Ultra-processed and fresh food consumption and symptoms of anxiety and depression during the COVID - 19 pandemic: COVID Inconfidentes

Clin Nutr ESPEN. 2022 Feb:47:206-214. doi: 10.1016/j.clnesp.2021.12.013. Epub 2021 Dec 20.


Background & aim: Psychological disorders are an important health problem worldwide. A healthy diet is recommended as one of the measures to prevent and control mental disorders. Epidemiological studies have shown important associations between the consumption of diets rich in nutrients and a lower risk of developing anxiety and depression. Therefore, the aim of this study was to evaluate the association between the prevalence of anxiety and depression symptoms and food consumption, according to the degree of processing, during the COVID-19 pandemic.

Methods: An epidemiological household survey was conducted in two cities in Brazil. Anxiety and depression symptoms were assessed using validated scales (Generalized Anxiety Disorder 7-item/Patient Health Questionnaire-9), and food consumption was assessed using a qualitative food frequency questionnaire referring to consumption within the last 3 months. The foods were categorized according to the NOVA classification for fresh/minimally processed food and ultra-processed food, using the average weekly consumption as the cutoff. For data analysis, adjusted Poisson regression with robust variance was utilized to estimate the prevalence ratio and 95% confidence interval (CI).

Results: The consumption of fresh/minimally processed foods above the weekly average frequency was associated with a lower prevalence of symptoms of depression (PR: 0.5, 95% CI: 0.3; 0.7). Consumption above the weekly average of ultra-processed foods was associated with a higher prevalence of anxiety (PR: 1.5 and 95% CI: 1.03; 2.3) and depression symptoms (PR: 1.5, 95% CI: 1.0; 2.1, P = 0.034).

Conclusion: Increased consumption of ultra-processed foods is associated with a higher occurrence of anxiety and depression symptoms; therefore, we recommend an increase in the consumption of fresh/minimally processed foods, as endorsed by the Dietary Guidelines for the Brazilian Population.

Keywords: Anxiety; Depression; Food consumption; Food processing industry; Mental health; Nutrition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / epidemiology
  • Anxiety Disorders
  • COVID-19*
  • Depression / epidemiology
  • Energy Intake
  • Fast Foods
  • Humans
  • Pandemics*
  • SARS-CoV-2