Sugar‐Sweetened Beverage Consumption and Anxiety Disorders in Adolescents: A Systematic Review and Meta‐Analysis

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BACKGROUND: Adolescence is a critical period for mental health, with anxiety disorders becoming increasingly prevalent. Sugar-sweetened beverages (SSBs) have been identified as a potential dietary factor influencing mental health outcomes. This systematic review aims to critically appraise the literature around the association between SSB consumption and anxiety disorders among adolescents. METHODS: A systematic search was conducted across electronic databases, including Medline Complete, CINAHL Complete, Scopus, Cochrane Library, Web of Science, and ScienceDirect for studies published between 2000 and 2025. Data on SSB intake and anxiety outcomes were extracted, and the quality of the studies was evaluated using the Risk of Bias in Non-randomised Studies from the Cochrane Handbook of Systematic Reviews of Exposure. Meta-analysis was conducted using random-effect model to estimate the odds ratios to assess the relationship between SSB intake and anxiety disorders with 95% confidence interval (CI). RESULTS: Nine studies meeting the inclusion criteria were selected, including seven cross-sectional studies and two longitudinal studies. Of the nine studies, seven reported a significant positive association between SSB consumption and anxiety, while two found no significant relationship. The longitudinal studies showed small but persistent associations over 1 year. The studies using multiple linear regression demonstrated a consistent, small positive relationship between SSB intake and anxiety symptoms. The meta-analysis random effects model which is limited to studies reporting anxiety disorder as binary outcome revealed that higher sugar-sweetened beverage consumption was associated with increased odds of anxiety disorders (OR: 1.34, 95% CI: 1.14-1.59). CONCLUSION: Given the predominance of observational designs, these findings should be interpreted as associations rather than evidence of causality. Public health initiatives and clinical interventions aimed at reducing SSB intake may help mitigate the rising prevalence of anxiety disorders, specifically among adolescents.

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