Ready-to-eat food intake associates with PHQ-9-based depression in US adults: a cross-sectional study

Depressive disorders are a contemporary global public health problem and amongst the leading causes of disability worldwide. Ready-to-eat foods require minimal preparation time and are designed to maximize consumer convenience while minimizing consumer efforts. Nutritional properties of ready-to-eat foods, such as their high saturated fat and sodium content, have been linked to depression. Studies from the United States (US) of America investigating the association between ready-to-eat food intake frequency and depression are scarce, although North America is currently the largest ready-to-eat food market.

Using crude and multivariate logistic regression models, this study explored potential associations between self-reported ready-to-eat food intake frequency and PHQ-9-based depression in US adults aged 20 years or older based on data from the cross-sectional National Health and Nutrition Examination Survey (2011-2018). Depression was assessed with the PHQ-9 questionnaire, a validated questionnaire and measure of reference in epidemiological depression research.

Data from n = 8,689 participants was analyzed. Participants with PHQ-9-based depression tended to be female, never married or separated and were characterized by a lower annual household income. Crude and adjusted multivariate logistic regression analyses revealed a significant association between ready-to-eat food intake frequency and depression. For each additional ready-to-eat food, the odds for PHQ-9-based depression increased by a factor of 1.014 (CI: 1.002-1.026; p = 0.022) after adjustment for sociodemographic and lifestyle characteristics. Compared to those who did not report any ready-to-eat foods, participants with an average intake frequency of ≥ 1 per day had a significantly higher likelihood of depression (OR: 2.02, CI: 1.18-3.43; p = 0.011) after adjustment for sociodemographic and lifestyle characteristics.

Ready-to-eat food intake frequency is associated with PHQ-9-based depression in the NHANES. Given the high popularity of ready-to-eat foods in the US, these findings have important public health nutrition implications, and warrant additional research and targeted interventions to promote healthier meals sold by food outlets.