{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:11:27Z","timestamp":1779804687277,"version":"3.53.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"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>Objective<\/jats:title>\n                    <jats:p>Acne vulgaris is highly prevalent among adolescents, and diet is considered a significant modifiable associated factor. However, evidence regarding the association between popular modern beverages and adolescent acne remains limited. This study aimed to investigate the prevalence of acne and to explore the influence of the cumulative effect of multiple high-sugar and high-fat dietary patterns on acne vulgaris in school aged children in Shanghai.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted in 2025 in shanghai, involving 1,299 students (aged 11\u201316\u202fyears) among five junior high schools. Data were collected via questionnaires and onsite clinical skin examinations. A Dietary Exposure Index (DEI), ranging from 0 to 5, based on the cumulative score of five dietary items, was constructed to quantify dietary exposure to high-sugar and high-fat patterns. Statistical analyses included univariate analysis and multivariate logistic regression, and a\n                      <jats:italic>p-<\/jats:italic>\n                      value less than 0.05 was viewed as statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall prevalence of acne was 64.43% (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f837) in junior high school students in Shanghai, and it increased with grade level, ranging from 38.7 to 92.1% across grades. Multivariate logistic regression revealed that the intake of sugar-sweetened beverages (odds ratio [OR]\u202f=\u202f1.56, 95% confidence interval [CI]: 1.09\u20132.23), milk tea (OR\u202f=\u202f1.43, 95% CI: 1.07\u20131.92), and coffee (OR\u202f=\u202f1.43, 95% CI: 1.08\u20131.88) was positively associated with acne vulgaris. Students with higher DEI score had a higher prevalence of acne vulgaris, and a significant dose\u2013response relationship was observed. Multi-logistic regression indicated that students with higher DEI scores had significantly increased prevalence of acne vulgaris, the adjusted OR was 1.61 (95% CI: 0.71\u20133.63) for DEI\u202f=\u202f2, 2.23 (95% CI: 1.06\u20134.69) for DEI\u202f=\u202f3, 2.14 (95% CI: 1.04\u20134.39) for DEI\u202f=\u202f4, and 3.12 (95% CI: 1.48\u20136.57) for DEI\u202f=\u202f5, compared to the reference group (DEI\u202f=\u202f0\/1) A stronger association between higher DEI scores and acne vulgaris was also observed in younger adolescents in sub-group analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Consumption of sugar-sweetened beverages, milk tea, and coffee was associated with an increased risk of adolescent acne, and cumulative exposure to high-sugar and high-fat dietary items significantly strengthened this association. Dietary intervention strategies targeting dietary patterns in younger adolescents is important for acne prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1827055","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:52:37Z","timestamp":1778219557000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The cumulative effect of multiple high-sugar and high-fat dietary patterns on acne vulgaris in school aged children: a cross-sectional study in Shanghai"],"prefix":"10.3389","volume":"14","author":[{"given":"Ruiqi","family":"Cai","sequence":"first","affiliation":[{"name":"Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"School of Public Health, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, 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Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanlingzi","family":"Shen","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangjin","family":"Gao","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiping","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"School of Public Health, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.abd.2022.01.006","article-title":"Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment","volume":"98","author":"Kutlu","year":"2023","journal-title":"An Bras Dermatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1093\/bjd\/ljae352","article-title":"Global, regional and national burdens of acne vulgaris in adolescents and young adults aged 10-24 years from 1990 to 2021: a trend analysis","volume":"192","author":"Zhu","year":"2025","journal-title":"Brit J 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