Abstract / Summary
Background: The prevalence of anxiety and depressive symptoms among children and adolescents has become a growing global public health concern. However, evidence regarding the association of milk and dairy intake with anxiety and depressive symptoms in children and adolescents remains inconsistent. Thus, we conducted a systematic review and meta-analysis to evaluate this association. Methods: PubMed, Embase, Ovid MEDLINE, Scopus, and Web of Science were systematically searched for observational studies published up to March 2026. Studies involving children and adolescents aged 6–19 years that assessed milk and dairy intake in relation to anxiety or depressive symptoms were eligible. Study quality was assessed using the National Institute of Health Quality of Observational Cohort and Cross-Sectional Studies tool. OR and 95% CI were pooled using a random-effects model. Subgroup and sensitivity analyses were conducted. The protocol was registered with PROSPERO (CRD420261328004). Results: A total of 10 studies were included, comprising eight cross-sectional studies and two cohort studies, with participants aged 7–19 years. A Meta-analysis of six cross-sectional studies (123,519 participants, eight effect sizes) found no significant association between dairy intake and depressive symptoms (OR = 0.70, 95% CI: 0.46–1.07, p = 0.10). Exploratory subgroup analyses suggested potential inverse associations among Asian children and adolescents (OR = 0.40, 95% CI: 0.17–0.94, p = 0.03) and for general dairy intake (OR = 0.39, 95% CI: 0.18–0.85, p = 0.02). Furthermore, only two individual studies reported inverse associations between milk and dairy intake and anxiety symptoms. However, these findings could not be quantitatively synthesized. Conclusions: Overall, milk and dairy intake was not significantly associated with depressive symptoms among children and adolescents. Exploratory subgroup analyses suggested potential inverse associations in the Asian subgroup and the general dairy intake subgroup. The evidence was limited by the predominance of cross-sectional studies, substantial heterogeneity, the small number of studies, limited geographic representation, and the inability to formally assess publication bias. Therefore, the findings should be interpreted cautiously, and further longitudinal studies are needed to clarify the temporal relationship between milk and dairy intake and mental health outcomes.