Uric Acid, BMI, and Neutrophil Lymphocyte Ratio Mediate the Relationship Between Soft Drink Consumption and Systolic Blood Pressure: A Nationwide Structural Equation Model Pathways Among Adolescents and Young Adults Across Indonesia.

This article investigates the mediating roles of body mass index (BMI), uric acid, and neutrophil-to-lymphocyte ratio (NLR) in the relationship between soft drink and fast-food consumption and systolic blood pressure (SBP) among Indonesian adolescents and young adults. Using a nationwide cross-sectional sample of 500 participants aged 10–24 years, the study found that soft drink consumption indirectly increases SBP through metabolic and inflammatory pathways involving BMI, NLR, and uric acid, whereas fast-food consumption showed weaker and nonsignificant mediation effects. The findings highlight the importance of early nursing-led interventions focusing on healthy dietary habits, metabolic screening, and school-based education to mitigate subclinical cardiovascular risk in this population. The study emphasizes the complex interplay between dietary sugar intake, metabolic dysregulation, inflammation, and blood pressure regulation in a rapidly urbanizing middle-income country context.