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

Abstract

Background Ultra-processed food (UPF) consumption has increased over the last decades in Westernized countries. Our objective was to investigate for the first time the association between the proportion of UPF (%UPF) in the diet and incident depressive symptoms in the NutriNet-Santé cohort. Methods The sample included 20,380 women and 6350 men (aged 18–86 years) without depressive symptoms at the first Center for Epidemiologic Studies Depression Scale (CES-D) measurement, using validated cut-offs (CES-D score ≥ 17 for men and ≥ 23 for women). The proportion of UPF in the diet was computed for each subject using the NOVA classification applied to dietary intakes collected by repeated 24-h records (mean = 8; SD = 2.3). The association between UPF and depressive symptoms was evaluated using multivariable Cox proportional hazards models. Results Over a mean follow-up of 5.4 years, 2221 incident cases of depressive symptoms were identified. After accounting for a wide range of potential confounders, an increased risk of depressive symptoms was observed with an increased %UPF in the diet. In the main model adjusted for sociodemographic characteristics, body mass index, and lifestyle factors, the estimated hazard ratio for a 10% increase in UPF was 1.21 (95% confidence interval = 1.15–1.27). Considering %UPF in food groups, the association was significant only for beverages and sauces or added fats. Conclusion Overall, UPF consumption was positively associated with the risk of incident depressive symptoms, suggesting that accounting for this non-nutritional aspect of the diet could be important for mental health promotion. Electronic supplementary material The online version of this article (10.1186/s12916-019-1312-y) contains supplementary material, which is available to authorized users.

Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression

“…An increased risk of depression was associated with a high proportion of processed foods in the diet, and for each 10% increase of the proportion of processed foods [18]. High intake of pro-inflammatory food was associated with significantly increased risk of depressive symptoms [17,18,20,22]. In subgroups of men, smokers and physically inactive, a diet consisting of a higher proportion of pro-inflammatory foods, significantly increased the risk of depressive symptoms [20].…”

“…Thus, the relationship was strongest in people with overweight and obesity [17]. An increased risk of depression was associated with a high proportion of processed foods in the diet, and for each 10% increase of the proportion of processed foods [18]. High intake of pro-inflammatory food was associated with significantly increased risk of depressive symptoms [17,18,20,22].…”

“…Those with the highest adherence to healthy dietary advice in the same study had thus less risk of depressive symptoms and a significantly higher intake of magnesium, folic acid, and B12 in the diet. In another study, high intake of processed food increased the risk of depression, and those with high intake of processed food had significantly lower intake of B12, magnesium, and folic acid in their diet, compared to the group that had the lowest intake of processed foods [18]. Significant associations in both genders have been calculated regarding vitamin B intake and the risk of depression [29].…”

“…Several studies showed an association between dietary intake with inflammatory potential and risk of depression in different populations [17,18,20,22,33]. Products associated with less impact on systemic inflammation have been found to be vegetables, whole grains, olive oil, and fish.…”

Instrumentos de avaliação da qualidade de dietas: desenvolvimento, adaptação e validação no Brasil

“…14,9 (12,7 -18,9) 4 16,5 (11,4 -21,6) 5 19,8 (14,9 -22,9) 5 13,9 (9,7 -18,0) Dado o acúmulo de evidências sobre a influência do consumo de alimentos ultraprocessados nas condições de saúde (ADJIBADE et al, 2019;DE DEUS;MENDONÇA et al, 2017;FIOLET et al, 2018;MENDONÇA et al, 2016;RAUBER, et al, 2018) et al, 2019). A importância da ênfase em alimentos de origem vegetal in natura ou minimamente processados é um consenso crescente na pesquisa em alimentação saudável.…”