{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:57:15Z","timestamp":1793278635085,"version":"4.5.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Excessive consumption of sugar-sweetened beverages (SSBs) is a major source of added sugars among adolescents and has been associated with adverse cardiometabolic, emotional, and sleep-related outcomes. However, longitudinal evidence from Asian populations remains limited. This 4-year prospective cohort study examined the associations between SSB intake and multiple health trajectories during adolescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1,204 adolescents (baseline age: 12.41\u202f\u00b1\u202f0.89\u202fyears; 51.2% girls) from 12 secondary schools in Chongqing, China, were followed annually from 2021 to 2024. SSB intake was assessed using a validated food frequency questionnaire adapted for use among Chinese adolescents. Outcomes included body mass index (BMI), body fat percentage, systolic blood pressure, depressive symptoms (CES-D), academic burnout, and sleep quality (Pittsburgh Sleep Quality Index, PSQI). Longitudinal associations were examined using linear mixed-effects models adjusted for age, sex, socioeconomic status, physical activity, screen time, and baseline BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher SSB intake was associated with significantly steeper increases in BMI (mean increase: +2.87 vs. +1.90\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), body fat percentage (+4.6% vs. +2.1%), systolic blood pressure (+4.8 vs. +2.1\u202fmmHg), depressive symptoms (CES-D: +6.0 vs. +2.0 points), and sleep disturbance (PSQI: +1.3 vs. +0.4 points) compared with the lowest intake tertile (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Adolescents in the highest SSB tertile exhibited a 62% greater increase in depressive symptoms over 4\u202fyears. Participants who reduced SSB intake by \u226530% showed significantly smaller increases across physical, emotional, and sleep-related outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High SSB intake is prospectively associated with unfavorable cardiometabolic, emotional, and sleep-related health trajectories during adolescence. Reducing SSB consumption represents a promising and actionable strategy for school-based health promotion and chronic disease prevention among Asian youth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1754072","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T06:35:36Z","timestamp":1768372536000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["High sugar-sweetened beverage intake predicts adverse physical, emotional, and sleep health trajectories in adolescents: a 4-year prospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Zeyu","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Educational Science, Xinjiang Normal University","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanjun","family":"Li","sequence":"additional","affiliation":[{"name":"Biological Education Teaching and Research Group, Chongqing Tongnan Experimental Middle School","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[{"name":"English Education Teaching and Research Group, Suqian Chongwen Junior Middle School","place":["Suqian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yike","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Accounting, Nanjing University of Finance and Economics","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.3390\/nu11081840","article-title":"Sugar-sweetened beverages and cardiometabolic health: an updated review of 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