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Processed Foods & Risk for Depression

iStock-473127440Analysis of a cohort study evaluating the association between the consumption of ultra-processed food (UPF) and depression was recently published in JAMA Network Open. UPF refers to energy-dense and micronutrient-poor packaged products, generally rich in fat, sugar, and salt. This prospective study was conducted within the Nurses’ Health Study II, between 2003 to 2017, and included nearly 32,000 women ages 42 to 62 and free of depression at baseline. UPF consumption was assessed every 4 years by a validated food frequency questionnaire, with depression defined by either strict criteria (clinician-diagnosed and regular medication use) or broader criteria (clinical diagnosis and/or medication use), both self-reported.

Women with a higher intake of UPF were more likely to have elevated BMI, to smoke, to have diabetes, hypertension, and hyperlipidemia, and to exercise less. Comparing the highest to lowest quintiles of UPF consumption, there was also a 49% greater risk for depression using the strict criteria, and a 34% increase using the broader criteria. Given that this was not a controlled trial, causality cannot be established. However, a statistical lag-analysis found similar associations making reverse causality unlikely, and adjusting for potential confounders also did not change the results.

Specific components of UPF were also examined; after multivariate analysis, only artificial sweeteners (26% greater risk) and artificial beverages (37% greater) were still linked with depression. Additionally, women who were able to reduce their intake of UPF by at least 3 servings per day had a 16% lower risk for depression compared to women with a stable intake during each 4-year period. While not a controlled trial and limited to primarily non-Hispanic white women, this large, prospective, long-term, and well-adjusted study adds to the potential dangers of UPF and artificial products.

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