Associação entre o consumo de alimentos ultraprocessados e desfechos de saúde mental: análises secundárias de ensaios clínicos

Abstract

Mental health is an essential component of overall well-being, and its relationship with the consumption of ultra-processed foods (UPF) has gained significant attention in research. This dissertation, composed of two articles, explored this relationship in different population groups, aiming to fill gaps in the literature. The first article, titled "Association between the consumption of ultra-processed foods and cognitive performance among adolescents from underdeveloped cities in Brazil," aimed to evaluate the association between cognitive performance and UPF consumption in adolescents residing in cities in the interior of northeastern Brazil. The study included 116 adolescents, with an average age of 14 years, of whom 50 (43.1%) exhibited low cognitive performance. The average energy intake was 1973.5 kcal, with 24.2% coming from UPF. Participants with low cognitive performance consumed 26.5% (95% CI: [22.2; 30.7] %) of their daily energy intake from UPF, compared to 22.5% (95% CI: [18.8; 26.2] %) in those with medium-high cognitive performance (P = 0.17). No significant differences in total energy and macronutrient intake were observed between the groups. Although UPF consumption was similar to the Brazilian average, no significant association was found between UPF consumption and cognitive performance in this sample of low-income adolescents. The second article, titled "Association between UPF consumption and generalized anxiety disorder in adults with obesity seeking weight loss," aimed to evaluate the relationship between symptoms of generalized anxiety disorder (GAD) and UPF consumption in adults with obesity attempting to lose weight. This cross-sectional study included 148 adults (19- 59 years) recruited from a Brazilian university. Food consumption was assessed using three 24-hour recalls, classified according to the NOVA classification. GAD was measured using the Generalized Anxiety Disorder 7 (GAD-7) scale. Linear regression models adjusted for confounding factors, such as sex, age, economic status, and physical activity, were used to analyze the association between anxiety symptoms and UPF consumption. Higher GAD-7 scores were associated with greater UPF consumption (β = 0.445%; 95% CI: 0.042%–0.849%; p = 0.031), which accounted for 22.8% of total energy intake. No significant association was found between anxiety and the consumption of sodium, sugar, or saturated fat. Adults with obesity seeking weight loss who exhibited higher anxiety symptoms consumed more UPF, suggesting a relationship between anxiety and eating patterns. This indicates that emotional state may influence food choices in this group. In summary, UPF consumption impacts each group differently: in low-income adolescents, no relationship was found with cognitive performance, but a link was observed with higher anxiety symptoms in adults with obesity. Contextual and individual factors play a crucial role in this relationship, and longitudinal studies are necessary to better understand the causalities and mechanisms involved.