High carbonated soft drink consumption is associated with externalizing but not internalizing behaviours among university students in five ASEAN states

Background: The investigation aimed to estimate the association between carbonated soft drink consumption frequency and externalizing and internalizing behaviour among university students in five ASEAN counties. Methods: A cross-sectional survey included 3353 university students from Indonesia, Malaysia, Myanmar, Thailand and Vietnam, median age 20 years (interquartile range 3 years). Results: In all five ASEAN countries, the study found a prevalence no soft drink consumption in the past 30 days of 20.3%, less than one time a day 44.7%, once a day 25.4% and two or more times a day 9.6%. In the adjusted logistic regression analysis, higher frequency of soft drink consumption (one and/or two or more times a day) was associated with externalizing behaviour (in physical fight, injury, current tobacco use, problem drinking, drug use, pathological internet use and gambling behaviour), and higher frequency of soft drink consumption (two or more times a day) was associated with depression in females, but no association was found for the general student population in relation to internalizing behaviour (depression, posttraumatic stress disorder, suicidal ideation, suicide plan, suicide attempt and sleeping problem). Conclusions: Findings suggest that carbonated soft drink consumption is associated with a number of externalizing but not internalizing health risk behaviours.