Increasing Minimally Processed Food Intake in Depression via Commercial Meal Delivery: Qualitative Accounts of...

Background/Objectives: Several randomized controlled trials have found that dietary interventions promoting self-guided shifts away from ultra-processed foods (UPFs) and toward minimally processed, nutrient-dense foods may alleviate depressive symptoms. However, translating these interventions into scalable and sustainable real-world approaches remains a key challenge. Adopting a minimally processed dietary pattern requires sustained effort (e.g., meal planning, shopping, and preparation) within environments where UPFs are pervasive and convenient. These demands may be especially burdensome for individuals experiencing depressive symptoms. Consequently, interventions that rely heavily on individual effort may be difficult to maintain. Commercial meal delivery services may offer a structural solution by reducing logistical and cognitive barriers to dietary change, yet little is known about how individuals with depressive symptoms experience this approach. Methods: In a parent study, we conducted a randomized pilot study of a meal delivery service designed to provide minimally processed meals to adults with moderate to moderately severe depressive symptoms; here we report qualitative findings from post-intervention interviews with participants assigned to the meal delivery condition (n = 20). Results: Participants appreciated reductions in preparatory effort and mental load, which supported adherence. Dietary changes were also linked to improved mood through increased energy, mood stability, and more positive self-evaluation. However, social settings were a near-universal barrier, and acceptability depended on palatability, compatibility with personal preferences, and perceived autonomy. Several participants also described a temporal adjustment process (early cravings/withdrawal followed by adaptation). Conclusions: Overall, these findings suggest participant-informed priorities for future testing and refinement of scalable meal delivery interventions for depression, including personalization and choice, quality control, and support for social and withdrawal-related challenges.