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

Estimating the Burden of Common Mental Disorders Attributable to Lifestyle Factors: Protocol for the Global Burden of Disease Lifestyle and Mental Disorder (GLAD) Project

BACKGROUND

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) collects and calculates risk-outcome data for modifiable lifestyle exposures (eg, dietary intake) and physical health outcomes (eg, cancers). These estimates form a critical digital resource tool, the GBD VizHub data visualization tool, for governments and policy makers to guide local, regional, and global health decisions. Despite evidence showing the contributions of lifestyle exposures to common mental disorders (CMDs), such as depression and anxiety, GBD does not currently generate these lifestyle exposure-mental disorder outcome pairings. This gap is due to a lack of uniformly collected and analyzed data about these exposures as they relate to CMDs. Such data are required to quantify whether, and to what degree, the global burden of CMDs could be reduced by targeting lifestyle factors at regional and global levels. We have established the Global burden of disease Lifestyle And mental Disorder (GLAD) Taskforce to address this gap.

OBJECTIVE

This study aims to generate the necessary estimates to afford the inclusion of lifestyle exposures as risk factors for CMDs in the GBD study and the GBD digital visualization tools, initially focusing on the relationship between dietary intake and CMDs.

METHODS

The GLAD project is a multicenter, collaborative effort to integrate lifestyle exposures as risk factors for CMDs in the GBD study. To achieve this aim, global epidemiological studies will be recruited to conduct harmonized data analyses estimating the risk, odds, or hazards of lifestyle exposures with CMD outcomes. Initially, these models will focus on the relationship between dietary intake, as defined by the GBD, and anxiety and depression.

RESULTS

As of August 2024, 18 longitudinal cohort studies from 9 countries (Australia: n=4; Brazil: n=1; France: n=1; Italy: n=3; The Netherlands: n=3; New Zealand: n=1; South Africa: n=1; Spain: n=1; and United Kingdom: n=3) have agreed to participate in the GLAD project.

CONCLUSIONS

Our comprehensive, collaborative approach allows for the concurrent execution of a harmonized statistical analysis protocol across multiple, internationally renowned epidemiological cohorts. These results will be used to inform the GBD study and incorporate lifestyle risk factors for CMD in the GBD digital platform. Consequently, given the worldwide influence of the GBD study, findings from the GLAD project can offer valuable insights to policy makers worldwide around lifestyle-based mental health care.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/65576.

Ultra-Processed Food Consumption and Its Association with Risk of Obesity, Sedentary Behaviors, and Well-Being in Adolescents

BACKGROUND/OBJECTIVES

The literature on consumption of ultra-processed food (UPF) using the NOVA classification is still limited. Therefore, the aim of the present study was twofold: (i) to compare the UPF consumption, sedentary behaviors, and well-being perception between boys and girls; and (ii) to investigate the association between the UPF consumption and risk of overweight, sedentary behaviors, and well-being in adolescents.

METHODS

The present cross-sectional study comprised a sample of 245 adolescents (131 boys) aged 12-17 years-old (M = 14.20; SD = 1.09). Height and weight were assessed, and subsequently, the BMI was computed; furthermore, total body fat percentage was measured with bioelectrical impedance. Daily consumption of UPF was assessed by the NOVA screener and time spent sedentary was assessed by the Midlands Behavior Health 2024 questionnaire. The Mental Health Continuum-Short Form (MHC-SF) was used to measure adolescents' psychosocial well-being. Pearson's correlations and logistic regression analysis were used, controlling for biological, behavioral, and socio-economic confounders.

RESULTS

No sex differences were observed for the different UPF NOVA subscales. Boys reported higher computer use levels than girls on the weekend (p = 0.025), and they spent more time playing electronic games during the week (p = 0.005) and on the weekend than their female counterparts (p < 0.001). Moreover, boys reported higher scores in all well-being dimensions (p < 0.001) than girls.

CONCLUSIONS

The findings revealed, after controlling for sex, sedentary time, and active behaviors, adolescents who consumed UPF on the previous day tended to be associated with a higher risk of being overweight, but also marginally without statistical significance (OR = 0.91, 95% CI: 0.83-1.01, p = 0.06). Of relevance, the present study revealed that both boys and girls of mothers with high educational levels were less likely to be classified as overweight or obese youth.

Food Consumption According to the NOVA Food Classification and Its Relationship with Symptoms of Depression, Anxiety, and Stress in Women

BACKGROUND/OBJECTIVES

Depression, anxiety, and stress are highly prevalent mental disorders worldwide, and food consumption can change in individuals with these conditions. We aimed to assess the food consumption of women with depressive symptoms and compare it to a control without symptoms.

METHODS

A cross-sectional study was conducted with 96 women, aged 18-59, allocated into two groups: control (n = 62) or depressive symptoms (n = 34). The participants underwent an anthropometric assessment, and food consumption was evaluated using a 24 h food recall and the NOVA classification. Depressive symptoms, anxiety, and stress were measured using the DASS-21 questionnaire.

RESULTS

Anthropometric parameters did not differ between the groups. Women with depressive symptoms consumed fewer calories (p = 0.006), carbohydrates (p = 0.014), proteins (p = 0.036), and lipids (0.011) from unprocessed and minimally processed foods (UMPF) compared to the control women. A negative correlation was found between the dietary consumption energy of UMPF and symptoms of depression (r = -0.337; p = 0.001), anxiety (r = -0.262; p = 0.014), and stress (r = -0.260; p = 0.014), as well as a positive correlation between energy intake from ultra-processed foods (UPF) and symptoms of depression (r = 0.218; p = 0.042) and stress (r = 0.227; p = 0.034). Regression analysis showed that depressive symptoms accounted for 7.6% of the lower energy consumption from UMPF.

CONCLUSIONS

Women with depressive symptoms displayed lower UMPF consumption, and this was negatively correlated with symptoms of depression, anxiety, and stress. Professional dietary advice can improve health status in these patients.

Relationship of the Prime Diet Quality Score (PDQS) and Healthy Eating Index (HEI-2015) with depression and anxiety: a cross-sectional study

BACKGROUND

Previous studies have suggested a significant association between diet quality and mental health. However, a limited number of studies have utilized the Prime Diet Quality Score (PDQS) to examine this association. Additionally, no study has yet compared the PDQS and Healthy Eating Index-2015 (HEI-2015) in terms of their association with depression and anxiety.

AIM

This cross-sectional study aimed to investigate the association between diet quality, measured by the PDQS and HEI-2015, and the odds of depression and anxiety in adults.

METHODS

This study utilized data from the LIPOKAP study, which was conducted between February 2018 and July 2019 in five cities in Iran. We included 1994 adults aged 18 and above who were selected through a multistage cluster sampling method. Participants completed a validated semiquantitative food frequency questionnaire (FFQ) to evaluate their dietary intake. The FFQ was used to calculate the PDQS and HEI-2015. Depression and anxiety levels were determined using the Hospital Anxiety and Depression Scale (HADS).

RESULTS

The participants had a mean age of 39.79 ± 13.87 years, with females accounting for 1,041 (52.2%) of the total population. PDQS showed a significant inverse association with the odds of depression (OR = 0.45, 95% CI: 0.28-0.71) and anxiety (OR = 0.40, 95% CI: 0.25-0.62) in the fully adjusted model. Similarly, the highest quartile of HEI-2015 showed a significantly lower odds of depression (OR = 0.60, 95% CI: 0.40-0.90) and anxiety (OR = 0.62, 95% CI: 0.42-0.92) compared to the lowest quartile.

CONCLUSION

Both PDQS and HEI-2015 were associated with a reduced risk of depression and anxiety. However, the PDQS demonstrated a stronger inverse association with these risks compared to the HEI-2015. This suggests that the PDQS could be a more beneficial dietary pattern for preventing depression and anxiety compared to HEI-2015. Further large-scale studies are required to confirm these findings.

Ultra-processed food consumption and risk of chronic respiratory diseases mortality among adults: evidence from a prospective cohort study

PURPOSE

The purpose of the study was to determine the relationships between ultra-processed food (UPF) consumption and risk of mortality due to chronic respiratory diseases (CRDs) overall, chronic obstructive pulmonary disease (COPD), and lung cancer.

METHODS

A total of 96,607 participants aged 55 years and over were included from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer trial. Dietary intake was measured using food frequency questionnaire. Cox regression was fitted to estimate the risk of all-cause mortality and mortality due to CRDs overall, COPD and lung cancer associated with UPF intake. Competing risk regression was used to account for deaths from other causes and censoring.

RESULTS

During the follow-up of 1,379,655.5 person-years (median 16.8 years), 28,700 all-cause, 4092 CRDs, 2015 lung cancer and 1,536 COPD mortality occurred. A higher intake of UPF increased the risk of mortality from CRDs overall by 10% (HR 1.10; 95% CI 1.01, 1.22) and COPD by 26% (HR 1.26; 95% CI 1.06, 1.49) but not associated with lung cancer mortality risk (HR 0.97; 95% CI 0.84, 1.12). However, the risk of lung cancer increased by 16% (HR 1.16; 95% CI 1.01, 1.34) in the highest UPF intake after multiple imputation. Dose-response relationships existed for CRDs and COPD mortality but not lung cancer.

CONCLUSION

UPF consumption was associated with an increased risk of CRD mortality. The association between UPF consumption and lung cancer mortality is inconclusive and only significant when multiple imputation was applied.

Ultra-Processed Foods: A Narrative Review of the Impact on the Human Gut Microbiome and Variations in Classification Methods

Ultra-processed foods (UPFs) are foods that are industrially processed and are often pre-packaged, convenient, energy-dense, and nutrient-poor. UPFs are widespread in the current Western diet and their proposed contribution to non-communicable diseases such as obesity and cardiovascular disease is supported by numerous studies. UPFs are hypothesized to affect the body in multiple ways, including by inducing changes in the gut microbiome. This review summarizes the available research on the effect of UPFs on the gut microbiome. We also review current usage of the NOVA food classification system in randomized controlled trials and observational studies and how its implementation effects UPF research. Despite some differences in methodology between studies, results often associate UPF consumption with a number of negative health consequences. There are attempts to standardize a UPF classification system; however, reaching and implementing a consensus is difficult. Future studies focusing on the mechanisms by which UPFs effect the body, including through the microbiome and metabolome, will be essential to refine our understanding of the effects of UPFs on human health.

Predispose, precipitate, perpetuate, and protect: how diet and the gut influence mental health in emerging adulthood

Medicine often employs the 4Ps of predisposing, precipitating, perpetuating, and protective factors to identify salient influences on illness states, and to help guide patient care. Mental illness is a significant cause of morbidity and mortality worldwide. Mental health is a complex combination of biological, psychological, environmental, and social factors. There is growing interest in the gut-brain-microbiome (GBM) axis and its impact on mental health. We use the medical model of the 4Ps to explore factors involving the connection between nutrition and the GBM axis and their associated risks with mental health problems in emerging adults (EAs), a life stage when mental illness onset is the most common. We review the impact of current dietary trends on the GBM and on mental health, and the role that gut microbiome-based interventions can have in modulating the GBM axis of EAs. We discuss the implications of gut health on the GBM and areas for clinical intervention.

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.

Ultra-Processed Foods, Diet Quality and Human Health

The increase in the volume of industrially processed products in the global food supply has coincided with an increasing prevalence of obesity and non-communicable diseases in many countries, suggesting that ultra-processed foods (UPF) consumption may be detrimental to human health [...].

Perspectives on Neuronutrition in Prevention and Treatment of Neurological Disorders

The term neuronutrition has been proposed as part of nutritional neuroscience, studying the effects of various dietary components on behavior and cognition. Other researchers underline that neuronutrition includes the use of various nutrients and diets to prevent and treat neurological disorders. The aim of this narrative review was to explore the current understanding of the term neuronutrition as the key concept for brain health, its potential molecular targets, and perspectives of its nutritional approach to the prevention and treatment of Alzheimer's and Parkinson's diseases, multiple sclerosis, anxiety, depressive disorders, migraine, and chronic pain. Neuronutrition can be defined as a part of neuroscience that studies the influence of various aspects of nutrition (nutrients, diet, eating behavior, food environment, etc.) on the development of nervous disorders and includes nutrition, clinical dietetics, and neurology. There is evidence that the neuronutritional approach can influence neuroepigenetic modifications, immunological regulation, metabolic control, and behavioral patterns. The main molecular targets in neuronutrition include neuroinflammation, oxidative/nitrosative stress and mitochondrial dysfunction, gut-brain axis disturbance, and neurotransmitter imbalance. To effectively apply neuronutrition for maintaining brain health, a personalized approach is needed, which includes the adaptation of the scientific findings to the genetic, biochemical, psycho-physiological, and environmental features of each individual.

Ultra-Processed Food Intakes Are Associated with Depression in the General Population: The Korea National Health and Nutrition Examination Survey

Depression is the most common mental illnesses worldwide. The consumption of ultra-processed food (UPF) has increased globally due to its affordability and convenience; however, only a few studies have investigated the link between UPF intake and depression in the general population. We investigated the associations between UPF and depression using the Korea National Health and Nutrition Examination Survey. A total of 9463 individuals (4200 males and 5263 females) aged above 19 years old participated in this study. The prevalence of depression was identified using the Patient Health Questionnaire-9. Dietary intake was assessed through a 24-h recall interview. The percentage of energy from UPFs was ascertained based on the NOVA classification. The associations between the quartile ranges of UPF intake and depression were estimated using logistic regression models. Individuals in the highest quartile had a 1.40 times higher likelihood of having depression, with marginal significance (95% confidence intervals (CIs) = 1.00-1.96). In a sex-specific stratification, only females demonstrated a significant association (odds ratio (OR) = 1.51, 95% CI 1.04-2.21), even after adjusting for confounders (p-value for trend = 0.023). Our findings revealed a significant association between higher UPF intake and depression among females but not among males in the Korean general population.

The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health

Marketing unhealthy products by multinational corporations has caused considerable harm to individual health, collective wellbeing, and environmental sustainability. This is a growing threat to all societies and a significant contributor to the rising global burden of non-communicable diseases and early mortality. While there is growing consideration of the commercial determinants of health, this is largely focused on the methods by which unhealthy products are marketed and disseminated, including efforts to manipulate policy. Little attention has been paid to the underlying psychological traits and worldviews that are driving corporate greed. Here, we consider the role of "dispositional greed" in the commercial determinants of health with a focus on the historical attitudes and culture in the ultra-processed food industry-exemplified by "The Founder" of the McDonald's franchise. We argue that greed and associated psychological constructs, such as social dominance orientation and collective narcissism, permeate the commercial determinants of health at a collective level. This includes how a culture of greed within organizations, and individual dispositional greed, can magnify and cluster at scale, perpetuated by social dominance orientation. We also consider the ways in which "showbiz" marketing specifically targets marginalized populations and vulnerable groups, including children-in ways that are justified, or even celebrated despite clear links to non-communicable diseases and increased mortality. Finally, we consider how greed and exploitative mindsets mirror cultural values and priorities, with trends for increasing collective narcissism at scale, recognizing that many of these attitudes are cultivated in early life. A healthier future will depend on navigating a path that balances material prosperity with physical and spiritual wellbeing. This will require cultural change that places higher value on kindness, reciprocity, and mutualistic values especially in early life, for more equitable flourishing.