Association Between Ultra-Processed Food Consumption and Risk of Developing Depression in Adults: A Systematic Review

Objective We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders. Methods The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model. Results Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 = 77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001). Conclusion Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.

Background: Global ultra-processed food (UPF) consumption has risen rapidly. The development and prognosis of depression and anxiety remain unclarified. Herein, we aimed to examine the association between UPF consumption and the incidence and progression trajectory of depression and anxiety. Methods: In our study, participants were recruited between 2006 and 2010. UPF consumption was expressed as UPF servings, energy ratio, and weight ratio. The relationships between UPF consumption and depression or anxiety were assessed using the Cox proportional hazards model. Multi-state models were used to explore the association between UPF consumption and the risks of all transitions from a healthy state to depression or anxiety and then to all-cause mortality. Results: Among the 183 474 participants, 5453 were diagnosed with depression and 6763 with anxiety during the follow-up of 13.1 years. The participants in the highest quartile (Q4) of UPF servings, energy ratio, and weight ratio had an increased risk of depression compared to those in the lowest quartile (Q1), with hazard ratios (HRs) and 95% confidence intervals [CIs] of 1.22 (1.13-1.31), 1.13 (1.05-1.22), and 1.26 (1.17-1.36), respectively. Similarly, participants in Q4 of UPF consumption had a higher risk of anxiety, with HRs (95% CIs) of 1.13 (1.06-1.21), 1.13 (1.05-1.21), and 1.11 (1.04-1.19), compared to those in Q1. The study also found a significant association between UPF consumption and all-cause mortality, which disappeared for participants with depression or anxiety. Conclusions: Our findings revealed that UPF consumption is associated with depression or anxiety.

The joint associations of physical activity and ultra-processed food consumption with depression: A cohort study in the UK Biobank

Background: Many low- and middle-income countries are now facing the “double burden” of malnutrition, one of them is overweight/obesity. Over 340 million children and adolescents were overweight and obesity in 2016. Obesity among adolescents may increase, in part due to changes in the food system, which now offers a wide range of ultra-processed foods (UPF) that minimize preparation time. Indonesia has also a large and rapidly growing market for unhealthy drinks, which are sold in various places including schools and hospitals. Objective: This study aimed to investigate the association of UPF and beverages consumption and other related factors with nutritional status of senior high school students in Pontianak, West Kalimantan, Indonesia. Methods: This cross-sectional study conducted in Pontianak investigated the association between UPF consumption and nutritional status of SHS students. Data collection was conducted at Imanuel and Petrus SHS Pontianak in June 2023, involving 273 students from grades 10th and 11th. Weight and height measurement was obtained for calculating the BMI for age Z-scores, while UPF and beverages consumption was obtained by FFQ. Structured questionnaire, 24-hours recall, and IPAQ-S were used for assessing sociodemographic status, Total Energy Intake and Physical Activity Level. Data analysis used SPSS version 26. Results: The result found 40.3% of students were overweight-obesity; 51.6% consumed excessive UPF and beverages. It showed an inverse association between UPF consumption and nutritional status. The study identifies UPF and beverages consumption, gender, mother's education level, and family income as factors associated with nutritional status among adolescents. Conclusion: The consumption of ultra-processed Foods was high, with the highest UPF intake came from snacks and sweets (22.4%). There was inverse association between UPF and beverages consumption with nutritional status. There was also significant association between UPF and beverages, gender, mother education level and family income with nutritional status.

Nutrition and Kidney Health: Processing Emerging Evidence About Foods

This study aimed to examine the interactions between ultraprocessed food (UPF) consumption and genetic predisposition with the risk of gout. This prospective cohort study analysed 181 559 individuals from the UK Biobank study who were free of gout at baseline. UPF was defined according to the NOVA classification. Assessment of genetic predisposition for gout was developed from a genetic risk score of 33 single nucleotide polymorphisms. Cox proportional hazards were used to estimate the associations between UPF consumption, genetic predisposition and the risk of gout. Among the 181 559 individuals in the study, 1558 patients developed gout over 1 648 167 person-years of follow-up. In the multivariable adjustment model, compared with the lowest quartile of UPF consumption, the hazard ratio (HR) and 95% CI of the highest UPF consumption was 1.16 (1.01, 1.33) for gout risk, and there was a non-linear correlation between UPF consumption and the development of gout. In substitution analyses, replacing 20% of the weight of UPF in the daily intake with an equal amount of unprocessed or minimally processed food resulted in a 13% lower risk of gout (HR: 0.87; 95% CI: 0.79, 0.95). In the joint-effect analysis, the HR (95% CI) for gout was 1.90 (1.39, 2.60) in participants with high genetic predisposition and high UPF consumption, compared with those with low genetic predisposition and low UPF consumption. In summary, UPF consumption was found to be associated with a higher risk of gout, particularly in those participants with genetic predisposition to gout. Our study indicated that reducing UPF consumption is crucial for gout prevention.

Introduction: Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States (US), yet their dietary patterns have seldom been described. Objectives: To characterize UPF consumption among AAs and determine whether acculturation is associated with increased UPF consumption. Methods: The National Health and Nutrition Examination Survey (NHANES) is an annual, cross-sectional survey representative of the US population. We examined NHANES dietary data, combining years in which AAs were over-sampled (2011-2018). We included 2,404 AAs ≥ 18 years old with valid 24-hour dietary recall data. Using day 1 dietary recalls, we characterized UPF consumption as the percentage of caloric intake from UPFs, using the NOVA classification system. This framework classifies foods from any culture based on degree of industrial processing. Acculturation was characterized by nativity, nativity/years in the US, home language, and an acculturation index (based on a sum of levels related to nativity/years in the US and home language). We assessed the relationship between each acculturation measure and UPF consumption using linear regression analyses adjusted for age, sex, marital status, education, income, self-reported health, and self-reported diet quality. All analyses accounted for the complex survey design. Results: Among all AAs, the percentage of caloric intake attributable to UPFs was 39.3% (95% CI: 38.1-40.5). In adjusted regression analyses, UPF consumption was 14% (95% CI: 9.5-17.5; p&lt;0.05) greater among those with the highest vs. lowest acculturation index score, 12% (95% CI: 8.5-14.7: p&lt;0.05) greater among those who speak English only vs. non-English only in the home, 12% (95% CI: 8.6-14.7: p&lt;0.05) greater among US-born vs. foreign-born AAs, and 15% (95% CI: 10.7-18.3: p&lt;0.05) greater among US-born vs. foreign-born AAs with less than ten years in the US. Conclusions: Among AAs, UPF consumption was common, and acculturation was strongly associated with greater proportional UPF intake. As the US-born AA population continues to grow, UPF consumption in this group is likely to increase. Further research is necessary to characterize trends in dietary patterns across disaggregated AA subgroups to better inform culturally tailored dietary interventions.

Objective: To assess the consumption of ultra-processed food and sugar-sweetened beverages and to identify the association of this consumption with overweight among vegetarians. Methods: A cross-sectional study with a convenience sampling method was conducted. Data were collected using an online questionnaire from 8/24/2015 to 10/8/2015. Subjects were male and female vegetarians aged &gt;16 years. Using a food frequency questionnaire, we assessed the weekly consumption of ultra-processed food and sugar-sweetened beverages and described the frequency of daily consumption overall and according to type of vegetarianism. The association between overweight and excessive daily intake of ultra-processed food was analyzed by multiple logistic regression (OR [95CI%]). Results: Information was retrieved from 503 individuals (29.8±8.5 years old); 83.7% were women. The most frequent types of vegetarianism in our sample were ovo-lacto (45.5%) and vegan (41.7%), and the median time of vegetarianism was 5.3 years. The consumption of sugar-sweetened beverages (≥2x/day) and ultra-processed food (≥3x/day) was 21.0% and 16.0%, respectively, and regarding the different vegetarianism types, vegans showed the lowest frequency of excessive daily sugar-sweetened beverages and ultra-processed food consumption. In the multivariable analysis, consumption of ultra-processed food ≥3x/day (2.33 [1.36-4.03]), male sex (1.73 [1.01-2.96]), age ≥35 years (2.03 [1.23-3.36]) and not preparing one’s food (1.67 [0.95-2.94]) were independently associated with overweight. Conclusion: Although vegetarianism is frequently associated with a healthier diet and, consequently, prevention of poor health outcomes, this study found that the excessive consumption of sugar-sweetened beverages and ultra-processed food was associated with overweight.

Impact of Fortified Ultra-Processed Foods on Risk of Anemia: A New Perspective for Pediatric Nutrition

BackgroundHigh consumption of UPFs has been proposed as a key driver in the global rise of non-communicable diseases. UK adolescents consume 66% of their daily energy (kcal/d) from UPFs. However,...

Background: During COVID-19, this study examined data on adolescents' eating habits. It proposes a new 'gateway food model' for ultra-processed foods (UPF). This model shows that certain UPFs when increased (decreased) drive consumption of other UPFs as well. This has important implications for managing hypertension risk factors since studies show that those in the highest tertile of UPF consumption have a higher risk of hypertension (adjusted HR, 1.21; CI, 1.06, 1.37; p = 0.004) (Mendonca, 2016). Methods: The study enrolled 315 participants aged 13-19 years in Florida, U.S. Participants' PIE scores (Processed Intake Evaluation scores, scale 0-100), were calculated based on averaged consumption of 12 ultra-processed food products. PIE scores, before COVID-19 in 2019, and after COVID-19 restrictions were eased in 2022, were assessed in the study. Results: The participants’ mean age was 16.2±1.4 years. The study classified participants into UPF+ (n=135) and UPF- (n=180) groups according to whether they increased or decreased their UPF intake during COVID-19. For both groups, a stepwise regression was employed to identify significant factors for change in UPF intake. In the UPF+ group, increased intake of candy, store pastries, or frozen desserts was associated with increased UPF intake across all other UPFs as well (+31.2, +12.0, or +10.5 respective change in PIE score, p&lt;0.01). Correspondingly, in the UPF- group, reduced intake of biscuits, white bread, or processed meat was associated with decreased overall UPF intake across all other UPFs as well (-9.6, -9.4, -8.6 respective change in PIE score, p&lt;0.01). Conclusions: Hypertension can begin during childhood and may be mediated by a focus on modifiable risk factors such as high UPF intake. These results indicate that for adolescents whose consumption of UPFs has not yet been established, certain gateway UPFs (candy, store pastries, and frozen desserts) should be given priority for preventive dietary interventions since increased intake in these UPFs leads to consumption of all other UPFs as well. In contrast, if an adolescent's UPF eating is already established, other UPFs (biscuits, white bread, or processed meat) can be targeted by dietary interventions as they decrease intake across all other UPFs.

Ultra-processed food consumption is positively associated with the incidence of depression in Brazilian adults (CUME project)

Whether ultra-processed food (UPF) consumption is associated with the risk of kidney stone is not explored. Furthermore, it remains unclear if kidney stone-related genetic predisposition could affect this association. Therefore, we aim to examine the associations of UPF consumption, genetic predisposition, and their interactions with the risk of kidney stone. In this study, 166,427 middle-aged participants from the UK Biobank were enrolled. UPF intake was assessed according to the NOVA food classification system and based on 24-h dietary recalls. A polygenic-risk score (PRS) of 20 single-nucleotide polymorphisms was calculated for kidney stone. Cox proportional hazards regression model was used to investigate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of incident kidney stone. After 1,510,300 person-years of follow-up, 1369 participants developed kidney stone. UPF consumption was positively associated with the risk of kidney stone (P for trend < 0.01). Compared with participants in the first tertile of UPF intake, those in the third tertile had a 24% (HR: 1.24; 95% CI 1.07-1.43) increased risk of kidney stone. Compared to total UPF intake, the consumption of UPF excluding yogurt and cereals was associated with a greater risk of kidney stones (HR: 1.32; 95% CI 1.15-1.51). Even though no significant interaction effect between UPF and PRS was found (P for interaction = 0.09), this association was only observed in participants with low and middle PRS, but not in those with high PRS. In the joint association analysis, compared to participants with low UPF consumption and PRS, those with high UPF consumption and PRS experienced the highest risk of kidney stone (HR: 1.95, 95% CI 1.51, 2.51). This association was consistently observed in participants regardless of sex, age, and BMI. The results demonstrated that higher consumption of UPF is associated with an increased risk of kidney stone. These insights could prove valuable for informing public health policies aimed at preventing kidney stone. Further intervention studies are needed to confirm and elaborate on our results.

Ultra-processed food consumption, genetic susceptibility, and the risk of hip/knee osteoarthritis

Ultra-processed food (UPF) consumption has been linked to increased risks of negative health outcomes such as type 2 diabetes, obesity, and all-cause mortality. Some studies have shown an increase of UPF consumption with acculturation, whereas the influence of the Western diet on non-US born individuals is an area of increasing interest. The aim of this work was to investigate UPF consumption with an acculturation index and to assess whether there was an interaction of UPF consumption with race/ethnicity in non-US born adults. Dietary intake of non-US born adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018 was assessed using day one of 24-h dietary recall, and the relative daily energy intake comprised of UPFs was used as the outcome of interest. The effect of acculturation assessed by an acculturation index (AcI) on UPF consumption was investigated after controlling for significant covariates. Complex survey sample regression analyses were used to evaluate the association between UPF consumption and AcI. Population sample (n = 3,639) was comprised of non-US born adults (50% male) between 19 and 70 (43.1 ± 0.40) years of age. Of the adults assessed, 42.2% had lower AcI scores of 0 to 2, whereas 57.8% were more accultured (AcI scores of 3-5). Overall, dietary energy from UPFs was about 43.3%. When controlling for co-variates, acculturation was significantly associated with UPF consumption (β = 0.03, s.e. = 0.004, p < 0.001), meaning that for every unit increase in AcI score, there was a 3 % increase in mean UPF consumption. When the interaction between AcI and race/ethnicity was assessed, there was no difference in the impact of AcI on UPF consumption among race/ethnicity groups (p = 0.052). Our findings indicate that greater acculturation is associated with higher UPF consumption. Given the links between high UPF consumption and adverse health outcomes, targeted interventions that promote healthier dietary choices-while preserving culturally relevant eating habits-are essential to support the well-being of non-US born populations.