Ultraprocessed Foods Associated With Depressive Symptoms Among Chinese Adolescents: Cross-Sectional Study

Ultraprocessed food (UPF) consumption is very common among adolescents. Previous studies have suggested an association between UPF consumption and adolescent mental health problems, but studies on multiethnic adolescents in China are rare.

This study investigated the association between UPF consumption and depressive symptoms in multiethnic adolescents in Yunnan Province, China.

A cluster sampling of 8500 middle school students from 11 counties in Yunnan Province was conducted. The Chinese version of the Depression Anxiety Stress Scale-21 was administered to assess depressive symptoms, and a food frequency questionnaire was used to collect UPF consumption data. A generalized linear model was used to analyze the association between UPF consumption and depressive symptoms, and a restricted cubic spline was used to fit the correlation plot. The association analysis was performed after adjusting for demographic and confounding variables that might have influenced depressive symptoms.

The detection rates of depressive symptoms in adolescents were 28.3% (2402/8500) for the sample, 25.5% (1069/4184) for males, and 30.9% (1333/4316) for females. After adjusting for confounding variables, instant food (all participants: β=.22, 95% CI 0.13-0.32; P<.001; males: β=.15, 95% CI 0.03-0.27; P=.01; females: β=.29, 95% CI 0.15-0.43; P<.001), carbonated beverage (β=.20, 95% CI 0.12-0.29; P<.001; β=.15, 95% CI 0.04-0.26; P=.006; β=.29, 95% CI 0.16-0.43; P<.001;), energy beverage (β=.21, 95% CI 0.10-0.32; P<.001; β=.22, 95% CI 0.08-0.36; P=.002; β=.22, 95% CI 0.04-0.40; P=.01), and other beverage (β=.24, 95% CI 0.14-0.34; P<.001; β=.21, 95% CI 0.08-0.35; P=.002; β=.25, 95% CI 0.10-0.41; P=.001) consumption were associated with depressive symptoms for all participants, males, and females, respectively. Females were more sensitive to the association between UPF consumption and depressive symptoms. Moreover, female interaction with instant foods (β=.31, 95% CI 0.18-0.44; P<.001), carbonated beverages (β=.27, 95% CI 0.15-0.39; P<.001), energy beverages (β=.18, 95% CI 0.01-0.35; P=.04), and other sugar-sweetened beverages (β=.17, 95% CI 0.02-0.32; P=.03) was associated with depressive symptoms, respectively.

These results indicated that UPF consumption was related to depressive symptoms in Yunnan multiethnic adolescents. Health education and behavioral interventions that reduce UPF consumption could protect adolescents from depressive symptoms.