The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants

Abstract

Objective: We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders.

Methods: The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model.

Results: Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I² = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I² = 77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I² = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I² = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001).

Conclusion: Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.

Keywords: Ultra-processed food; adults; anxiety; depression; dose-response; mental health; meta-Analysis; systematic review.