Relação do consumo de alimentos ultraprocessados e atividade física com a incidência de sintomas transtornos mentais comuns

Introduction: Diet and physical activity are associated with the incidence of common mental disorders symptoms.This thesis aims to expanding the research of how ultraprocessed foods and domain-based physical activity could be independently and jointly associated with symptoms of common mental disorders.Objective: To investigate the prospective associations of diet quality indicators and physical activity with the incidence of symptoms of common mental disorders in adults.Methods: Data from the cohorts 1982 Pelotas Birth Cohort (n=5,914 in 1982), 1993 Pelotas Birth Cohort (n=5,249 in 1993) and NutriNet Brasil cohort.The 2004/05 and 2012 waves of the 1982 Pelotas Birth Cohort were used, while cohort members were 23 and 30 years old, respectively.The 2011 and 2015 waves were used in the 1993 Pelotas Birth Cohort, when cohort members were 18 and 22 years old, respectively.Dietary intake was assessed using a food frequency questionnaire during the first selected wave of each cohort, and the consumption of ultra-processed foods was estimated using the Nova classification.The incidence of symptoms of common mental disorders was assessed using the Self-Reporting Questionnaire.In the NutriNet Brazil cohort, dietary intake was assessed using two 24-h dietary recalls, and the contribution of ultra-processed foods to the diet was estimated using the Nova classification.Two food screeners (Nova24h screener) were also used (i.e., ultra-processed foods and whole plant foods).The incidence of depressive symptoms was estimated using the Patient Health Questionnaire-9.The first manuscript investigates the association between consumption of ultra-processed foods and the incidence of symptoms of common mental disorders using data from the 1982 and 1993 Pelotas Birth Cohorts.The second manuscript investigates the association between adherence to the ultra-processed diet pattern and incident depressive symptoms using data from the NutriNet Brazil cohort.The third manuscript investigates the independent and combined associations of consumption of ultra-processed foods, whole plant foods, and domain-based physical activity with the incidence of depressive symptoms using data from the NutriNet Brazil cohort.Results: There were no associations between higher dietary share of ultra-processed foods and the incidence of symptoms of common mental disorders in both Pelotas Birth Cohorts (reference: Q1: Q2: HR = 1.15, 95% CI: 0.93-1.42;Q3 = 0.91, 0.73-1.14;Q4 = 0.97, 0.77-1.21).However, higher adherence to the ultra-processed diet pattern was associated with a higher incidence of depressive symptoms in the NutriNet Brazil cohort, with a 10% increase in the dietary share of ultra-processed foods being associated with a 10% higher risk for the development of depressive symptoms (HR: 1.10; 95%CI: 1.07-1.14).Moreover, this association was attenuated but not eliminated when including the nutritional profile of the diet and the consumption of fruits and vegetables in the model.In the systematic review, followed by a metaanalysis, conducted including the findings of the NutriNet Brazil cohort, people with a higher consumption of ultra-processed foods (highest quartile or quintile) had a 32% higher risk than people with lower consumption (lowest quartile or quintile) for the incidence of depressive outcomes.Regarding the Nova24h screeners, it was found that both a higher consumption of ultra-processed foods and a lower consumption of whole plant foods were independently associated with a higher risk for incident depressive symptoms in the NutriNet cohort.Only leisure-time physical activity was associated with a lower incidence of depressive symptoms.There was an additive interaction between higher consumption of ultra-processed foods and the lack of leisure-time physical activity practice, resulting in a combined risk higher than the sum of the individual risks (relative excess risk of interaction: 0.18; 95%CI: 0.01 -0.35).Conclusions: Higher adherence to the ultra-processed diet pattern is associated with higher incident depressive symptoms, while higher consumption of whole plant foods and leisure-time physical activity are associated with lower incident depressive symptoms.The main findings indicate that measures promoting the reduction of ultraprocessed food consumption and encouraging leisure-time physical activity should be taken together.

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