Ultra-Processed Food Is Positively Associated With Depressive Symptoms Among United States Adults

Liwen Zheng, Jing Sun, Xiaohui Yu, Dongfeng Zhang, Liwen Zheng, Jing Sun, Xiaohui Yu, Dongfeng Zhang

Abstract

Ultra-processed foods (UPFs) are popular in the United States. In recent years, there has been an increasing interest in the health impact of UPF. This study is conducted to assess the association between UPF consumption and depressive symptoms among United States adults. Data were collected from the National Health and Nutrition Examination Survey 2011-2016. Dietary data were obtained through 24-h dietary recall interviews. Depressive symptoms were detected by a nine-item Patient Health Questionnaire; participants with more than 10 points were diagnosed with depressive symptoms. Results of logistic regression revealed a positive association between UPF consumption and depressive symptoms. The study suggests that UPF may increase the risk of depressive symptoms, particularly in people with less exercise.

Keywords: NHANES; cross-sectional study; depressive symptoms; dose-response; ultra-processed food.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 Zheng, Sun, Yu and Zhang.

Figures

Figure 1
Figure 1
Flow chart of screening process for the selection of the study participants.
Figure 2
Figure 2
Dose–response relationship of ultra-processed food and risk of depressive symptoms. Model adjusted for age, sex, race, BMI, educational level, annual family income, marital status, physical activity, drinking, smoking, current hypertension, diabetes history, heart disease history, and chronic bronchitis. Solid line and dash line represent the estimated relative risks and their 95% CIs, respectively.

References

    1. Ludwig DS. Technology, diet, and the burden of chronic disease. JAMA. (2011) 305:1352–3. 10.1001/jama.2011.380
    1. Monteiro C, Cannon G, Levy R, Moubarac J-C, Jaime P, Martins A. NOVA. The star shines bright. Position paper 2. World Nutr. (2016) 7:28–38. Available online at:
    1. Monteiro CA, Levy RB, Claro RM, Castro IRRd, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. (2010) 26:2039–49. 10.1590/s0102-311x2010001100005
    1. Martinez Steele E, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. Popul Health Metrics. (2017) 15:6. 10.1186/s12963-017-0119-3
    1. Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obesity Rev. (2013) 14(Suppl. 2):21–8. 10.1111/obr.12107
    1. Moodie R, Stuckler D, Monteiro C, Sheron N, Neal B, Thamarangsi T, et al. . Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet. (2013) 381:670–9. 10.1016/S0140-6736(12)62089-3
    1. Luiten CM, Steenhuis IH, Eyles H, Ni Mhurchu C, Waterlander WE. Ultra-processed foods have the worst nutrient profile, yet they are the most available packaged products in a sample of New Zealand supermarkets. Public Health Nutr. (2016) 19:530–8. 10.1017/s1368980015002177
    1. Rauber F, da Costa Louzada ML, Steele EM, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and chronic non-communicable diseases-related dietary nutrient profile in the UK (2008–2014). Nutrients. (2018) 10:587. 10.3390/nu10050587
    1. Owen L, Corfe B. The role of diet and nutrition on mental health and wellbeing. Proc Nutr Soc. (2017) 76:425–6. 10.1017/s0029665117001057
    1. Li Y, Lv MR, Wei YJ, Sun L, Zhang JX, Zhang HG, et al. . Dietary patterns and depression risk: a meta-analysis. Psychiatry Res. (2017) 253:373–82. 10.1016/j.psychres.2017.04.020
    1. Scrinis G, Monteiro CA. Ultra-processed foods and the limits of product reformulation. Public Health Nutr. (2018) 21:247–52. 10.1017/s1368980017001392
    1. Martinez Steele E, Monteiro CA. Association between dietary share of ultra-processed foods and urinary concentrations of phytoestrogens in the US. Nutrients. (2017) 9:209. 10.3390/nu9030209
    1. Buckley JP, Kim H, Wong E, Rebholz CM. Ultra-processed food consumption and exposure to phthalates and bisphenols in the US national health and nutrition examination survey, 2013–2014. Environ Int. (2019) 131:105057. 10.1016/j.envint.2019.105057
    1. Laudisi F, Stolfi C, Monteleone G. Impact of food additives on gut homeostasis. Nutrients. (2019) 11:2334. 10.3390/nu11102334
    1. Chassaing B, Koren O, Goodrich JK, Poole AC, Srinivasan S, Ley RE, et al. . Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature. (2015) 519:92–6. 10.1038/nature14232
    1. Leonard B, Maes M. Mechanistic explanations how cell-mediated immune activation, inflammation and oxidative and nitrosative stress pathways and their sequels and concomitants play a role in the pathophysiology of unipolar depression. Neurosci Biobehav Rev. (2012) 36:764–85. 10.1016/j.neubiorev.2011.12.005
    1. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, et al. . A meta-analysis of cytokines in major depression. Biol Psychiatry. (2010) 67:446–57. 10.1016/j.biopsych.2009.09.033
    1. Rico-Campà A, Martínez-González MA, Alvarez-Alvarez I, Mendonça RD, de la Fuente-Arrillaga C, Gómez-Donoso C, et al. . Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ (Clin Res ed). (2019) 365:l1949. 10.1136/bmj.l1949
    1. Blanco-Rojo R, Sandoval-Insausti H, López-Garcia E, Graciani A, Ordovás JM, Banegas JR, et al. . Consumption of ultra-processed foods and mortality: a national prospective cohort in Spain. Mayo Clin Proc. (2019) 94:2178–88. 10.1016/j.mayocp.2019.03.035
    1. Kim H, Hu EA, Rebholz CM. Ultra-processed food intake and mortality in the USA: results from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994). Public Health Nutr. (2019) 22:1777–85. 10.1017/s1368980018003890
    1. Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, et al. . Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ (Clin Res ed). (2018) 360:k322. 10.1136/bmj.k322
    1. Srour B, Fezeu LK, Kesse-Guyot E, Allès B, Debras C, Druesne-Pecollo N, et al. . Ultraprocessed food consumption and risk of type 2 diabetes among participants of the Nutrinet-Santé prospective cohort. JAMA Intern Med. (2019) 180:283–91. 10.1001/jamainternmed.2019.5942
    1. Srour B, Fezeu LK, Kesse-Guyot E, Alles B, Mejean C, Andrianasolo RM, et al. . Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Sante). BMJ (Clin Res ed). (2019) 365:l1451. 10.1136/bmj.l1451
    1. Sandoval-Insausti H, Blanco-Rojo R, Graciani A, López-García E, Moreno-Franco B, Laclaustra M, et al. . Ultra-processed food consumption and incident frailty: a prospective cohort study of older adults. J Gerontol A Biol Sci Med Sci. (2020) 75:1126–33. 10.1093/gerona/glz140
    1. Juul F, Martinez-Steele E, Parekh N, Monteiro CA, Chang VW. Ultra-processed food consumption and excess weight among US adults. Br J Nutr. (2018) 120:90–100. 10.1017/s0007114518001046
    1. Gomez-Donoso C, Sanchez-Villegas A, Martinez-Gonzalez MA, Gea A, Mendonca RD, Lahortiga-Ramos F, et al. . Ultra-processed food consumption and the incidence of depression in a Mediterranean cohort: the SUN Project. Eur J Nutr. (2020) 59:1093–103. 10.1007/s00394-019-01970-1
    1. Adjibade M, Julia C, Alles B, Touvier M, Lemogne C, Srour B, et al. . Prospective association between ultra-processed food consumption and incident depressive symptoms in the French NutriNet-Sante cohort. BMC Med. (2019) 17:78. 10.1186/s12916-019-1312-y
    1. Prentice RL, Mossavar-Rahmani Y, Huang Y, Van Horn L, Beresford SA, Caan B, et al. . Evaluation and comparison of food records, recalls, and frequencies for energy and protein assessment by using recovery biomarkers. Am J Epidemiol. (2011) 174:591–603. 10.1093/aje/kwr140
    1. Subar AF, Kipnis V, Troiano RP, Midthune D, Schoeller DA, Bingham S, et al. . Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: the OPEN study. Am J Epidemiol. (2003) 158:1–13. 10.1093/aje/kwg092
    1. Blanton CA, Moshfegh AJ, Baer DJ, Kretsch MJ. The USDA automated multiple-pass method accurately estimates group total energy and nutrient intake. J Nutr. (2006) 136:2594–9. 10.1093/jn/136.10.2594
    1. Martínez Steele E, Baraldi L, Louzada M, Moubarac J, Mozaffarian D, Monteiro C. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. (2016) 6:e009892. 10.1136/bmjopen-2015-009892
    1. Martínez Steele E, Juul F, Neri D, Rauber F, Monteiro C. Dietary share of ultra-processed foods and metabolic syndrome in the US adult population. Prev Med. (2019) 125:40–8. 10.1016/j.ypmed.2019.05.004
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. (2001) 16:606–13. 10.1046/j.1525-1497.2001.016009606.x
    1. Akbaraly TN, Brunner EJ, Ferrie JE, Marmot MG, Kivimaki M, Singh-Manoux A. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. (2009) 195:408–13. 10.1192/bjp.bp.108.058925
    1. Northstone K, Joinson C, Emmett P. Dietary patterns and depressive symptoms in a UK cohort of men and women: a longitudinal study. Public Health Nutr. (2018) 21:831–7. 10.1017/s1368980017002324
    1. Molendijk M, Molero P, Ortuño Sánchez-Pedreño F, Van der Does W, Angel Martínez-González M. Diet quality and depression risk: a systematic review and dose-response meta-analysis of prospective studies. J Affect Disord. (2018) 226:346–54. 10.1016/j.jad.2017.09.022
    1. Xu H, Li S, Song X, Li Z, Zhang D. Exploration of the association between dietary fiber intake and depressive symptoms in adults. Nutrition (Burbank, Los Angeles County, Calif). (2018) 54:48–53. 10.1016/j.nut.2018.03.009
    1. Li Z, Wang W, Xin X, Song X, Zhang D. Association of total zinc, iron, copper and selenium intakes with depression in the US adults. J Affect Disord. (2018) 228:68–74. 10.1016/j.jad.2017.12.004
    1. Canella DS, Louzada MLdC, Claro RM, Costa JC, Bandoni DH, Levy RB, et al. . Consumption of vegetables and their relation with ultra-processed foods in Brazil. Rev Saude Publica. (2018) 52:50. 10.11606/s1518-8787.2018052000111
    1. Saad JF, Kohn MR, Clarke S, Lagopoulos J, Hermens DF. Is the theta/beta EEG marker for ADHD inherently flawed? J Atten Disord. (2018) 22:815–26. 10.1177/1087054715578270
    1. Clarke G, Stilling RM, Kennedy PJ, Stanton C, Cryan JF, Dinan TG. Minireview: gut microbiota: the neglected endocrine organ. Mol Endocrinol. (2014) 28:1221–38. 10.1210/me.2014-1108
    1. Shepherd SJ, Lomer MCE, Gibson PR. Short-chain carbohydrates and functional gastrointestinal disorders. Am J Gastroenterol. (2013) 108:707–17. 10.1038/ajg.2013.96
    1. Clemente JC, Pehrsson EC, Blaser MJ, Sandhu K, Gao Z, Wang B, et al. . The microbiome of uncontacted Amerindians. Sci Adv. (2015) 1:e1500183. 10.1126/sciadv.1500183
    1. Pinget G, Tan J, Janac B, Kaakoush NO, Angelatos AS, O'Sullivan J, et al. Impact of the food additive titanium dioxide (E171) on gut microbiota-host interaction. Front Nutr. (2019) 6:57 10.3389/fnut.2019.00057
    1. Ghaisas S, Maher J, Kanthasamy A. Gut microbiome in health and disease: linking the microbiome-gut-brain axis and environmental factors in the pathogenesis of systemic and neurodegenerative diseases. Pharmacol Ther. (2016) 158:52–62. 10.1016/j.pharmthera.2015.11.012
    1. Koopman M, El Aidy S, consortium MI. Depressed gut? The microbiota-diet-inflammation trialogue in depression. Curr Opin Psychiatry. (2017) 30:369–77. 10.1097/YCO.0000000000000350
    1. Beslay M, Srour B, Méjean C, Allès B, Fiolet T, Debras C, et al. . Ultra-processed food intake in association with BMI change and risk of overweight and obesity: a prospective analysis of the French NutriNet-Santé cohort. PLoS Med. (2020) 17:e1003256. 10.1371/journal.pmed.1003256
    1. Sandoval-Insausti H, Jiménez-Onsurbe M, Donat-Vargas C, Rey-García J, Banegas JR, Rodríguez-Artalejo F, et al. . Ultra-processed food consumption is associated with abdominal obesity: a prospective cohort study in older adults. Nutrients. (2020) 12:2368. 10.3390/nu12082368
    1. Subar AF, Freedman LS, Tooze JA, Kirkpatrick SI, Boushey C, Neuhouser ML, et al. . Addressing current criticism regarding the value of self-report dietary data. J Nutr. (2015) 145:2639–45. 10.3945/jn.115.219634

Source: PubMed

3
Abonnieren