Sugar-sweetened beverage consumption, waist-to-height ratio and psychological symptoms among Chinese adolescents

The prevalence of psychological symptoms among adolescents continues to rise, negatively impacting academic performance and future achievements. However, past research has rarely examined the independent and combined associations between sugar-sweetened beverage (SSB) consumption, waist-to-height ratio (WHtR), and psychological symptoms. This study may provide insights for the prevention and intervention of psychological symptoms among Chinese adolescents. A self-assessment questionnaire survey was conducted among 51,716 adolescents aged 13–18 years across multiple regions in China. Assessment items included SSB consumption, WHtR, psychological symptoms, and related covariates. Univariate analysis, binary logistic regression analysis, and generalized linear model binary logistic regression analysis were employed to examine the independent and combined associations between SSB consumption, WHtR, and psychological symptoms. The P50 value for WHtR among Chinese adolescents was 0.413. Boys exhibited a statistically significantly higher WHtR than girls (Z = -20.767, P < 0.001). The prevalence of psychological symptoms among adolescents was 20.8%. Boys demonstrated a statistically significantly higher prevalence of psychological symptoms than girls (χ2 = 11.167, P < 0.01). Binary logistic regression analysis within a generalized linear model revealed that adolescents with SSB consumption > 4 times/week and a WHtR in the 4th quartile (OR = 3.20, 95%CI: 2.69 ~ 3.80) exhibited the highest risk of psychological symptoms (P < 0.001), compared to adolescents with SSB consumption < 1 time/week and WHtR in the 1th quartile serving as the reference group. There is an association between SSB consumption, WHtR, and psychological symptoms among Chinese adolescents. Effective reductions in SSB intake and lower WHtR may be associated with lower prevalence of psychological symptoms in adolescents. Future research should consider the impact of SSB consumption and WHtR on psychological symptoms in adolescents.