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

TY - JOUR

T1 - Adherence to the ultra-processed dietary pattern and risk of depressive outcomes

T2 - Findings from the NutriNet Brasil cohort study and an updated systematic review and meta-analysis

AU - Werneck, André O.

AU - Steele, Euridice M.

AU - Delpino, Felipe M.

AU - Lane, Melissa M.

AU - Marx, Wolfgang

AU - Jacka, Felice N.

AU - Stubbs, Brendon

AU - Touvier, Mathilde

AU - Srour, Bernard

AU - Louzada, Maria LC

AU - Levy, Renata B.

AU - Monteiro, Carlos A.

N1 - Publisher Copyright: © 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism

PY - 2024/5

Y1 - 2024/5

N2 - 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.

AB - 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.

KW - Food processing

KW - Major depressive disorder

KW - Mental health

KW - Nova food classification system

KW - Nutritional psychiatry

UR - http://www.scopus.com/inward/record.url?scp=85190144680&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2024.03.028

DO - 10.1016/j.clnu.2024.03.028

M3 - Article

C2 - 38613906

AN - SCOPUS:85190144680

SN - 0261-5614

VL - 43

SP - 1190

EP - 1199

JO - CLINICAL NUTRITION

JF - CLINICAL NUTRITION

IS - 5

ER -