Dissecting ultra-processed foods and drinks: Do they have a potential to impact the brain?

Excess weight is associated with neurological and neuropsychiatric symptoms in post-COVID-19 condition: A systematic review and meta-analysis

BACKGROUND/PURPOSE

Excess weight has been identified as a potential risk factor for post-COVID-19 condition (PCC). This systematic review and meta-analysis aimed to investigate whether excess weight is associated with the development or experience of neurological and neuropsychiatric symptoms in PCC.

METHODS

We conducted a comprehensive search of eight databases (PubMed, Embase, Scopus, Web of Science, VHL, Google Scholar, ProQuest, and medRxiv) for studies published up to July 2023. Studies were included if they assessed PCC symptoms in relation to nutritional status, specifically the development of neurological and neuropsychiatric symptoms more than 12 weeks post-infection. The analysis compared exposure and controls groups (excess weight vs. normal weight; obesity vs. non-obesity). Data were synthesized using a random-effects model.

RESULTS

Of the 10,122 abstracts screened, 18 studies (n = 139,091 adults) were included. These studies included 79,050 individuals with excess weight vs 57,926 normal-weight individuals and 30,694 individuals with obesity vs 107,612 non-obese individuals. The presence of excess weight in PCC was significantly associated with persistent depression (RR = 1.21; 95% CI: 1.03-1.42), headache (OR = 1.23; 95% CI: 1.10-1.37), memory issues (RR = 1.43; 95% CI: 1.24-1.65), sleep disturbance (RR = 1.31; 95% CI: 1.16-1.48), and vertigo (RR = 1.21; 95% CI: 1.04-1.41). Obesity was significantly associated with persistent headache (OR = 1.45; 95% CI: 1.37-1.53), numbness (RR = 1.61; 95% CI: 1.46-1.78), smell disorder (OR = 1.16; 95% CI: 1.11-1.22), taste disorder (OR = 1.22; 95% CI: 1.08-1.38), and vertigo (RR = 1.44; 95% CI: 1.35-1.53).

CONCLUSIONS

Excess weight, including overweight and obesity, is associated with experiencing neuro-symptoms related to PCC. Individuals with these conditions urgently need enhanced personalized care management in current post-pandemic context.

Higher Ultraprocessed Food Consumption Is Associated With Depression Persistence and Higher Risk of Depression Incidence in the Brazilian Longitudinal Study of Adult Health

BACKGROUND

Ultraprocessed foods (UPF) consumption has been associated with depression risk, but its association with depression persistence is unclear.

OBJECTIVE

The objective of this study was to evaluate the association of UPF consumption with depression persistence and incidence.

DESIGN

The Brazilian Longitudinal Study of Adult Health is a multicenter prospective cohort study with 3 waves (2008-2010, 2012-2014, and 2017-2019). Baseline percentage of energy from UPF, measured using a food frequency questionnaire, was divided into quartiles.

PARTICIPANTS/SETTING

Civil servants aged 35 to 74 years at baseline were included in the Brazilian Longitudinal Study of Adult Health. Participants with Parkinson disease, dementia, stroke history, extreme energy intake, and missing dietary or depression data at baseline were excluded.

MAIN OUTCOME MEASURES

Depression was based on the Clinical Interview Schedule-Revised, depression persistence on depression status at each wave and depression incidence on time to first depression diagnosis.

STATISTICAL ANALYSES PERFORMED

Clustering large applications algorithm, multinomial logistic regression, Cox proportional-hazard models, and partition substitution model were performed.

RESULTS

Among 13 870 participants free from depression at baseline, 731 (5.3%) had depression after 8 years of follow-up. Participants in Cluster 1 did not have depression in any wave, in Cluster 2 had depression in 1 wave, and in Cluster 3 had persistent depression in 2 or more waves. Compared with the first quartile of UPF consumption, participants in Quartiles 2, 3, and 4 had a 1.30 (95% CI 1.29 to 1.31), 1.39 (95% CI 1.38 to 1.40), and 1.58 (95% CI 1.56 to 1.60) higher odds of persistent depression (P = .019), respectively. Compared with the first UPF quartile, participants in Quartiles 3 and 4 had a 1.32 (95% CI 1.07 to 1.64) and 1.30 (95% CI 1.04 to 1.61) higher risk of incident depression (P = .017), respectively. Substituting 5%, 10%, and 20% of UPF with unprocessed/minimally processed foods and culinary ingredients was associated with a 6%, 11%, and 22% decreased depression incidence, respectively.

CONCLUSIONS

Higher consumption of UPF at baseline was associated with higher odds of persistent depression and higher risk of incident depression over 8 years of follow-up.

The association between ultra-processed food consumption and adiposity indexes in adults living in Tehran: a dose-response analysis within a cross-sectional study

BACKGROUND

Ultra-process foods (UPF) were suspected to induce many diseases and threaten consumers' health. The aim of this study was to examine the association between the consumption of highly processed foods and adiposity indexes in Tehranian adults.

METHOD

In a cross-sectional design, 850 Tehranian adults were included. NOVA classification was used to assess the intake of UPF in participants. The amount of calorie intake through processed foods was assessed. Adiposity indexes outcomes include body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), visceral adiposity index (VAI), body roundness index (BRI), and body adiposity index (BAI). Lipid accumulation product (LAP) and triglyceride-glucose index (TyG) were also assessed. Binary logistic regression was used to evaluate the association between the intake of UPF and adiposity indexes measurements.

RESULT

there was a higher intake of UPF in men than women (p < 0.001). The results of logistic regression revealed that there is a significant association between intake of UPF with WHR (odds ratio (OR): 1.09, 95% confidence interval (CI): 0.73-1.61) and BRI (OR: 2.10, 95% CI: 1.38-3.19) in the crude model. Nevertheless, after adjusting for confounders, the results were insignificant (WHR: OR, 0.77, 95% CI, 0.46-1.27, and BRI: OR, 1.70, 95% CI, 1.05-2.73). No significant association was seen for other outcomes (p > 0.001 for all). The results of dose-response analyses revealed a substantial association between UPF intake and BMI, WHrT, WC, VAI, BRI, BAI, LAP, and TyG.

CONCLUSION

UPF consumption was significantly related to increased risk of high-risk adiposity indexes in the dose-response analysis. More studies are needed to strengthen the results of this study.

Recurrence of Tic disorders in children after medication withdrawal: A cohort study on long-term outcomes

AIM

To evaluate the relapse rate in children with tic disorders following medication withdrawal and to identify the risk factors associated with tic recurrence.

METHODS

This prospective cohort study enrolled 387 children who had recently discontinued medication and had been tic-free for at least 3 months. Participants were followed monthly for 12 months to monitor tic relapse. The primary outcome was the time from medication discontinuation to tic recurrence, while the secondary outcome was the characteristics of the recurrence. Cox regression models were used to identify prognostic factors associated with relapse.

RESULTS

During the 12-month follow-up, 235 participants (61 %) experienced tic relapse. Among these, 120 participants (51 %) had a recurrence of their original tic symptoms, 75 (32 %) developed new symptoms alongside their original tics, and 39 (17 %) presented with entirely new tic symptoms. Significant prognostic factors for tic recurrence included treatment duration, Yale Global Tic Severity Scale score at the worst-ever phase, average daily screen time, negative emotional stimuli, and snack consumption.

CONCLUSION

Tic recurrence following medication discontinuation is common in children with tic disorders and is associated with several modifiable prognostic factors. Clinicians should address these predictors to develop more effective prevention strategies and reduce tic recurrence.

Food for thought: The relationship between poor eating habits, delay discounting, and quality of life in substance use recovery

BACKGROUND

Research on poor eating habits among individuals recovering from substance use disorders (SUD) is limited. This study examines the relationship between poor eating habits, delay discounting (DD), quality of life (QOL), and remission status, in addition to examining DD as a mediator of the relationship between poor eating and QOL.

METHODS

Participants (n = 257) in recovery from SUD, completed the Health Behaviors Questionnaire (poor eating was measured using the food domain), a DD task, the World Health Organization QOL questionnaire, demographics, and SUD-related questions. Multivariate linear regression was used to test associations between poor eating and DD, as well as each QOL domain. Mediation analyses were conducted to evaluate the role of DD in the relationship between poor eating and QOL. A binary logistic regression was used to test associations between poor eating and remission status, as well as DD and remission status.

RESULTS

Poor eating habits were significantly associated with higher rates of DD (β = 0.08, p < .001) and lower QOL across psychological (β = -0.88, p < .001, only for those in remission), physical (β = -0.58, p < .001), and environmental (β = -0.75, p < .001) domains. Additionally, DD significantly mediated the relationship between poor eating habits and reduced QOL in these domains (ꞵs < -0.08, ps < 0.003). Poor eating (ꞵ = 0.05, p = .014; OR = 1.05, p = .012) and high DD rates (ꞵ = 0.12, p = .049; OR = 1.12, p = .038) were associated with a lower likelihood of remission from SUD.

CONCLUSIONS

Our findings highlight the integral role of dietary habits in the recovery trajectory of individuals with SUD. The study supports the need for holistic treatment approaches that consider the impacts of nutrition on both psychological and physiological aspects of recovery.

Low Self-Perceived Cooking Skills Are Linked to Greater Ultra-Processed Food Consumption Among Adolescents: The EHDLA Study

Introduction: Ultra-processed foods (UPFs) are widely consumed despite their established associations with obesity, cardiovascular diseases, and other metabolic disorders. One potential factor contributing to high UPF consumption is the decline in cooking skills, particularly among younger generations. This study aimed to describe the cooking skill perceptions of a sample of Spanish adolescents to examine the relationship between perceived cooking skills and UPF consumption, and to identify the specific UPF subcategories most associated with perceived cooking skills. Methods: This study is a secondary cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) study, which was conducted among 847 Spanish adolescents (12-17 years) from three secondary schools in Valle de Ricote (Region of Murcia, Spain). The participants' perceptions of their cooking skills were assessed through the following question: "How would you rate your cooking skills?". The response options included (a) very adequate, (b) adequate, (c) inadequate, and (d) very inadequate. UPF consumption was evaluated via a self-administered food frequency questionnaire (FFQ) previously validated for the Spanish population. UPFs were classified according to the NOVA system, which distinguishes four groups: (1) unprocessed or minimally processed foods; (2) processed culinary ingredients, such as salt, sugar, and oils, used to enhance the preparation of fresh foods; (3) processed foods; and (4) UPF and drink products. To examine the associations between perceived cooking skills and UPF consumption, marginal means and 95% confidence intervals for servings of individual UPF groups were calculated via generalized linear models. These models were adjusted for age, sex, socioeconomic status, physical activity, sedentary behavior, sleep duration, and body mass index to control for potential confounders. Post hoc comparisons between cooking skill categories were conducted via false discovery rate correction following the Benjamini-Hochberg procedure, with significance set at p < 0.05. Results: Most participants (47%) rated their cooking skills as adequate (47%) or very adequate (18%). Overall UPF intake showed a decreasing trend across skill levels, with the "very adequate" group consuming significantly fewer servings than the "very inadequate" group did (p = 0.015). Among the specific UPF categories, adolescents in the "very adequate" category consumed significantly fewer sweets than those in the "very inadequate" and "inadequate" categories did (p < 0.05 for all). Conclusions: This study revealed evidence of a relationship between cooking skills and overall UPF intake. These results support the importance of interventions that promote cooking competencies among adolescents. School-based culinary programs and community initiatives that teach adolescents simple, time-efficient, and cost-effective cooking techniques could help reduce the overall intake of UPFs.

The effect of garlic and stevia extract with aerobic exercise on hypothalamic leptin and ghrelin receptor mRNA expression and insulin resistance in obese rats

BACKGROUND

Obesity has recently become the most prevalent diet-related disease worldwide. This study aimed to investigate the effects of aerobic exercise, stevia, and garlic extract on leptin and ghrelin receptor mRNA, as well as the interactions between insulin and glucose in relation to these genes.

METHODS

A total of 50 male Wistar rats were split into two groups: one group was fed regular rodent food, while the other was fed a high-fat diet for 12 weeks to induce obesity. The obese rats were then divided into six groups of five (N = 5) based on Lee's index: an obese control group (OC), obese treated with garlic, stevia (OGS), obese aerobic exercise (OE), obese garlic and aerobic exercise (OGE), Obese stevia and aerobic exercise (OSE), and a Normal weight group (NC). The exercise groups participated in a gradually increasing aerobic walking program, whereas the stevia and garlic groups received daily oral doses of their respective extracts. The expression of leptin and ghrelin receptor genes in the hypothalamus was measured using real-time PCR, and insulin resistance was calculated using the HOMA/IR formula. Statistical analysis was conducted using ANOVA, with a significance level set at P < 0.05.

RESULTS

The obese (O) rats experienced a significant increase in body weight compared with the control (C) rats (p = 0.013), whereas the treated rats showed no significant changes in weight. Leptin receptor mRNA levels were significantly lower in O rats than in C rats (p = 0.00), but increased significantly in the OS (p = 0.000) and OSE (p = 0.034) groups compared with obese rats. Ghrelin receptor mRNA levels were significantly higher in the O group than in the C group (p = 0.035), but decreased in all treatment groups, with the OE (p = 0.001), OGE (p = 0.001), and OSE (p = 0.004) groups showing the greatest reductions. Insulin resistance increased slightly in the O group compared with the C group (p = 0.112), but was lowest in the OS group among all groups (p = 0.018).

CONCLUSIONS

Stevia significantly improved leptin and ghrelin receptor mRNA expression, glucose levels, and insulin resistance in obese rats, showing its potential as an effective dietary intervention for managing obesity.

Appetite Self-Regulation in Childhood: A Narrative Review and Conceptual Model of Processes and Mechanisms With Implications for Research and Practice

The purpose of the present narrative review was to propose a unifying generalized conceptual model of mechanisms and processes in appetite self-regulation (ASR) in childhood. Appetite self-regulation, along with other domains of self-regulation, develops across childhood and contributes to energy intake and balance, diet quality, weight, and therefore long-term health outcomes. There have been efforts to conceptualize and measure components of ASR and associated processes/mechanisms, but, at present, there is no unifying conceptualization of ASR in childhood. A search of key databases supplemented by snowballing was undertaken for definitions/conceptions and theoretical models of ASR with a focus on children. An interpretive synthesis approach was used to identify themes from the definitions and models. The themes formed the basis of the proposed unifying generalized model of ASR in childhood, which is the main contribution of the article. At the center of the model is bottom-up reactivity to food, food cues and hunger, satiation and satiety signals, together with top-down regulatory control. An additional contribution is the proposed 5 interacting and overlapping domains (biological, hedonics, cognitive, behavioral, and traits) that function in and influence both bottom-up reactivity and top-down regulation. The domains also contribute to ASR outcomes of enactment and competence. External contextual and intrapersonal factors are conceived as impacting the domains and the bottom-up, top-down processes. The relevance of the model for explanations of ASR phenomena in childhood and children's food choice and diet quality, as well as its implications for research directions and approaches to preventive intervention, including food parenting practices, are discussed. The model provides a framework for researchers and practitioners to support and interpret children's problems and competence in self-directing food choices, energy intake, and nutrition.

Reason's Triumph over Passion? Chinese Adults' Attention to Information on Ultra-Processed Foods' Fat and Sodium Contents in Nutrition Facts Tables

BACKGROUND

It is common for consumers to purchase ultra-processed foods that are perceived to have health risks, and this phenomenon is rarely explained in the existing literature from the perspective of consumers' responses to the intuitive marketing of flavor labels and the packaging.

METHODS

This study aimed to fill this knowledge gap and investigated the attention of 920 participants aged 18~59 across China toward fat and sodium content information for six ultra-processed foods (pastry foods, quick-frozen foods, dessert foods, puffed foods, beverages, and sauces) presented in nutrition facts tables based on the theoretical analysis framework for purchasing decisions on ultra-processed foods by using the binary logit model.

RESULTS

It was found that the respondent' s attention to fat and sodium content information was positively influenced by health risk perception levels and levels of knowledge about fat and sodium but negatively influenced by the interaction term between flavor labels (or the packaging) that stimulated the purchase desire and health risk perception levels (or levels of knowledge about fat and sodium).

CONCLUSIONS

The stimulation of purchase desire by flavor labels and the packaging weakened the consumer' s increased attention to fat and sodium content information being enhanced by the health risk perception level and the level of knowledge about fat and sodium, especially the probability of attention to such information for dessert foods, puffed foods, quick-frozen foods, and sauces, which dropped the most. Additionally, the attention of females, youth, low-income individuals, those with below-college education, and non-overweight and obese individuals to such information dropped more, and the decrease was the largest for dessert foods, puffed foods, quick-frozen foods, and sauces.

Association between ultraprocessed foods consumption, eating disorders, food addiction and body image: a systematic review

OBJECTIVE

This study aimed to assess the association between ultraprocessed foods (UPF) consumption, eating disorders (EDs), food addiction and body image concerns.

DESIGN

Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

Medline, Scopus, Web of Science, EMBASE, LILACS and APA PsycInfo databases, for studies published between 2009 and July 2024.

ELIGIBILITY CRITERIA

We included cross-sectional and cohort studies involving individuals of all ages, evaluating the association between UPF consumption, classified by the 'NOVA system', EDs, food addiction and body image. No restrictions were placed on diagnostic criteria, age and gender. Studies that modelled UPF consumption as both an exposure and an outcome were included.

DATA EXTRACTION AND SYNTHESIS

Data extraction and quality assessment were performed by two independent reviewers. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal checklist.

RESULTS

We did not identify any longitudinal studies. Nine cross-sectional studies were included (n=54 367 participants). One study assessed EDs types, including restrictive, bulimic, binge eating and other (not otherwise specified); three studies examined body dissatisfaction, while five studies investigated food addiction. The consumption of UPF was significantly associated with bulimic, binge eating and other ED and food addiction. No significant associations were identified between restrictive ED and body dissatisfaction.

CONCLUSION

This systematic review highlights a significant gap in research on this topic. Although some associations have been found, the findings are limited to cross-sectional studies with methodological limitations. The lack of longitudinal studies emphasises the need for more rigorous research to accurately assess the direction of these relationships.

PROSPERO REGISTRATION NUMBER

CRD42022365154.

Association Between Ultraprocessed Food Consumption and Metabolic Disorders in Children and Adolescents with Obesity

BACKGROUND/OBJECTIVES

We investigated the effects of ultraprocessed food (UPF) consumption on metabolic disorders (e.g., adiposity, metabolic associated steatotic liver disease [MASLD], and insulin resistance) in children and adolescents with obesity to improve dietary guidelines and public health strategies.

METHODS

The dietary intake of 149 participants (aged 8-17 years) was assessed with food diaries. The NOVA classification system was used to classify food according to the degree of processing. Metabolic outcomes, including the fat mass index (FMI), hepatic fat percentage, and insulin resistance, were measured via dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging proton density fat fraction (MRI-PDFF), and biochemical analysis, respectively.

RESULTS

Greater UPF consumption from baseline to the 6-month follow-up was significantly associated with increased insulin and decreased total cholesterol and LDL-cholesterol. UPF consumption was positively associated with the prevalence of MASLD (liver MRI-PDFF ≥ 5%; odds ratio T3 vs. T1 = 1.75; 95% confidence interval [CI] 1.03, 3.00), moderate-to-severe MASLD (liver MRI-PDFF ≥ 10%; OR T3 vs. T1 = 4.19; 95% CI 1.72, 10.22), and insulin resistance (OR T3 vs. T1 = 2.44; 95% CI 1.33, 4.48), after adjusting for covariates. A linear dose-response relationship was observed between UPF consumption and the odds of moderate-to-severe MASLD and insulin resistance.

CONCLUSIONS

Greater UPF consumption was strongly associated with MASLD and insulin resistance in children and adolescents with obesity, underscoring the importance of reducing UPF consumption through dietary guidelines and public health interventions to mitigate the risk of obesity-related metabolic conditions in young populations.

Association Between Ultra-Processed Food Consumption and Cognitive Performance Among Adolescent Students From Underdeveloped Cities in Brazil: A Cross-Sectional Study

Objectives

The association between ultra-processed foods (UPF) consumption and cognitive performance needs to be better characterized in adolescents, especially in low-income settings, where the cost of human capital is high. This study investigated the association between cognitive performance and UPF in adolescents from the countryside of the Brazilian Northeast.

Methods

Adolescents (15-18 years old) from three public high schools were included. Food intake was assessed using three 24-hour dietary recalls. The classification of foods as UPF was determined according to the Nova classification. Cognitive performance was evaluated using the Non-Verbal General Intelligence Test.

Results

116 adolescents were included, of which 50 (43.1%) showed low cognitive performance. The average energy intake was 1973.5 kcal, with 24.2% coming from UPF. Participants with low cognitive performance consumed 26.5% (95% CI: [22.2; 30.7]%) of daily energy intake from UPF compared to 22.5% ([18.8; 26.2]%) of those with medium-high cognitive performance (P = 0.17), without differences in energy and macronutrient intake.

Conclusion

Despite similar UPF consumption compared to the Brazilian average, no association was found between UPF consumption and cognitive performance in this low-income adolescent sample.

The Intersection of Ultra-Processed Foods, Neuropsychiatric Disorders, and Neurolaw: Implications for Criminal Justice

Over the last decade there has been increasing interest in the links between the consumption of ultra-processed foods and various neuropsychiatric disorders, aggression, and antisocial behavior. Neurolaw is an interdisciplinary field that seeks to translate the rapid and voluminous advances in brain science into legal decisions and policy. An enhanced understanding of biophysiological mechanisms by which ultra-processed foods influence brain and behavior allows for a historical reexamination of one of forensic neuropsychiatry's most famous cases-The People v. White and its associated 'Twinkie Defense'. Here in this Viewpoint article, we pair original court transcripts with emergent research in neurolaw, including nutritional neuroscience, microbiome sciences (legalome), pre-clinical mechanistic research, and clinical intervention trials. Advances in neuroscience, and related fields such as the microbiome, are challenging basic assumptions in the criminal justice system, including notions of universal free will. Recent dismissals of criminal charges related to auto-brewery syndrome demonstrate that courts are open to advances at the intersection of neuromicrobiology and nutritional neuroscience, including those that relate to criminal intent and diminished capacity. As such, it is our contention that experts in the neurosciences will play an increasing role in shaping research that underpins 21st-century courtroom discourse, policy, and decision-making.

Consumption of ultra-processed foods and mental health of pregnant women from the South of Brazil

The objective of this study is to evaluate the association between the consumption of ultra-processed foods (UPF) and the mental health of pregnant women from the South of Brazil. This is a cross-sectional study carried out in Criciúma, Brazil, through face-to-face interviews, from April to December 2022. Pregnant women aged 18 or older who underwent prenatal care in the forty-eight basic health care units of the municipality and who were in their third trimester of pregnancy were included. High consumption of UPF was considered as six or more items or subgroups of UPF consumed on the day before the interview, using the Nova-UPF screener. The mental health variables were depressive symptoms, stress, sadness and anxiety. Crude and adjusted analyses were conducted using the Fisher's exact test and the Poisson regression with robust variance. In total, 428 pregnant women were studied; most of them were aged between 20 and 25 years and were white. Pregnant women who presented high consumption of UPF were 1·42-fold (95 % CI 1·06, 1·92) more likely to experience anxiety and presented a prevalence 56 % (95 % CI 1·18, 2·07) higher of stress when compared with those who did not present high consumption of UPF. The prevalence of depressive symptoms and feelings of sadness was 1·31-fold (95 % CI 1·08, 1·60) and 3·41-fold (95 % CI 1·77, 6·58) higher among those with high consumption of UPF, respectively. The results suggest that diet quality is associated with the mental health of pregnant women. Promoting joint actions focused on food and nutritional education, and mental health, for pregnant women, is necessary.

Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle?

Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14-20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders.

The Human Interference Scoring System (HISS): A New Tool for Quantifying Food Quality Based on Its Level of Processing

The Human Interference Scoring System (HISS) is a novel food-based diet-quality-classification system based on the existing NOVA method. HISS involves food and fluid allocation into categories from digital imagery based on food processing levels, followed by meal plan analysis using food-servings quantification. The primary purpose of this work was to evaluate the reliability of HISS. Trained nutrition professionals analyzed digital photographs from five hypothetical 24 h food recalls and categorized foods into one of four HISS categories. A secondary purpose was to assess the nutrient composition of the food recalls and other selected foods from the HISS categories. Participants effectively categorized foods into HISS categories, with only minor discrepancies noted. High inter-rater reliability was observed in the outer HISS categories: unprocessed and ultra-processed foods. Ultra-processed items consistently displayed elevated energy, carbohydrates, and sugar compared to unprocessed foods, while unprocessed foods exhibited notably higher dietary fiber. This study introduces the HISS as a potentially useful tool for quantifying a food-quality-based system using digital-photography-based assessments. Its high inter-rater reliability and ability to capture relationships between food processing levels and nutrient composition make it a promising method for assessing dietary habits and food quality.

Diet composition and energy intake in humans

Absolute energy from fats and carbohydrates and the proportion of carbohydrates in the food supply have increased over 50 years. Dietary energy density (ED) is primarily decreased by the water and increased by the fat content of foods. Protein, carbohydrates and fat exert different effects on satiety or energy intake (EI) in the order protein > carbohydrates > fat. When the ED of different foods is equalized the differences between fat and carbohydrates are modest. Covertly increasing dietary ED with fat, carbohydrate or mixed macronutrients elevates EI, producing weight gain and vice versa. In more naturalistic situations where learning cues are intact, there appears to be greater compensation for the different ED of foods. There is considerable individual variability in response. Macronutrient-specific negative feedback models of EI regulation have limited capacity to explain how availability of cheap, highly palatable, readily assimilated, energy-dense foods lead to obesity in modern environments. Neuropsychological constructs including food reward (liking, wanting and learning), reactive and reflective decision making, in the context of asymmetric energy balance regulation, give more comprehensive explanations of how environmental superabundance of foods containing mixtures of readily assimilated fats and carbohydrates and caloric beverages elevate EI through combined hedonic, affective, cognitive and physiological mechanisms. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.

Association between total dietary antioxidant capacity and food groups and incidence of depression in a cohort of Brazilian graduates (CUME Project)

This study aims to evaluate the association between Dietary Total Antioxidant Capacity (dTAC) and Total Antioxidant Capacity of food groups (fgTAC) with the incidence of depression in Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). The sample consisted of 2572 participants without a medical diagnosis of depression at baseline who responded to at least one follow-up questionnaire from the CUME Project. The Ferric Reducing Antioxidant Power assay was used to determine dTAC. Incidence of depression was estimated by self-reported medical diagnosis of depression during the years of cohort follow-up. Cox regression models were used to relate dTAC and fgTAC to the incidence of depression. The mean follow-up time was 2·96 (1·00) years, and 246 cases of depression were observed (32·3/1000 person-years). The mean dTAC was 11·03 (4·84) mmol/d. We found no associations between higher dTAC and lower risk of developing depression after adjusting for possible confounders. The incidence of depression was inversely associated with fgTAC of the beans and lentils group (hazard ratio (HR): 0·61; 95 % CI 0·41, 0·90). The fgTAC of the junk food group was positively associated with higher incidence of depression after all adjustments (HR: 1·57; 95 % CI 1·08, 2·26). Our findings do not support an association between dTAC and the incidence of depression in a highly educated Brazilian population. However, associations of fgTAC show the importance of analysing the food matrix in which these antioxidants are inserted. We highlight the need for more prospective studies with different nationalities to confirm these results.

Oxidative Stress and Inflammatory Biomarkers Are Related to High Intake of Ultra-Processed Food in Old Adults with Metabolic Syndrome

In the last few decades the consumption of ultra-processed foods (UPFs) worldwide has substantially augmented. Increasing evidence suggests that high UPF consumption is associated with an increase in non-communicable diseases, being overweight, and obesity. The aim of this study was to assess how UPF consumption affects oxidative and inflammatory status in the plasma, neutrophils, and urine of old adults with metabolic syndrome. Participants (n = 92) were classified into two groups according to UPF consumption. Dietary intakes were measured by a validated semi-quantitative 143-item food frequency questionnaire and UPF consumption was determined according to the NOVA classification system. Low UPF consumers showed higher adherence to the Mediterranean diet than high UPF consumers. A high intake of fiber and a high concentration of polyphenols in urine were also observed in subjects with low UPF consumption. Despite the absence of differences in biochemical profile, oxidative and inflammatory biomarkers showed some significant changes. Catalase and superoxide dismutase activities were lower in high UPF consumers, whereas myeloperoxidase activity was higher. ROS production in neutrophils stimulated with zymosan was higher in high UPF consumers than in low UPF consumers. Biomarkers such as xanthine oxidase, tumor necrosis factor α (TNFα), interleukin (IL)-6, IL-15, and leptin levels were higher in participants with high intake of UPF. No differences were found in malondialdehyde and other inflammatory cytokines. The current study evidenced that MetS participants with high UPF consumption have a more pro-oxidant and inflammatory profile than those with low UPF consumption, despite showing similar blood biochemical profiles.

Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods

Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.

Consumption of ultra-processed foods is associated with depression, mesocorticolimbic volume, and inflammation

BACKGROUND

The consumption of ultra-processed foods and drinks (UPF) has been associated with depression and inflammation and preclinical studies showed that some UPF components disrupt the amygdala-hippocampal complex. We combine diet, clinical and brain imaging data to investigate the relationship between the UPF consumption, depressive symptoms, and brain volumes in humans, considering interactions with obesity, and the mediation effect of inflammation biomarkers.

METHODS

One-hundred fifty-two adults underwent diet, depressive symptoms, anatomic magnetic resonance imaging assessments and laboratory tests. Relationships between the % of UPF consumption (in grams) of the total diet, depressive symptoms, and gray matter brain volumes were explored using several adjusted regression models, and in interaction with the presence of obesity. Whether inflammatory biomarkers (i.e., white blood cell count, lipopolysaccharide-binding protein, c-reactive protein) mediate the previous associations was investigated using R mediation package.

RESULTS

High UPF consumption was associated with higher depressive symptoms in all participants (β = 0.178, CI = 0.008-0.261) and in those with obesity (β = 0.214, CI = -0.004-0.333). Higher consumption was also associated with lower volumes in the posterior cingulate cortex and the left amygdala, which in the participants with obesity also encompassed the left ventral putamen and the dorsal frontal cortex. White blood count levels mediated the association between UPF consumption and depressive symptoms (p = 0.022).

LIMITATIONS

The present study precludes any causal conclusions.

CONCLUSIONS

UPF consumption is associated with depressive symptoms and lower volumes within the mesocorticolimbic brain network implicated in reward processes and conflict monitoring. Associations were partially dependent on obesity and white blood cell count.

Applications of nanotechnology to combat the problems associated with modern food

Currently, modern lifestyle diseases (LSD) such as cancer, diabetes, hypertension, cardiovascular and thyroid disease are commonly seen among people of different age groups. One of the root causes of this LSD is the type of food that we are eating. Staple crops like rice, sugarcane, vegetables and wheat are grown with the application of agrochemicals (e.g., glyphosate), traces of which are found in our food; after that, it gets ultra-processed in factories; e.g., chips and snacks are fried using saturated fats (trans fat); sugar and wheat (derivatives bread, buns, cookies) are processed using toxic chemicals (bleaching agents). As a result, the nutritional value of food is compromised due to low dietary fiber content and synthetic additives - e.g., sucralose (artificial sweetener) - which promotes inflammation and weakens our immune system, causing our body to become sensitive to microbial infection and many other LSDs. To strengthen the immune system, people start taking synthetically prepared supplements and drugs for a prolonged time, which further deteriorates the body organs and their normal function; e.g., prolonged medication for hypothyroidism poses a risk of heart attack and joint pain. Nanotechnology solves the above problems in the food, nutraceuticals and agriculture sectors. Nanotechnology-based naturally processed products such as nano-nutraceuticals, nanofood, nanofertilizers and nanopesticides will benefit our health. They possess desirable properties such as high bioavailability, targeted delivery, least processing and sustained release. With the help of nanotechnology, we can get nutritional and agrochemical-free food. © 2022 Society of Chemical Industry.

Ultra-Processed Food Consumption and Depressive Symptoms in a Mediterranean Cohort

Excess consumption of ultra-processed foods (UPFs) is currently under investigation for its potentially detrimental impact on human health. Current evidence demonstrates a substantial association with an increased risk of metabolic disorders, but data on mental health outcomes are just emerging. The aim of this study was to investigate the relationship between the consumption of UPFs and depressive symptoms in a sample of younger Italian adults. A cross-sectional study was conducted on 596 individuals (age 18-35 y) recruited in southern Italy. Food frequency questionnaires and the NOVA classification were used to assess dietary factors; the Center for the Epidemiological Studies of Depression Short Form (CES-D-10) was used to assess presence of depressive symptoms. Individuals in the highest quartile of UPF consumption had higher odds of having depressive symptoms in the energy-adjusted model (odds ratio (OR) = 1.89, 95% confidence interval (CI): 1.06, 3.28); the association remained significant after adjusting for potential confounding factors (OR = 2.04, 95% CI: 1.04, 4.01) and became even stronger after further adjustment for adherence to the Mediterranean diet as a proxy of diet quality (OR = 2.70, 95% CI: 1.32, 5.51). In conclusion, a positive association between UPF consumption and likelihood of having depressive symptoms was found in younger Italian individuals. Given the consistency of the findings after adjustment for diet quality, further studies are needed to understand whether non-nutritional factors may play a role in human neurobiology.

Ultra-Processed Foods and Drinks Consumption Is Associated with Psychosocial Functioning in Adolescents

Adolescents show one of the highest rates of ultra-processed foods and drinks (UPF) consumption, and studies indicate an association between their consumption and internalizing problems. We aim to investigate whether UPF consumption associates with dysfunctions in other psychosocial domains, as well as sex effects. In 560 Spanish adolescents (14-17 years old), we assessed the UPF products consumed in the previous day, fruits and vegetables consumption (servings/day), and physical activity (days/week). Psychosocial functioning (total and subscales) was assessed through the Pediatric Symptom Checklist-Youth self-report. Associations between UPF and psychosocial functioning were assessed using linear regression models, adjusting for sex, age, fruits and vegetables consumption, and physical activity. Sex-specific associations were also explored. Participants reported a daily consumption of 7.72 UPF servings per day, with male adolescents showing higher consumption than female adolescents. Consumption of fruits and vegetables and physical activity levels were lower than recommended. Psychosocial impairment was present in 26.2% of the participants. Higher UPF consumption was associated with higher presence of depressive symptoms and internalizing and externalizing problems in the whole sample and in male adolescents. The present study supports previous studies suggesting that UPF consumption may interact with mental health problems and indicates that these effects may go beyond internalizing problems.

The influence of the subcortex and brain stem on overeating: How advances in functional neuroimaging can be applied to expand neurobiological models to beyond the cortex

Functional neuroimaging has become a widely used tool in obesity and eating disorder research to explore the alterations in neurobiology that underlie overeating and binge eating behaviors. Current and traditional neurobiological models underscore the importance of impairments in brain systems supporting reward, cognitive control, attention, and emotion regulation as primary drivers for overeating. Due to the technical limitations of standard field strength functional magnetic resonance imaging (fMRI) scanners, human neuroimaging research to date has focused largely on cortical and basal ganglia effects on appetitive behaviors. The present review draws on animal and human research to highlight how neural signaling encoding energy regulation, reward-learning, and habit formation converge on hypothalamic, brainstem, thalamic, and striatal regions to contribute to overeating in humans. We also consider the role of regions such as the mediodorsal thalamus, ventral striatum, lateral hypothalamus and locus coeruleus in supporting habit formation, inhibitory control of food craving, and attentional biases. Through these discussions, we present proposals on how the neurobiology underlying these processes could be examined using functional neuroimaging and highlight how ultra-high field 7-Tesla (7 T) fMRI may be leveraged to elucidate the potential functional alterations in subcortical networks. Focus is given to how interactions of these regions with peripheral endocannabinoids and neuropeptides, such as orexin, could be explored. Technical and methodological aspects regarding the use of ultra-high field 7 T fMRI to study eating behaviors are also reviewed.

Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective

Purpose of Review

To examine the prevalence rates of ultra-processed food addiction across different weight classes and offer guidelines for diagnosis and treatment. Clinicians are provided with practical considerations in the assessment of ultra-processed food addiction beyond the use of validated instruments.

Recent Findings

The weighted mean prevalence of ultra-processed food addiction is approximately 20% worldwide and varies widely based on the sample. At first glance, there appears a linear relationship between ultra-processed food addiction and BMI class. Further investigation indicates a J-shaped curve with heightened prevalence among the underweight. These findings highlight the need to assess for additional factors that may increase objective or subjective food addiction symptoms including eating disorders, dietary restraint, and other mental health diagnoses.

Summary

While clinical considerations across different weight classes vary, overemphasis on weight status may detract from the clinical utility of the ultra-processed food addiction construct. Considering weight status in conjunction with other psychiatric symptoms helps to better understand the various biopsychosocial mechanisms that influence eating behavior and can inform individualized treatment strategies.