The role of ultra-processed food consumption and depression on type 2 diabetes incidence: a prospective community study in Quebec, Canada.

OBJECTIVES: The goal of the present study was to evaluate the association between depression and ultra-processed food (UPF) consumption as risk factors for developing type 2 diabetes (T2D). DESIGN: A prospective community study. SETTING: Baseline data (2009-2010) from CARTaGENE community health study from Quebec, Canada, were used. Food and drink consumption was assessed using the Canadian-Diet History Questionnaire II and grouped according to their degree of processing by the NOVA classification, and participants were categorised into tertiles of UPF (g/d). Depression was defined using either a validated cut-off score on the Patient Health Questionnaire-9 or antidepressant use. The outcome was the incidence of T2D, examined in 3880 participants by linking survey data with administrative health insurance data. Cox regression models estimated the associations between UPF, depression and incident T2D. PARTICIPANTS: 40-69-year-old individuals at baseline. RESULTS: In total, 263 (6·8 %) individuals developed T2D. Participants with high depressive symptoms and high UPF consumption showed the highest risk for T2D (adjusted hazard ratios (aHR) = 1·58, 95 % CI (0·98, 2·68)), compared to those with low depressive symptoms and low UPF consumption. The risk for T2D was similar when high depressive symptoms and antidepressant use were combined with high UPF (aHR 1·62, 95 % CI (1·02, 2·57)). CONCLUSIONS: This study shows that co-occurring depression and high UPF consumption were associated with a higher risk for T2D. Early management and monitoring of both risk factors might be essential for diabetes prevention.

Ultra-processed foods consumption, depression, and the risk of diabetes complications in the CARTaGENE project: a prospective cohort study in Quebec, Canada.

Introduction: This study aimed to assess the association between depression, ultra-processed food consumption (UPFs), and the risk of developing diabetes-specific complications in adults with type 2 diabetes (T2D). Methods: Baseline data came from the CARTaGENE study, a health survey of adults (40-69 years) in Quebec, Canada. The incidence of T2D complications was examined in N= 683 participants with T2D without complications at baseline by linking survey data with administrative health data. Food and drink consumption was assessed using the Canadian Diet History Questionnaire and categorized by NOVA classification. Participants were categorized into tertiles of UPFs consumption. Depression was defined as having elevated depressive symptoms based on the Patient Health Questionnaire-9 or the use of antidepressant medications. Cox regression models were used to estimate the associations between UPFs, depression, and T2D complications. Results: In total, 105 individuals developed diabetes-related complications over a 7-year period. Participants with high depressive symptoms and high UPFs consumption had the highest risk for diabetes complications (adjusted hazard ratio (aHR) 2.07, 95% CI: 0.91 - 4.70), compared to participants with low depressive symptoms and low UPFs consumption. Higher risks for diabetes complications were observed when high depressive symptoms and antidepressant use were combined with high UPFs consumption (aHR 2.59, 95% CI: 1.32 - 5.06). Conclusion: This study indicates that those with co-occurring depression and high UPFs consumption have a greater risk of diabetes complications. Early management and monitoring of both risk factors might be essential to prevent diabetes complications.