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

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Werneck, Andre O. ; Steele, Euridice M. ; Delpino, Felipe M. ; Lane, Melissa M. ; Marx, Wolfgang ; Jacka, Felice N. ; Stubbs, Brendon ; Touvier, Mathilde ; Srour, Bernard ; Louzada, Maria LC. ; Levy, Renata B. ; Monteiro, Carlos A.

• Document type: Journal article
• Source: Clinical Nutrition; v. 43, n. 5, p. 10-pg., 2024-04-12.

Abstract

Background & aims: We aimed to analyze the prospective association between adherence to the ultraprocessed 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. (c) 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. (AU)

• FAPESP's process: 19/24124-7 - Prospective association of ultra-processed food consumption and physical inactivity in the prediction of depressive symptoms among adults
• Grantee: André de Oliveira Werneck
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 22/05636-0 - Program of population studies on the consumption of ultraprocessed foods and health
• Grantee: Carlos Augusto Monteiro
• Support Opportunities: Research Projects - Thematic Grants