Food and Behaviour Research

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Prospective association between ultra-processed food consumption and incident depressive symptoms in the French NutriNet-Santé cohort

Adjibade M, Julia C, Allès B, Touvier M, Lemogne C, Srour B, Hercberg S, Galan P, Assmann KE, Kesse-Guyot E. (2019) BMC Med  17(1) 78. doi: 10.1186/s12916-019-1312-y. 

Web URL: View this and related abstracts via Pubmed here. Free full text of this article is available online



Ultra-processed food (UPF) consumption has increased over the last decades in Westernized countries. Our objective was to investigate for the first time the association between the proportion of UPF (%UPF) in the diet and incident depressive symptoms in the NutriNet-Santé cohort.


The sample included 20,380 women and 6350 men (aged 18-86 years) without depressive symptoms at the first Center for Epidemiologic Studies Depression Scale (CES-D) measurement, using validated cut-offs (CES-D score ≥ 17 for men and ≥ 23 for women). The proportion of UPF in the diet was computed for each subject using the NOVA classification applied to dietary intakes collected by repeated 24-h records (mean = 8; SD = 2.3). The association between UPF and depressive symptoms was evaluated using multivariable Cox proportional hazards models.


Over a mean follow-up of 5.4 years, 2221 incident cases of depressive symptoms were identified. After accounting for a wide range of potential confounders, an increased risk of depressive symptoms was observed with an increased %UPF in the diet. In the main model adjusted for sociodemographic characteristics, body mass index, and lifestyle factors, the estimated hazard ratio for a 10% increase in UPF was 1.21 (95% confidence interval = 1.15-1.27). Considering %UPF in food groups, the association was significant only for beverages and sauces or added fats.


Overall, UPF consumption was positively associated with the risk of incident depressive symptoms, suggesting that accounting for this non-nutritional aspect of the diet could be important for mental health promotion.


In this large general population study of French adults who initially had no depressive symptoms, higher consumption of ultra-processed food significantly predicted the development of depression over a 5 year follow-up period.

High intakes of ultra-processed foods (UPF) - i.e. industrial products made primarily from highly refined ingredients, typically containing artificial additives to enhance their taste, texture and/or appearance as well as their shelf-life - are already strongly linked with increased risks for obesity, Type 2 diabetes and other systemic physical health disorders.

These findings indicate that diets high in ultra-processed foods may also significantly increase risks for poor mental health - a finding that is important, if not entirely surprising.

The broad UPF category now includes the majority of foods consumed in most developed countries, especially by chldren and younger adults, but the main links with depression in this study came from 'beverages, sauces, and added fats'.

For more information on this topic, please see the following list, which is regularly updated:

And for a more extensive list of news or research articles on UPF, see: