Sugar-sweetened beverages consumption and the risk of depression in youth: A systematic review and meta-analysis of observational studies.

BACKGROUND: Research on the association between sugar-sweetened beverages (SSBs) and depression has advanced, but most studies are cross-sectional and focus on adults. This meta-analysis assesses their association in youth using observational data. METHODS: We searched Ovid Cochrane, Ovid Embase, Ovid Medline, and PsycINFO databases up until December 2024 for relevant studies. Two reviewers performed data extraction and assessed the risk of bias. A random-effects model calculated the pooled odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted to explore heterogeneity. RESULTS: A total of 19 articles with 26 independent studies were included, totaling 275,168 participants with an average age of 16.1 years (range 11-25). Overall, a statistically significant pooled estimate was observed in youth (OR = 1.28, 95%CI = 1.16-1.41; I2 = 94.3%). When separated by study design, cross-sectional studies yielded a statistically significant pooled estimate with considerable heterogeneity (OR = 1.33, 95%CI = 1.18-1.50, I2 = 94.5%), whereas the pooled estimate from cohort studies was not statistically significant (OR = 1.13, 95%CI = 0.97-1.31, I2 = 69.1%), consistent across both adolescents and young adults. Results from subgroup analyses revealed that region, measurement of exposure, type of outcome, and follow-up period (for cohort studies only) may be the sources of heterogeneity (all Pinteraction< 0.05). CONCLUSION: Despite an overall association between SSBs and depression, separate analysis by study design has yielded inconsistent findings, with a statistically significant estimate found in cross-sectional but not in cohort studies. Future research should focus on longitudinal studies with longer follow-up periods.