Association of sugary drinks intake with chronic diseases in people with depression —a national cross-sectional analysis in a Chinese population

Association of sugary drinks intake with chronic diseases in people with depression —a national cross-sectional analysis in a Chinese population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Association of sugary drinks intake with chronic diseases in people with depression —a national cross-sectional analysis in a Chinese population Xinyi Kong, Jialei Chen, Jie Li, Xia Yang, Kui Li, Zicheng Jiang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7131825/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The aim of this cross-sectional study is to evaluate the association between a moderate intake of sugary drinks and the prevalence of chronic diseases in middle-aged and young Chinese adults with depression. Methods: A cross-sectional survey was conducted in 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in China from June 20 to August 31, 2022. Effect estimates, including odds ratios (ORs) and their corresponding 95% confidence intervals (Cis), were used to assess the strength of independent variables and chronic disease prevalence. Results: A total of 24614 participants were included in this cross-sectional study. Univariate analysis showed that the prevalence of chronic diseases gradually increased with age (p < 0.001). People under the age of 48 with depressive symptoms had a significantly higher risk of developing chronic diseases (p < 0.05). Moderate consumption of sugary drinks (≤ 900ml/week) was correlated with the occurrence of chronic diseases with a reduced risk for about 5% compared to those consume hardly any sugary drinks or excessive amount of sugary drinks (≥ 900ml/week) (p < 0.05). Conclusions: We observed that a moderate consumption of sugary drinks was correlated with a lower prevalence of chronic diseases in middle-aged and young adults with depression in Chinese populations, promoting a well-informed recommendation of sugary drinks intake for public well-beings, especially the middle-aged and young adults. Trial registration This study has been registered with the China Clinical Trials Registry, registration number ChiCTR2200061046. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors sugary drinks sugary consumption chronic diseases middle-aged and young adults depression Figures Figure 1 Figure 2 Figure 3 Introduction Psychological problems, also called mental health issues, are clinically manifested with significant disturbance in an individual’s cognition, emotional control, or behaviors(World Health Organization, 2022 ). Major depression disorder is a serious psychological problem that presented with depressed mood, irritability, loss of interest, difficulty in concentrating, disrupted sleep pattern, decreased appetite, impaired cognition and tendency to suicide (Nestler et al., 2002 ). It is estimated that major depression disorder is to become the second-leading cause of disease burden in high-income countries by 2030 according to WHO (Mathers and Loncar, 2006 ). Epidemiology studies have shown that the prevalence rate of psychiatric disorders ranges widely from 5 to 18% in children and adolescents in developing countries (Mullick and Goodman, 2005 ). In Chinese population, a low rate of seeking professional assistance and treatment was observed in people aged 30–79 years old living with depression, highlighting the large disparity in mental health care(Chen et al., 2017 ). Additionally, the ‘one-child’ family planning policy, large scale rural to urban population transmission and rapidly increasing divorce rate in China, has all contributed to a large amount of ‘single-parent family’ and ‘left behind one child’ (Hesketh et al., 2010 ). Depression and chronic diseases could be inter-related, and plenty of clinical groups have recommended to practice depression screening in the chronic disease population(Wang et al., 2022). A cohort study investigating 7819 participants in China showed that the risk of depression increased with rise in the number of chronic diseases in people aged ≥ 45 without depression, during the follow-up time from 2011–2015 (Bi et al., 2021 ). Patients with depressive symptoms may not be able to recognize or be reluctant to acknowledge depression as a separate risk factor condition, perhaps due to overlapping physical symptoms. It induces profound changes in the life of patients, adding to social and economic burden and contributes to the transitions of mortality patterns in China with a shift from infectious diseases to non-communicable diseases(Zhou et al., 2019 ). Middle-aged and young people are faced with an increase of intergenerational challenges, such as family responsibilities of caring for aging parents, adolescents, and grandchildren; financial vulnerabilities that often come from economic failures, labor market volatility, the shrinking social and healthcare safety net (Infurna et al., 2020 ). There is now a rapidly growing number of aging population worldwide, and in China, it is predicted that people older than 60 years old would be reaching 28% by 2040, because of longer life expectancy and a decrease of fertility rates (World Health Organization, 2024 ). Many studies have reported the evidence that depressive symptoms are most likely experienced by middle-aged and elderly participants(Liu et al., 2018 ). As the population pattern and social circumstances change, it is crucial to bring the attention to physical and mental challenges confronted by middle-aged and younger people at an early stage. However, little information is available on affective management of chronic diseases in people with depression, especially on young adults and middle-aged people. Over the past few years, sugary drinks have emerged as a significant factor in the increased consumption of added sugary drinks in modern diet (Vanderlee et al., 2021 ). It comprises carbonated soft drinks, coffees/teas, sodas, flavored fruit drinks, and energy drinks containing additional caloric sweeteners like fruit juice concentrates, sucrose, and high fructose corn syrup in all age groups(Popkin, 2010 ) , (Hu, 2013 ) , (Rosinger et al., n.d.) , (Malik et al., 2013 ). This pattern change of beverages intake has been recognized as a pressing issue from a public health perspective. Although studies have shown that sugary intake will increase the risk of developing global epidemics of chronic diseases including cardiovascular diseases, chronic kidney diseases, type 2 diabetes mellitus and cancers(Fung et al., 2009 ) , (Bomback et al., 2010 ) , (de Koning et al., 2012 ) , (Yuzbashian et al., 2016 ) , (de Lorgeril et al., 2020 ) , (Chazelas et al., 2019 ) , (Kmietowicz, 2018 ) , (Leung et al., 2021 ) , (Malik and Hu, 2022 ), probably through the increased production of oxidative stress(Bomback et al., 2010 ), it is still unknown whether a controlled amount of sugary drinks consumption is correlated with the risk of chronic diseases onset in middle-aged and young adults with depressive symptoms. As Healthy People 2023 (a national effort that sets goals and objectives to improve the health and well-being of people in the United States) objectives addressed, health conditions, health behaviors, populations, settings and systems, social determinants of health are five main intuitive topics covered(Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, n.d.). Mental health and mental disorders are one of the most pressing issues and the focus of Healthy People 2030 on the prevention, screening, evaluation, and treatment of these five topics (The Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, n.d.). Therefore, we conduct this study to investigate the association between moderate intake of sugary drinks and well-beings of middle-aged and young adults with cross-sectional data in a Chinese population. Methods Study design and Data collection This study is a cross-sectional survey, and the data used come from the Psychological and Behavioral Survey of Chinese Residents (PBICR)(Wang et al., 2022). This large-scale survey was conducted in 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in China from June 20 to August 31, 2022. The survey adopted multi-stage sampling, and the specific quota method was reported in the previous study by Wang et al. This study has been registered with the China Clinical Trials Registry on 15th June 2022, registration number ChiCTR2200061046. Human Ethics and Consent to Participate declarations are not applicable. This research is conducted in accordance with the Declaration of Helsinki In each sample city, investigators were openly recruited from local universities. Researchers were trained in sampling methods, research tools, and quality control. Participation in the survey was only possible after passing the mock survey test. Investigators contacted potential participants by phone or in person. Information was collected through face-to-face interviews with each participant using a pre-tested structured questionnaire. Before the data collection process, informed consent form was obtained by participants or parents of participants and that the patients (or guardian) consented to the publishing of all images, clinical data, and other data included in the manuscript. Participants who agree to participate will be provided with a valid link to the electronic questionnaire. Participants who met the following criteria were included in this study: being older than 12 years, being identified as a permanent resident of China with Chinese nationality, and having sufficient ability to read and understand the questionnaire. Participants can complete an online questionnaire by themselves or with the help of a surveyor. Given that the current study was on the general population, participants who had a diagnosed or self-reported mental disorder were not eligible. In addition, participants who were unwilling to participate or have already participated in similar studies were also excluded. A total of 24,614 participants were included in the final analysis sample. Variables Chronic diseases Chronic diseases defined in this study refers to chronic physical disease, specifically hypertension, chronic gastroenteritis, arthritis, osteoporosis, abnormal blood lipids, diabetes, fracture, coronary heart disease, cataract, fatty liver disease, chronic respiratory diseases, benign tumor, stroke of the brain, chronic kidney disease, malignant tumor, viral hepatitis, Parkinson’s disease and other 17 kinds of chronic diseases, as shown in Table 1 . Chronic diseases are coded as No pathologies, One pathology, Two or more pathologies separately in this study. Table 1 Type of chronic diseases among participants (N = 5754). Type of chronic diseases Number % Hypertension 1805 31.37% Chronic gastroenteritis 967 16.81% Arthritis 815 14.16% Osteoporosis of bone 808 14.04% Abnormal blood lipids 686 11.92% Diabetes 613 10.65% Fracture 389 6.76% Coronary heart disease 383 6.66% Cataracts 355 6.17% Fatty liver disease 304 5.28% Chronic respiratory diseases 217 3.77% Benign tumor 178 3.09% Stroke of the brain 147 2.55% Chronic kidney disease 132 2.29% Malignant tumor 95 1.65% Viral hepatitis 68 1.18% Parkinson's disease 44 0.76% Others 787 13.68% Depression The Patient Health Questionnaire (PHQ) is a tool for making criteria-based diagnoses of depression and measuring mental diseases in primary care(Kroenke et al., 2001 ). Participants’ depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9), which contained 9 questions based on the Diagnostic and Statistical Manual of Depression (DSM) diagnostic criteria. The PHQ-9 has been shown to be a psychometrically valid and reliable measure of depression which is applicable to a variety of populations aged > 12 years old(Fonseca-Pedrero et al., 2023 ) (Sekhar et al., 2022 )(Kroenke et al., 2001 ). The Chinese version of PHQ-9 has been verified to have good reliability and validity in Chinese patients with diverse disease such as psoriasis and epilepsy(Xia et al., 2019 ) , (Ye et al., 2020 ). Each item is scored on a 4-point Likert scale ranging from 0 (not at all) to 3 (almost every day). The total score ranges from 0 to 27, with higher scores indicating higher levels of depressive symptoms. A total score of < 5 indicates no depressive symptoms, 5–9 means mild depression, 10–14 means moderate depression, 15–19 means moderate to severe depression, 20–27 indicates severe depression. In this study, the Cronbach’s alpha value for the PHQ-9 was 0.922. Assessment of sugary drinks intake Sugary drinks include common milk tea, carbonated drinks, sports drinks, fruit juice drinks, etc. Participants were asked to record their sugary drinks they consumed on average per week to assess weekly intake of sugary drinks, coded as None, ≤ 900ml/900-1800ml and > 1800ml. Covariates Covariates were identified based on previous research and common sense. The demographic and socioeconomic characteristics of the participants are mainly collected. The final covariates include Age (1 = 12–18, 2 = 18–60, 3 = > 60 ,years), Gender (1 = Female, 2 = Male), Residence (1 = Town, 2 = Rural), Education (1 = Senior school & above, 2 = Junior high school & below), Marital status (Married/ Single/ Widowed/ Divorced), Smoking (0 = Never, 1 = Ever), Drinking (0 = Never, 1 = Ever), Income (1 = ≤ 3000, 2 = > 3000 yuan, CNY), Pet (0 = Not, 1 = Yes), and Exercise (None/1–2 days every week/3–5 days every week/6–7 days every week). Statistical analysis This study aims to understand the general situation of Chinese residents' psychology and health-related behaviors through a survey questionnaire, and provide a basis for the promotion of the "Healthy China" strategy. Statistical analysis was performed using SPSS version 25.0 software. Descriptive analysis was used to demonstrate the sociodemographic characteristics of the samples, and categorical variable data were presented as frequencies (percentages). Grouped by chronic disease prevalence status, chi-square test was used to determine the association between independent variables and chronic disease prevalence. Ordinal logistic regression analysis was performed to identify potential risk factors for chronic disease prevalence, including 3 dimensions. The reason for using this 3-dimension variable is that traditional model regression methods can not fit this dependent variable, but ordered logistic regression can solve this problem by dividing multiple classifications of the dependent variable into multiple binary logistic regressions. Effect estimates, including odds ratios (ORs) and their corresponding 95% confidence intervals (CIs), were used to assess the strength of association between independent variables and chronic disease prevalence. A p-value (both sides) < 0.05 was considered as statistically significant. Ethics and Consent All informed consent is obtained from all participants including minors (aged < 18), in addition to parental/guardian consent, via communication, discussion, and shared decision making. This study was approved by Shaanxi Institute of International Trade & Commerce (Ethics number # JKWH-2022-02). Results The characteristics of the participants A total of 24614 participants (42.82% male) were included in this cross-sectional study. Most of the participants were 18–60 years old (78.13%), lived in urban areas (72.74%), receiving senior high school education and above (67.32%). A predominant number of participants claimed to be non-smoker (84.64%) and never drank alcohol (71.22%). A majority of participants had a monthly income of > 3000 (CNY) (66.80%) and kept pets as companion (79.10%). Individuals experiencing none to mild depressive symptoms (0–4, 5–9) were more than three times the number of those having moderate to severe symptoms combined (10–14, 15–19, 20–27) (77.69% vs 22.32%). Nearly half of the participants consumed moderate amount of sugary drinks (45.91%) whereas 36.11% had hardly any sugary drinks, which is approximately three times higher than those took 900-1800ml per week (36.11% vs 12.77), and more than seven times higher than ones having > 1800ml per week (36.11% vs 5.21%). The characteristics of the participants included were described in Table 2 . Table 2 Distribution characteristics of questionnaire population, China, June 20 to August 31, 2022. Factor Total (N = 24614) No pathologies (N = 18860) One pathology (N = 3860) Two or more pathologies (N = 1894) P_value N Ratio (%) N Ratio (%) N Ratio (%) N Ratio (%) Age(years) 12–18 1657 6.73 1566 8.30 78 2.02 13 0.69 P 60 3726 15.14 1573 8.34 1126 29.17 1027 54.22 Gender Female 14075 57.18 11025 58.46 2077 53.81 973 51.37 P < 0.001 Male 10539 42.82 7835 41.54 1783 46.19 921 48.63 Residence Town 17905 72.74 13938 73.90 2530 65.54 1437 75.87 P < 0.001 Rural 6709 27.26 4922 26.10 1330 34.46 457 24.13 Education Senior school & above 16569 67.32 12896 68.38 2153 55.78 1520 80.25 P < 0.001 Junior high school & below 8045 32.68 5964 31.62 1707 44.22 374 19.75 Marital status Married 12795 51.98 9603 50.92 2519 65.26 673 35.53 P < 0.001 Divorced, widowed, or unmarried 11819 48.02 9257 49.08 1341 34.74 1221 64.46 Smoking status Never 20833 84.64 16034 85.02 3205 83.03 1594 84.16 0.007 Ever 3781 15.36 2826 14.98 655 16.97 300 15.84 Alcohol intake Never 17530 71.22 13423 71.17 2878 74.56 1229 64.89 P 3000 16442 66.80 12458 66.06 2764 71.61 1220 64.41 P < 0.001 ≤ 3000 8172 33.20 6402 33.94 1096 28.39 674 35.59 Pet Not 19469 79.10% 15046 79.78% 3018 78.19% 1405 74.18% P < 0.001 Yes 5145 20.90% 3814 20.22% 842 21.81% 489 25.82% PHQ_9 0–4 10236 41.59 8034 42.60 1593 41.27 609 32.15 P < 0.001 5–9 8886 36.10 6677 35.40 1460 37.82 749 39.55 10–14 3414 13.87 2598 13.78 526 13.63 290 15.31 15–19 1547 6.29 1157 6.13 213 5.52 177 9.35 20–27 531 2.16 394 2.09 68 1.76 69 3.64 Exercise(day/week) None 10090 40.99% 7670 40.67% 1746 45.23% 674 35.59% P < 0.001 1–2 5968 24.25% 4634 24.57% 773 20.03% 561 29.62% 3–5 6097 24.77% 4642 24.61% 956 24.77% 499 26.35% 6–7 2459 9.99% 1914 10.15% 385 9.97% 160 8.45% Sugary drinks(ml) None 8887 36.11 6655 35.29 1795 46.50 437 23.07 P 1800 1283 5.21 1000 5.30 147 3.81 136 7.18 Figure 1 shows that the proportion of men (N = 10539) suffering from chronic diseases is about 25.66%, which is about 4% higher than the proportion of women suffering from chronic diseases (N = 14075). The incidence of chronic diseases among people living in rural areas was slightly higher than that of people living in urban areas, at about 4.47%. The incidence of chronic diseases among single individuals (N = 10945) was about 21.07%, which was about 3% -9% lower than that of married individuals. Among them, the proportion of people with only one chronic disease was the lowest, at about 10.42%. The proportion of people suffering from various chronic diseases was the highest, at about 10.65%. The incidence of chronic diseases among people with incomes above 3000 yuan was about 24.23%, which was about 2.57% higher than those with incomes below 3000 yuan. Results of ordinal logistic regression In order to accurately estimate the comprehensive impact of multiple factors, according to the single factor analysis results in Table 2 , statistically significant factors were subjected to ordinal logistic regression analysis to fit the regression equation. The multicollinearity test had no statistical significance and is consistent with the foundation established by ordered logistic regression analysis. Table 3 shows the results of ordinal logistic regression analysis. Variables identified as significant factors in the univariate analysis were included in the ordinal logistic regression analysis. After adjusting for covariates, older age was associated with a higher risk of chronic disease (OR = 1.24, 95% CI: 1.06–1.45, P < 0.001). Men had a significantly higher risk of reporting chronic disease than women (OR = 1.98, 95% CI: 1.97–1.99, P < 0.001). The risk of developing chronic diseases among participants whose income was more than 3,000 yuan was 1.31 times that of those whose income was less than 3,000 yuan (OR = 1.31, 95% CI: 1.13–1.52, P = 0.028). Married status may have a positive influence defending chronic diseases (OR = 0.59, 95% CI:0.43–0.82, P = 0.02). Living in an urban area may be a protective factor for chronic disease (OR = 0.60, 95% CI: 0.46–0.78, P = 0.005). People without a pet companion was found to be associated with a higher risk of chronic disease risk (OR = 1.03, 95% CI: 1.01–1.05, P < 0.001) compared to those having pets. People with higher PHQ-9 scores had a higher risk of chronic diseases as expected, especially susceptible to multiple chronic diseases ( P < 0.001). Notably, consumption of moderate amount of sugary drinks (< 900ml per week) could act as a preventive measure against chronic diseases (OR = 0.57, 95% CI:0.47–0.70, P < 0.001). Table 3 The association between chronic disease association risk factors explored by ordered logistic regression. OR P value One pathology - 0.001 Two or more pathologies - P < 0.001 Age(years) 12–18 18–60 1.02(1.01–1.03) P 60 1.24(1.06–1.45) P < 0.001 Gender Female Male 1.98(1.97–1.99) P < 0.001 Residence Town 0.60(0.46–0.78) 0.01 Rural Education Senior school & above Junior high school & below 1.15(0.99–1.35) 0.39 Marital status Married 0.59(0.43–0.82) 0.02 Divorced, widowed, or unmarried Smoking status Never Ever 0.99(0.97–1.01) 0.17 Alcohol intake Never Ever 1.06(0.83–1.34) 0.18 Income(Yuan) > 3000 1.31(1.13–1.52) 0.03 ≤ 3000 Pet Not 1.03(1.01–1.05) p < 0.001 Yes PHQ_9 0–4 5–9 1.01(1.01–1.01) P < 0.001 10–14 1.05(1.04–1.07) 0.02 15–19 1.98(1.96–1.99) 0.01 20–27 0.76(0.61–0.93) P < 0.001 Exercise None 1–2 0.96(0.94-1.00) 0.317 3–5 0.98(0.96–0.99) 0.287 6–7 0.96(0.93–0.99) 0.304 Sugary drinks None ≤ 900 0.57(0.47–0.70) P 1800 1.00(0.99–1.02) 0.54 Correlation between PHQ-9 score and chronic disease at different ages In our study, people with different numbers of pathologies were marked in grey (no pathology), blue (one pathology) and red (two or more pathologies) respectively. The mean values of the population for these three groups were 28, 48 and 62 correspondingly. It can be seen from the figure that the incidence of chronic diseases in the population before the age of 48 was relatively flat, and then the prevalence rate began to increase gradually. At the age of 28, the proportion of people without chronic diseases was as high as 90.61%, while at the age of 48 and 62, the proportion of people without chronic diseases dropped to 66.51% and 55.60% (Suppl.1). It can be seen from Fig. 3 that the population without chronic diseases was mainly concentrated in the area without depressive symptoms (the median score of PHQ-9 was less than 5)(Fig. 2 A), the population with only one chronic disease was mainly concentrated in the area of mild to moderate depressive symptoms (the median score of PHQ-9 is 5–15) (Fig. 2 B), and people with multiple chronic diseases were mainly concentrated in the moderate to severe depressive symptom area (median score of PHQ-9 is greater than 10) (Fig. 2 C). Additionally, the PHQ-9 score fluctuated more obviously under the age of 48 in people with one or more pathologies, suggesting middle-aged and young (< 48 years old) people with depressive symptoms had a significantly higher risk of developing chronic diseases. Logistic regression analysis (Suppl.2) shows that for people aged 48 and under, Sugary drinks, Residence, Education were negatively correlated with chronic disease risk (OR 1). We then further analyze the association of sugary drinks with chronic diseases in the middle-aged and young population. Intriguingly, the prevalence rate of chronic diseases in people who hardly take sugary drinks was the highest, about 16.28%, and the prevalence rate of one pathology was about 5% higher than that of the people who take sugary drinks. Comparatively, the lowest prevalence rate was 12.21% among people who consumed a moderate amount of sugary drinks (≤ 900ml) every week (Suppl.3). No association was found between the increase of sugary drinks intake and the prevalence of a single chronic disease, but the prevalence of multiple chronic diseases had a certain growing trend. Correlation between weekly intake of sugary drinks, PHQ-9 scores, and chronic disease in the young and middle-aged adults The median PHQ-9 score for individuals with chronic diseases was 6.5–11(Table 5 ) while individuals with Coronary heart diseases (N = 52, med = 9), Stroke of the brain (N = 27, med = 11), Cataracts (N = 22, med = 10.5) and other chronic diseases had relatively high PHQ-9 scores (> 8).The proportion of people with chronic diseases such as Fracture (N = 253, 80.24%), Coronary heart disease (N = 52, 84.62%), Parkinson's disease (N = 4, 100%) consuming sugary drinks every week was relatively high (more than 80%), while the proportion of people with diabetes ingested the least (N = 127, 53.54%). Table 5 Distribution characteristics of chronic diseases (N = 2429), weekly intake of sugary drinks and PHQ-9 scores in middle-aged and young adults. Type of chronic diseases Number PHQ-9 (median) Sugary drink per week(ml) None (%) 1800 (%) Stroke of the brain 27 11 22.22 40.74 18.52 18.52 Cataracts 22 10.5 27.27 22.73 36.36 13.64 Chronic respiratory diseases 91 9 20.88 50.55 20.88 7.69 Coronary heart disease 52 9 15.38 44.23 21.15 19.23 Chronic gastroenteritis 603 8 21.39 55.56 16.92 6.14 Hypertension 386 8 35.75 47.93 9.33 6.99 Others 563 8 14.64 58.57 19.64 7.14 Fracture 253 8 19.76 48.62 23.72 7.91 Fatty liver disease 173 8 26.0 49.13 15.61 9.25 Osteoporosis of bone 152 8 30.92 45.39 17.76 5.92 Diabetes 127 8 46.46 37.80 9.45 6.30 Benign tumor 92 8 20.65 53.26 18.48 7.61 Chronic kidney disease 48 8 20.83 56.25 14.58 8.33 Viral hepatitis 41 8 29.27 41.46 17.07 12.20 Arthritis 234 7 32.91 45.30 13.25 8.55 Abnormal blood lipids 232 7 38.79 44.83 9.05 7.33 Malignant tumor 35 7 28.57 57.14 11.43 2.86 Parkinson's disease 4 6.5 0.00 25.00 0.00 75.00 The prevalence rate of chronic diseases among people aged 29 to 48 years was 19.79%, higher than those between 19 to 28 (19.79% vs 8.94%) and 12 to 18 years old (19.79% vs 13.35%) (Table 6 ). The weekly intake of sugary drinks among people aged 29 to 48 years old was the lowest, and that among people without intake was 39.69%, 26.5% and 21.93% higher than those between 19 to 28 and 12 to 18 years old. Among people without chronic diseases, PHQ-9 scores were positively correlated with the intake of sugary drinks, especially among minors (12–18 years old, Kruskal. P < 0.001). Table 6 Kruskal Test between weekly intake of sugary drinks, PHQ-9 scores and chronic disease in middle-aged and young adults (N = 17664). Age (years) Number of pathologies Number Ratio Sugary drink per week(ml) Kruskal.P None 1800 12–18 - 2376 100% 17.76% 55.30% 18.69% 8.25% - No 2223 93.56% 2% 5% 6% 7.5 3.25×10 − 26 One 132 5.56% 10% 7% 9% 15 6.56 ×10 − 2 Two or more 21 0.88% 8% 9% 14.5% 27 0.20 19–28 - 8385 100% 13.19% 59.38% 19.65% 7.78% - No 7475 89.15% 5% 6% 7% 8% 3.15×10 − 19 One 774 9.23% 9% 8% 9% 10% 0.03 Two or more 136 1.62% 11.5% 9% 13% 10% 0.49 29–48 - 6903 100% 39.69% 45.55% 10.20% 4.56% - No 5537 80.21% 4% 6% 8% 6% 2.77×10 − 31 One 1041 15.08% 6% 8% 9% 7% 4.54×10 − 6 Two or more 325 4.71% 6% 8% 10% 8% 6.28×10 − 4 Figure 3 shows that among the people suffering from only one pathology, the PHQ-9 score of the people who properly consumed sugary drinks every week (< 900ml per week) was relatively low, especially the people aged 12–28. Among people suffering from multiple pathologies, PHQ-9 scores were positively correlated with the intake of sugary drinks. Additionally, among middle-aged and young people, especially the 19–28 range, those who properly consumed sugary drinks every week (< 900ml per week) had relatively low PHQ-9 scores. Discussion In this study, we demonstrated that middle-aged and young people (< 48 years old) with depression are at a higher risk of developing chronic diseases, and we are the first one to report that a moderate amount of sugary drinks intakes (< 900ml per week) was associated with the well-beings of middle-aged and young adults in a Chinese population. Demographic characteristics and various conditions are known to be associated with the risk of developing chronic diseases, including age, gender, smoking status, residence, mental status, education, marital status, and income. In this study, the risk of developing chronic diseases was positively associated with age, which was in consistency with previous studies(Prasad et al., 2012 ) , (Niccoli and Partridge, 2012 ). We found that middle-aged and young people with depressive symptoms had a significant predisposition to developing chronic diseases, as characterized by more than one pathology manifestation. Reciprocally, people developing chronic diseases, whether with only one pathology or multiple pathologies, were mainly presented with moderate to severe depressive symptom (PHQ-9 > 10). The reasons behind this could be attributable to increased inflammation, physiologic changes such as heart rate, contractility and metabolic regulation including stress hormones release. A Chinese nationwide study showed that the degree of pain played a critical role on chronic disease and depression in people aged 45 years and older(Ma et al., 2021 ). Limitation of activities could also lead to continuing withdrawal from rewarding participation, having an substantial impact on quality of life(Prince et al., 1998 )(Spitzer et al., 1995 ). The association between sugary drinks consumption and the ease of depressive symptoms and/or chronic diseases have not been explained explicitly yet. We observed that a moderate amount of sugary drinks (< 900 per week) intake could be a potentially protective factor in chronic diseases development in middle-aged and young people, and the controlled intake of sugary drinks could also improve depression mutually. Previously, the consumption of sugary drinks was considered as positively correlated with mortality rate through cardiovascular incidents in US adults(Malik et al., 2019 ). Although the excessive sugar intake may cause fluctuations in blood sugar and lead to inflammation, the psychological factors such as emotional stability after sugary drinks consumption may contribute to a balanced physical and mental health. Previous studies stated that limiting the intake of sugary consumption may cause the increase of plasma high-density lipoprotein cholesterol (HDL) cholesterol levels(Wise, 2015 ), which may be conveyed as a protective factor in lowering the risk of chronic diseases such as chronic kidney disease(Heo et al., 2024 )(Zoppini et al., 2009 ). HDL is provided as a critically diagnostic and therapeutic biomarker for predicting cardiovascular diseases via altering the inflammation status(Lanktree et al., 2018 ) , (Miao et al., 2021 ) , (Wang et al., 2020 ) , (Estrada-Luna et al., 2018 ) , (Kim et al., 2021 ) , (Otocka-Kmiecik et al., 2012 ). A prospective from UK showed that a lower consumption of sugary drinks may reduce the risk of developing CKD. However, patient-level phenotype and genotype information were unavailable in these studies. What’s more, interpretation should be noted with caution in regard to the consumption number of sugary drinks. Indeed, in our study, PHQ-9 scores were found to be positively associated with the intake of sugary drinks in people without chronic diseases. Therefore, it is important and feasible to prioritize a well-controlled intake of sugary drink consumption in people with depression. There are still several limitations in our study. Firstly, due to the nature of survey, the self-reported data may introduce recall bias and imprecise measurements of sugary drinks consumption. However, we have thus adjusted potential confounders as much as possible so as to establish a causal relationship between sugary drinks intake and the risk of developing chronic diseases in people with depression. Moreover, the heterogeneity and complexity of depression make it difficult to generalize findings across diverse ethnics. Taking this into consideration, other confounding factors, such as dietary patterns, workout frequency, et al., could also be analyzed accordingly in various populations. Although we have added first evidence suggesting the advantages of having a limited amount (≤ 900ml/week) of sugary drinks in reducing the prevalence of chronic diseases in people with depressive symptoms, it is important to interpret this finding with caution and not use it as a justification for excessive sugary drink consumption without mentioning about consumption limitation. Further research is warranted to fully understand the potential mechanisms and implications of this intriguing relationship between sugary drinks and risks of chronic diseases in individuals of different age groups with depressive symptoms. Furthermore, studies in analyzing other populations should also be noted for a confirmed conclusion worldwide. In summary, limited consumption of sugary drinks (≤ 900ml per week) can resist the onset of depressive symptoms as presented by a comparatively lower PHQ-9 scoring, which can ultimately decrease the prevalence of chronic diseases as presented by one or more pathologies, especially for those younger than 48 years old. There is no doubt a need for greater consumer understanding of dichotomous role of sugary drinks, which could probably be achieved through educational avenues like public education campaigns or on-package information labels to allow for a much well-informed recommendations for overall public health. Declarations Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Trial registration This study has been registered with the China Clinical Trials Registry, registration number ChiCTR2200061046. Declaration of competing interest: All the authors declare no conflict of interest. Data availability statement All data for the current study are included in figures/tables in the main text, or the supplemental data. These data are available from the corresponding author upon reasonable request. Acknowledgments The authors are grateful for the data support provided by Psychological and Behavioral Survey of Chinese Residents (PBICR). Author Contribution Xinyi Kong developed the conception and designed the study. Jialei Chen and Jie Li assisted with data acquisition. Xia Yang, Kui Li, Zicheng Jiang, Shishi Ma and Lingyun Kong performed data analysis and interpretation. Xinyi Kong drafted the original manuscript with input from all authors, Shishi Ma and Lingyun Kong supervised the study. All authors approved of the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. References Bi, Y.H., Pei, J.J., Hao, C., Yao, W., Wang, H.X., 2021. The relationship between chronic diseases and depression in middle-aged and older adults: A 4-year follow-up study from the China Health and Retirement Longitudinal Study. J. Affect. Disord. 289, 160–166. https://doi.org/10.1016/j.jad.2021.04.032 Bomback, A.S., Derebail, V.K., Shoham, D.A., Anderson, C.A., Steffen, L.M., Rosamond, W.D., Kshirsagar, A. V, 2010. Sugar-sweetened soda consumption, hyperuricemia, and kidney disease. Kidney Int. 77, 609–616. https://doi.org/https://doi.org/10.1038/ki.2009.500 Chazelas, E., Srour, B., Desmetz, E., Kesse-Guyot, E., Julia, C., Deschamps, V., Druesne-Pecollo, N., Galan, P., Hercberg, S., Latino-Martel, P., Deschasaux, M., Touvier, M., 2019. Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort. BMJ 366, l2408. https://doi.org/10.1136/bmj.l2408 Chen, Y., Bennett, D., Clarke, R., Guo, Y., Yu, C., Bian, Z., Ma, L., Huang, Y., Sun, Q., Zhang, N., Zheng, X., Chen, J., Peto, R., Kendler, K.S., Li, L., Chen, Z., 2017. Patterns and correlates of major depression in Chinese adults: a cross-sectional study of 0.5 million men and women. Psychol. Med. 47, 958–970. https://doi.org/10.1017/S0033291716002889 de Koning, L., Malik, V.S., Kellogg, M.D., Rimm, E.B., Willett, W.C., Hu, F.B., 2012. Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation 125, 1735–41, S1. https://doi.org/10.1161/CIRCULATIONAHA.111.067017 de Lorgeril, M., Salen, P., Rabaeus, M., 2020. Sugary drinks and cancer risk. Transl. Cancer Res. https://doi.org/10.21037/tcr-2020-003 Estrada-Luna, D., Ortiz-Rodriguez, M.A., Medina-Briseño, L., Carreón-Torres, E., Izquierdo-Vega, J.A., Sharma, A., Cancino-Díaz, J.C., Pérez-Méndez, O., Belefant-Miller, H., Betanzos-Cabrera, G., 2018. Current Therapies Focused on High-Density Lipoproteins Associated with Cardiovascular Disease. Molecules 23. https://doi.org/10.3390/molecules23112730 Fonseca-Pedrero, E., Díez, A., perez-albeniz, A., Al-Halabí, S., Lucas-Molina, B., Debbané, M., 2023. Youth Screening Depression: Validation of the Patient Health Questionnaire-9 (PHQ-9) in a representative sample of adolescents. Psychiatry Res. 115486. https://doi.org/10.1016/j.psychres.2023.115486 Fung, T.T., Malik, V., Rexrode, K.M., Manson, J.E., Willett, W.C., Hu, F.B., 2009. Sweetened beverage consumption and risk of coronary heart disease in women. Am. J. Clin. Nutr. 89, 1037–1042. https://doi.org/10.3945/ajcn.2008.27140 Heo, G.Y., Koh, H.B., Park, J.T., Han, S.H., Yoo, T.-H., Kang, S.-W., Kim, H.W., 2024. Sweetened Beverage Intake and Incident Chronic Kidney Disease in the UK Biobank Study. JAMA Netw. open 7, e2356885. https://doi.org/10.1001/jamanetworkopen.2023.56885 Hesketh, T., Zhen, Y., Lu, L., Dong, Z.X., Jun, Y.X., Xing, Z.W., 2010. Stress and psychosomatic symptoms in Chinese school children: cross-sectional survey. Arch. Dis. Child. 95, 136–140. https://doi.org/10.1136/adc.2009.171660 Hu, F.B., 2013. Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes. Rev. an Off. J. Int. Assoc. Study Obes. 14, 606–619. https://doi.org/10.1111/obr.12040 Infurna, F.J., Gerstorf, D., Lachman, M.E., 2020. Midlife in the 2020s: Opportunities and challenges. Am. Psychol. 75, 470–485. https://doi.org/10.1037/amp0000591 Kim, J.Y., Park, J.T., Kim, H.W., Chang, T.-I., Kang, E.W., Ahn, C., Oh, K.-H., Lee, J., Chung, W., Kim, Y.-S., Kim, S.W., Yoo, T.-H., Kang, S.-W., Han, S.H., 2021. Inflammation Alters Relationship Between High-Density Lipoprotein Cholesterol and Cardiovascular Risk in Patients With Chronic Kidney Disease: Results From KNOW-CKD. J. Am. Heart Assoc. 10, e021731. https://doi.org/10.1161/JAHA.120.021731 Kmietowicz, Z., 2018. Type 2 diabetes: sweetened drinks pose greater risk than other sugary foods. BMJ. https://doi.org/10.1136/bmj.k4943 Kroenke, K., Spitzer, R.L., Williams, J.B.W., 2001. The PHQ-9. J. Gen. Intern. Med. 16, 606–613. https://doi.org/10.1088/1751-8113/44/8/085201 Lanktree, M.B., Thériault, S., Walsh, M., Paré, G., 2018. HDL Cholesterol, LDL Cholesterol, and Triglycerides as Risk Factors for CKD: A Mendelian Randomization Study. Am. J. kidney Dis. Off. J. Natl. Kidney Found. 71, 166–172. https://doi.org/10.1053/j.ajkd.2017.06.011 Leung, C.Y., Abe, S.K., Sawada, N., Ishihara, J., Takachi, R., Yamaji, T., Iwasaki, M., Hashizume, M., Inoue, M., Tsugane, S., 2021. Sugary Drink Consumption and Subsequent Colorectal Cancer Risk: The Japan Public Health Center-Based Prospective Cohort Study. Cancer Epidemiol. biomarkers Prev. a Publ. Am. Assoc. Cancer Res. cosponsored by Am. Soc. Prev. Oncol. 30, 782–788. https://doi.org/10.1158/1055-9965.EPI-20-1364 Liu, Q., Cai, H., Yang, L.H., Xiang, Y.B., Yang, G., Li, H., Gao, Y.T., Zheng, W., Susser, E., Shu, X.O., 2018. Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people. Sci. Rep. 8, 1–11. https://doi.org/10.1038/s41598-018-22175-2 Ma, Y., Xiang, Q., Yan, C., Liao, H., Wang, J., 2021. Relationship between chronic diseases and depression: the mediating effect of pain. BMC Psychiatry 21, 1–11. https://doi.org/10.1186/s12888-021-03428-3 Malik, V.S., Hu, F.B., 2022. The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nat. Rev. Endocrinol. 18, 205–218. https://doi.org/10.1038/s41574-021-00627-6 Malik, V.S., Li, Y., Pan, A., Koning, L. De, Schernhammer, E., Willett, W.C., Hu, F.B., 2019. Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults. Circulation 139, 2113–2125. https://doi.org/10.1161/CIRCULATIONAHA.118.037401 Malik, V.S., Willett, W.C., Hu, F.B., 2013. Global obesity: trends, risk factors and policy implications. Nat. Rev. Endocrinol. 9, 13–27. https://doi.org/10.1038/nrendo.2012.199 Mathers, C.D., Loncar, D., 2006. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 3, e442. https://doi.org/10.1371/journal.pmed.0030442 Miao, L., Min, Y., Qi, B., Zhu, C.-M., Chen, J.-H., Deng, G.-X., Wang, Y., Li, J.-F., Li, R.-S., 2021. Causal effect between total cholesterol and HDL cholesterol as risk factors for chronic kidney disease: a mendelian randomization study. BMC Nephrol. 22, 35. https://doi.org/10.1186/s12882-020-02228-3 Mullick, M.S.I., Goodman, R., 2005. The prevalence of psychiatric disorders among 5–10 year olds in rural, urban and slum areas in Bangladesh. Soc. Psychiatry Psychiatr. Epidemiol. 40, 663–671. https://doi.org/10.1007/s00127-005-0939-5 Nestler, E.J., Barrot, M., DiLeone, R.J., Eisch, A.J., Gold, S.J., Monteggia, L.M., 2002. Neurobiology of depression. Neuron 34, 13–25. https://doi.org/10.1016/s0896-6273(02)00653-0 Niccoli, T., Partridge, L., 2012. Ageing as a Risk Factor for Disease. Curr. Biol. 22, R741–R752. https://doi.org/https://doi.org/10.1016/j.cub.2012.07.024 Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S.D. of H. and H.S., n.d. Healthy People 2030 [WWW Document]. URL https://health.gov/healthypeople/objectives-and-data/browse-objectives Otocka-Kmiecik, A., Mikhailidis, D.P., Nicholls, S.J., Davidson, M., Rysz, J., Banach, M., 2012. Dysfunctional HDL: a novel important diagnostic and therapeutic target in cardiovascular disease? Prog. Lipid Res. 51, 314–324. https://doi.org/10.1016/j.plipres.2012.03.003 Popkin, B.M., 2010. Patterns of beverage use across the lifecycle. Physiol. Behav. 100, 4–9. https://doi.org/10.1016/j.physbeh.2009.12.022 Prasad, S., Sung, B., Aggarwal, B.B., 2012. Age-associated chronic diseases require age-old medicine: role of chronic inflammation. Prev. Med. (Baltim). 54 Suppl, S29-37. https://doi.org/10.1016/j.ypmed.2011.11.011 Prince, M.J., Harwood, R.H., Thomas, A., Mann, A.H., 1998. A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol. Med. 28, 337–350. https://doi.org/10.1017/s0033291797006478 Rosinger, A., Herrick, K.A., Gahche, J.J., Park, S., n.d. Sugar-sweetened beverage consumption among U.S. youth, 2011-2014. NCHS Data Brief, NCHS data brief ; no. 271. Sekhar, D.L., Batra, E., Schaefer, E.W., Walker-Harding, L.R., Pattison, K.L., Molinari, A., Rosen, P., Kraschnewski, J.L., Waxmonsky, J.G., 2022. Adolescent Suicide Risk Screening: A Secondary Analysis of the SHIELD Randomized Clinical Trial. J. Pediatr. 251, 172–177. https://doi.org/https://doi.org/10.1016/j.jpeds.2022.07.036 Spitzer, R.L., Kroenke, K., Linzer, M., Hahn, S.R., Williams, J.B., deGruy, F.V. 3rd, Brody, D., Davies, M., 1995. Health-related quality of life in primary care patients with mental disorders. Results from the PRIME-MD 1000 Study. JAMA 274, 1511–1517. The Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S.D. of H. and H.S., n.d. Mental Health and Mental Disorders [WWW Document]. URL https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders Vanderlee, L., Czoli, C.D., Pauzé, E., Potvin Kent, M., White, C.M., Hammond, D., 2021. A comparison of self-reported exposure to fast food and sugary drinks marketing among parents of children across five countries. Prev. Med. (Baltim). 147, 106521. https://doi.org/10.1016/j.ypmed.2021.106521 Wang, L., Xiang, F., Ji, J., Ding, X., Shen, B., Chen, J., Chen, Y., Xue, N., Zhang, L., Jiang, X., Cao, X., 2020. Indoxyl sulfate and high-density lipoprotein cholesterol in early stages of chronic kidney disease. Ren. Fail. 42, 1157–1163. https://doi.org/10.1080/0886022X.2020.1845731 Wang, YuJia, Kaierdebieke, A., Fan, S., Zhang, R., Huang, M., Li, H., Sun, XiaoNan, Li, Q., Meng, W., Wu, W., Lin, Z., Liu, J., Wang, X., Wu, YunChou, Tang, J., Sun, Y., Chen, K., Ge, P., Ming, W., Zhang, C., Feei, Z., Feng, L., Zhang, X., Niu, Y., Yan, Y., Jin, Y., Dai, S., Li, Y., Tan, Y., Wu, YiWei, Zhang, Q., Gui, G., Pan, X., Liao, Y., Zhao, X., Zhang, Y., Chen, H., Qiu, Y., Fu, X., JiangLing Zhou, J.Z., Li, D., Li, K., Xu, M., Wang, Z., Wang, YueQi, Ma, Y., Sun, XinYing, Wu, YiBo, 2022. Study protocol: A cross-sectional study on psychology and behavior investigation of Chinese residents, PBICR. Psychosom. Med. Res. 4, 19. https://doi.org/10.53388/202219 Wise, J., 2015. Reducing sugary drink intake is linked to raised HDL cholesterol levels. BMJ. https://doi.org/10.1136/bmj.h4738 World Health Organization, 2024. Aging and health [WWW Document]. URL https://www.who.int/china/health-topics/ageing#:~:text=402 million by 2040,over the age of 60. World Health Organization, 2022. Mental disorders [WWW Document]. World Heal. Organ. URL https://www.who.int/news-room/fact-sheets/detail/mental-disorders Xia, N., Lin, J., Ding, S., Dong, F., Shen, J., Du, Y., Wang, X., Chen, Y., Zhu, Z., Zheng, R., Xu, H., 2019. Reliability and validity of the Chinese version of the Patient Health Questionnaire 9 (C-PHQ-9) in patients with epilepsy. Epilepsy Behav. 95, 65–69. https://doi.org/https://doi.org/10.1016/j.yebeh.2019.03.049 Ye, X., Shu, H.-L., Feng, X., Xia, D.-M., Wang, Z.-Q., Mi, W.-Y., Yu, B., Zhang, X.-L., Li, C., 2020. Reliability and validity of the Chinese version of the Patient Health Questionnaire-9 (C-PHQ-9) in patients with psoriasis: a cross-sectional study. BMJ Open 10, e033211. https://doi.org/10.1136/bmjopen-2019-033211 Yuzbashian, E., Asghari, G., Mirmiran, P., Zadeh-Vakili, A., Azizi, F., 2016. Sugar-sweetened beverage consumption and risk of incident chronic kidney disease: Tehran lipid and glucose study. Nephrology (Carlton). 21, 608–616. https://doi.org/10.1111/nep.12646 Zhou, M., Wang, H., Zeng, X., Yin, P., Zhu, J., Chen, W., Li, X., Wang, Lijun, Wang, Limin, Liu, Y., Liu, J., Zhang, M., Qi, J., Yu, S., Afshin, A., Gakidou, E., Glenn, S., Krish, V.S., Miller-Petrie, M.K., Mountjoy-Venning, W.C., Mullany, E.C., Redford, S.B., Liu, H., Naghavi, M., Hay, S.I., Wang, Linhong, Murray, C.J.L., Liang, X., 2019. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 394, 1145–1158. https://doi.org/10.1016/S0140-6736(19)30427-1 Zoppini, G., Targher, G., Chonchol, M., Perrone, F., Lippi, G., Muggeo, M., 2009. Higher HDL cholesterol levels are associated with a lower incidence of chronic kidney disease in patients with type 2 diabetes. Nutr. Metab. Cardiovasc. Dis. 19, 580–586. https://doi.org/10.1016/j.numecd.2008.11.003 Additional Declarations No competing interests reported. Supplementary Files Supplementary.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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2","display":"","copyAsset":false,"role":"figure","size":175778,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation between chronic disease and PHQ-9 score.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7131825/v1/d33c4ed6bc39c555bf0cd5b8.png"},{"id":88782095,"identity":"2d8ed7d3-1fe1-4cc7-ba7b-5640dbd58aef","added_by":"auto","created_at":"2025-08-11 10:57:59","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":129351,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation between weekly intake of Sugary drinks, PHQ-9 scores and chronic 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10:49:59","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":198854,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementary.docx","url":"https://assets-eu.researchsquare.com/files/rs-7131825/v1/4dca7df9b20b6f545cc38bc9.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association of sugary drinks intake with chronic diseases in people with depression —a national cross-sectional analysis in a Chinese population","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePsychological problems, also called mental health issues, are clinically manifested with significant disturbance in an individual’s cognition, emotional control, or behaviors(World Health Organization, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Major depression disorder is a serious psychological problem that presented with depressed mood, irritability, loss of interest, difficulty in concentrating, disrupted sleep pattern, decreased appetite, impaired cognition and tendency to suicide (Nestler et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). It is estimated that major depression disorder is to become the second-leading cause of disease burden in high-income countries by 2030 according to WHO (Mathers and Loncar, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Epidemiology studies have shown that the prevalence rate of psychiatric disorders ranges widely from 5 to 18% in children and adolescents in developing countries (Mullick and Goodman, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). In Chinese population, a low rate of seeking professional assistance and treatment was observed in people aged 30–79 years old living with depression, highlighting the large disparity in mental health care(Chen et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Additionally, the ‘one-child’ family planning policy, large scale rural to urban population transmission and rapidly increasing divorce rate in China, has all contributed to a large amount of ‘single-parent family’ and ‘left behind one child’ (Hesketh et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Depression and chronic diseases could be inter-related, and plenty of clinical groups have recommended to practice depression screening in the chronic disease population(Wang et al., 2022). A cohort study investigating 7819 participants in China showed that the risk of depression increased with rise in the number of chronic diseases in people aged ≥ 45 without depression, during the follow-up time from 2011–2015 (Bi et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Patients with depressive symptoms may not be able to recognize or be reluctant to acknowledge depression as a separate risk factor condition, perhaps due to overlapping physical symptoms. It induces profound changes in the life of patients, adding to social and economic burden and contributes to the transitions of mortality patterns in China with a shift from infectious diseases to non-communicable diseases(Zhou et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMiddle-aged and young people are faced with an increase of intergenerational challenges, such as family responsibilities of caring for aging parents, adolescents, and grandchildren; financial vulnerabilities that often come from economic failures, labor market volatility, the shrinking social and healthcare safety net (Infurna et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). There is now a rapidly growing number of aging population worldwide, and in China, it is predicted that people older than 60 years old would be reaching 28% by 2040, because of longer life expectancy and a decrease of fertility rates (World Health Organization, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Many studies have reported the evidence that depressive symptoms are most likely experienced by middle-aged and elderly participants(Liu et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). As the population pattern and social circumstances change, it is crucial to bring the attention to physical and mental challenges confronted by middle-aged and younger people at an early stage. However, little information is available on affective management of chronic diseases in people with depression, especially on young adults and middle-aged people.\u003c/p\u003e\u003cp\u003eOver the past few years, sugary drinks have emerged as a significant factor in the increased consumption of added sugary drinks in modern diet (Vanderlee et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). It comprises carbonated soft drinks, coffees/teas, sodas, flavored fruit drinks, and energy drinks containing additional caloric sweeteners like fruit juice concentrates, sucrose, and high fructose corn syrup in all age groups(Popkin, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2010\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Hu, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2013\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Rosinger et al., n.d.)\u003csup\u003e,\u003c/sup\u003e(Malik et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). This pattern change of beverages intake has been recognized as a pressing issue from a public health perspective. Although studies have shown that sugary intake will increase the risk of developing global epidemics of chronic diseases including cardiovascular diseases, chronic kidney diseases, type 2 diabetes mellitus and cancers(Fung et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2009\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Bomback et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2010\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(de Koning et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2012\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Yuzbashian et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2016\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(de Lorgeril et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Chazelas et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2019\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Kmietowicz, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Leung et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Malik and Hu, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), probably through the increased production of oxidative stress(Bomback et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), it is still unknown whether a controlled amount of sugary drinks consumption is correlated with the risk of chronic diseases onset in middle-aged and young adults with depressive symptoms. As Healthy People 2023 (a national effort that sets goals and objectives to improve the health and well-being of people in the United States) objectives addressed, health conditions, health behaviors, populations, settings and systems, social determinants of health are five main intuitive topics covered(Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, n.d.). Mental health and mental disorders are one of the most pressing issues and the focus of Healthy People 2030 on the prevention, screening, evaluation, and treatment of these five topics (The Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, n.d.). Therefore, we conduct this study to investigate the association between moderate intake of sugary drinks and well-beings of middle-aged and young adults with cross-sectional data in a Chinese population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cb\u003eStudy design and Data collection\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study is a cross-sectional survey, and the data used come from the Psychological and Behavioral Survey of Chinese Residents (PBICR)(Wang et al., 2022). This large-scale survey was conducted in 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in China from June 20 to August 31, 2022. The survey adopted multi-stage sampling, and the specific quota method was reported in the previous study by Wang et al. This study has been registered with the China Clinical Trials Registry on 15th June 2022, registration number ChiCTR2200061046. Human Ethics and Consent to Participate declarations are not applicable. This research is conducted in accordance with the Declaration of Helsinki\u003c/p\u003e\u003cp\u003eIn each sample city, investigators were openly recruited from local universities. Researchers were trained in sampling methods, research tools, and quality control. Participation in the survey was only possible after passing the mock survey test. Investigators contacted potential participants by phone or in person. Information was collected through face-to-face interviews with each participant using a pre-tested structured questionnaire. Before the data collection process, informed consent form was obtained by participants or parents of participants and that the patients (or guardian) consented to the publishing of all images, clinical data, and other data included in the manuscript. Participants who agree to participate will be provided with a valid link to the electronic questionnaire.\u003c/p\u003e\u003cp\u003eParticipants who met the following criteria were included in this study: being older than 12 years, being identified as a permanent resident of China with Chinese nationality, and having sufficient ability to read and understand the questionnaire. Participants can complete an online questionnaire by themselves or with the help of a surveyor. Given that the current study was on the general population, participants who had a diagnosed or self-reported mental disorder were not eligible. In addition, participants who were unwilling to participate or have already participated in similar studies were also excluded. A total of 24,614 participants were included in the final analysis sample.\u003c/p\u003e\u003cp\u003e\u003cb\u003eVariables\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eChronic diseases\u003c/b\u003e\u003c/p\u003e\u003cp\u003eChronic diseases defined in this study refers to chronic physical disease, specifically hypertension, chronic gastroenteritis, arthritis, osteoporosis, abnormal blood lipids, diabetes, fracture, coronary heart disease, cataract, fatty liver disease, chronic respiratory diseases, benign tumor, stroke of the brain, chronic kidney disease, malignant tumor, viral hepatitis, Parkinson’s disease and other 17 kinds of chronic diseases, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Chronic diseases are coded as No pathologies, One pathology, Two or more pathologies separately in this study.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eType of chronic diseases among participants (N = 5754).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType of chronic diseases\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1805\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic gastroenteritis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e967\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.81%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eArthritis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e815\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOsteoporosis of bone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e808\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.04%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbnormal blood lipids\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e686\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.92%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e613\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.65%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFracture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e389\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.76%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCoronary heart disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e383\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.66%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCataracts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e355\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.17%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFatty liver disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e304\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.28%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic respiratory diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.77%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBenign tumor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e178\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.09%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStroke of the brain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.55%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic kidney disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMalignant tumor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.65%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eViral hepatitis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.18%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParkinson's disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.76%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e787\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.68%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003cb\u003eDepression\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe Patient Health Questionnaire (PHQ) is a tool for making criteria-based diagnoses of depression and measuring mental diseases in primary care(Kroenke et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). Participants’ depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9), which contained 9 questions based on the Diagnostic and Statistical Manual of Depression (DSM) diagnostic criteria. The PHQ-9 has been shown to be a psychometrically valid and reliable measure of depression which is applicable to a variety of populations aged \u0026gt; 12 years old(Fonseca-Pedrero et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) (Sekhar et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2022\u003c/span\u003e)(Kroenke et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). The Chinese version of PHQ-9 has been verified to have good reliability and validity in Chinese patients with diverse disease such as psoriasis and epilepsy(Xia et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2019\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Ye et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Each item is scored on a 4-point Likert scale ranging from 0 (not at all) to 3 (almost every day). The total score ranges from 0 to 27, with higher scores indicating higher levels of depressive symptoms. A total score of \u0026lt; 5 indicates no depressive symptoms, 5–9 means mild depression, 10–14 means moderate depression, 15–19 means moderate to severe depression, 20–27 indicates severe depression. In this study, the Cronbach’s alpha value for the PHQ-9 was 0.922.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAssessment of sugary drinks intake\u003c/b\u003e\u003c/p\u003e\u003cp\u003eSugary drinks include common milk tea, carbonated drinks, sports drinks, fruit juice drinks, etc. Participants were asked to record their sugary drinks they consumed on average per week to assess weekly intake of sugary drinks, coded as None, ≤ 900ml/900-1800ml and \u0026gt; 1800ml.\u003c/p\u003e\u003cp\u003e\u003cb\u003eCovariates\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCovariates were identified based on previous research and common sense. The demographic and socioeconomic characteristics of the participants are mainly collected. The final covariates include Age (1 = 12–18, 2 = 18–60, 3 = \u0026gt; 60 ,years), Gender (1 = Female, 2 = Male), Residence (1 = Town, 2 = Rural), Education (1 = Senior school \u0026amp; above, 2 = Junior high school \u0026amp; below), Marital status (Married/ Single/ Widowed/ Divorced), Smoking (0 = Never, 1 = Ever), Drinking (0 = Never, 1 = Ever), Income (1 = ≤ 3000, 2 = \u0026gt; 3000 yuan, CNY), Pet (0 = Not, 1 = Yes), and Exercise (None/1–2 days every week/3–5 days every week/6–7 days every week).\u003c/p\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eThis study aims to understand the general situation of Chinese residents' psychology and health-related behaviors through a survey questionnaire, and provide a basis for the promotion of the \"Healthy China\" strategy. Statistical analysis was performed using SPSS version 25.0 software. Descriptive analysis was used to demonstrate the sociodemographic characteristics of the samples, and categorical variable data were presented as frequencies (percentages). Grouped by chronic disease prevalence status, chi-square test was used to determine the association between independent variables and chronic disease prevalence. Ordinal logistic regression analysis was performed to identify potential risk factors for chronic disease prevalence, including 3 dimensions. The reason for using this 3-dimension variable is that traditional model regression methods can not fit this dependent variable, but ordered logistic regression can solve this problem by dividing multiple classifications of the dependent variable into multiple binary logistic regressions. Effect estimates, including odds ratios (ORs) and their corresponding 95% confidence intervals (CIs), were used to assess the strength of association between independent variables and chronic disease prevalence. A p-value (both sides) \u0026lt; 0.05 was considered as statistically significant.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthics and Consent\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAll informed consent is obtained from all participants including minors (aged \u0026lt; 18), in addition to parental/guardian consent, via communication, discussion, and shared decision making. This study was approved by Shaanxi Institute of International Trade \u0026amp; Commerce (Ethics number # JKWH-2022-02).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cb\u003eThe characteristics of the participants\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA total of 24614 participants (42.82% male) were included in this cross-sectional study. Most of the participants were 18\u0026ndash;60 years old (78.13%), lived in urban areas (72.74%), receiving senior high school education and above (67.32%). A predominant number of participants claimed to be non-smoker (84.64%) and never drank alcohol (71.22%). A majority of participants had a monthly income of \u0026gt;\u0026thinsp;3000 (CNY) (66.80%) and kept pets as companion (79.10%). Individuals experiencing none to mild depressive symptoms (0\u0026ndash;4, 5\u0026ndash;9) were more than three times the number of those having moderate to severe symptoms combined (10\u0026ndash;14, 15\u0026ndash;19, 20\u0026ndash;27) (77.69% vs 22.32%). Nearly half of the participants consumed moderate amount of sugary drinks (45.91%) whereas 36.11% had hardly any sugary drinks, which is approximately three times higher than those took 900-1800ml per week (36.11% vs 12.77), and more than seven times higher than ones having\u0026thinsp;\u0026gt;\u0026thinsp;1800ml per week (36.11% vs 5.21%). The characteristics of the participants included were described in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution characteristics of questionnaire population, China, June 20 to August 31, 2022.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;24614)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eNo pathologies\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;18860)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eOne pathology\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;3860)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eTwo or more pathologies\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;1894)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP_value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRatio\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRatio\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRatio\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRatio\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge(years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u0026ndash;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1657\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1566\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19231\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e78.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15721\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e83.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2656\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e68.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e854\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e45.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3726\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1573\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e29.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e54.22\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14075\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e58.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e53.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e973\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e51.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10539\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7835\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1783\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e46.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e921\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e48.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTown\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17905\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13938\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e73.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2530\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e65.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1437\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e75.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6709\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4922\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e26.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e34.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e457\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e24.13\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSenior school \u0026amp; above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16569\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e67.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12896\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e68.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e55.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1520\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e80.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior high school \u0026amp; below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8045\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5964\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e31.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1707\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e44.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e374\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e19.75\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12795\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9603\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2519\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e65.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e673\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e35.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced, widowed, or unmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11819\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9257\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e49.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1341\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e34.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1221\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e64.46\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20833\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e84.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e85.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3205\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e83.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1594\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e84.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEver\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3781\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2826\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e655\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e16.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e15.84\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlcohol intake\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17530\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13423\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e71.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e74.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1229\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e64.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEver\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7084\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5437\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e28.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e982\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e25.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e665\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e35.11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncome(Yuan)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16442\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12458\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e66.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2764\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e71.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1220\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e64.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;3000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8172\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6402\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e33.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e28.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e674\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e35.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19469\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79.10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15046\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e79.78%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e78.19%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1405\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e74.18%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.90%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3814\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20.22%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e842\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e21.81%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e489\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e25.82%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePHQ_9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1593\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e41.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e609\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e32.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u0026ndash;9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8886\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6677\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e35.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1460\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e37.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e749\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e39.55\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u0026ndash;14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3414\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2598\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e526\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e13.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e290\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e15.31\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u0026ndash;19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1547\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1157\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e213\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e5.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e177\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e9.35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u0026ndash;27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e531\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e394\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e3.64\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExercise(day/week)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10090\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40.99%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7670\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40.67%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1746\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e45.23%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e674\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e35.59%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5968\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.25%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4634\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24.57%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e773\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e20.03%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e561\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e29.62%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u0026ndash;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6097\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.77%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4642\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24.61%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e956\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e24.77%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e26.35%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2459\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.99%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1914\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10.15%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e385\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e9.97%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e8.45%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSugary drinks(ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8887\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6655\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e35.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1795\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e46.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e437\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e23.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;900\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e45.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8790\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e46.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1482\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e38.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1028\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e54.28\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e900\u0026ndash;1800\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2415\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e436\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e11.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e293\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e15.47\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1800\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1283\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e3.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e136\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e7.18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows that the proportion of men (N\u0026thinsp;=\u0026thinsp;10539) suffering from chronic diseases is about 25.66%, which is about 4% higher than the proportion of women suffering from chronic diseases (N\u0026thinsp;=\u0026thinsp;14075). The incidence of chronic diseases among people living in rural areas was slightly higher than that of people living in urban areas, at about 4.47%. The incidence of chronic diseases among single individuals (N\u0026thinsp;=\u0026thinsp;10945) was about 21.07%, which was about 3% -9% lower than that of married individuals. Among them, the proportion of people with only one chronic disease was the lowest, at about 10.42%. The proportion of people suffering from various chronic diseases was the highest, at about 10.65%. The incidence of chronic diseases among people with incomes above 3000 yuan was about 24.23%, which was about 2.57% higher than those with incomes below 3000 yuan.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults of ordinal logistic regression\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn order to accurately estimate the comprehensive impact of multiple factors, according to the single factor analysis results in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, statistically significant factors were subjected to ordinal logistic regression analysis to fit the regression equation. The multicollinearity test had no statistical significance and is consistent with the foundation established by ordered logistic regression analysis.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the results of ordinal logistic regression analysis. Variables identified as significant factors in the univariate analysis were included in the ordinal logistic regression analysis. After adjusting for covariates, older age was associated with a higher risk of chronic disease (OR\u0026thinsp;=\u0026thinsp;1.24, 95% CI: 1.06\u0026ndash;1.45, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Men had a significantly higher risk of reporting chronic disease than women (OR\u0026thinsp;=\u0026thinsp;1.98, 95% CI: 1.97\u0026ndash;1.99, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The risk of developing chronic diseases among participants whose income was more than 3,000 yuan was 1.31 times that of those whose income was less than 3,000 yuan (OR\u0026thinsp;=\u0026thinsp;1.31, 95% CI: 1.13\u0026ndash;1.52, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.028). Married status may have a positive influence defending chronic diseases (OR\u0026thinsp;=\u0026thinsp;0.59, 95% CI:0.43\u0026ndash;0.82, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02). Living in an urban area may be a protective factor for chronic disease (OR\u0026thinsp;=\u0026thinsp;0.60, 95% CI: 0.46\u0026ndash;0.78, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005). People without a pet companion was found to be associated with a higher risk of chronic disease risk (OR\u0026thinsp;=\u0026thinsp;1.03, 95% CI: 1.01\u0026ndash;1.05, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) compared to those having pets. People with higher PHQ-9 scores had a higher risk of chronic diseases as expected, especially susceptible to multiple chronic diseases (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Notably, consumption of moderate amount of sugary drinks (\u0026lt;\u0026thinsp;900ml per week) could act as a preventive measure against chronic diseases (OR\u0026thinsp;=\u0026thinsp;0.57, 95% CI:0.47\u0026ndash;0.70, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eThe association between chronic disease association risk factors explored by ordered logistic regression.\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOne pathology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTwo or more pathologies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge(years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u0026ndash;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.02(1.01\u0026ndash;1.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.24(1.06\u0026ndash;1.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.98(1.97\u0026ndash;1.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTown\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.60(0.46\u0026ndash;0.78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSenior school \u0026amp; above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior high school \u0026amp; below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.15(0.99\u0026ndash;1.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.39\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.59(0.43\u0026ndash;0.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced, widowed, or unmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEver\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.99(0.97\u0026ndash;1.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.17\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlcohol intake\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEver\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.06(0.83\u0026ndash;1.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncome(Yuan)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.31(1.13\u0026ndash;1.52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;3000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.03(1.01\u0026ndash;1.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePHQ_9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u0026ndash;9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.01(1.01\u0026ndash;1.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u0026ndash;14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.05(1.04\u0026ndash;1.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u0026ndash;19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.98(1.96\u0026ndash;1.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u0026ndash;27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.76(0.61\u0026ndash;0.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExercise\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.96(0.94-1.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.317\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u0026ndash;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.98(0.96\u0026ndash;0.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.287\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.96(0.93\u0026ndash;0.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.304\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSugary drinks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;900\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.57(0.47\u0026ndash;0.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e900\u0026ndash;1800\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.13(1.08\u0026ndash;1.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1800\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.00(0.99\u0026ndash;1.02)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.54\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eCorrelation between PHQ-9 score and chronic disease at different ages\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn our study, people with different numbers of pathologies were marked in grey (no pathology), blue (one pathology) and red (two or more pathologies) respectively. The mean values of the population for these three groups were 28, 48 and 62 correspondingly. It can be seen from the figure that the incidence of chronic diseases in the population before the age of 48 was relatively flat, and then the prevalence rate began to increase gradually. At the age of 28, the proportion of people without chronic diseases was as high as 90.61%, while at the age of 48 and 62, the proportion of people without chronic diseases dropped to 66.51% and 55.60% (Suppl.1).\u003c/p\u003e\u003cp\u003eIt can be seen from Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e that the population without chronic diseases was mainly concentrated in the area without depressive symptoms (the median score of PHQ-9 was less than 5)(Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA), the population with only one chronic disease was mainly concentrated in the area of mild to moderate depressive symptoms (the median score of PHQ-9 is 5\u0026ndash;15) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB), and people with multiple chronic diseases were mainly concentrated in the moderate to severe depressive symptom area (median score of PHQ-9 is greater than 10) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC). Additionally, the PHQ-9 score fluctuated more obviously under the age of 48 in people with one or more pathologies, suggesting middle-aged and young (\u0026lt;\u0026thinsp;48 years old) people with depressive symptoms had a significantly higher risk of developing chronic diseases.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eLogistic regression analysis (Suppl.2) shows that for people aged 48 and under, Sugary drinks, Residence, Education were negatively correlated with chronic disease risk (OR\u0026thinsp;\u0026lt;\u0026thinsp;1). Variables such as Age, Income, Gender, PHQ_9 were all influential factors that positively associated with the risk of developing chronic diseases (OR\u0026thinsp;\u0026gt;\u0026thinsp;1).\u003c/p\u003e\u003cp\u003eWe then further analyze the association of sugary drinks with chronic diseases in the middle-aged and young population. Intriguingly, the prevalence rate of chronic diseases in people who hardly take sugary drinks was the highest, about 16.28%, and the prevalence rate of one pathology was about 5% higher than that of the people who take sugary drinks. Comparatively, the lowest prevalence rate was 12.21% among people who consumed a moderate amount of sugary drinks (\u0026le;\u0026thinsp;900ml) every week (Suppl.3). No association was found between the increase of sugary drinks intake and the prevalence of a single chronic disease, but the prevalence of multiple chronic diseases had a certain growing trend.\u003c/p\u003e\u003cp\u003e\u003cb\u003eCorrelation between weekly intake of sugary drinks, PHQ-9 scores, and chronic disease in the young and middle-aged adults\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe median PHQ-9 score for individuals with chronic diseases was 6.5\u0026ndash;11(Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e5\u003c/span\u003e) while individuals with Coronary heart diseases (N\u0026thinsp;=\u0026thinsp;52, med\u0026thinsp;=\u0026thinsp;9), Stroke of the brain (N\u0026thinsp;=\u0026thinsp;27, med\u0026thinsp;=\u0026thinsp;11), Cataracts (N\u0026thinsp;=\u0026thinsp;22, med\u0026thinsp;=\u0026thinsp;10.5) and other chronic diseases had relatively high PHQ-9 scores (\u0026gt;\u0026thinsp;8).The proportion of people with chronic diseases such as Fracture (N\u0026thinsp;=\u0026thinsp;253, 80.24%), Coronary heart disease (N\u0026thinsp;=\u0026thinsp;52, 84.62%), Parkinson's disease (N\u0026thinsp;=\u0026thinsp;4, 100%) consuming sugary drinks every week was relatively high (more than 80%), while the proportion of people with diabetes ingested the least (N\u0026thinsp;=\u0026thinsp;127, 53.54%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution characteristics of chronic diseases (N\u0026thinsp;=\u0026thinsp;2429), weekly intake of sugary drinks and PHQ-9 scores in middle-aged and young adults.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eType of chronic diseases\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNumber\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePHQ-9\u003c/p\u003e\u003cp\u003e(median)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003eSugary drink per week(ml)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;900\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e900\u0026ndash;1800\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;1800\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStroke of the brain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e22.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e18.52\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCataracts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e27.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e22.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e13.64\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic respiratory diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e7.69\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCoronary heart disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e44.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e21.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e19.23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic gastroenteritis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e603\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e55.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e6.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e386\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e35.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e47.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e6.99\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e563\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e58.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e19.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e7.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFracture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e253\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e19.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e48.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e7.91\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFatty liver disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e173\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e26.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e49.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e15.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e9.25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOsteoporosis of bone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e5.92\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e46.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e37.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e6.30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBenign tumor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e53.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e7.61\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic kidney disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e56.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e14.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e8.33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eViral hepatitis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e29.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12.20\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eArthritis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e234\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e32.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e8.55\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbnormal blood lipids\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e232\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e38.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e44.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e7.33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMalignant tumor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e28.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e57.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.86\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParkinson's disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e25.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e75.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe prevalence rate of chronic diseases among people aged 29 to 48 years was 19.79%, higher than those between 19 to 28 (19.79% vs 8.94%) and 12 to 18 years old (19.79% vs 13.35%) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e6\u003c/span\u003e). The weekly intake of sugary drinks among people aged 29 to 48 years old was the lowest, and that among people without intake was 39.69%, 26.5% and 21.93% higher than those between 19 to 28 and 12 to 18 years old. Among people without chronic diseases, PHQ-9 scores were positively correlated with the intake of sugary drinks, especially among minors (12\u0026ndash;18 years old, Kruskal. \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eKruskal Test between weekly intake of sugary drinks, PHQ-9 scores and chronic disease in middle-aged and young adults (N\u0026thinsp;=\u0026thinsp;17664).\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003cp\u003e(years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNumber of\u003c/p\u003e\u003cp\u003epathologies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNumber\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eRatio\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e\u003cp\u003eSugary drink per week(ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKruskal.P\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;900\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e900\u0026ndash;1800\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;1800\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e12\u0026ndash;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2376\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17.76%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e55.30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e18.69%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8.25%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2223\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e93.56%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003e3.25\u0026times;10\u003c/em\u003e\u003csup\u003e\u003cem\u003e\u0026minus;\u0026thinsp;26\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.56%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e6.56\u003cem\u003e\u0026times;10\u003c/em\u003e\u003csup\u003e\u0026minus;\u0026thinsp;2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTwo or more\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.88%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e14.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e19\u0026ndash;28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8385\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.19%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e59.38%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e19.65%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7.78%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7475\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e89.15%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003e3.15\u0026times;10\u003c/em\u003e\u003csup\u003e\u0026minus;\u0026thinsp;19\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e774\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.23%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003e0.03\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTwo or more\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e136\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.62%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.49\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e29\u0026ndash;48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6903\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e39.69%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e45.55%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4.56%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5537\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80.21%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003e2.77\u0026times;10\u003c/em\u003e\u003csup\u003e\u0026minus;\u0026thinsp;31\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1041\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.08%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003e4.54\u0026times;10\u003c/em\u003e\u003csup\u003e\u0026minus;\u0026thinsp;6\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTwo or more\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e325\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.71%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003e6.28\u0026times;10\u003c/em\u003e\u003csup\u003e\u0026minus;\u0026thinsp;4\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows that among the people suffering from only one pathology, the PHQ-9 score of the people who properly consumed sugary drinks every week (\u0026lt;\u0026thinsp;900ml per week) was relatively low, especially the people aged 12\u0026ndash;28. Among people suffering from multiple pathologies, PHQ-9 scores were positively correlated with the intake of sugary drinks. Additionally, among middle-aged and young people, especially the 19\u0026ndash;28 range, those who properly consumed sugary drinks every week (\u0026lt;\u0026thinsp;900ml per week) had relatively low PHQ-9 scores.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we demonstrated that middle-aged and young people (\u0026lt;\u0026thinsp;48 years old) with depression are at a higher risk of developing chronic diseases, and we are the first one to report that a moderate amount of sugary drinks intakes (\u0026lt;\u0026thinsp;900ml per week) was associated with the well-beings of middle-aged and young adults in a Chinese population.\u003c/p\u003e\u003cp\u003eDemographic characteristics and various conditions are known to be associated with the risk of developing chronic diseases, including age, gender, smoking status, residence, mental status, education, marital status, and income. In this study, the risk of developing chronic diseases was positively associated with age, which was in consistency with previous studies(Prasad et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Niccoli and Partridge, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). We found that middle-aged and young people with depressive symptoms had a significant predisposition to developing chronic diseases, as characterized by more than one pathology manifestation. Reciprocally, people developing chronic diseases, whether with only one pathology or multiple pathologies, were mainly presented with moderate to severe depressive symptom (PHQ-9\u0026thinsp;\u0026gt;\u0026thinsp;10). The reasons behind this could be attributable to increased inflammation, physiologic changes such as heart rate, contractility and metabolic regulation including stress hormones release. A Chinese nationwide study showed that the degree of pain played a critical role on chronic disease and depression in people aged 45 years and older(Ma et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Limitation of activities could also lead to continuing withdrawal from rewarding participation, having an substantial impact on quality of life(Prince et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e1998\u003c/span\u003e)(Spitzer et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e1995\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe association between sugary drinks consumption and the ease of depressive symptoms and/or chronic diseases have not been explained explicitly yet. We observed that a moderate amount of sugary drinks (\u0026lt;\u0026thinsp;900 per week) intake could be a potentially protective factor in chronic diseases development in middle-aged and young people, and the controlled intake of sugary drinks could also improve depression mutually. Previously, the consumption of sugary drinks was considered as positively correlated with mortality rate through cardiovascular incidents in US adults(Malik et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Although the excessive sugar intake may cause fluctuations in blood sugar and lead to inflammation, the psychological factors such as emotional stability after sugary drinks consumption may contribute to a balanced physical and mental health. Previous studies stated that limiting the intake of sugary consumption may cause the increase of plasma high-density lipoprotein cholesterol (HDL) cholesterol levels(Wise, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), which may be conveyed as a protective factor in lowering the risk of chronic diseases such as chronic kidney disease(Heo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e)(Zoppini et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). HDL is provided as a critically diagnostic and therapeutic biomarker for predicting cardiovascular diseases via altering the inflammation status(Lanktree et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2018\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Miao et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2021\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Wang et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2020\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Estrada-Luna et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Kim et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2021\u003c/span\u003e)\u003csup\u003e,\u003c/sup\u003e(Otocka-Kmiecik et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). A prospective from UK showed that a lower consumption of sugary drinks may reduce the risk of developing CKD. However, patient-level phenotype and genotype information were unavailable in these studies. What\u0026rsquo;s more, interpretation should be noted with caution in regard to the consumption number of sugary drinks. Indeed, in our study, PHQ-9 scores were found to be positively associated with the intake of sugary drinks in people without chronic diseases. Therefore, it is important and feasible to prioritize a well-controlled intake of sugary drink consumption in people with depression.\u003c/p\u003e\u003cp\u003eThere are still several limitations in our study. Firstly, due to the nature of survey, the self-reported data may introduce recall bias and imprecise measurements of sugary drinks consumption. However, we have thus adjusted potential confounders as much as possible so as to establish a causal relationship between sugary drinks intake and the risk of developing chronic diseases in people with depression. Moreover, the heterogeneity and complexity of depression make it difficult to generalize findings across diverse ethnics. Taking this into consideration, other confounding factors, such as dietary patterns, workout frequency, et al., could also be analyzed accordingly in various populations. Although we have added first evidence suggesting the advantages of having a limited amount (\u0026le;\u0026thinsp;900ml/week) of sugary drinks in reducing the prevalence of chronic diseases in people with depressive symptoms, it is important to interpret this finding with caution and not use it as a justification for excessive sugary drink consumption without mentioning about consumption limitation. Further research is warranted to fully understand the potential mechanisms and implications of this intriguing relationship between sugary drinks and risks of chronic diseases in individuals of different age groups with depressive symptoms. Furthermore, studies in analyzing other populations should also be noted for a confirmed conclusion worldwide.\u003c/p\u003e\u003cp\u003eIn summary, limited consumption of sugary drinks (\u0026le;\u0026thinsp;900ml per week) can resist the onset of depressive symptoms as presented by a comparatively lower PHQ-9 scoring, which can ultimately decrease the prevalence of chronic diseases as presented by one or more pathologies, especially for those younger than 48 years old. There is no doubt a need for greater consumer understanding of dichotomous role of sugary drinks, which could probably be achieved through educational avenues like public education campaigns or on-package information labels to allow for a much well-informed recommendations for overall public health.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has been registered with the China Clinical Trials Registry, registration number ChiCTR2200061046.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of competing interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data for the current study are included in figures/tables in the main text, or the supplemental data. These data are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful for the data support provided by Psychological and Behavioral Survey of Chinese Residents (PBICR).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eXinyi Kong developed the conception and designed the study. Jialei Chen and Jie Li assisted with data acquisition. Xia Yang, Kui Li, Zicheng Jiang, Shishi Ma and Lingyun Kong performed data analysis and interpretation. Xinyi Kong drafted the original manuscript with input from all authors, Shishi Ma and Lingyun Kong supervised the study. All authors\u0026nbsp;approved of the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBi, Y.H., Pei, J.J., Hao, C., Yao, W., Wang, H.X., 2021. The relationship between chronic diseases and depression in middle-aged and older adults: A 4-year follow-up study from the China Health and Retirement Longitudinal Study. J. Affect. Disord. 289, 160\u0026ndash;166. https://doi.org/10.1016/j.jad.2021.04.032\u003c/li\u003e\n\u003cli\u003eBomback, A.S., Derebail, V.K., Shoham, D.A., Anderson, C.A., Steffen, L.M., Rosamond, W.D., Kshirsagar, A. V, 2010. Sugar-sweetened soda consumption, hyperuricemia, and kidney disease. Kidney Int. 77, 609\u0026ndash;616. https://doi.org/https://doi.org/10.1038/ki.2009.500\u003c/li\u003e\n\u003cli\u003eChazelas, E., Srour, B., Desmetz, E., Kesse-Guyot, E., Julia, C., Deschamps, V., Druesne-Pecollo, N., Galan, P., Hercberg, S., Latino-Martel, P., Deschasaux, M., Touvier, M., 2019. Sugary drink consumption and risk of cancer: results from NutriNet-Sant\u0026eacute; prospective cohort. BMJ 366, l2408. https://doi.org/10.1136/bmj.l2408\u003c/li\u003e\n\u003cli\u003eChen, Y., Bennett, D., Clarke, R., Guo, Y., Yu, C., Bian, Z., Ma, L., Huang, Y., Sun, Q., Zhang, N., Zheng, X., Chen, J., Peto, R., Kendler, K.S., Li, L., Chen, Z., 2017. Patterns and correlates of major depression in Chinese adults: a cross-sectional study of 0.5 million men and women. Psychol. Med. 47, 958\u0026ndash;970. https://doi.org/10.1017/S0033291716002889\u003c/li\u003e\n\u003cli\u003ede Koning, L., Malik, V.S., Kellogg, M.D., Rimm, E.B., Willett, W.C., Hu, F.B., 2012. Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation 125, 1735\u0026ndash;41, S1. https://doi.org/10.1161/CIRCULATIONAHA.111.067017\u003c/li\u003e\n\u003cli\u003ede Lorgeril, M., Salen, P., Rabaeus, M., 2020. Sugary drinks and cancer risk. Transl. Cancer Res. https://doi.org/10.21037/tcr-2020-003\u003c/li\u003e\n\u003cli\u003eEstrada-Luna, D., Ortiz-Rodriguez, M.A., Medina-Brise\u0026ntilde;o, L., Carre\u0026oacute;n-Torres, E., Izquierdo-Vega, J.A., Sharma, A., Cancino-D\u0026iacute;az, J.C., P\u0026eacute;rez-M\u0026eacute;ndez, O., Belefant-Miller, H., Betanzos-Cabrera, G., 2018. Current Therapies Focused on High-Density Lipoproteins Associated with Cardiovascular Disease. Molecules 23. https://doi.org/10.3390/molecules23112730\u003c/li\u003e\n\u003cli\u003eFonseca-Pedrero, E., D\u0026iacute;ez, A., perez-albeniz, A., Al-Halab\u0026iacute;, S., Lucas-Molina, B., Debban\u0026eacute;, M., 2023. Youth Screening Depression: Validation of the Patient Health Questionnaire-9 (PHQ-9) in a representative sample of adolescents. Psychiatry Res. 115486. https://doi.org/10.1016/j.psychres.2023.115486\u003c/li\u003e\n\u003cli\u003eFung, T.T., Malik, V., Rexrode, K.M., Manson, J.E., Willett, W.C., Hu, F.B., 2009. Sweetened beverage consumption and risk of coronary heart disease in women. Am. J. Clin. Nutr. 89, 1037\u0026ndash;1042. https://doi.org/10.3945/ajcn.2008.27140\u003c/li\u003e\n\u003cli\u003eHeo, G.Y., Koh, H.B., Park, J.T., Han, S.H., Yoo, T.-H., Kang, S.-W., Kim, H.W., 2024. Sweetened Beverage Intake and Incident Chronic Kidney Disease in the UK Biobank Study. JAMA Netw. open 7, e2356885. https://doi.org/10.1001/jamanetworkopen.2023.56885\u003c/li\u003e\n\u003cli\u003eHesketh, T., Zhen, Y., Lu, L., Dong, Z.X., Jun, Y.X., Xing, Z.W., 2010. Stress and psychosomatic symptoms in Chinese school children: cross-sectional survey. Arch. Dis. Child. 95, 136\u0026ndash;140. https://doi.org/10.1136/adc.2009.171660\u003c/li\u003e\n\u003cli\u003eHu, F.B., 2013. Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes. Rev. an Off. J. Int. Assoc. Study Obes. 14, 606\u0026ndash;619. https://doi.org/10.1111/obr.12040\u003c/li\u003e\n\u003cli\u003eInfurna, F.J., Gerstorf, D., Lachman, M.E., 2020. Midlife in the 2020s: Opportunities and challenges. Am. Psychol. 75, 470\u0026ndash;485. https://doi.org/10.1037/amp0000591\u003c/li\u003e\n\u003cli\u003eKim, J.Y., Park, J.T., Kim, H.W., Chang, T.-I., Kang, E.W., Ahn, C., Oh, K.-H., Lee, J., Chung, W., Kim, Y.-S., Kim, S.W., Yoo, T.-H., Kang, S.-W., Han, S.H., 2021. Inflammation Alters Relationship Between High-Density Lipoprotein Cholesterol and Cardiovascular Risk in Patients With Chronic Kidney Disease: Results From KNOW-CKD. J. Am. Heart Assoc. 10, e021731. https://doi.org/10.1161/JAHA.120.021731\u003c/li\u003e\n\u003cli\u003eKmietowicz, Z., 2018. Type 2 diabetes: sweetened drinks pose greater risk than other sugary foods. BMJ. https://doi.org/10.1136/bmj.k4943\u003c/li\u003e\n\u003cli\u003eKroenke, K., Spitzer, R.L., Williams, J.B.W., 2001. The PHQ-9. J. Gen. Intern. Med. 16, 606\u0026ndash;613. https://doi.org/10.1088/1751-8113/44/8/085201\u003c/li\u003e\n\u003cli\u003eLanktree, M.B., Th\u0026eacute;riault, S., Walsh, M., Par\u0026eacute;, G., 2018. HDL Cholesterol, LDL Cholesterol, and Triglycerides as Risk Factors for CKD: A Mendelian Randomization Study. Am. J. kidney Dis. Off. J. Natl. Kidney Found. 71, 166\u0026ndash;172. https://doi.org/10.1053/j.ajkd.2017.06.011\u003c/li\u003e\n\u003cli\u003eLeung, C.Y., Abe, S.K., Sawada, N., Ishihara, J., Takachi, R., Yamaji, T., Iwasaki, M., Hashizume, M., Inoue, M., Tsugane, S., 2021. Sugary Drink Consumption and Subsequent Colorectal Cancer Risk: The Japan Public Health Center-Based Prospective Cohort Study. Cancer Epidemiol. biomarkers Prev. a Publ. Am. Assoc. Cancer Res. cosponsored by Am. Soc. Prev. Oncol. 30, 782\u0026ndash;788. https://doi.org/10.1158/1055-9965.EPI-20-1364\u003c/li\u003e\n\u003cli\u003eLiu, Q., Cai, H., Yang, L.H., Xiang, Y.B., Yang, G., Li, H., Gao, Y.T., Zheng, W., Susser, E., Shu, X.O., 2018. Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people. Sci. Rep. 8, 1\u0026ndash;11. https://doi.org/10.1038/s41598-018-22175-2\u003c/li\u003e\n\u003cli\u003eMa, Y., Xiang, Q., Yan, C., Liao, H., Wang, J., 2021. Relationship between chronic diseases and depression: the mediating effect of pain. BMC Psychiatry 21, 1\u0026ndash;11. https://doi.org/10.1186/s12888-021-03428-3\u003c/li\u003e\n\u003cli\u003eMalik, V.S., Hu, F.B., 2022. The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nat. Rev. Endocrinol. 18, 205\u0026ndash;218. https://doi.org/10.1038/s41574-021-00627-6\u003c/li\u003e\n\u003cli\u003eMalik, V.S., Li, Y., Pan, A., Koning, L. De, Schernhammer, E., Willett, W.C., Hu, F.B., 2019. Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults. Circulation 139, 2113\u0026ndash;2125. https://doi.org/10.1161/CIRCULATIONAHA.118.037401\u003c/li\u003e\n\u003cli\u003eMalik, V.S., Willett, W.C., Hu, F.B., 2013. Global obesity: trends, risk factors and policy implications. Nat. Rev. Endocrinol. 9, 13\u0026ndash;27. https://doi.org/10.1038/nrendo.2012.199\u003c/li\u003e\n\u003cli\u003eMathers, C.D., Loncar, D., 2006. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 3, e442. https://doi.org/10.1371/journal.pmed.0030442\u003c/li\u003e\n\u003cli\u003eMiao, L., Min, Y., Qi, B., Zhu, C.-M., Chen, J.-H., Deng, G.-X., Wang, Y., Li, J.-F., Li, R.-S., 2021. Causal effect between total cholesterol and HDL cholesterol as risk factors for chronic kidney disease: a mendelian randomization study. BMC Nephrol. 22, 35. https://doi.org/10.1186/s12882-020-02228-3\u003c/li\u003e\n\u003cli\u003eMullick, M.S.I., Goodman, R., 2005. The prevalence of psychiatric disorders among 5\u0026ndash;10 year olds in rural, urban and slum areas in Bangladesh. Soc. Psychiatry Psychiatr. Epidemiol. 40, 663\u0026ndash;671. https://doi.org/10.1007/s00127-005-0939-5\u003c/li\u003e\n\u003cli\u003eNestler, E.J., Barrot, M., DiLeone, R.J., Eisch, A.J., Gold, S.J., Monteggia, L.M., 2002. Neurobiology of depression. Neuron 34, 13\u0026ndash;25. https://doi.org/10.1016/s0896-6273(02)00653-0\u003c/li\u003e\n\u003cli\u003eNiccoli, T., Partridge, L., 2012. Ageing as a Risk Factor for Disease. Curr. Biol. 22, R741\u0026ndash;R752. https://doi.org/https://doi.org/10.1016/j.cub.2012.07.024\u003c/li\u003e\n\u003cli\u003eOffice of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S.D. of H. and H.S., n.d. Healthy People 2030 [WWW Document]. URL https://health.gov/healthypeople/objectives-and-data/browse-objectives\u003c/li\u003e\n\u003cli\u003eOtocka-Kmiecik, A., Mikhailidis, D.P., Nicholls, S.J., Davidson, M., Rysz, J., Banach, M., 2012. Dysfunctional HDL: a novel important diagnostic and therapeutic target in cardiovascular disease? Prog. Lipid Res. 51, 314\u0026ndash;324. https://doi.org/10.1016/j.plipres.2012.03.003\u003c/li\u003e\n\u003cli\u003ePopkin, B.M., 2010. Patterns of beverage use across the lifecycle. Physiol. Behav. 100, 4\u0026ndash;9. https://doi.org/10.1016/j.physbeh.2009.12.022\u003c/li\u003e\n\u003cli\u003ePrasad, S., Sung, B., Aggarwal, B.B., 2012. Age-associated chronic diseases require age-old medicine: role of chronic inflammation. Prev. Med. (Baltim). 54 Suppl, S29-37. https://doi.org/10.1016/j.ypmed.2011.11.011\u003c/li\u003e\n\u003cli\u003ePrince, M.J., Harwood, R.H., Thomas, A., Mann, A.H., 1998. A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol. Med. 28, 337\u0026ndash;350. https://doi.org/10.1017/s0033291797006478\u003c/li\u003e\n\u003cli\u003eRosinger, A., Herrick, K.A., Gahche, J.J., Park, S., n.d. Sugar-sweetened beverage consumption among U.S. youth, 2011-2014. NCHS Data Brief, NCHS data brief ; no. 271.\u003c/li\u003e\n\u003cli\u003eSekhar, D.L., Batra, E., Schaefer, E.W., Walker-Harding, L.R., Pattison, K.L., Molinari, A., Rosen, P., Kraschnewski, J.L., Waxmonsky, J.G., 2022. Adolescent Suicide Risk Screening: A Secondary Analysis of the SHIELD Randomized Clinical Trial. J. Pediatr. 251, 172\u0026ndash;177. https://doi.org/https://doi.org/10.1016/j.jpeds.2022.07.036\u003c/li\u003e\n\u003cli\u003eSpitzer, R.L., Kroenke, K., Linzer, M., Hahn, S.R., Williams, J.B., deGruy, F.V. 3rd, Brody, D., Davies, M., 1995. Health-related quality of life in primary care patients with mental disorders. Results from the PRIME-MD 1000 Study. JAMA 274, 1511\u0026ndash;1517.\u003c/li\u003e\n\u003cli\u003eThe Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S.D. of H. and H.S., n.d. Mental Health and Mental Disorders [WWW Document]. URL https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders\u003c/li\u003e\n\u003cli\u003eVanderlee, L., Czoli, C.D., Pauz\u0026eacute;, E., Potvin Kent, M., White, C.M., Hammond, D., 2021. A comparison of self-reported exposure to fast food and sugary drinks marketing among parents of children across five countries. Prev. Med. (Baltim). 147, 106521. https://doi.org/10.1016/j.ypmed.2021.106521\u003c/li\u003e\n\u003cli\u003eWang, L., Xiang, F., Ji, J., Ding, X., Shen, B., Chen, J., Chen, Y., Xue, N., Zhang, L., Jiang, X., Cao, X., 2020. Indoxyl sulfate and high-density lipoprotein cholesterol in early stages of chronic kidney disease. Ren. Fail. 42, 1157\u0026ndash;1163. https://doi.org/10.1080/0886022X.2020.1845731\u003c/li\u003e\n\u003cli\u003eWang, YuJia, Kaierdebieke, A., Fan, S., Zhang, R., Huang, M., Li, H., Sun, XiaoNan, Li, Q., Meng, W., Wu, W., Lin, Z., Liu, J., Wang, X., Wu, YunChou, Tang, J., Sun, Y., Chen, K., Ge, P., Ming, W., Zhang, C., Feei, Z., Feng, L., Zhang, X., Niu, Y., Yan, Y., Jin, Y., Dai, S., Li, Y., Tan, Y., Wu, YiWei, Zhang, Q., Gui, G., Pan, X., Liao, Y., Zhao, X., Zhang, Y., Chen, H., Qiu, Y., Fu, X., JiangLing Zhou, J.Z., Li, D., Li, K., Xu, M., Wang, Z., Wang, YueQi, Ma, Y., Sun, XinYing, Wu, YiBo, 2022. Study protocol: A cross-sectional study on psychology and behavior investigation of Chinese residents, PBICR. Psychosom. Med. Res. 4, 19. https://doi.org/10.53388/202219\u003c/li\u003e\n\u003cli\u003eWise, J., 2015. Reducing sugary drink intake is linked to raised HDL cholesterol levels. BMJ. https://doi.org/10.1136/bmj.h4738\u003c/li\u003e\n\u003cli\u003eWorld Health Organization, 2024. Aging and health [WWW Document]. URL https://www.who.int/china/health-topics/ageing#:~:text=402 million by 2040,over the age of 60.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization, 2022. Mental disorders [WWW Document]. World Heal. Organ. URL https://www.who.int/news-room/fact-sheets/detail/mental-disorders\u003c/li\u003e\n\u003cli\u003eXia, N., Lin, J., Ding, S., Dong, F., Shen, J., Du, Y., Wang, X., Chen, Y., Zhu, Z., Zheng, R., Xu, H., 2019. Reliability and validity of the Chinese version of the Patient Health Questionnaire 9 (C-PHQ-9) in patients with epilepsy. Epilepsy Behav. 95, 65\u0026ndash;69. https://doi.org/https://doi.org/10.1016/j.yebeh.2019.03.049\u003c/li\u003e\n\u003cli\u003eYe, X., Shu, H.-L., Feng, X., Xia, D.-M., Wang, Z.-Q., Mi, W.-Y., Yu, B., Zhang, X.-L., Li, C., 2020. Reliability and validity of the Chinese version of the Patient Health Questionnaire-9 (C-PHQ-9) in patients with psoriasis: a cross-sectional study. BMJ Open 10, e033211. https://doi.org/10.1136/bmjopen-2019-033211\u003c/li\u003e\n\u003cli\u003eYuzbashian, E., Asghari, G., Mirmiran, P., Zadeh-Vakili, A., Azizi, F., 2016. Sugar-sweetened beverage consumption and risk of incident chronic kidney disease: Tehran lipid and glucose study. Nephrology (Carlton). 21, 608\u0026ndash;616. https://doi.org/10.1111/nep.12646\u003c/li\u003e\n\u003cli\u003eZhou, M., Wang, H., Zeng, X., Yin, P., Zhu, J., Chen, W., Li, X., Wang, Lijun, Wang, Limin, Liu, Y., Liu, J., Zhang, M., Qi, J., Yu, S., Afshin, A., Gakidou, E., Glenn, S., Krish, V.S., Miller-Petrie, M.K., Mountjoy-Venning, W.C., Mullany, E.C., Redford, S.B., Liu, H., Naghavi, M., Hay, S.I., Wang, Linhong, Murray, C.J.L., Liang, X., 2019. Mortality, morbidity, and risk factors in China and its provinces, 1990\u0026ndash;2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 394, 1145\u0026ndash;1158. https://doi.org/10.1016/S0140-6736(19)30427-1\u003c/li\u003e\n\u003cli\u003eZoppini, G., Targher, G., Chonchol, M., Perrone, F., Lippi, G., Muggeo, M., 2009. Higher HDL cholesterol levels are associated with a lower incidence of chronic kidney disease in patients with type 2 diabetes. Nutr. Metab. Cardiovasc. Dis. 19, 580\u0026ndash;586. https://doi.org/10.1016/j.numecd.2008.11.003\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"sugary drinks, sugary consumption, chronic diseases, middle-aged and young adults, depression","lastPublishedDoi":"10.21203/rs.3.rs-7131825/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7131825/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eThe aim of this cross-sectional study is to evaluate the association between a moderate intake of sugary drinks and the prevalence of chronic diseases in middle-aged and young Chinese adults with depression.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eA cross-sectional survey was conducted in 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in China from June 20 to August 31, 2022. Effect estimates, including odds ratios (ORs) and their corresponding 95% confidence intervals (Cis), were used to assess the strength of independent variables and chronic disease prevalence.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eA total of 24614 participants were included in this cross-sectional study. Univariate analysis showed that the prevalence of chronic diseases gradually increased with age (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). People under the age of 48 with depressive symptoms had a significantly higher risk of developing chronic diseases (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Moderate consumption of sugary drinks (\u0026le;\u0026thinsp;900ml/week) was correlated with the occurrence of chronic diseases with a reduced risk for about 5% compared to those consume hardly any sugary drinks or excessive amount of sugary drinks (\u0026ge;\u0026thinsp;900ml/week) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e\u003cp\u003eWe observed that a moderate consumption of sugary drinks was correlated with a lower prevalence of chronic diseases in middle-aged and young adults with depression in Chinese populations, promoting a well-informed recommendation of sugary drinks intake for public well-beings, especially the middle-aged and young adults.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e\u003cp\u003eThis study has been registered with the China Clinical Trials Registry, registration number ChiCTR2200061046.\u003c/p\u003e","manuscriptTitle":"Association of sugary drinks intake with chronic diseases in people with depression —a national cross-sectional analysis in a Chinese population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-11 10:49:54","doi":"10.21203/rs.3.rs-7131825/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fbe9969d-eb3f-409f-85c6-f13f4680afe7","owner":[],"postedDate":"August 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":52727745,"name":"Health sciences/Diseases"},{"id":52727747,"name":"Health sciences/Health care"},{"id":52727749,"name":"Health sciences/Medical research"},{"id":52727751,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-03-04T12:56:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-11 10:49:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7131825","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7131825","identity":"rs-7131825","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}