Evidence map›Paper›PMID 40128798›Full record

Trial reportBMC medicine2025

The risk associated with ultra-processed food intake on depressive symptoms and mental health in older adults: a target trial emulation.

Belayneh Mengist, Mojtaba Lotfaliany, Julie A Pasco, Bruno Agustini, Michael Berk, Malcolm Forbes, Melissa M Lane, Suzanne G Orchard, Joanne Ryan, Alice J Owen and 3 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Belayneh MengistDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia. b.miteku@deakin.edu.au.
Mojtaba LotfalianyDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia.
Julie A PascoDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia.
Bruno AgustiniDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia.
Michael BerkDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia.
Malcolm ForbesDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia.
Melissa M LaneDeakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Geelong, VIC, Australia.
Suzanne G OrchardSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Joanne RyanSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Alice J OwenSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Robyn L WoodsSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
John J McNeilSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Mohammadreza MohebbiBiostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLongitudinal cohort studies across the lifespan suggest an association between ultra-processed food (UPF) and depression. However, the effect of UPF on depression and mental health in older adults has not been determined. Therefore, this study investigated the effect of UPF on depressive symptoms and mental health in community-dwelling older adults.

methodsA pragmatic target trial was designed and emulated using the ASPirin in Reducing Events in the Elderly longitudinal data. Participants were community-dwelling older adults (≥ 70 years) in Australia. We specified and emulated the protocol of a two-arm randomised pragmatic clinical trial using the level of UPF consumption as the intervention. Greater than or equal to 4 servings of UPF per day was considered the intervention, with less than 4 servings per day the control. Dietary consumption was assessed using a mail-based diet screening questionnaire, and the level of food processing was classified based on the NOVA classification. The study outcomes were depressive symptoms, defined as a score of ≥ 8 on the Center for Epidemiological Studies Depression 10-item scale, and general mental health, defined by the mental component summary score of the Short Form-12. We applied inverse probability treatment weighting to balance confounders. Marginal structural models were employed to estimate the population-level average effect of intervention using generalised estimated equations.

resultsA total of 11,192 participants (3415 intervention and 7777 control) were eligible for the emulation. High UPF consumption at time zero was associated with an increased risk of depressive symptoms at follow-ups (RR: 1.10; CI: 1.04-1.18). The finding was consistent with sensitivity analyses; after excluding participants on antidepressants at time zero, the risk of depressive symptoms in the intervention group was increased by 11% compared to the control (RR: 1.11; 95% CI: (1.04-1.20)). Consumption of UPF adversely affected the mental component quality of life (β: - 0.40; CI: - 0.65 to - 0.15).

conclusionsA higher level of UPF consumption was associated with a higher risk of depressive symptoms and adversely affected mental health among older adults.

Indexed as

DepressionFast FoodsMental HealthAgedAged, 80 and overAustraliaFemaleFood, ProcessedHumansLongitudinal StudiesMaleRisk FactorsDepressionMental healthTarget trial emulationUltra-processed food

Identifiers

PMID40128798
PMCPMC11934811

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.