School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China.
School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China.
J Affect Disord. 2020 Nov 1;276:104-111. doi: 10.1016/j.jad.2020.07.030. Epub 2020 Jul 15.
Although fast food and sugar-sweetened beverages (SSBs) consumption have been closely linked to childhood and adolescent obesity, the data regarding their co-consumption and relationship to mental health remains controversial.
A multi-centered population-based survey was conducted among Chinese adolescents from grades 7 to 12. Data about participants' consumption of fast foods and SSBs were obtained from self-reported questionnaires. Psychological symptoms were assessed using the Multi-dimensional Sub-health Questionnaire of Adolescents (MSQA). The association between co-consumption of fast food and SSBs and psychological symptoms was assessed using quantile regression analysis, adjusting for covariates.
Approximately one-fifth of the 14,500 participants reported psychological symptoms. The regression coefficient (β) value increased as the quantile of fast food, SSBs, and co-consumption increased in the quantile regression model, and the model had an excellent goodness-of-fit (F = 192.51, p < 0.001). In the interaction model, fast food and SSBs in combination were associated with greater odds of psychological symptoms (aOR = 1.90, 95% CI: 1.69, 2.12). The synergy index, relative excess risk of interaction, and attributable proportions were 1.86 (95% CI: 1.17, 2.96), 0.4 (95% CI: 0.20, 0.63), and 0.22 (95% CI: 0.11, 0.33), respectively.
Information bias is inevitable in self-reported data among participants. The ability to assess causal relationships is reduced by a cross-sectional study design.
Our findings suggest that co-consumption of fast food and SSBs was cross-sectionally associated with mental health problems among adolescents.
尽管快餐和含糖饮料（SSBs）的消费与儿童和青少年肥胖密切相关，但关于它们的共同消费及其与心理健康的关系的数据仍存在争议。
在中国，对来自 7 至 12 年级的青少年进行了一项多中心、基于人群的调查。参与者的快餐和 SSB 消费数据来自自我报告的问卷。使用青少年多维亚健康问卷（MSQA）评估心理症状。使用分位数回归分析，调整协变量后，评估快餐和 SSB 的共同消费与心理症状之间的关联。
大约五分之一的 14500 名参与者报告存在心理症状。在分位数回归模型中，当快餐、SSB 和共同消费的分位数增加时，回归系数（β）值增加，并且该模型具有良好的拟合优度（F=192.51，p<0.001）。在交互模型中，快餐和 SSB 的组合与更大的心理症状发生几率相关（aOR=1.90，95%CI：1.69，2.12）。协同指数、交互超额相对风险和归因比例分别为 1.86（95%CI：1.17，2.96）、0.4（95%CI：0.20，0.63）和 0.22（95%CI：0.11，0.33）。
参与者的自我报告数据中存在信息偏倚是不可避免的。横断面研究设计降低了评估因果关系的能力。
我们的研究结果表明，快餐和 SSB 的共同消费与青少年的心理健康问题存在横断面关联。
