Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, USA.
Nutr Bull. 2024 Dec;49(4):429-443. doi: 10.1111/nbu.12702. Epub 2024 Aug 13.
High-sugar intake is a risk factor for chronic diseases such as cardiovascular disease and type 2 diabetes, but less is known about its role in anxiety disorders. This systematic review aimed to systematically synthesise and assess the existing evidence regarding the association between dietary sugars intake and anxiety disorders. Following PRISMA guidelines, a systematic search of PubMed, MEDLINE, Embase, APA PsycArticles and APA PsycINFO was conducted up to 19th August 2022. Study quality was assessed by the Newcastle-Ottawa scale (NOS) and the Cochrane risk of bias tool. Eleven studies (10 cross-sectional and 1 randomised controlled trial [RCT]) were included. Seven cross-sectional studies had very good quality or good quality, and the quality of the RCT was at low risk of bias. These studies examined sugar-sweetened beverages (n = 7), sugar-sweetened foods (n = 4) and/or added sugar (n = 5). The findings suggest a possible positive relationship of added sugar consumption with anxiety disorders, with age as a potential moderator in such association. No conclusions can be drawn on the associations between sugar-sweetened beverages, sugar-sweetened foods consumption and anxiety disorders. Due to the included studies being mostly cross-sectional, the conclusions drawn from the existing evidence should be interpreted with caution. The longitudinal design is warranted to investigate any causal relationship and the potential mechanisms underlying these heterogeneous results. The potential difference in effect at different ages observed in this review should be further examined.
高糖摄入是心血管疾病和 2 型糖尿病等慢性疾病的一个风险因素，但人们对其在焦虑症中的作用知之甚少。本系统评价旨在系统综合和评估饮食糖摄入量与焦虑症之间关联的现有证据。根据 PRISMA 指南，对 PubMed、MEDLINE、Embase、APA PsycArticles 和 APA PsycINFO 进行了系统搜索，截至 2022 年 8 月 19 日。研究质量由纽卡斯尔-渥太华量表（NOS）和 Cochrane 偏倚风险工具评估。纳入了 11 项研究（10 项横断面研究和 1 项随机对照试验[RCT]）。7 项横断面研究具有很好的质量或良好的质量，RCT 的质量存在低偏倚风险。这些研究检查了含糖饮料（n=7）、含糖食品（n=4）和/或添加糖（n=5）。研究结果表明，添加糖的摄入量与焦虑症之间可能存在正相关关系，年龄可能是这种关联的一个潜在调节因素。然而，不能得出关于含糖饮料、含糖食品摄入与焦虑症之间关联的结论。由于纳入的研究主要是横断面研究，因此应该谨慎解释现有证据中得出的结论。需要进行纵向设计来研究任何因果关系以及这些异质结果背后的潜在机制。本综述中观察到的不同年龄效应的潜在差异应进一步研究。
