Consumption of Commercial Non-Alcoholic Beverages Is Associated with Refractive Changes, Axial Length Changes and Myopia in Children and Adolescents

Background: Myopia has become a major public health issue for the ocular health of children and adolescents worldwide and has been found to be associated with dietary factors, including the consumption of beverages. However, current research lacks detailed classification and longitudinal analysis of the relationship between different types of commercial non-alcoholic beverages and children’s visual function and related measurements. Methods: From 2021 to 2024, we conducted a four-year cohort study in Shanghai, China, aiming to explore the association between consumption of various commercial non-alcoholic beverages, including sugar-sweetened beverages (SSBs), non-sugar-sweetened beverages (NSSBs), and fruit and vegetable beverages, and the vision of children and adolescents. Participants were surveyed once a year, including the collection of beverage consumption frequency using a semi-quantitative food frequency questionnaire (FFQ), as well as ophthalmological examinations covering binocular uncorrected visual acuity, refraction, and axial length (AL). A total of 5199 participants with complete data were included in the study. Generalized Estimating Equations (GEE) were used to analyze the longitudinal associations between the frequency of consumption of various beverages and myopia as well as vision-related measurements. Results: Among the 5199 participants included in the study, 37.9% were defined as myopic at baseline, with this proportion rising to 65.6% by the end of the study in 2024. Participants with myopia typically had lower consumption frequencies of 100% and non-100% fruit and vegetable juices and higher consumption frequencies of carbonated beverages and milk tea beverages. Increased consumption of 100% and non-100% fruit and vegetable juices was associated with reduced odds of myopia, increased spherical equivalent (SE), and decreased AL in children. In contrast, increased consumption of carbonated beverages, milk tea beverages, and NSSBs was associated with higher odds of myopia, reduced SE, and increased AL in children. Conclusions: Different types of commercial non-alcoholic beverages have varying effects on the vision of children and adolescents. Consumption of carbonated beverages, milk tea beverages, and NSSBs is associated with myopia and AL growth in children, whereas drinking fruit and vegetable juice has been found to be associated with slower myopia progression.