Objective To explore the association between processed food consumption and anxiety symptoms among college students in Yunnan Province,so as to provide a reference for the prevention and treatment of anxiety symptoms in this population.Methods A cluster random sample of 2 515 first-year students from two universities in Yunnan Province was selected to carry out a longitudinal investigation which included a baseline survey(November 2021,Tl)and three follow-up visits(June 2022,T2;No-vember 2022,T3;June 2023,T4).The food frequency questionnaire was administered to assess processed food consumption,and the Depression Anxiety Stress Scale-21(DASS-21,Chinese version)was used to evaluate anxiety symptoms.A generalized estima-tion equation model was used to analyze the relationship between processed food consumption and anxiety symptoms.Results The detection rates of T1-T4 anxiety symptoms among college students in Yunnan Province were 29.70％,36.70％,37.69％and 38.73％,respectively,and the corresponding anxiety symptom scores were 4(0,8),4(0,10),4(0,12),2(0,14).After control-ling for demographic variables and confounding factors in the generalized estimation equation model,a statistically significant associ-ation was found between consumption of carbonated beverages(β=0.06,95％CI=0.03-0.08),and other processed snacks(β=0.04,95％CI=0.01-0.07)(P＜0.05).The stratified analysis by gender showed that the consumption of carbonated beverages(β=0.08,95％CI=0.05-0.12)and fast food(β=0.03,95％CI=0.00-0.06)was significantly associated with anxiety symptoms in fe-male college students(P＜0.05).There was no significant association between processed food consumption and anxiety symptoms in male college students(P＞0.05).Conclusions Processed food consumption by college students in Yunnan Province may increase the risk of anxiety symptoms,particularly among female students.There is a need to strengthen guidance in respect to processed food consumption,so as to prevent and treat anxiety symptoms.
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