Ultra-processed food intake is associated with worse mental health in Southern Italian individuals

Background

A growing body of literature suggests that inclusion of ultra-processed foods (UPFs) in the diet may be associated with various non-communicable diseases, including obesity, cardiometabolic diseases, and increased mortality. However, one of the most underrated research topics is represented by the potential role of diet for mental disorders. The aim of this study was to explore whether there was an association between UPF consumption and mental health outcomes in a cohort of southern Italian individuals.

Methods

Demographic and dietary data from 1572 adults living in southern Italy was collected. Food items were categorized by the level of processing according to the NOVA classification. Multivariate logistic regressions were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between UPF intake and mental health outcomes, including sleep quality and depressive symptoms.

Results

Individuals in the highest quintile of UPF intake were more likely to have low sleep quality compared to those with the least intake (OR = 1.54, 95% CI: 1.02-2.34). Among the main component of sleep quality, high UPF intake was associated with sleep latency and efficacy individually. No apparent associations were found between UPF intake and depressive symptoms. However, when considering different age groups, younger individuals (age <40 y) consuming more UPF were more likely to have depressive symptoms than low consumers (OR = 3.50, 95% CI: 1.53-7.99).

Conclusions

These findings show a potential association between UPF consumption and mental health outcomes. Further studies are needed to understand whether the retrieved relation depends on alteration of the physiological feeding patterns leading to food-anticipatory and binge-type behaviors or on nutritional (i.e., high sugars and unhealthy fats) and non-nutritional factors (i.e., additives) triggering pro-inflammatory pathways.

Key messages

• Ultra-processed food consumption is associated with worse sleep quality and depressive symptoms in Italian adults.

• The detrimental associations between ultra-processed food consumption and depressive symptoms seem stronger among younger individuals.

The prevalence of negative attitudes towards nurses and depressive symptoms in nurses working in cardiology departments in Malopolska region, preliminary results

Funding Acknowledgements

Type of funding sources: None.

Introduction

A significant increase in negative attitudes towards nurses accompanied by exacerbation of depressive symptoms in nurses working in cardiology departments have been observed.

Objective

The assessment of the intensity of negative attitudes towards nurses and depressive symptoms experienced by nurses working in cardiology departments in Malopolska region.

Methods

A cross-sectional study was conducted between 2020 and 2022. It was carried out in a group of 130 nurses working in conservative cardiology departments and 72 nurses working in interventional cardiology departments. The nurses were randomly selected from the register of hospital employed nurses of Malopolska Regional Chamber of Nurses and Midwives. The incidence and intensity of negative experiences at work were determined based on NAQ (The Negative Acts Questionnaire) and the incidence and intensity of depressive symptoms were measured by means of Beck’s depression scale.

Results

Among all the nurses surveyed 58% of them experienced some negative attitudes and the exacerbation of mild, moderate and severe depressive symptoms was observed in 37.1%, 18.3% and 4.5% of respondents respectively; no significant differences were found between conservative cardiology departments and interventional cardiology departments. A positive correlation was observed between the exacerbation of depressive symptoms and negative attitudes towards nurses r=0.335, p<0.001, and this correlation was stronger in interventional cardiology departments r=0.397, p<0.001. The risk of developing depressive symptoms was 3.4 times higher in nurses exposed to negative attitudes than in those who did not experience such behaviours (95% CI: 1.61-7.62).

Conclusions

The results of this study show that nurses working in cardiology departments in Malopolska region are exposed to negative attitudes and suffer from exacerbated depressive symptoms, which might affect the quality of the patient care they provide.

Nutrient and energy contribution of ultra-processed foods in the diet of nations: a meta-analysis

Background

Existing scientific literature indicates that dietary nutritional imbalance is an essential risk factor of many non-communicable diseases. The rapid changes in global food systems worldwide and accompanying it a growth in consumption of ultra-processed foods (UPFs) raised a concern and strengthened the importance of investigating of the extent in which the dietary contribution of these foods determines the overall nutritional quality. A method of production and processing may have detrimental effect on food properties and may disturb a nutritional content of a diet. Moreover, a growing body of literature suggests that the healthy dietary patterns are grossly displaced by UPFs leading to poor nutritional profile. We designed a systematic review and meta-analysis aimed to assess the nutrient profile of the overall diet according to dietary share of UPFs.

Methods

From articles included, the content of individual products (as % of energy) and ingredients in a diet across quintiles of UPFs was extracted; the slopes and intercepts of separately regressed for each food item on the dietary share of UPFs were calculated and pooled in a bivariate meta-analysis.

Results

Out of 13 articles, the mean contribution of UPFs to total energy consumption was 37.22% (95% CI: 27.40, 47.04), with great variation across studies. UPFs consumption was linearly inversely associated with less processed ones (containing fruits, vegetables, eggs, seafood, beans and legumes), whereas positively related to excess in calories from free sugars and unhealthy saturated fats as well as to diet poor in fiber and various micronutrients (potassium, magnesium, vitamin D, zinc, phosphorus, vitamin B12, niacin).

Conclusions

Our results suggests that the UPFs are major drivers of poor nutritional content in the diet, while consumed alternatively to unprocessed or minimally processed foods.

Key messages

Higher intake of ultra-processed foods is associated with unbalanced calories and nutrient intake. There is a need for further evidence to support future policy action on ultra-processed foods in order to inform the consumers or regulate their distribution in the market.

Plant-based polyphenol-rich foods and beverages influence metabolic health in a Mediterranean cohort

Background

There is convincing evidence that a healthy diet may affect metabolic disorders and reduce the risk of chronic non-communicable diseases. Plant-based dietary patterns have been the focus of major interest for their potential in improving metabolic status of the general population. Besides their content in fiber, healthy fats, and antioxidant vitamins, also phytochemicals, such as polyphenols, have been called out as potential compounds driving the aforementioned benefits. This study aimed to explore the association between a plant-based foods and beverages rich in polyphenols and metabolic outcomes irrespectively of the role of the whole diet.

Methods

Demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Multivariate logistic regression analyses were used to calculate odds ratios and 95% confidence intervals of the association between polyphenol-rich foods and beverage consumption and metabolic status, adjusted for adherence to the Mediterranean diet.

Results

Individuals with a higher total polyphenol-rich beverage intake (including coffee, tea, and red wine) had higher polyphenols intake and were less likely to have hypertension, type-2 diabetes, and dyslipidemia; however, when adjusted for potential confounding factors, only the association with hypertension remained significant (OR = 0.69, 95% CI: 0.50-0.94). Higher nut intake was inversely associated with occurrence of hypertension, type-2 diabetes, and dyslipidemia. However, the association did not remain significant for the latter after adjusting for the main background characteristics, while an inverse association was stably confirmed for hypertension (OR = 0.61, 95% CI: 0.46-0.80 and OR = 0.44, 95% CI: 0.26-0.74, respectively) even after adjusting for adherence to the Mediterranean diet.

Conclusions

Plant-based polyphenol-rich foods and beverages are major driver of metabolic benefits irrespectively of the overall adherence to the Mediterranean diet.

Key messages

Higher intake of plant-based polyphenol-rich foods may contribute to better metabolic health. Plant-based polyphenol-rich foods not characteristics of the Mediterranean diet could be underrated among individuals living in the Mediterranean area.

The potential role of diet on mental health outcomes in a Mediterranean cohort

Background

The prevalence of mental and sleep disorders is rising globally generating great costs to medical health care and several modifiable risk factors, including diet, has been recognized as major contributors. An escalation of overnutrition as a consequence of the transition from traditional dietary patterns, like Mediterranean diet, in favor to Western-like dietary patterns, rich in high-calorie processed and ultra-processed foods and deprived from bioactive components, has been observed.

Methods

The demographic and dietary habits of 2044 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) were used to assess dietary intake and adherence to the Mediterranean diet. Polyphenol content in foods was estimated using the Phenol-Explorer database. Sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI), while cognitive status using the Short Portable Mental Status Questionnaire (SPMSQ). Multivariate logistic regression analyses were used to test the associations.

Results

Higher adherence to the Mediterranean diet was significantly associated with adequate sleep quality and inversely associated with impaired cognitive status. When considering bioactive components of the Mediterranean diet, a significant inverse association between a higher dietary intake of lignans and inadequate sleep quality was found. Similarly, a significant inverse association between higher dietary intake of total flavonoids and impaired cognitive status was observed.

Conclusions

The evidence indicates that diet Mediterranean diet together with its bioactive components may exert plausible effects toward cognitive health and sleep quality. There is a need to translate this evidence and to advocate healthy dietary practices as strategies for the prevention of these disorders.

Key messages

Higher adherence to the Mediterranean diet rich in bioactive compounds is recognized as healthy dietary practice associated with mental and sleep disorders. Dissemination of the benefits of adherence to the Mediterranean may contribute to the control of the rising prevalence of mental and sleep disorders.

Coffee consumption and risk of hypertension in the Polish arm of the HAPIEE cohort study

Background/objectives

Coffee consumption has been hypothesized to be associated with blood pressure, but previous findings are not homogenous. The aim of this study was to evaluate the association between coffee consumption and the risk of developing hypertension.

Subjects/Methods

Data on coffee consumption, blood pressure, and use of anti-hypertensive medicament were derived from 2,725 participants of the Polish arm of the HAPIEE project (Health, Alcohol and Psychosocial factors In Eastern Europe) who were free of hypertension at baseline and followed up for an average of 5 years. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariate logistic regression analyses and stratified for potential confounding factors.

Results

Coffee consumption was related with decreased age, smoking status, and total energy intake. Compared to persons who drink <1 cup coffee per day, systolic blood pressure was significantly associated with coffee consumption and the risk of hypertension was lower for individuals consuming 3-4 cups/day. Despite the analysis stratified by gender showed that the protective effect of coffee consumption on hypertension was significant only in women, the analysis after stratification by smoking status revealed a decreased risk of hypertension in non-smokers drinking 3-4 cups of coffee per day, in both sexes (OR 0.41, 95% CI: 0.21, 0.79 for men and OR 0.54, 95% CI: 0.29, 0.99 for women). Upper category coffee consumption (>4 cups per day) was not related with significant increased risk of hypertension.

Conclusions

Relation between coffee consumption and incidence of hypertension was related to smoking status. Consumption of 3-4 cups of coffee per day decreased risk of hypertension in non-smoking men and women only.