Abstract
BackgroundUltra-processed food (UPF) consumption has increased over the last decades in Westernized countries. Our objective was to investigate for the first time the association between the proportion of UPF (%UPF) in the diet and incident depressive symptoms in the NutriNet-Santé cohort.MethodsThe sample included 20,380 women and 6350 men (aged 18–86 years) without depressive symptoms at the first Center for Epidemiologic Studies Depression Scale (CES-D) measurement, using validated cut-offs (CES-D score ≥ 17 for men and ≥ 23 for women). The proportion of UPF in the diet was computed for each subject using the NOVA classification applied to dietary intakes collected by repeated 24-h records (mean = 8; SD = 2.3). The association between UPF and depressive symptoms was evaluated using multivariable Cox proportional hazards models.ResultsOver a mean follow-up of 5.4 years, 2221 incident cases of depressive symptoms were identified. After accounting for a wide range of potential confounders, an increased risk of depressive symptoms was observed with an increased %UPF in the diet. In the main model adjusted for sociodemographic characteristics, body mass index, and lifestyle factors, the estimated hazard ratio for a 10% increase in UPF was 1.21 (95% confidence interval = 1.15–1.27). Considering %UPF in food groups, the association was significant only for beverages and sauces or added fats.ConclusionOverall, UPF consumption was positively associated with the risk of incident depressive symptoms, suggesting that accounting for this non-nutritional aspect of the diet could be important for mental health promotion.
Highlights
Depression is a very common disorder, one of the five leading causes of years lived with disability in 2016 [1] and, according to WHO, the 1st leading cause of disease burden globally [2]
Adjibade et al BMC Medicine (2019) 17:78 that reported associations between these diets and depression considered nutritional characteristics of the diet and interaction within the food matrix. Some of those diets integrate a large part of ultra-processed food (UPF) which consumption has drastically increased over the past decades [11, 12]
In the French NutriNet-Santé study, Ultra-processed food (UPF) contributed to 35.9% of the daily energy intake and the proportion of UPF (%UPF) in the diet has been associated with a poor overall quality of the diet [14]
Summary
Depression is a very common disorder, one of the five leading causes of years lived with disability in 2016 [1] and, according to WHO, the 1st leading cause of disease burden globally [2]. Adjibade et al BMC Medicine (2019) 17:78 that reported associations between these diets and depression considered nutritional characteristics of the diet and interaction within the food matrix. Some of those diets integrate a large part of ultra-processed food (UPF) (i.e., industrial recipes that are practical, ready to eat, and palatable [10]) which consumption has drastically increased over the past decades [11, 12]. In the French NutriNet-Santé study, UPF contributed to 35.9% of the daily energy intake and the proportion of UPF (%UPF) in the diet has been associated with a poor overall quality of the diet [14]. Our objective was to investigate for the first time the association between the proportion of UPF (%UPF) in the diet and incident depressive symptoms in the NutriNet-Santé cohort
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