Systematic review indicates higher sugary drink consumption linked to increased anxiety symptoms in teenagers — Evidence Review
Published in Journal of Human Nutrition and Dietetics, by researchers from Bournemouth University, Lebanese American University
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Table of Contents
A new systematic review finds that higher consumption of sugary drinks is consistently associated with increased anxiety symptoms in teenagers. Most related research supports this link, with studies across multiple countries and populations reporting similar associations between sugar-sweetened beverage intake and poor mental health outcomes in youth, as detailed in the Journal of Human Nutrition and Dietetics.
- Multiple large observational studies in diverse regions (such as China, Norway, Korea, and Australia) have found that frequent consumption of sugar-sweetened beverages or added sugars is linked to higher rates of anxiety, depression, stress, and related symptoms among adolescents and young adults, even after adjusting for confounding variables 1 2 3 5 6 7 10 12.
- While the association is robust, causality has not been established: cross-sectional designs dominate the literature, and potential bidirectional effects or shared risk factors (e.g., poor sleep, food insecurity, family circumstances) may contribute to both higher sugary drink intake and anxiety symptoms 1 2 5 6 7 10.
- Related studies also suggest that diet quality as a whole, not just sugary beverages, is relevant to adolescent mental health, with higher diet quality linked to lower anxiety and depression symptoms, and energy drinks or fast foods showing particularly strong correlations with negative outcomes 3 5 7 10 12.
Study Overview and Key Findings
Adolescent mental health is a growing concern, with anxiety disorders rising sharply in recent years. While public health campaigns often focus on the physical risks of poor diet, such as obesity and diabetes, the potential mental health effects of dietary patterns—particularly the role of sugary beverages—are only beginning to be systematically explored. This new study is timely, providing a comprehensive synthesis of global evidence on the relationship between sugar-sweetened drink consumption and anxiety symptoms in teenagers, an area previously underrepresented in nutrition research.
| Property | Value |
|---|---|
| Study Year | 2023 |
| Organization | Bournemouth University, Lebanese American University |
| Journal Name | Journal of Human Nutrition and Dietetics |
| Authors | Dr. Chloe Casey, Dr. Karim Khaled |
| Population | Teenagers |
| Methods | Systematic Review |
| Outcome | Sugary drink consumption, anxiety symptoms |
| Results | Higher sugary drink intake linked to greater anxiety symptoms. |
Literature Review: Related Studies
To place these findings in context, we searched the Consensus paper database, which contains over 200 million research papers. The following search queries were used to identify relevant literature:
- sugary drinks anxiety symptoms teens
- sugar intake mental health adolescents
- beverage consumption anxiety levels youth
Summary Table of Key Topics and Findings
| Topic | Key Findings |
|---|---|
| Does high sugary drink intake relate to adolescent anxiety and other mental health issues? | - High consumption of sugary drinks is associated with greater anxiety, depression, hyperactivity, and conduct problems among adolescents 1 2 3 4 5 6 7 10 12. - The association persists across diverse populations and after accounting for confounding variables 1 2 5 6 7 10. |
| Is there evidence for causality or directionality in the sugar-anxiety relationship? | - Most studies are cross-sectional and cannot establish causality; anxiety could also lead to increased sugar intake or both could share common underlying factors 1 2 5 6 7. - Some longitudinal and meta-analytic evidence suggests a possible link but remains inconclusive 13. |
| How do other dietary and lifestyle factors influence adolescent mental health? | - Poor overall diet quality and high intake of free sugars (from foods and drinks) are associated with increased depressive and anxiety symptoms, while better diet quality correlates with reduced symptoms 5 6 7. - Combined consumption of sugary drinks and fast food worsens mental health outcomes 3 10. |
| What role do energy drinks or specific beverage types play in adolescent mental health? | - Frequent energy drink consumption is linked to higher anxiety, stress, depressive symptoms, and suicidality in adolescents and young adults 10 12. - These associations are often stronger than for other sweetened beverages and may be influenced by additional factors such as caffeine content 10 12. |
Does high sugary drink intake relate to adolescent anxiety and other mental health issues?
A consistent pattern emerges from the literature: higher intake of sugar-sweetened beverages is associated with increased anxiety and other mental health symptoms in adolescents. This finding is supported by studies from various countries, using large samples and validated mental health measures. The new systematic review aligns with these findings, reinforcing the observed association across different populations and methodological approaches.
- Multiple studies report that adolescents consuming sugary drinks frequently (e.g., daily or multiple times per week) show higher levels of anxiety, depression, and behavioral problems 1 2 3 4 5 6 7 10 12.
- Large cross-sectional surveys in China, Norway, Korea, and Australia all find significant links between soft drink or added sugar consumption and mental health difficulties 1 2 3 4 5 6 7 10 12.
- These associations persist even after adjusting for socioeconomic, behavioral, and dietary confounders 1 2 5 6 7 10.
- The new systematic review's findings are in line with the bulk of existing research in this area 1 2 3 4 5 6 7 10 12.
Is there evidence for causality or directionality in the sugar-anxiety relationship?
While the association between sugary drink intake and anxiety is robust, most available evidence is cross-sectional, limiting the ability to draw conclusions about causality. Some studies suggest bidirectional effects or shared risk factors, and longitudinal research has produced mixed results regarding directionality.
- The majority of studies, including those cited above, use cross-sectional designs, which cannot determine whether sugary drink consumption causes anxiety or vice versa 1 2 5 6 7.
- Shared risk factors—such as sleep problems, food insecurity, or family/environmental influences—may contribute to both higher sugary drink intake and anxiety symptoms 1 5 6 7.
- A meta-analysis found only suggestive evidence for anxiety in childhood/adolescence predicting later alcohol use disorders, with inconsistent results and no clear directionality for generalized anxiety disorder 13.
- The reviewed systematic study appropriately notes these limitations and cautions against interpreting the association as causal 1 2 5 7 13.
How do other dietary and lifestyle factors influence adolescent mental health?
Sugary drink intake is not the only dietary factor linked to adolescent mental health. Poor overall diet quality, high intake of added sugars from foods as well as beverages, and unhealthy eating patterns generally are also associated with increased risk of anxiety and depressive symptoms. Conversely, better diet quality is linked to improved mental health outcomes.
- Studies show that higher daily free sugar intake, regardless of source, is associated with increased depressive and/or anxiety symptoms, while better overall diet quality is protective 5 6 7.
- Combined consumption of sugar-sweetened beverages and fast foods may have a synergistic negative impact on stress, depression, and suicidality in adolescents 3 10.
- Other modifiable lifestyle behaviors, such as adequate sleep, physical activity, and limited screen time, are also linked to lower anxiety and depression symptoms 7.
- The new systematic review builds on this evidence, highlighting sugary drinks as a specific modifiable dietary risk factor within the broader context of adolescent nutrition 3 5 6 7 10.
What role do energy drinks or specific beverage types play in adolescent mental health?
Energy drinks, which typically contain both high sugar and caffeine, are particularly associated with negative mental health outcomes in adolescents and young adults. Their effects may be more pronounced than those of other sugary beverages, and frequent consumption is linked to anxiety, depression, stress, and suicidal behaviors.
- Energy drink intake is associated with higher odds of sleep dissatisfaction, severe stress, depressive mood, suicidal ideation, and suicide attempts in adolescents 10.
- In young adult males, energy drink consumption is specifically associated with increased anxiety, even after adjusting for other factors 12.
- The detrimental effect of energy drinks may be exacerbated in those who also consume high amounts of junk food, suggesting a compounding risk from multiple unhealthy dietary behaviors 10.
- While the systematic review under discussion considers sugary drinks broadly, these findings suggest energy drinks may warrant particular attention in public health strategies targeting youth mental health 10 12.
Future Research Questions
While evidence for an association between sugary drink intake and adolescent anxiety is strong, important gaps remain. Most studies are cross-sectional, limiting causal inference, and the mechanisms underlying these associations are not well understood. The influence of confounding factors, the potential for bidirectional relationships, and the impact of interventions targeting sugary drink consumption all warrant further investigation.
| Research Question | Relevance |
|---|---|
| Does reducing sugary drink intake decrease anxiety symptoms in adolescents? | Intervention studies are needed to determine if lowering sugary beverage consumption leads to measurable improvements in anxiety, moving beyond the associations observed in cross-sectional research 1 2 5 7. |
| What are the biological mechanisms linking sugar consumption to anxiety in youth? | Understanding physiological or neurobiological pathways (e.g., blood sugar fluctuations, inflammation, gut-brain axis) could clarify how sugary drinks might influence mental health and inform targeted interventions 2 4 5. |
| Are the effects of sugary drinks on anxiety different from those of energy drinks or other caffeinated beverages? | Energy drinks may have unique effects due to caffeine and other ingredients; separating their impact from other sugary beverages is important for effective policy and prevention 10 12. |
| How do socioeconomic and family factors influence the relationship between sugary drink consumption and anxiety in adolescents? | Social and environmental factors, such as family circumstances, food insecurity, and parental education, may confound or moderate the observed associations, and understanding these interactions could improve intervention targeting 1 5 6 7. |
| Does improving overall diet quality reduce anxiety and depression symptoms in youth? | Examining the effects of comprehensive dietary interventions, rather than focusing solely on sugary beverages, may have broader public health implications for adolescent mental health 5 6 7. |