sweetened Soda and Bottled Water: An Australian Population Study

Reducing consumption of free sugars, such as those found in high concentrations in manufactured products such as sugar-sweetened beverages (SSBs) and 100% fruit juices, is a global public health priority. This study aimed to measure prevalence of widely available pre-packaged non-alcoholic water-based beverages (carbonated sodas, sports drinks, energy drinks, artificially-sweetened sodas, fruit juices (any type), and bottled water) and to comprehensively examine behavioral, environmental, current health, and demographic correlates of consumption. A cross-sectional, nationally-representative population survey of 3430 Australian adults (18+ years) was conducted using computer-assisted telephone (mobile and landline) interviewing. Past week prevalence of pre-packaged drinks containing free sugar was 47.3%; daily prevalence was 13.6%. Of all the pre-packaged drinks assessed, consumption of fruit juices (any type) was the most prevalent (38.8%), followed by bottled water (37.4%), soda (28.9%), artificially-sweetened soda (18.1%), sports drinks (8.1%), and energy drinks (4.2%). Higher soda consumption was associated with males, younger age, socio-economic disadvantage, frequent takeaway food consumption, availability of soda in the home, obesity, and a diagnosis of heart disease or depression. A diagnosis of Type 2 Diabetes was associated with increased likelihood of consuming artificially-sweetened sodas and decreased likelihood of consuming sugar-sweetened soda. SSB consumption is prevalent in Australia, especially among young adults and males, foreshadowing continued population weight gain and high burdens of chronic disease. To reduce consumption, Australia must take a comprehensive approach, incorporating policy reform, effective community education, and active promotion of water.

Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression

BACKGROUND

Mental illness is one of the fastest rising threats to public health, of which depression and anxiety disorders are increasing the most. Research shows that diet is associated with depressive symptoms or depression (depression).

AIM

This study aimed to investigate the diets impact on depression, by reviewing the scientific evidence for prevention and treatment interventions.

METHOD

A systematic review was conducted, and narrative synthesis analysis was performed.

RESULT

Twenty scientific articles were included in this review. The result showed that high adherence to dietary recommendations; avoiding processed foods; intake of anti-inflammatory diet; magnesium and folic acid; various fatty acids; and fish consumption had a depression. Public health professionals that work to support and motivate healthy eating habits may help prevent and treat depression based on the evidence presented in the results of this study. Further research is needed to strengthen a causal relationship and define evidence-based strategies to implement in prevention and treatment by public healthcare.

The association between banana consumption and the depressive symptoms in Chinese general adult population: A cross-sectional study

BACKGROUND

Banana contains many kinds of substances that are beneficial to depressive symptoms. However, there are no epidemiological researches directly to explore the association between banana consumption and depressive symptoms. This study aimed to investigate whether the banana consumption is related to depressive symptoms in a general adult population.

METHODS

A cross-sectional study was performed in 24,673 adults in Tianjin. Banana consumption was evaluated via a validated food frequency questionnaire. Depressive symptoms were assessed by using Self-Rating Depression Scale (SDS). The association between banana consumption and depressive symptoms was analyzed by multiple logistic regression analysis.

RESULTS

The prevalence of depressive symptoms was 16.1% in males and 18.4% in females (SDS ≥ 45), respectively. In males, comparing to the reference group (almost never), the multivariable adjusted odds ratios (ORs) (95% confidence intervals) of depressive symptoms across banana consumption were 0.86 (0.74, 0.99) for <1 time/week, 0.76 (0.66, 0.88) for 1-3 times/week and 0.97 (0.82, 1.16) for ≥4 times/week. By contrast, the multivariable adjusted ORs (95% confidence intervals) were 1.11 (0.94, 1.32) for <1 time/week, 0.99 (0.85, 1.16) for 1-3 times/week and 1.22 (1.02, 1.46) for ≥4 times/week in females. Similar association was observed when other cut-offs (SDS ≥ 48 and 50) were used to define depressive symptoms.

LIMITATION

This is a cross-sectional study, causality remains unknown.

CONCLUSION

Findings from this study suggested a negative association between moderate banana consumption and depressive symptoms in males. In females, high banana consumption is positively related to depressive symptoms.

Association of problematic smartphone use with poor sleep quality, depression, and anxiety: A systematic review and meta-analysis

To quantitatively assess the association of problematic smartphone use (PSU) with poor sleep quality, depression, and anxiety, we reviewed current evidence from observational studies and performed a systematic review and meta-analysis. The EBSCO PsycARTICLES, EMBASE, PubMed and Web of Science databases were searched, and 14 studies were included for the systematic review and meta-analysis. We calculated odds risk and 95% confidence intervals (CIs), using random-effect or fixed-effect models. Heterogeneity was assessed using I² and chi² statistics. Subgroup analyses were conducted based on country, adjusted variables, the methods of statistical analysis, outcome measures and publication year. We found significantly increased risks of poor sleep quality, depression, and anxiety in people with PSU. Our findings highlight the necessity of managing the PSU. However, further studies are required to confirm the results due to the high heterogeneity and methodological limitations.

Depression Relationship with Dietary Patterns and Dietary Inflammatory Index in Women: Result from Ravansar Cohort Study

BACKGROUND AND AIMS

Chronic inflammation is thought to have a major role in the pathophysiology of depression. Diet has been shown to modulate the inflammatory state, thus emphasizing its potential as a therapeutic role in depression. But, little is known about the relationship between dietary intake and depression. The current study aimed to investigate the relationship between major dietary patterns, a dietary inflammatory index (DII) score, and depression among women.

METHODS AND MATERIALS

This cross-sectional study included 4630 women aged 35-65 years using baseline data from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in Western Iran. Diet was evaluated using a validated 125-item food frequency questionnaire (FFQ) to determine DII scores and dietary patterns. Traditional, healthy, and unhealthy dietary patterns were extracted using factor analyses.

RESULTS

A significant upward trend in the odds of depression was observed across the tertiles s of DII scores (P-trend: 0.019). After the adjustment for possible risk factors, a high adherence to an unhealthy dietary pattern was associated with a higher risk of depression than a low adherence (OR: 1.63; 95% CI: 1.1-2.4). A high adherence to a healthy dietary pattern was associated with the lower odds (OR: 0.61; 95% CI: 0.04-0.92). Among the main food groups, a high intake of eggs and refined grains was associated with a higher risk of depression.

CONCLUSION

In women, a refined grain dietary pattern is a risk factor for depression, whereas a healthy dietary pattern is protective. We have also shown that adherence to a pro-inflammatory diet was significantly associated with depression. Adherence to a dietary pattern with high intakes of dairy products, seafood, red meats, nuts, vegetables, fruits, flavor, and vegetable oils and diets with low inflammatory properties were associated with a lower risk of depression in women.

I was truly addicted to sugar: A consumer-focused classification system of behaviour change strategies for sugar reduction

The reduction of free sugars has been identified as a priority issue internationally. A range of public health initiatives have been recommended, including the provision of information and support for sugar reduction. To inform these approaches, it is important to know what people actually do in real world settings to reduce their consumption. This study documents and defines the range of consumer-based behaviour change strategies for sugar reduction. A total of 1145 strategies were extracted from 47 internet sources (i.e., consumer, popular and professional). Using a pragmatic content analysis, hundreds of strategies were organized into 25 discrete categories of strategies. Categories were grouped into the Rubicon Model of Action Phases and classified as pre-decisional (i.e., decisional balance, feedback, realisation, seek knowledge and information), post-decisional (i.e., action planning, coping planning, set goal intention, sugar guidelines) and actional phase. Actional strategies were the most prolific and included avoidance, consumption control, consumption planning, environmental restructuring, healthy eating focus, maintain readiness, professional support, refocusing, self-monitoring, social support, substance substitution, tapering, address underlying issues, urge management, well-being and withdrawal management. There was one post-actional strategy which was associated with self-evaluation (i.e., reviewing a change attempt in order to plan for the future). Four categories of strategies differed according to the source. Substance substitution was substantially less frequently discussed by consumers than professionals and few professional sites acknowledged or advised strategies to manage the struggle of maintaining readiness following a change attempt. Hundreds of individual strategies are discussed or promoted in online settings, and more information is needed on the effectiveness of these self-initiated approaches.

Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression

Studies have shown that diet and nutrition play significant roles in the prevention of depression and its clinical treatment. The present review aims to provide a clear understanding of the associations between diet patterns, specific foods, nutrients such as antioxidants, and depression. As a result, balanced dietary patterns such as the Mediterranean diet and certain foods such as fish, fresh vegetables, and fruits have been associated with a lower risk of depression or depressive symptoms, while high-fat Western diets and sugar-sweetened beverages have been associated with higher risk of depression or depressive symptoms. Dietary antioxidants such as green tea polyphenols or isoflavonoid intake have been negatively associated with depression or depressive symptoms. It is concluded that diet patterns, specific foods, and antioxidants play important roles in the prevention and clinical treatment of depression.