摘要：Objectives. We examined whether high levels of consumption of sugar-containing soft drinks were associated with mental distress, hyperactivity, and conduct problems among adolescents. Methods. A cross-sectional population-based survey was conducted with 10th-grade students in Oslo, Norway (n = 5498). We used the Hopkins Symptom Checklist and the Strengths and Difficulties Questionnaire to assess mental health outcomes. Results. There was a J-shaped dose–response relationship between soft drink consumption and mental distress, conduct problems, and total mental health difficulties score; that is, adolescents who did not consume soft drinks had higher scores (indicating worse symptoms) than those who consumed soft drinks at moderate levels but lower scores than those with high consumption levels. The relationship was linear for hyperactivity. In a logistic regression model, the association between soft drink consumption and mental health problems remained significant after adjustment for behavioral, social, and food-related variables. The highest adjusted odds ratios were observed for conduct problems among boys and girls who consumed 4 or more glasses of sugar-containing soft drinks per day. Conclusions. High consumption levels of sugar-containing soft drinks were associated with mental health problems among adolescents even after adjustment for possible confounders. Refined sugar has gained worldwide attention as a result of its possible adverse effects on conditions such as obesity and dental caries. 1 Evidence of the negative effects of sugar on mental health has not been as convincing, 2 although for many years parents and teachers have claimed that high sugar intakes lead to attention and conduct problems in children. 3 – 5 Norway has the highest soft drink consumption rate in the world, 115 L (245 pt) per inhabitant per year. 6 One of the primary ingredients in soft drinks is sugar, with an average soft drink containing 100 g/L. Two ecological studies have shown a correlation between per capita sugar consumption levels and prevalence rates of depression. 7 , 8 In addition, in both a cross-sectional investigation and a cohort study, insulin resistance was found to be inversely linked to suicide rates and depression, probably as a consequence of increased serotonin concentrations. 9 , 10 To our knowledge, no population-based cross-sectional studies have analyzed the association between sugar consumption and mental health problems among adolescents. Hypothesizing that Norwegian adolescents who consumed large quantities of sugar-containing soft drinks would tend to report more mental health problems than adolescents who consumed low or moderate amounts of such beverages, we examined the association between intake of soft drinks and mental distress, conduct problems, and hyperactivity, controlling for eating habits and social and behavioral variables.
