Ultra-processed food linked to higher risk of depression, research finds

https://www.theguardian.com/food/2023/sep/20/ultra-processed-food-linked-higher-risk-depression-research-finds

by PaulHoule • 3 years ago

77 67 3 years ago

aquajet2• 3 years ago

From article:

```

Others urged greater caution. Prof David Curtis, an honorary professor at University College London Genetics Institute, said: “The only foodstuffs which [this study] shows are associated with increased risk of depression are artificial sweeteners. Of course, this does not mean that an effect of artificial sweeteners is to increase depression risk – it is just that people with increased risk of developing depression tend to consume larger quantities of artificial sweeteners.”

But the authors disagree. Prof Andrew T Chan, chief of the clinical and translational epidemiology unit at Massachusetts general hospital and co-author of the research, said: “The strength of our study is that we were able to assess diet several years before the onset of depression. This minimises the likelihood that our findings are simply due to individuals with depression being more likely to choose ultra-processed foods.

```

Seems to be a correlation study to me. I also don't see any controls for other circumstances, so it can also be explained that other factors could contribute both to eating processed foods and getting depressed (ex: working long hours, having low income, relationship stress)

mjevans• 3 years ago

The correlation might still be useful as identifying how society is failing both in providing (tasty, easy, cost equivalent or better, healthy) alternative foods and how rampant a problem this is.

retrac• 3 years ago

Depression impairs motivation, decreases tolerance of physical discomfort, and is also associated with impairment of planning abilities, and also has a correlation with eating disorders.

Occam's razor: the depressed can't plan and then cook a good meal for themselves, and so buy ready-to-eat processed food.

Anecdotally, when I was younger and very poor, I could not eat well unless I did everything from scratch -- several hours of work a day in the kitchen. When I got depressed, I'd try to cook while hungry, and get more and more agitated at my discomfort until I lost emotional control, and nothing got cooked. Cry. Eat instant noodles or crackers. Repeat the next day. When I finally made or got my hands on a proper hot meal with protein, my mood would noticeably improve.

My mood is still very susceptible to my diet, but these days I can afford stop-gap solutions to having no energy to cook, like just getting some reasonably healthy takeout.

ShamelessC• 3 years ago

Oh well in that case yeah throw out any concerns or criticisms. `retrac`'s anecdote and invocation of the law of Occam's Razor is proof that the study is iron clad.

andrei_says_• 3 years ago

Also impulse control and relationship to instant gratification and addictive behaviors.

Processed foods are formulated to induce addictive behavior.

esafak• 3 years ago

"We used 2 definitions for depression:

(1) a strict definition requiring self-reported clinician–diagnosed depression and regular antidepressant use and

(2) a broad definition requiring clinical diagnosis and/or antidepressant use.

We estimated hazard ratios (HRs) and 95% CIs for depression according to quintiles of UPF intake using Cox proportional hazards models, with adjustment for known and suspected risk factors for depression, including age, total caloric intake, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), physical activity, smoking status, menopausal hormone therapy, total energy intake, alcohol, comorbidities (eg, diabetes, hypertension, dyslipidemia), median family income, social network levels, marital status, sleep duration, and pain."

https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

nerdjon5• 3 years ago

I know that when my mental health starts to become a problem again the first thing that goes is any desire to cook. Which often leads to gettin take out, frozen meals, or just constant snacking.

I have had basically zero desire to cook (or really do much of anything in complete honesty) for the last couple weeks and I am super thankful for "processed" things like Huel.

Edit: Also I am 100% going to reach for that frozen meal from Trader joes that gives me a brief amount of joy and makes me feel good.

aquajet2• 3 years ago

Hope you feel better soon :)

But this shows that theres no eating processed food --> get depressed causation, just a correlation. Otherwise a perfectly happy person who eats a lot of tv dinners would inexplicably get sad with nothing else in their life changing.

jancsika• 3 years ago

I have had basically zero desire to cook (or really do much of anything in complete honesty) for the last couple weeks and I am super thankful for "processed" things like Huel.

I'd never heard of Huel. Just looking at the info on their bag of pasta bolognese:

* bag size is 721 grams but serving size is 101g!

* they put the "per day" measurement at 505g? But even there, you're be consuming 3200mg of sodium-- 139% of the daily recommended value

Honestly, eating a 101g serving sounds to me like attempting to eat 1/8 of a bag of M&Ms.

If I open that 721g bag for lunch, it's going to be gone by end of day, guaranteed. (Probably with half a baguette for dipping.)

Edit: I forgot it's for lunch and dinner in my example. So make that a whole baguette. :)

vorpalhex3• 3 years ago

I wonder if depression simply starts much earlier than diagnostic controls detect it.

Even though this study started years before these people were diagnosed, they may have already had depression.

llm_nerd4• 3 years ago

Researchers love dunking on artificial sweeteners. It is one of the guaranteed methods of getting loads of press. Press yields prestige. Given that artificial sweeteners often correlate with people with weight / health problems like diabetes for very functional reasons, it's like shooting fish in a barrel.

Paradoxically this same data source (the Nurses' Health study, which is a continuous series of questionnaires) has had a prior paper claiming "sugar-sweetened soft drinks, refined grains, and red meat" led to depression. Now that "ultra-processed foods" and artificial sweeteners are the public demon, they take centre stage for the next round. I suspect with a bit of p-hacking one can contrive whatever aha result they desire out of it.

Their argument regarding eliminating correlation seems suspect. They analyzed diet in period 1 against reported depression in period 1 and found a given correlation. They then analyzed diet in period 1 against reported depression in period 2 (apparently 4 years later) and claim to have found the same correlation, which is what he cites in defence. Yet they never state that depression in period 2 in those cases is worse than period 1, invalidating it.

The Nurses' Health Study is a really fascinating exercise and certainly holds massive use, but it also has been a source of a lot of incredibly dubious nutritional "science".

https://nurseshealthstudy.org/participants/questionnaires

The NHS II surveys were the ones they used for this "get press" study, and looking at the actual surveys it seems doubtful that they yielded the results they did.

Probably could build a lot of fun blog entries p-hacking the data from these surveys.

hedora7• 3 years ago

There is a lot of evidence that artificial^W non-caloric sweeteners are terrible.

There are correlation studies in humans showing many different health issues (weight gain, cancer, mental health issues, among others) that correct for all sorts of confounding factors.

There are experimental studies in rodents that show all of the above across multiple products.

They're known to interact poorly with certain drugs taken for mental illness, and can cause all sorts of brain-related problems in some people (such as migraines).

They're also known to screw up your gut's microbial community, and that's shown to cause depression.

(I'm not commenting on the quality of this particular study, to be clear.)

jcampbell1• 3 years ago

What if the deep subconscious keeps track of sweetness in the mouth and nutritional requirements (conscience hunger and cravings)? Artificial sweeteners would break the biological programming and cause all sorts of problems including depression and inappropriate hunger.

Edit: I hadn’t fully thought this through, but in my experience sometimes looking at a clock causes the physical hunger sensation. I have also been painfully starving which immediately stopped after the first swallow of a chugging a coke. Artificial sweeteners would have thrown a monkey wrench in my biological machinery.

roughly2• 3 years ago

I also don't see any controls for other circumstances, so it can also be explained that other factors could contribute both to eating processed foods and getting depressed (ex: working long hours, having low income, relationship stress)

Of course there were controls.

Directly from the article: “Adjusting for other health, lifestyle and socioeconomic risk factors for depression…”

As noted in another comment, the paper goes into further details on the controls they used.

Honestly, this kind of thing is insulting. If you’re going to levy that kind of accusation of incompetence against someone, you at least owe it to them to read the source material before doing so.

fshbbdssbbgdd2• 3 years ago

It’s good of you make this correction, we need to be accurate when discussing the research at hand.

That said, it’s worth pointing out that “adjusting for” a factor isn’t quite as effective as it sounds: https://dynomight.net/control/

Having built some regression models in my time, throwing a ton of extra variables in doesn’t fill me with confidence that I am “controlling” much of anything.

coffeeling• 3 years ago

The counterargument by Chan misses Curtis' point - people with higher RISK of developing depression. Depression goes hand in hand with high trait neuroticism, and both the internalizing and externalizing branches of neuroticism contain subtraits related to lower self-control (though we're mostly with the internalizing one here, I'd imagine)

29athrowaway2• 3 years ago

In this era of highly processed foods and added sugar, consuming fiber supplement has never been more essential.

NovemberWhiskey• 3 years ago

Contradiction: your fiber supplement is also probably a highly processed food.

29athrowaway2• 3 years ago

What about seaweed?

Telemakhos• 3 years ago

That's an interesting way of expressing "eating more salad."

A_D_E_P_T• 3 years ago

Salad is probably the most acutely dangerous thing you can order in a restaurant or buy in a supermarket. Especially if it contains sprouts.

Something I learned the hard way, especially when traveling (which is most of the time,) is to avoid ordering salad at restaurants.

Cooked veggies are better. But I'll take metamucil over salad, easy.

plaguuuuuu• 3 years ago

am I depressed because I'm eating microwavable pizza pockets at 4am, or the other way round?

GoToRO2• 3 years ago

First one. I think all brain problems exist because it doesn't get what it needs to get in order to function properly. So it starts to malfunction. The brain illnesses are different because you can't use your ill brain to diagnose your brain. You can use your healthy brain to diagnose any other body part.

nerdjon5• 3 years ago

That is a big jump to make since you don't know what else they are eating.

This is like assuming that because I may have gone to get a candy bar or desert with dinner it means that I am not getting my proper nutrients in other places. Which is absurd.

Personally I feel like it is likely the other way around (and actually seems to be backed up by part of this artless with some calling question.

SamoyedFurFluff• 3 years ago

Sure, I’ll just take some salads for lunch to cure my traumatic brain injury :)

vorpalhex3• 3 years ago

Probably a bit of both.

Depression makes it hard to have executive function. Lack of executive function makes depression worse. It's a vicious self feeding cycle.

hedora7• 3 years ago

The important thing is that you remember to pair your samsung fridge with your samsung tv so that advertisers know that their plan to get you to eat the pizza pockets has succeeded.

Remember, anything short of setting that up is stealing.

kif2• 3 years ago

Anecdata: during a period of essentially eliminating all added sugar (save for a small piece of dark chocolate a day which amounted to 2-3g of sugar), I never felt better. It was two to three months long. I'm hoping I can repeat that again.

craftkiller3• 3 years ago

Since we're sharing anecdata: I eliminated all sugar from my diet for a month[1], it didn't change a thing. I didn't feel better or worse. I didn't have more or fewer sugar "cravings". Food didn't taste more or less sweet than before.

[1] This was during the early pandemic so I was staying inside, cooking all my own meals from scratch, and since I was dieting I was strictly controlling what I ate.

vorpalhex3• 3 years ago

Before you changed your diet, did strawberries taste actually sweet to you?

Post diet change, do they taste sweet now?

Aerroon• 3 years ago

Have you tried supplementing magnesium or zinc or some other minerals? One of the troubles with processed food is that it reduces the minerals you get out of the food. Maybe the grand parent had a positive reaction because their alternate foods with less processing. Eg dark chocolate tends to contain a lot of magnesium.

I personally felt a big difference with magnesium supplementation.

kif2• 3 years ago

Interesting. So my cravings went down significantly, almost to zero. Normally I have such a sweet tooth, that I cannot resist desserts. During my no-sugar period, I was completely indifferent to it.

Food tasted the same, but my sensitivity to sugar was significantly increased. For example, half the usual amount of sugar in my tea would be enough.

hedora7• 3 years ago

I've recently increased the amount of fiber, decreased added sugar and decreased salt. (I check the percent daily value of each on the back of the package. Fiber has to be above the carbs percentage, and the other two have to be below my target calorie percentage.)

I highly, highly recommend doing that. Such a diet has been shown to reduce your risk of heart disease, cancer and diabetes.

As importantly, I feel much better, and am slowly (sustainably?) losing weight and decreasing my body fat percentage, despite eating how much I want, and regularly cheating on the diet.

Following it even half the time is a huge improvement. The only real discipline it requires is at the grocery store, which is easier than when I'm hungry.

PaulHoule• 3 years ago

Now that I think of it, it reminds of me of the notorious case of Dan White who shot Harvey Milk and George Moscone who invoked

https://en.wikipedia.org/wiki/Twinkie_defense

There was a lot of anger about him getting a relatively short sentence leading to

https://en.wikipedia.org/wiki/White_Night_riots

but his mental health struggle may well have been real because he died by his own hand less than two years after he got out of prison.

gnicholas• 3 years ago

My brain now automatically replaces "linked to" with "correlated with, and no evidence of causing" whenever I read a headline. Obviously if they had evidence of causation they would lead with that.

spywaregorilla2• 3 years ago

"Linked to" does mean "correlated with" so there's no problem there. "No evidence of causing" is not the right takeaway. A strong correlation does not mean this is the causal link. But it does suggest there is something in that ballpark worth thinking about that is at least a noteworthy cofounder. Causal studies of some things are basically impossible.

TheAlchemist• 3 years ago

Of course it is. Consuming a lot of ultra-processed food is one of worst things you can do to yourself. Occasional consumption is perfectly OK, but it doesn't take a rocket scientist to observe some patterns in obesity, well-being and general health, between people (or countries for that matter) consuming a healthy diet vs those consuming mostly ultra-processed garbage.

Correlation vs causation - my understanding is that this is the point of the study - they measured the ultra-processed food consumption patterns way before the onset of depression.

nerdjon5• 3 years ago

Is tofu unhealthy? I mean that seems pretty processed to me.

There are also things like Huel and Soylent which is probably about as processed as you are going to get and I really don't see any health issues with those (outside of the usual "its not real food" people but I really don't care about them).

It doesn't help that "ultra processed" is such a blanket term that it's basically meaningless.

I mean just because I buy "whole" ingredients doesn't mean that I magically cooked a healthy meal either. It could be just as bad (or worse with a few of the recipes I have made from Julia Child's book... as good as they are) than some of the processed meals I see out there. Maybe just less sodium.

Much of the same correlation you are looking at can also be attributed to the type of active (or less so) style that people have. Less walking, more relying on cars, etc.

hedora7• 3 years ago

I think "ultra-processed" is code for "food with all the fiber ripped out, and lots of added sugar and/or salt".

The latter is more obviously bad, and also very actionable for consumers.

Also, since I left "lots of artificial stuff" out of my definition, I intentionally included a broad range of "healthy organic snacks" that are actually terrible for you. It's probably best to avoid artificial crap in your food, but that should be(?) obvious.

Anyway, regarding tofu, it was hard to find a nutrition label, but this story has a bunch of them in a picture at the top: https://sporked.com/article/best-tofu/

They all have no salt, high fiber (vs. carbs), high protein and no sugar.

Also, they all have one ingredient (fermented soybeans) and a few preservatives(?)

downWidOutaFite• 3 years ago

I get annoyed at all the "processed food" studies because when you go to look up the definition of ultraprocessed and processed it's all very hand-wavy "you know it when you see it" kind of thing so there's no way to know what to avoid in your diet.

swayvil• 3 years ago

They ask you to create an account.

The options are "Sign up" and "I'll sign up later".

How about that distasteful mindfuckery.

Seeing it a lot.

naetd• 3 years ago

I think there's probably a decent correlation with people who are depressed going for convenience meals rather than take the time to cook or shop for healthy foods and that type of thing. It sounds like they tried to control for some of this but it's not clear how successful that was (I'm not a statistician so I can't speak to that).

At the same time, I think diet and gut health can have major impacts on physical and mental health as well so it makes some intuitive sense that certain foods might be linked with depression. I've always been suspicious of artificial sweeteners, they just seem a lot more chemical and artificial than the natural ones which we evolved to properly ingest.

mrandish• 3 years ago

To add to the significant caveats already posted by others (correlation<>causation, confounding factors, etc), diary studies of diet are known to have very poor signal to noise.

Also, there's a notable counter-example since diabetics are a large, distinct group which has had substantially higher average artificial sweetener consumption than the general population for many decades.

spywaregorilla2• 3 years ago

are you asserting that diabetics have lower depression rates than the general population?

MrPatan• 3 years ago

Is "processed" the problem? What's the process that makes you fat and sick? Is it boiling? Stirring? Heating? Freezing?

Or is it the added sugar?

It's the sugar

avgcorrection2• 3 years ago

“Processed” is pretty well-documented at this point. There's a range and ultraprocessed seems to be the highest culmnination.

m4632• 3 years ago

Highly processed foods eliminate fiber. lack of fiber leads to blood sugar spike and insulin release. insulin stores blood sugar as fat. next is a blood sugar crash which means low energy, depression and cravings. It becomes a cycle.

also, some artificial sweeteners can cause an insulin response, and affect gut health

hedora7• 3 years ago

Everything you said is correct, but too much salt also causes trouble, and processed foods have way more salt than most people use when cooking in the kitchen.

dalore2• 3 years ago

Is this another case where science got the causation and correlation backwards? Is it not more likely that depressed people eat processed food rather then the other way around?

m4632• 3 years ago

More likely highly processed food has no fiber. That leads to glucose spikes when eating. They release insulin to protect the body from high blood sugar. that leads to glucose stored as fat. Eventually there is a blood sugar crash. the whole process plays havoc with the body and its hormones. depression is probably really easy to create in this environment.

22c• 3 years ago

I've recently taken a greater interest in my fibre intake. It is quite shocking to see how little fibre is in most foods on the shelves, even in things that you thought surely had a at least some fibre.

The best thing I've found so far in terms of somewhat "shelf stable" sources of fibre is dried figs (and dates to a lesser degree) and certain brands of high fibre digestive cookies.

Low fibre content in a frozen TV dinner seems obvious, but it seems less obvious when you say "practically anything other than a handful of items outside of the fresh fruits/vegetable section".

dalore2• 3 years ago

I have not eaten fibre for many years. It's one of those overhyped health things. Fibre is not needed at all https://www.youtube.com/watch?v=xqUO4P9ADI0

It does help I guess if you eat so much sugar and fibre helps mop it up and digest it slowly. But the solution isn't to eat more fibre, it's to eat less or no sugar.

A body can survive without glucose and burn fat for energy instead.

npunt• 3 years ago

This makes complete sense when paired with growing body of research [1] [2] on the gut-brain axis and how gut health impacts cognition, mood, and various neurological functions.

We already know that processed foods with low fiber, lots of sugar, and various chemicals can worsen gut biome diversity, increase bad bacteria, cause inflammation and gut permeability ('leaky gut'), etc. It follows that this would have an impact on mood from both depression-as-inflammation and gut-brain axis theories.

From [2]:

Several studies have shown that fecal transplants rich with bacteria from depressed rats, as well as from depressed humans, can induce depression in recipient rats. In December 2021, a review of 34 human studies showed a similar pattern of bacterial species in the guts of people diagnosed with depression, bipolar disorder and schizophrenia.

I know of at least one microbiome startup staffed by a lot of great researchers that are working on this line of research to treat depression. I'm also personally involved in a study on the gut biome connection to MECFS & long covid [3]. Tests on my gut biome show I have a leaky gut (high gram negative lipopolysaccharides and various imbalances) and after 6 weeks of repairing this with pre & probiotics and a more restrictive diet I'm seeing notable improvement in my energy, cognition, and mood.

[1] https://www.washingtonpost.com/wellness/2023/01/31/gut-micro...

[2] https://www.npr.org/sections/health-shots/2023/07/08/1186092...

[3] https://remissionbiome.org

Ultra-processed food linked to higher risk of depression, research finds

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