Sun Yunxiang, Correia Poliana E, Teixeira Paula P, Spiazzi Bernardo F, Brietzke Elisa, Socal Mariana P, Gerchman Fernando
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21202, USA.
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-003, RS, Brazil.
Nutrients. 2025 Jul 28;17(15):2454. doi: 10.3390/nu17152454.
Recent studies linked a diet rich in ultra-processed foods (UPFs) with depression and diabetes. Although common risk factors, such as aging, are defined for both diseases, how UPFs are associated with the bidirectional relationship between them is not known. This study aimed to investigate whether UPF intake modifies the association between depression and diabetes within the Brazilian adult population. This cross-sectional analysis utilized data from the 2019 Brazilian National Health Survey, involving over 87,000 adults (aged 18-92 years). Participants provided self-reported data on diabetes and depression diagnoses, dietary habits (assessed by qualitative FFQ), as well as demographic, and socioeconomic variables. Multivariate logistic regression models were used to evaluate the associations, employing two classification methods-UPF1 and UPF2-based on different thresholds of weekly consumption, for high/low UPF intake. Analyses were stratified by age groups to identify variations in associations. There was a significant association between depression and diabetes, especially among participants with high UPF consumption. Models adjusted by demographic characteristics, as well as meat and vegetable consumptions, demonstrated elevated odds ratios (ORs) for diabetes among individuals with depression consuming high levels of UPF, compared to those with a low UPF intake (OR: 1.258; 95% CI: 1.064-1.489 for UPF1 and OR: 1.251; 95% CI: 1.059-1.478 for UPF2). Stratified analysis by age further amplified these findings, with younger individuals showing notably stronger associations (non-old adult group OR: 1.596; 95% CI: 1.127-2.260 for UPF1, and OR: 6.726; 95% CI: 2.625-17.233 for UPF2). These findings suggest that high UPF intake may influence the relationship between depression and diabetes, especially in younger adults. Future longitudinal studies are warranted to establish causality, investigate underlying biological mechanisms, and examine whether improving overall nutrient intake through dietary interventions can reduce the co-occurrence of depression and diabetes.
近期研究将富含超加工食品（UPF）的饮食与抑郁症和糖尿病联系起来。尽管这两种疾病都有一些共同的风险因素，如衰老，但UPF如何与它们之间的双向关系相关联尚不清楚。本研究旨在调查巴西成年人群中UPF摄入量是否会改变抑郁症与糖尿病之间的关联。这项横断面分析利用了2019年巴西全国健康调查的数据，涉及超过87000名成年人（年龄在18 - 92岁之间）。参与者提供了关于糖尿病和抑郁症诊断、饮食习惯（通过定性食物频率问卷评估）以及人口统计学和社会经济变量的自我报告数据。多元逻辑回归模型用于评估关联，采用基于每周消费不同阈值的两种分类方法——UPF1和UPF2，以区分高/低UPF摄入量。分析按年龄组进行分层，以确定关联的差异。抑郁症与糖尿病之间存在显著关联，尤其是在高UPF消费的参与者中。根据人口统计学特征以及肉类和蔬菜消费量进行调整的模型显示，与低UPF摄入量的抑郁症患者相比，高UPF摄入量的抑郁症患者患糖尿病的比值比（OR）升高（UPF1的OR为1.258；95%置信区间：1.064 - 1.489；UPF2的OR为1.251；95%置信区间：1.059 - 1.478）。按年龄进行的分层分析进一步放大了这些发现，年轻人显示出明显更强的关联（非老年成年组UPF1的OR为1.596；95%置信区间：1.127 - 2.260，UPF2的OR为6.726；95%置信区间：2.625 - 17.233）。这些发现表明，高UPF摄入量可能会影响抑郁症与糖尿病之间的关系，尤其是在年轻人中。未来有必要进行纵向研究以确定因果关系，研究潜在的生物学机制，并研究通过饮食干预改善总体营养摄入是否可以减少抑郁症和糖尿病的共病情况。
