Prospective association between ultra-processed food consumption and incident depressive symptoms in the French NutriNet-Santé cohort

Dietary Patterns and Major Depression: Results from 15,262 Participants (International ALIMENTAL Study)

BACKGROUND

Different patterns of food consumption may be associated with a differential risk of depression. Differences in dietary patterns between men and women and across different age groups have been reported, but their influence on the risk of depression has not been fully explored.

OBJECTIVES

To investigate the associations between dietary patterns and risk of depression across sex and age groups to identify vulnerable subpopulations, which may inform targeted prevention and intervention strategies.

METHODS

The ALIMENTAL study was a cross-sectional, online international survey conducted between 2021 and 2023. Dietary data were collected using a validated food frequency questionnaire; depression data were collected using a self-reported validated questionnaire. Principal component analysis (PCA) was applied to identify distinct food consumption patterns. Multivariate analyses were then conducted to assess the associations between these patterns and depression, adjusting for multiple potential confounders.

RESULTS

Among 15,262 participants without chronic diseases or current psychotropic treatments, 4923 (32.2%) were classified in the depression group. Among those aged 18-34, the PCA-derived factor of ultra-processed foods consumption was significantly associated with increased risk of depression in both sexes with similar odds ratios (women 1.21, 95% confidence interval (CI): (1.15; 1.27), men 1.21, 95% CI: (1.07-1.18)). In women aged 18-34, the PCA factors for sodas (aOR 1.10, 95% CI: (1.06; 1.95) and canned and frozen foods (aOR 1.10, 95% CI: (1.04; 1.15) were associated with an increased risk of depression. In participants aged 35-54 years, the association between ultra-processed foods and depression was only observed in women (35-54 years: aOR 1.30, 95% CI: (1.20; 1.42), ≥55 years: 1.41, 95% CI: (1.11; 1.79)), with a significant association between a higher adherence to the PCA-derived "healthy diet" factor (e.g., fruits, nuts, green vegetables) and a lower risk of depression (35-54 years: aOR 0.82, 95% CI: (0.75; 0.89), ≥55 years: aOR 0.79, 95% CI: (0.64; 0.97)).

CONCLUSIONS

These results show significant differences between men and women and between age groups regarding associations between dietary patterns and the risk of depression. These findings can help better target public health interventions.

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.

Factors Affecting Ultra-Processed Food Consumption: Hedonic Hunger, Food Addiction, and Mood

Ultra-processed foods (UPF) play a central role in modern diets but pose a serious threat to public health. The aim of this study was to investigate the relationship between UPF consumption and hedonic hunger, food addiction, and mood and to explain the impact of these factors on dietary habits. This cross-sectional study included 3997 adults (2517 female, 1480 male), aged 18-65 years, recruited through snowball sampling in Ankara, Turkey. Data were collected via a web-based survey that included demographic information, self-reported anthropometric measurements, and validated scales: Screening Questionnaire of Highly Processed Food Consumption, The Power of Food Scale, Yale Food Addiction Scale, and Depression Anxiety Stress Scale-21. The mean age of the participants was 31.7 ± 12.82 years. The Screening Questionnaire of Highly Processed Food Consumption was positively correlated with the Yale Food Addiction Scale score and the subdimension scores of the Depression Anxiety Stress Scale-21 (p < 0.05). According to linear regression analysis, it was determined that gender, age, Yale Food Addiction Scale score, and the scores of depression, anxiety, and stress affected the Screening Questionnaire of Highly Processed Food Consumption score (p < 0.05). There was a difference between the groups with low and high levels of UPF consumption in terms of age, gender, marital and working status, Yale Food Addiction Scale score, and the subdimension scores of the Depression Anxiety Stress Scale-21 (p < 0.05). In conclusion, considering the influence of food addiction and mood on UPF consumption, policies and interventions targeting the psychosocial processes of individuals should be developed and further research conducted in this area to limit the UPF consumption and promote healthy eating habits along with conscious eating behaviors.

Health impacts of exposure to synthetic chemicals in food

Humans are widely exposed to synthetic chemicals, especially via food. The types of chemical contaminants in food (including food contact chemicals) are diverse, and many of these are known to be hazardous, with mounting evidence that some contribute to noncommunicable diseases. The increasing consumption of ultra-processed foods, which contain synthetic chemicals, also contributes to adverse health. If the chemical contamination of foods were better characterized, then this issue would likely receive more attention as an important opportunity for disease prevention. In this Review, we discuss types and sources of synthetic food contaminants, focusing on food contact chemicals and their presence in ultra-processed foods. We outline future research needs and highlight possible responses at different food system levels. A sustainable transition of the food system must address the health impacts of synthetic chemicals in food; we discuss existing solutions that do justice to the complexity of the issue while avoiding regrettable substitutions and rebound effects.

Impact of ultra-processed foods on human health: A comprehensive review of genomic instability and molecular mechanisms

In this review the nexus between genomic instability and human health is investigated, emphasizing the rising consumption of ultra-processed foods (UPFs). Introducing the NOVA food classification system, we explore the significant surge in UPF consumption over the past 3 decades and its correlation with heightened mortality rates. This exploration extends to the development of health issues such as obesity, cancer, type 2 diabetes, inflammatory bowel diseases, cardiovascular diseases, and depression. Existing evidence, including studies involving healthy adolescents and older adults, underscores a clear link between increased consumption of UPFs and heightened DNA damage. The primary objective of this review is to offer a comprehensive examination of the repercussions of elevated UPF consumption on human health. With a specific focus on unraveling the intricate relationship between these dietary choices and genomic instability, the review seeks to enhance our understanding. Through a targeted exploration of molecular pathways, the aim is to illuminate how dependence on UPFs may impact physical and mental well-being.

Ultraprocessed Foods and Neuropsychiatric Outcomes: Putative Mechanisms

A body of evidence indicates an association between ultraprocessed foods (UPFs) and health outcomes. Most of it has been obtained through preclinical studies, although a number of observational studies substantiate how a high intake of these products increases the risk of neuropsychiatric disorders, and an increasing amount of dietary intervention studies confirm these findings. The aim of this narrative review is to describe some of the putative mechanisms involved in the deleterious effects of a high intake of UPFs on neuropsychiatric outcomes. A myriad of unhealthy actions may be associated with the consumption of UPFs, and some mechanisms are being discussed. They include UPFs' high caloric density; their high sugar, sodium, and additives content and low amounts of fiber; and a high palatability that induces overconsumption, acting as obesogens. Moreover, thermal treatment of these foods generates oxidative products such as glycotoxins, lipotoxins, and acrolein, all of which affect the brain. The chemical products act, directly or indirectly, on the gut microbiome and affect the gut-brain axis, causing neuroinflammation, oxidative stress, and neurodegeneration. UPFs also exert various epigenetic effects that affect mental health and might explain the intergenerational inheritance of neuropsychiatric disorders. A diet containing a high proportion of these foods has a low nutritional density, including bioactive protective agents such as antioxidant and anti-inflammatory compounds that promote eubiosis. The evidence shows that UPFs intake affects neuropsychiatric outcomes such as neurodegeneration, cognitive decline, dementia, and mood disorders and reinforces the need to promote a healthy dietary pattern throughout all life stages, thus interfering with the current commercial determinants of health.

The risk associated with ultra-processed food intake on depressive symptoms and mental health in older adults: a target trial emulation

BACKGROUND

Longitudinal cohort studies across the lifespan suggest an association between ultra-processed food (UPF) and depression. However, the effect of UPF on depression and mental health in older adults has not been determined. Therefore, this study investigated the effect of UPF on depressive symptoms and mental health in community-dwelling older adults.

METHODS

A pragmatic target trial was designed and emulated using the ASPirin in Reducing Events in the Elderly longitudinal data. Participants were community-dwelling older adults (≥ 70 years) in Australia. We specified and emulated the protocol of a two-arm randomised pragmatic clinical trial using the level of UPF consumption as the intervention. Greater than or equal to 4 servings of UPF per day was considered the intervention, with less than 4 servings per day the control. Dietary consumption was assessed using a mail-based diet screening questionnaire, and the level of food processing was classified based on the NOVA classification. The study outcomes were depressive symptoms, defined as a score of ≥ 8 on the Center for Epidemiological Studies Depression 10-item scale, and general mental health, defined by the mental component summary score of the Short Form-12. We applied inverse probability treatment weighting to balance confounders. Marginal structural models were employed to estimate the population-level average effect of intervention using generalised estimated equations.

RESULTS

A total of 11,192 participants (3415 intervention and 7777 control) were eligible for the emulation. High UPF consumption at time zero was associated with an increased risk of depressive symptoms at follow-ups (RR: 1.10; CI: 1.04-1.18). The finding was consistent with sensitivity analyses; after excluding participants on antidepressants at time zero, the risk of depressive symptoms in the intervention group was increased by 11% compared to the control (RR: 1.11; 95% CI: (1.04-1.20)). Consumption of UPF adversely affected the mental component quality of life (β: - 0.40; CI: - 0.65 to - 0.15).

CONCLUSIONS

A higher level of UPF consumption was associated with a higher risk of depressive symptoms and adversely affected mental health among older adults.

Prevalence of processed foods in major US grocery stores

The offering of grocery stores is a strong driver of consumer decisions. While highly processed foods such as packaged products, processed meat and sweetened soft drinks have been increasingly associated with unhealthy diets, information on the degree of processing characterizing an item in a store is not straightforward to obtain, limiting the ability of individuals to make informed choices. GroceryDB, a database with over 50,000 food items sold by Walmart, Target and Whole Foods, shows the degree of processing of food items and potential alternatives in the surrounding food environment. The extensive data gathered on ingredient lists and nutrition facts enables a large-scale analysis of ingredient patterns and degrees of processing, categorized by store, food category and price range. Furthermore, it allows the quantification of the individual contribution of over 1,000 ingredients to ultra-processing. GroceryDB makes this information accessible, guiding consumers toward less processed food choices.

Association between ultra-processed food consumption and inflammation: insights from the STANISLAS cohort

PURPOSE

High consumption of ultra-processed food (UPF) is associated with an increased risk of developing chronic diseases. Inflammation may be one of the underlying mechanisms behind this association. However, only a limited number of studies have investigated the association between UPF consumption and a few selected inflammation biomarkers, yielding inconsistent results. This study aimed to assess the cross-sectional association between UPF consumption (as a whole and 10 sub-categories), and 78 circulating proteins related to inflammation.

METHODS

The present study included 1594 adult participants from the STANISLAS cohort. UPF consumption was estimated using the NOVA classification, and linear regression models were used to assess their association with circulating proteins.

RESULTS

UPFs accounted for 28% of the total energy intake and 5.7 servings on average per day. In the unadjusted model, 15 circulating proteins had a significant association with UPF consumption. After adjustment, only (FGF-19) was significantly associated with UPF consumption (β =  - 0.02[- 0.03; - 0.003]).

CONCLUSION

UPF consumption was negatively associated with Fibroblast Growth Factor 19 (FGF-19) serum levels. When considering UPF sub-categories, no circulating proteins were associated with dairy products and dairy desserts. Of note, circulating proteins were differentially associated depending on the sub-category of UPF. Further studies are needed to better understand the link between UPF and inflammation.

Factors influencing the quality of life and mental health of Brazilian Federal Education Network Employees: An epidemiological cross-sectional study

Understanding the aspects of quality of life (QoL) and mental health can offer valuable insights into the well-being of educational employees. Therefore, this study assessed the factors influencing the QoL and mental health of Brazilian Federal Network Employees. This cross-sectional epidemiological study was conducted in 2022, with 1563 participants. We used the WHOQOL-bref, DASS-21, BackPEI, PeNSE, and a self-developed sociodemographic questionnaire. The results showed that female participants had poorer mental health, showing higher symptoms of depression (p = 0.010) and anxiety and stress (p < 0.001), and lower QoL in the physical and psychological domains (p < 0.001) compared with male participants. The older age group (>53 years) indicated higher QoL in the psychological (p < 0.001) and environmental (p < 0.015) domains, with differences in mental health-related symptoms (p < 0.001), compared with the younger age group. Higher levels of education were related to higher QoL in the psychological and environmental domains (p < 0.001). The consumption of ultra-processed foods, sodas, and sweets was negatively associated with mental health (p < 0.001), as was the consumption of fried snacks, which indicated higher symptoms of depression (p = 0.002), anxiety (p = 0.006), and stress (p < 0.001). Conversely, the consumption of healthy foods (vegetables and fruits) was related to better QoL in all domains (p < 0.001). Regarding alcoholic beverages, the results showed symptoms of anxiety (p = 0.003) and stress (p < 0.001) in employees who consumed these for more than 3 days in a month. Furthermore, regular physical activity was related to fewer symptoms related to mental health and higher QoL (p < 0.001). Conversely, spending 5 h or more using a computer indicated lower QoL in the psychological (p = 0.002) and environmental (p < 0.001) domains. The current findings emphasize the need for intervention measures for Brazilian education employees to promote physical activity, healthy food consumption, reduced screen time, and awareness of the harm of risky behaviors, such as tobacco and alcohol, to enhance their QoL and mental health.

Evaluation of the toxic effects of food additives, alone or in mixture, in four human cell models

Food additives are present in more than 50% of food products. Several studies have suggested a link between the consumption of certain food additives and an increased risk of developing cancer. This study aimed to evaluate the genotoxicity of 32 additives and six mixtures identified by the NutriNet-Santé cohort as the most widely consumed. Genotoxicity screening was conducted using the γH2AX (for clastogenic compounds) and pH3 (for aneugenic compounds) biomarkers in four human cell models (colon, liver, kidney, and neurons) representing the target organs of food contaminants. The 32 compounds were categorized into five groups based on their toxicological profiles. Eight additives were cytotoxic, four promoted cell proliferation, two were genotoxic with a clastogenic mode of action, and the remaining 19 were neither cytotoxic nor genotoxic at the concentration tested. Among the six mixtures tested, three were neither cytotoxic nor genotoxic, one was cytotoxic, and two were genotoxic at the highest tested concentrations. The observed genotoxicity of the mixtures could not be attributed to the relative concentrations of the individual additives. These findings suggest the possibility of toxic synergies in mixtures and highlight the challenges of studying the combined effects of multiple substances.

Food consumption associated with depression, anxiety and stress in students entering a public university

Cross-sectional study investigated the association of fresh or minimally processed foods and ultra-processed food consumption with symptoms of depression, anxiety and stress in students from a Brazilian public university. Undergraduate students admitted in 2022 answered an online questionnaire during their first semester. Consumption of 12 subgroups of fresh or minimally processed foods and 13 of ultra-processed foods on the previous day were investigated (affirmative answer for ≥ 5 subgroups was classified as high consumption). Depression, anxiety and stress were investigated using the DASS-21 and mild to extremely severe symptoms were grouped to be compared with individuals without symptoms. Adjusted logistic regression models estimated the Odds Ratio (OR) of the association between symptoms of depression, anxiety and stress (outcomes) and food consumption (exposures), with a significance level of 5%. A total of 924 students were evaluated, of whom 57.7% presented symptoms of depression, 51.9% of anxiety and 59.4% of stress. A high consumption of fresh or minimally processed foods was observed in 80.3% of the students, with a higher frequency among those without symptoms of depression, anxiety, and stress, while 38.9% showed a high consumption of ultra-processed foods, without differences according to symptoms. High consumption of fresh or minimally processed foods was associated with a lower likelihood of symptoms of depression (OR: 0.62; p=0.011), anxiety (OR: 0.58; p=0.003) and stress (OR: 0.69; p=0.043). No association was found between ultra-processed and mental health outcomes. Actions that support and encourage the consumption of healthy food in the university environment can contribute to mental health outcomes.

Processed and ultra-processed foods are associated with depression and anxiety symptoms in a cross-sectional sample of urban Lebanese adults

While low dietary quality has been linked to poor mental health, evidence on more direct relations of specific dietary quality indicators, namely degrees of food processing, with mental health disorders remains limited. This study aims to investigate the association between food groups' intakes, defined based on their degree of food processing, with depression and anxiety symptoms in a sample of Lebanese adults. We hypothesized that higher intakes of ultra-processed foods (UPF) will be related to higher risk of depression and anxiety while an opposite association will be observed for unprocessed or minimally processed foods (MPF). Data come from a Lebanese cross-sectional study (n = 188 adults). The NOVA classification was adopted for evaluating the intakes of the 4 food groups: unprocessed or minimally processed foods (MPF); processed culinary ingredients (PCI); processed foods (PF) and ultra-processed foods (UPF). Associations between food group intakes in quartiles with depression and anxiety symptoms were analyzed using multivariable regression analyses adjusted for several confounders. Median energy intake was 2481.65 (2617.2) kcal/d, with 36.12% of Total Energy Intakes coming from MPF, 29.71% from PF, 25.25% from UPF, and 5.75% from PCI. Among participants, 33% and 27.7% had elevated depression and anxiety symptoms, respectively. Higher PF intake was associated with significantly lower odds of both depression and anxiety symptoms while a higher UPF intake was associated with higher odds of depression. Results confirm the hypothesized links between UPF and adverse mental health outcomes and highlight the need for further studies on PF intakes and mental health given the culture-specific nature of foods constituting this group.

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

BACKGROUND

Despite substantial evidence regarding independent associations between physical activity (PA) and ultra-processed foods (UPF) consumption with depression, the joint effects of these two factors remain unknown.

METHODS

This study included 99,126 participants without depression in the UK Biobank at baseline. A 24-h recall method was used to assess UPF consumption, and self-reported total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), and vigorous physical activity (VPA) were assessed by metabolic equivalent task (MET). A series of Cox proportional hazard regression models were used to explore the independent and joint effects of TPA, MVPA, VPA and UPF consumption on depression.

RESULTS

The incidence rate of depression was 1.94 % [95 % confidence interval (CI): 1.80 %-2.10 %] per 1000 person-years after an average follow-up of 12.10 years. We found that MVPA and UPF consumption had additive interactions on depression risk (p < 0.05). Participants in Q1 of TPA and Q4 of UPF consumption (HR: 1.83, 95%CI: 1.45-2.31) showed a higher risk for depression than those in Q4 of TPA and Q1 of UPF consumption. Compared with the participants with WHO guideline-recommended MVPA and the lowest UPF consumption, those below recommended MVPA (HR: 1.51, 95%CI: 1.20-1.89) or above recommended MVPA (HR: 1.40, 95%CI: 1.10-1.78) and with the highest UPF consumption had a higher risk for depression.

LIMITATIONS

Study limitations include use of self-reported data, observational study and concerns regarding generalizability.

CONCLUSION

Higher UPF consumption, accompanied by lower PA levels regardless of TPA, MVPA, and VPA, is associated with a higher risk of depression. Our study offers insights on public health priorities to decrease the risk of depression in the population by addressing both PA and UPF consumption together.

Meat-egg-dairy consumption and depressive symptoms among Chinese older adults: exploring rural/urban and gender disparities

Introduction

This study examines the association between Meat, Egg, and Dairy (MED) product consumption and depressive symptoms among older adults in China, focusing on rural/urban and gender differences.

Methods

This study employed data from the latest wave (year 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and Ordinary Least Squares (OLS) models were applied to examine the association between MED consumption and depression levels.

Findings

The findings revealed a consistent negative relationship between MED consumption and depression, with higher MED intake associated with lower depression levels. Urban residents and males exhibited higher MED consumption, which correlated with less depressive symptoms. However, the impact of MED consumption on depression varied by subgroups; urban older adults benefited more from MED consumption than their rural counterparts, and the relationship between MED intake and depression was more pronounced in males than in females. The study highlighted the influence of socio-demographic factors, such as literacy, income, and self-rated health, on depression levels.

Discussion

The results suggested that MED consumption may offer protective effects on mental health in older adults, although the association may not be causal. The study underscored the need for further research to explore the complex interplay between diet and mental health in older adults, particularly in diverse cultural contexts.

Anxiety Symptoms Influence Food Consumption Differently Depending on Nutritional Status During the COVID-19 Pandemic: A Longitudinal Study with University Students

BACKGROUND

Anxiety symptoms are factors that directly affect eating habits, but this interference can be heterogeneous depending on the nutritional status of the individuals.

OBJECTIVES

To analyze whether the presence of anxiety symptoms at the beginning of the pandemic influenced the change in food consumption according to its purpose and extent of processing during a one-year follow-up and whether this association occurs equally with excess weight and without excess weight university students.

METHODS

This longitudinal study was carried out with 583 university students from a public Higher Education Institution (HEI) in Brazil. The Generalized Estimating Equation (GEE) was used to verify whether anxiety symptoms were associated with changes in food consumption over time.

RESULTS

The results showed that previous moderate/severe anxiety symptoms were associated with an increased frequency of consumption of both fresh or minimally processed foods (β: 0.2 95%CI: 0.1; 0.7 p = 0.013) and ultra-processed foods (β: 5.6 95%CI: 1.8; 17.7 p = 0.003), but with different magnitudes. In university students who were not excess weight, previous moderate/severe anxiety symptoms were associated with a reduction in the frequency of consumption of fresh or minimally processed foods (β: -2.0 95%CI: -3.5; -0.5 p = 0.008), while in those who were excess weight, there was an increase in consumption of ultra-processed foods (β: 4.5 95%CI: 2.2; 6.8 p < 0.001).

CONCLUSION

This study confirms the influence of anxiety symptoms on food consumption according to the extent and purpose of processing. In addition, these results emphasize the role of psychological distress in the university population, and that this factor can affect excess weight and without excess weight individuals differently.

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.

Influence of ultra-processed food in the diet of South Indian young adults: an explanatory mixed method study

PURPOSE

To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India.

METHODS

This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant's anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling.

RESULTS

Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework.

CONCLUSION

UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage.

An Anti-Inflammatory Diet and Its Potential Benefit for Individuals with Mental Disorders and Neurodegenerative Diseases-A Narrative Review

This narrative review synthesizes current evidence regarding anti-inflammatory dietary patterns and their potential benefits for individuals with mental disorders and neurodegenerative diseases. Chronic low-grade inflammation is increasingly recognized as a key factor in the etiology and progression of these conditions. The review examines the evidence for the anti-inflammatory and neuroprotective properties of dietary components and food groups, focusing on whole foods rather than specific nutrients or supplements. Key dietary components showing potential benefits include fruits and vegetables (especially berries and leafy greens), whole grains, legumes, fatty fish rich in omega-3, nuts (particularly walnuts), olive oil, and fermented foods. These foods are generally rich in antioxidants, dietary fiber, and bioactive compounds that may help modulate inflammation, support gut health, and promote neuroprotection. Conversely, ultra-processed foods, red meat, and sugary beverages may be harmful. Based on this evidence, we designed the Brain Anti-Inflammatory Nutrition (BrAIN) diet. The mechanisms of this diet include the modulation of the gut microbiota and the gut-brain axis, the regulation of inflammatory pathways, a reduction in oxidative stress, and the promotion of neuroplasticity. The BrAIN diet shows promise as an aid to manage mental and neurodegenerative disorders.

Decoding the Foodome: Molecular Networks Connecting Diet and Health

Diet, a modifiable risk factor, plays a pivotal role in most diseases, from cardiovascular disease to type 2 diabetes mellitus, cancer, and obesity. However, our understanding of the mechanistic role of the chemical compounds found in food remains incomplete. In this review, we explore the "dark matter" of nutrition, going beyond the macro- and micronutrients documented by national databases to unveil the exceptional chemical diversity of food composition. We also discuss the need to explore the impact of each compound in the presence of associated chemicals and relevant food sources and describe the tools that will allow us to do so. Finally, we discuss the role of network medicine in understanding the mechanism of action of each food molecule. Overall, we illustrate the important role of network science and artificial intelligence in our ability to reveal nutrition's multifaceted role in health and disease.

Dietary inflammatory potential and arterial stiffness in a French cohort: Insights from the STANISLAS study

BACKGROUND AND AIMS

Chronic inflammation plays a key role in arterial stiffness pathogenesis. Dietary components can display anti- or pro-inflammatory properties. Nonetheless, the association between the diet's overall inflammatory potential and arterial stiffness is unclear. This study aimed to assess the association between the diet's overall inflammatory potential and arterial stiffness assessed by carotid-femoral pulse wave velocity (cfPWV).

METHODS AND RESULTS

This cross-sectional study included 1307 participants from the STANISLAS family cohort study. Dietary data were collected using a validated food frequency questionnaire. The adapted dietary inflammatory index (ADII) score was calculated to assess the inflammatory potential of the participants' diet. The association of ADII score quartile with cfPWV was assessed using IPW-weighted linear mixed models with random family effect. The median (Q1-Q3) ADII score was 0.45 (-1.57, 2.04). Participants exhibiting higher ADII scores demonstrated elevated energy intake, dietary saturated fat, and ultra-processed foods. Conversely, individuals with lower ADII scores exhibited higher vitamins and omega intakes, and a higher diet quality, as assessed by the DASH score. Despite these observations from the descriptive analyses, ADII score quartiles were not significantly associated with cfPWV (β(95% CI) were 0.01 (-0.02,0.04) for Q2, 0.02 (-0.01,0.05) for Q3, and 0.02 (-0.01,0.05) for Q4 compared to Q1).

CONCLUSION

In this cross-sectional study, participants had a relatively modest consumption of pro-inflammatory foods, no substantial associations were observed between the diet inflammatory potential and arterial stiffness. Further longitudinal studies in larger cohorts are needed to better understand the link between inflammatory diet and arterial stiffness.

Association Between Diet, Physical Activity, Smoking, and Ultra-Processed Food and Cardiovascular Health, Depression, and Sleep Quality

BACKGROUND

This study evaluated cardiovascular health, dietary habits, physical activity, depression, and sleep quality in young university adults.

MATERIALS AND METHODS

A cross-sectional design was used to assess anthropometric, biochemical, and cardiovascular health behaviors. The study included 158 university students aged 18 to 30 years (65% women, 35% men, average age: 20.3 ± 2.4 years), selected through non-probabilistic sampling. Measurements included BMI, waist circumference, blood pressure, glucose, triglycerides, HDL and LDL cholesterol, and visceral fat using bioelectrical impedance. Health behaviors were evaluated via questionnaires on physical activity, fruit and vegetable consumption, smoking, ultra-processed food consumption, and sleep quality using the Pittsburgh Sleep Quality Index. The cardiovascular health index was assessed with the "Life's Essential 8" questionnaire and depression was assessed with Beck Depression Inventory. Statistical analyses included ANOVA, Fisher's F test, Student's t-test, and simple linear regression, conducted using SPSS Statistics version 25.0 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp), with significance set at p<0.05.

RESULTS

Women showed better adherence to healthy behaviors. Higher fruit and vegetable consumption and physical activity were associated with lower visceral fat. Higher visceral fat is correlated with increased blood pressure and decreased HDL cholesterol. Smoking and frequent ultra-processed food consumption were linked to higher depression scores, which were associated with poorer sleep quality.

CONCLUSION

Healthy lifestyle habits are crucial for physical and mental health, providing a basis for public health interventions.

"Food faddists and pseudoscientists!": Reflections on the history of resistance to ultra-processed foods

The term 'ultra-processed food' emerged in the 1980s, mostly used in reference to highly-processed convenience foods and snacks, often energy-dense, poor in nutrients, and inclusive of various synthetic additives such as emulsifiers, colors, artificial sweeteners, and/or flavor enhancers. Concern over such foods was part of the growing holistic and environmental health movements of the 1970-80s; yet, those who raised alarm about the encroachment of ultra-processed foods were often labeled, especially by industry and their powerful allies, as 'food faddists' and 'pseudoscientists'. Today, the topic of ultra-processed foods is generating massive personal, public, and planetary health interest. However, other than discussing the history of the NOVA food classification system, a useful tool that has allowed researchers to more accurately separate foods based on processing, most lay media and academic articles are ahistorical. That is, there is a tendency to present the term ultra-processed food(s) as a relatively new entrance into the lexicon, and by default, the idea that health-related pushback on ultra-processed foods is a relatively new phenomenon. This omission overlooks decades of determined advocacy and clinical work, much of it by pioneers within the holistic medicine (now integrative, functional, and lifestyle medicine) movement. Here in this reflection paper, the authors will use historical research and reporting to fill in the historical gap and articulate the saliency of why it matters.

Association between junk food consumption and mental health problems in adults: a systematic review and meta-analysis

BACKGROUND

Anxiety and depression can seriously undermine mental health and quality of life globally. The consumption of junk foods, including ultra-processed foods, fast foods, unhealthy snacks, and sugar-sweetened beverages, has been linked to mental health. The aim of this study is to use the published literature to evaluate how junk food consumption may be associated with mental health disorders in adults.

METHODS

A systematic search was conducted up to July 2023 across international databases including PubMed/Medline, ISI Web of Science, Scopus, Cochrane, Google Scholar, and EMBASE. Data extraction and quality assessment were performed by two independent reviewers. Heterogeneity across studies was assessed using the I2 statistic and chi-square-based Q-test. A random/fixed effect meta-analysis was conducted to pool odds ratios (ORs) and hazard ratios (HRs).

RESULTS

Of the 1745 retrieved articles, 17 studies with 159,885 participants were suitable for inclusion in the systematic review and meta-analysis (seven longitudinal, nine cross-sectional and one case-control studies). Quantitative synthesis based on cross-sectional studies showed that junk food consumption increases the odds of having stress and depression (OR = 1.15, 95% CI: 1.06 to 1.23). Moreover, pooling results of cohort studies showed that junk food consumption is associated with a 16% increment in the odds of developing mental health problems (OR = 1.16, 95% CI: 1.07 to 1.24).

CONCLUSION

Meta-analysis revealed that consumption of junk foods was associated with an increased hazard of developing depression. Increased consumption of junk food has heightened the odds of depression and psychological stress being experienced in adult populations.

Association between watching eating shows and unhealthy food consumption in Korean adolescents

BACKGROUND

Eating habits formed during adolescence greatly influence the maintenance of health in adulthood. With the recent development of social media and easy access to the Internet, adolescents watch plenty of food videos, particularly Mukbang and Cookbnag(eating show)content. This media genre's impact on food choices has been covered in several studies; however, studies on unhealthy eating habits directly related to adolescents' exposure to eating shows are insufficient.

METHODS

For this study, we used data from the 18th Korea Youth Risk Behavior Survey conducted in 2022 and finalized 50,451 participants. The extent of exposure to eating show media over the course of a week, as well as the consumption of fast food, sugar-sweetened beverages (SSBs), and high caffeinated beverages within that week were measured through self-reporting questionnaires. We classified the participants into two groups based on their frequency of watching eating shows. A multiple logistic regression analysis was performed to investigate the association between eating show and unhealthy food consumption.

RESULTS

For both males and females, eating show exposure was strongly associated with the consumption of fast food (male: OR:1.37, 95% CI:1.26-1.49; female: OR:1.46, 95% CI:1.36-1.57), SSB (male: OR:1.42, 95% CI:1.26-1.60; female: OR:1.51, 95% CI:1.35-1.70), and high caffeinated beverage (male: OR:1.30, 95% CI:1.23-1.37; female: OR:1.24, 95% CI:1.18-1.31). It was observed that both sexes were more likely to frequently eat unhealthy food than students who did not watch eating shows.

CONCLUSION

Among Korean adolescents, students exposed to eating shows, which primarily aim to entertain, were more likely to consume fast food, SSBs, and high caffeinated beverages. Therefore, this study's findings suggest that eating show could influence adolescents' food choices, highlighting the need for interest in emerging cultures and corresponding health policies.

Ultra-Processed Food Consumption and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis

INTRODUCTION

Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk.

METHODS

PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model.

RESULTS

Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03-1.21; P = 0.01; I2 = 31%), colon cancer (HR 1.12; 95% CI 1.02-1.23; P = 0.02; I2 = 0%), and non-cardia gastric cancer (HR 1.43; 95% CI 1.02-2.00; P = 0.04; I2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer.

DISCUSSION

The highest level of UPF consumption was significantly associated with colorectal and non-cardia gastric cancer.

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio

Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

Adherence to the ultra-processed dietary pattern and risk of depressive outcomes: Findings from the NutriNet Brasil cohort study and an updated systematic review and meta-analysis

BACKGROUND & AIMS

We aimed to analyze the prospective association between adherence to the ultra-processed dietary pattern and risk of depressive outcomes using original data from the NutriNet Brasil cohort and via a systematic review and meta-analysis of observational studies that have investigated the same association.

METHODS

In our original research analysis, we used data from 15,960 adults (≥18 y) participating in the NutriNet Brasil cohort study, free of depression or depressive symptoms during the baseline (77.5% women, 45.8 ± 13.0 y). The mean dietary share of ultra-processed foods (%Kcal/d), calculated from two baseline 24-h dietary recalls, was used to measure the adherence to the ultra-processed dietary pattern. New cases of depressive symptoms were assessed using the Patient Health Questionnaire-9 over the follow-up period (mean: 18.3 months). Cox proportional hazards models were used for the main analyses. In our systematic review and meta-analysis, we incorporated effect estimates from six prospective cohort studies that have examined the same association, including ours.

RESULTS

In the adjusted model, each 10% increase in the dietary share of ultra-processed foods was associated with a 10% increase in the hazard of incident cases of depressive symptoms (HR:1.10; 95%CI: 1.07-1.14). This association was slightly attenuated in the models including potential mediators. In our meta-analysis of six prospective studies, high versus low exposure to ultra-processed foods was associated with a summary hazard ratio of depressive outcomes of 1.32; 95%CI: 1.19-1.46; I2: 71%.

CONCLUSION

A higher adherence to the ultra-processed dietary pattern was associated with a higher risk of developing depressive outcomes in the NutriNet Brasil cohort and in the meta-analysis.

Ultra-processed foods - a scoping review for Nordic Nutrition Recommendations 2023

Ultra-processed foods (UPFs) are increasingly consumed worldwide and have been linked to several chronic diseases. This paper aims to describe the totality of the available evidence regarding UPFs in relation to health-related outcomes as a basis for setting food-based dietary guidelines for the Nordic Nutrition Recommendations 2023. Systematic literature searches were conducted to identify systematic reviews, meta-analyses, randomized controlled trials (RCTs), and prospective cohort studies examining the association between UPF intake and non-communicable diseases or mortality. A total of 12 systematic reviews (including five meta-analyses) and 44 original research studies (43 prospective cohort studies and one RCT) were included. All original research studies were deemed to be of good methodological quality. The current evidence supports that greater consumption of UPFs is associated with weight gain and increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality. The available literature also supports an association between UPFs and hypertension, cancer, and depression; however, the limited number of studies and subjects investigated preclude strong conclusions. Due to the highly diverse nature of UPFs, additional studies are warranted, with special emphasis on disentangling mediating mechanisms, whether nutritional or non-nutrient based. Nevertheless, the available evidence regarding UPFs in relation to weight gain, CVD, type 2 diabetes, and all-cause mortality is considered strong enough to support dietary recommendations to limit their consumption.

A policy approach to identifying food and beverage products that are ultra-processed and high in added salt, sugar and saturated fat in the United States: a cross-sectional analysis of packaged foods

Background

Governments globally aim to reduce the intake of unhealthy foods. Many policies exist that aim to address foods high in saturated fat, salt and sugar (HFSS) but the identification of ultra-processed foods (UPF) have presented a greater challenge due to the lack of an appropriate policy definition. To support policymakers, we provide approaches that can support governments to identify both HFSS foods and UPFs.

Methods

Four approaches combining elements of UPF definitions (i.e., presence of additives) and HFSS definitions were compared attempting to simplify and standardize the identification of less healthy products. Nationally representative food purchase data from NielsenIQ linked with nutrition facts label data were used to examine the mean proportion of product volume purchased by US households to be targeted. Differences between approaches were examined using Student t test; Bonferroni adjusted P value < 0.0001 was considered significant.

Findings

In 2020, 50% of 33,054,687 products purchased by US households were considered UPFs (65% of foods and 38% of beverages) and 43% HFSS (65% of foods and 26% of beverages), however there was not 100% agreement between the two definitions (P < 0.0001). By starting with HFSS criteria and adding elements of UPF (colors and flavors), we were able to provide a method with 100% agreement between the identification of UPFs and HFSS products.

Interpretation

Results demonstrated how combining HFSS criteria with UPF criteria can be used to identify less healthy foods and ensure policymakers have both a simple and accurate method to target products for policy intervention.

Funding

Bloomberg Philanthropies and the Global Food Research Program of UNC-Chapel Hill provided funds.

From ultra-processed foods towards healthy eating for CKD patients: a proposal of educational infographics

Ultraprocessed food (UPF) is defined as industrialized, packaged and ready-to-eat food produced on a large scale, using sophisticated industrial machinery. Examples of UPFs include salty and sweet snacks, industrialized biscuits and packaged meals, processed meats and sugary drinks. Ultraprocessed food has a long-shelf life, is highly palatable, microbiologically safe, affordable and most of all, easy to consume. For these reasons, its consumption has been increasing worldwide, and is replacing healthy homemade meals. The main concern of this dietary shift is that UPFs come with the addition of salt, sugar, unhealthy fats, and several additives and taste enhancers that contain, among other substances, relevant quantities of potassium, phosphate and sodium. A large proportion of UPF in the diet may carry risks for patients with chronic kidney disease (CKD) since it can worsen blood pressure and glycemic control, and lead to constipation, hyperkalemia and hyperphosphatemia. Acknowledging the importance of UPF in kidney health implies integrating nutritional counseling with information on UPFs, and specific educational material can be helpful for patients, caregivers, and also for health care providers. We developed a set of 3 infographics dedicated to CKD patients, with information on how to identify UPFs, reasons for decreasing consumption, how to compose a healthy CKD plate and tips for reading food labels in supermarkets and grocery shops. We hope that this material can be useful in CKD outpatient clinics and dialysis centers as well as in general practitioners' offices, caring for early stage CKD.

Gut microbiota, nutrition, and mental health

The human brain remains one of the greatest challenges for modern medicine, yet it is one of the most integral and sometimes overlooked aspects of medicine. The human brain consists of roughly 100 billion neurons, 100 trillion neuronal connections and consumes about 20-25% of the body's energy. Emerging evidence highlights that insufficient or inadequate nutrition is linked to an increased risk of brain health, mental health, and psychological functioning compromise. A core component of this relationship includes the intricate dynamics of the brain-gut-microbiota (BGM) system, which is a progressively recognized factor in the sphere of mental/brain health. The bidirectional relationship between the brain, gut, and gut microbiota along the BGM system not only affects nutrient absorption and utilization, but also it exerts substantial influence on cognitive processes, mood regulation, neuroplasticity, and other indices of mental/brain health. Neuroplasticity is the brain's capacity for adaptation and neural regeneration in response to stimuli. Understanding neuroplasticity and considering interventions that enhance the remarkable ability of the brain to change through experience constitutes a burgeoning area of research that has substantial potential for improving well-being, resilience, and overall brain health through optimal nutrition and lifestyle interventions. The nexus of lifestyle interventions and both academic and clinical perspectives of nutritional neuroscience emerges as a potent tool to enhance patient outcomes, proactively mitigate mental/brain health challenges, and improve the management and treatment of existing mental/brain health conditions by championing health-promoting dietary patterns, rectifying nutritional deficiencies, and seamlessly integrating nutrition-centered strategies into clinical care.

How and why ultra-processed foods harm human health

The analysis of food using a perspective centred on nutrients seems inadequate for understanding the dietary transition and its impact on the growth of obesity and chronic diseases. Industrial food processing is now proposed as the key to explain the relationship between food and health. The NOVA food classification considers the degree and the purpose of food processing, which includes physical, biological and chemical processes used after foods are separated from nature, and before being consumed or prepared as dishes and meals. NOVA has four food groups: (1) unprocessed and minimally processed foods; (2) processed culinary ingredients; (3) processed foods and (4) ultra-processed foods, which are formulations made mostly or entirely from substances derived from group 1 foods and additives, with little if any intact group 1 food. Many investigations linking high ultra-processed food consumption with deterioration of diets and adverse health outcomes are reinforced by prospective studies, systematic reviews and meta-analyses. There are various plausible explanations of why diets high in ultra-processed foods are harmful. Their production and consumption continue to rise worldwide. Efficient and effective public policies and actions that reduce production and consumption of ultra-processed products are needed, to protect human health now and in future.

Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice

There is mounting concern over the potential harms associated with ultra-processed foods, including poor mental health and antisocial behavior. Cutting-edge research provides an enhanced understanding of biophysiological mechanisms, including microbiome pathways, and invites a historical reexamination of earlier work that investigated the relationship between nutrition and criminal behavior. Here, in this perspective article, we explore how this emergent research casts new light and greater significance on previous key observations. Despite expanding interest in the field dubbed 'nutritional psychiatry', there has been relatively little attention paid to its relevancy within criminology and the criminal justice system. Since public health practitioners, allied mental health professionals, and policymakers play key roles throughout criminal justice systems, a holistic perspective on both historical and emergent research is critical. While there are many questions to be resolved, the available evidence suggests that nutrition might be an underappreciated factor in prevention and treatment along the criminal justice spectrum. The intersection of nutrition and biopsychosocial health requires transdisciplinary discussions of power structures, industry influence, and marketing issues associated with widespread food and social inequalities. Some of these discussions are already occurring under the banner of 'food crime'. Given the vast societal implications, it is our contention that the subject of nutrition in the multidisciplinary field of criminology-referred to here as nutritional criminology-deserves increased scrutiny. Through combining historical findings and cutting-edge research, we aim to increase awareness of this topic among the broad readership of the journal, with the hopes of generating new hypotheses and collaborations.

A review of the impact of social disruptions on food security and food choice

At times of severe social disruption, be that war, conflict, pandemic, or economic downturn, both the availability and consumption of healthy dietary patterns can be adversely affected with any effects often outlasting the initial social disruption. For instance, when the COVID-19 pandemic hit and lockdown restrictions followed, households were reported to consume unhealthy diets. In some cases, this seemed to be a response to the situation and a coping mechanism. In contrast, in other cases, it was a consequence of limited food availability or access, with some communities finding that fresh foods became difficult to source due to the disruption in global supply chains. The example presented by the impact of conflict in Ukraine, which has also disrupted global food supply chains, at a macrolevel, food systems and at a microlevel, individual and community shows that food choices may respond to different global events in similar ways. Therefore, in this review, a range of events/disruptions are considered, beyond pandemics and wars, including climate disasters (e.g., fire, famine, and floods) that have been shown to impact food supply and consequently, food security. The importance of this can be seen as inadequate and nutritionally poor diets have a concomitant effect on health, which extends beyond the initial period of societal stress and disruption of food supply chains. Hence, the impact of such disruptions on consumer behavior which includes food choice needs to be corroborated. Therefore, this review aims to discuss the impact of such disruptions on consumer behavior and food choices. Additionally, this review provides some practical strategies that can be used to ensure the availability of healthy diets.

Association between ultra-processed foods and recurrence of depressive symptoms: the Whitehall II cohort study

OBJECTIVES

To examine the association between high intakes of ultra-processed foods (UPF) and recurrence of depressive symptoms (DepS) in a Western non-Mediterranean country and its contribution to the overall diet-depression relationship.

METHODS

Analyses were carried out on British participants from the Whitehall II cohort. Present analyses were restricted to white participants N = 4554 (74% men, mean age = 61; SD = 5.9). UPF consumption was estimated from a 127-item food frequency questionnaire using the NOVA classification, and cumulative average of UPF intakes (g/day) over 11 years of exposure (1991/1994-2002/2004) was computed. Recurrent DepS after measurement of UPF was defined as having two or more episodes of DepS (the Center for Epidemiologic Studies Depression Scale (CES-D) score ≥ 16 or antidepressants use) during four phases of follow-up (2002/2004-2015/2016).

RESULTS

Over the follow-up, 588 (12.9%) cases of recurrent DepS were observed. After adjusting for socio-demographic factors, health behaviours and health status, participants in top quintile of UPF intakes [mean 33% of total daily intakes in grams] had 31% higher odds of recurrent DepS (odds ratio 1.31; 95% CI 1.04-1.64) compared to participants in the four lowest quintiles of UPF [mean 18.1% of total daily intakes in grams]. Additional analyses showed that associations between adherence to several diet quality measures and recurrent DepS were partially attenuated (17-27%) by UPF intakes.

CONCLUSION

In this British population, high intakes of ultra-processed foods were associated with increased odds of recurrent depressive symptoms and contributed to the overall diet quality-depressive symptoms association.

Flavour, emulsifiers and colour are the most frequent markers to detect food ultra-processing in a UK food market analysis

OBJECTIVE

To elucidate which markers of ultra-processing (MUP) and their combinations are best suited to detect ultra-processed food (UPF).

DESIGN

The study was based on the 206 food and 32 beverage items of the Oxford WebQ which encompass all major foods consumed in the UK. For each Oxford WebQ question, ingredient lists of up to ten matching different commercial products (n 2146) were researched online using data from the two market leaders of groceries in the UK sorted by relevance (Tesco) and by top sellers (Sainsbury's), respectively. According to the NOVA classification, sixty-five MUP were defined, and if the ingredient list of a food product was positive for at least one MUP, it was regarded as UPF. The percentage of UPF items containing specific MUP was calculated. In addition, all combinations of two to six different MUP were assessed concerning the percentage of identified UPF items.

SETTING

Cross-sectional analysis.

PARTICIPANTS

None.

RESULTS

A total of 990 products contained at least one MUP and were, therefore, regarded as UPF. The most frequent MUP were flavour (578 items, 58·4 % of all UPF), emulsifiers (353 items, 35·7 % of all UPF) and colour (262 items, 26·5 % of all UPF). Combined, these three MUP detected 79·2 % of all UPF products. Detection rate increased to 88·4 % of all UPF if ingredient lists were analysed concerning three additional MUP, that is, fibre, dextrose and firming agent.

CONCLUSIONS

Almost 90 % of all UPF items can be detected by six MUP.

Motives and food craving: Associations with frequency of hyper-palatable food intake among college students

BACKGROUND

College food environments provide wide access to hyper-palatable foods (HPF). Palatable eating motives and craving are individual factors that may impact HPF intake. Nevertheless, no study to date has examined the relationship between these factors and frequency of HPF intake in a dormitory all-you-can-eat-style cafeteria meal, a typical college food setting.

METHODS

College students (N = 218) self-reported frequency of HPF intake at a college cafeteria meal and their frequency of HPF intake in the overall diet. Quasipoisson and logistic regression models tested whether palatable eating motives (assessed via the Palatable Eating Motives Scale) and craving (assessed via the Food Craving Inventory) were associated with the rate of HPF intake during the cafeteria meal and excess frequency of HPF intake in the overall diet.

RESULTS

Craving was associated with a 19% higher rate of HPF intake during the cafeteria meal (RR = 1.19; p = .015) and a >2-fold higher likelihood of excess frequency of HPF intake the overall diet (OR = 2.69; p < .001). Coping motive was associated with an 87% higher likelihood of excess frequency of HPF intake in the overall diet (OR = 1.87; p = .002), but not in the cafeteria meal. Reward enhancement, social and conformity motives were not significantly associated with the frequency of HPF intake in either setting.

CONCLUSIONS

Results highlight the role of craving and coping motive in the frequency of HPF intake among college students. Prevention efforts may consider targeting craving and eating to cope to potentially address frequency of HPF intake among college students.

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.

The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants

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.

Consumption of Ultraprocessed Food and Risk of Depression

This cohort study examines the consumption of ultraprocessed food and risk of depression among 31 172 US females aged 42 to 62 years.

Association of ultra-processed food consumption with incident depression and anxiety: a population-based cohort study

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.

Diet quality, ultra-processed food consumption, and quality of life in a cross-sectional cohort of adults and teens with celiac disease

BACKGROUND

Coeliac disease (CeD), a common autoimmune condition, requires strict adherence to a gluten-free diet (GFD). Adherence to the GFD has been associated with quality of life (QOL). However, there may be other diet-related concerns, such as overall diet patterns, including diet quality or ultra-processed food (UPF) consumption, possibly associated with QOL among people with CeD following a GFD that have not been examined.

METHODS

Diet quality was determined based on 24-h diet recalls of a cross-sectional prospectively recruited sample of 80 participants (50 adults and 30 teens) with biopsy-confirmed CeD ('Study Sample') using the Healthy Eating Index and Alternate Mediterranean Diet score. The amount of UPF consumed was assessed using Nova, a food processing classification system. QOL was measured using Celiac Disease-Specific Quality of Life (CDQOL) and Celiac Disease Pediatric-Specific Quality of Life (CDPQOL). The Study Sample's diet patterns were compared with National Health and Nutrition Examination Survey (NHANES) groups (25 adults reporting prior CeD and GFD; 51 adults with new CeD and no GFD; 15,777 adults and 2296 teens without CeD). The relationship of the Study Sample's diet patterns with CDQOL/CDPQOL was assessed using analysis of covariance.

RESULTS

The Study Sample's diet patterns were suboptimal but generally favourable compared with all NHANES groups. Compared to Study Adults with the highest tertile of UPF, those with the lowest tertile had significantly higher CDQOL (mean: 67.6 vs. 78.3, p < 0.001). Compared to Study Teens with the lowest tertile of AMED, those with the highest tertile had significantly higher CDPQOL (mean: 67.0 vs. 79.9, p < 0.01).

CONCLUSIONS

Maintaining high diet quality and minimising UPF may be important for CeD-specific QOL among individuals with CeD maintaining a GFD.

Ultra-processed food intake and incident venous thromboembolism risk: Prospective cohort study

BACKGROUND & AIMS

Ultra-processed food (UPF) intake has been associated with multiple health outcomes, but data on the association between UPF intake and venous thromboembolism (VTE) risk are lacking. We conducted this study to examine the association between UPF intake and the risk of incident VTE.

METHODS

This prospective cohort study was based on 186,323 participants free of baseline VTE from the UK Biobank. UPF intake was assessed by 24-h recall questionnaires. Data on incident VTE came from the nationwide inpatient and primary care datasets and the death registry. Cox proportional hazards regression was used to estimate the association between UPF intake and incident VTE risk. Multiplicative interactions and stratified analyses by age, sex, and body mass index were performed.

RESULTS

During a 10.5-year (median) follow-up, 4235 incident VTE cases were diagnosed. After adjusting for covariates, the hazard ratio of VTE among individuals with the highest quintile of UPF intake was 1.05 (95% confidence interval [CI] 0.94, 1.17) for UPF in servings, 1.12 (95% CI 1.01, 1.24) in grams, 1.10 (95% CI 1.00, 1.22) in grams %, 1.21 (95% CI 1.10, 1.33) in energy, and 1.15 (95% CI 1.05, 1.27) in energy % compared to those in the lowest quintile. Age, sex, and body mass index did not modify the associations (Pinteraction > 0.05).

CONCLUSIONS

Higher UPF intake was associated with a moderately increased risk of VTE.

Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet

Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.

Food Allergens in Ultra-Processed Foods According to the NOVA Classification System: A Greek Branded Food Level Analysis

Ultra-processed foods' (UPFs') consumption has been positively linked to the presence of allergic symptoms, but it is yet unknown whether this is linked to their nutritional composition or allergen load. This study used the ingredient lists available in the Greek Branded Food Composition Database, HelTH, to classify foods (n = 4587) into four grades of food processing (NOVA1-4) according to the NOVA System. Associations between NOVA grades and the presence of allergens (as an ingredient or trace) were studied. Overall, UPFs (NOVA4) were more likely to contain allergens than unprocessed foods, NOVA1 (76.1% vs. 58.0%). However, nested analyses among similar foods showed that in >90% of cases, processing degree was not linked to allergens' presence. Recipe/matrix complexity was more strongly linked to allergens' presence with NOVA4 foods declaring 1.3 allergenic ingredients vs. 0.4 allergenic ingredients in NOVA1 foods (p < 0.01). Exposure to trace allergens was more common for NOVA4 than NOVA1 foods (45.4% vs. 28.7%), but the extent of contamination was similar (2.3 vs. 2.8 trace allergens). Overall, UPFs are more complex mixtures with higher numbers of allergens per food and are more prone to cross-contamination. However, indicating a food's degree of processing is not sufficient to help identify allergen-free choices within the same subcategory.

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.

Evaluation of nutritional status and clinical depression classification using an explainable machine learning method

Introduction

Depression is a prevalent disorder worldwide, with potentially severe implications. It contributes significantly to an increased risk of diseases associated with multiple risk factors. Early accurate diagnosis of depressive symptoms is a critical first step toward management, intervention, and prevention. Various nutritional and dietary compounds have been suggested to be involved in the onset, maintenance, and severity of depressive disorders. Despite the challenges to better understanding the association between nutritional risk factors and the occurrence of depression, assessing the interplay of these markers through supervised machine learning remains to be fully explored.

Methods

This study aimed to determine the ability of machine learning-based decision support methods to identify the presence of depression using publicly available health data from the Korean National Health and Nutrition Examination Survey. Two exploration techniques, namely, uniform manifold approximation and projection and Pearson correlation, were performed for explanatory analysis among datasets. A grid search optimization with cross-validation was performed to fine-tune the models for classifying depression with the highest accuracy. Several performance measures, including accuracy, precision, recall, F1 score, confusion matrix, areas under the precision-recall and receiver operating characteristic curves, and calibration plot, were used to compare classifier performances. We further investigated the importance of the features provided: visualized interpretation using ELI5, partial dependence plots, and local interpretable using model-agnostic explanations and Shapley additive explanation for the prediction at both the population and individual levels.

Results

The best model achieved an accuracy of 86.18% for XGBoost and an area under the curve of 84.96% for the random forest model in original dataset and the XGBoost algorithm with an accuracy of 86.02% and an area under the curve of 85.34% in the quantile-based dataset. The explainable results revealed a complementary observation of the relative changes in feature values, and, thus, the importance of emergent depression risks could be identified.

Discussion

The strength of our approach is the large sample size used for training with a fine-tuned model. The machine learning-based analysis showed that the hyper-tuned model has empirically higher accuracy in classifying patients with depressive disorder, as evidenced by the set of interpretable experiments, and can be an effective solution for disease control.

High ultra-processed food consumption is associated with elevated psychological distress as an indicator of depression in adults from the Melbourne Collaborative Cohort Study

BACKGROUND

Few studies have tested longitudinal associations between ultra-processed food consumption and depressive outcomes. As such, further investigation and replication are necessary. The aim of this study is to examine associations of ultra-processed food intake with elevated psychological distress as a marker for depression after 15 years.

METHOD

Data from the Melbourne Collaborative Cohort Study (MCCS) were analysed (n = 23,299). We applied the NOVA food classification system to a food frequency questionnaire (FFQ) to determine ultra-processed food intake at baseline. We categorised energy-adjusted ultra-processed food consumption into quartiles by using the distribution of the dataset. Psychological distress was measured by the ten-item Kessler Psychological Distress Scale (K10). We fitted unadjusted and adjusted logistic regression models to assess the association of ultra-processed food consumption (exposure) with significant psychological distress (outcome and defined as K10 ≥ 20). We fitted additional logistic regression models to determine whether these associations were modified by sex, age and body mass index.

RESULTS

After adjusting for sociodemographic characteristics and lifestyle and health-related behaviours, participants with the highest relative intake of ultra-processed food were at increased odds of significant psychological distress compared to participants with the lowest intake (aOR: 1.23; 95%CI: 1.10, 1.38, p for trend = 0.001). We found no evidence for an interaction of sex, age and body mass index with ultra-processed food intake.

CONCLUSION

Higher ultra-processed food intake at baseline was associated with subsequent elevated psychological distress as an indicator of depression at follow-up. Further prospective and intervention studies are necessary to identify possible underlying pathways, specify the precise attributes of ultra-processed food that confer harm, and optimise nutrition-related and public health strategies for common mental disorders.

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

OBJECTIVE

To evaluate the association between the consumption of ultra-processed food and the incidence of depression in Brazilian adults.

METHODS

This longitudinal study included 2572 participants (M = 936 and F = 1636, mean age of 36.1 years) from the Cohort of Universities of Minas Gerais - CUME Project, Brazil. Ultra-processed food (UPF) consumption (in % of daily energy intake, DEI), as defined by the NOVA food classification system, was assessed at baseline using a validated semi-quantitative 144-item food frequency questionnaire. Participants were classified as incident cases of depression if they reported a medical diagnosis of depression in at least one of the follow-up questionnaires. Crude and adjusted cox regression models were used to assess the relationship between UPF consumption and the incidence of depression.

RESULTS

After a mean of follow-up of 2,96 years, a total of 246 incident cases of depression were identified. The mean consumption of UPF was 44 g/d or 24 % of DEI. Participants in the highest quartile of UPF consumption (31 to 72 % of DEI) had a higher risk of developing depression (HR = 1.82 95 % CI = 1.15-2.88) than those in the lowest quartile (0 to 16 % of DEI) after adjusting for potential confounders.

CONCLUSION

Higher UPF consumption is a risk factor of depression incidence in Brazilian adults with high education level.