Abstract
Purpose
Ultra-processed food (UPF) consumption is associated with a range of adverse health outcomes, including poor mental health, but evidence remains limited in pregnant women. We aimed to examine associations between UPF consumption during pregnancy and perinatal depression (PND) symptoms.
Methods
Prospective observational study of women recruited during their first trimester of pregnancy (2018-2021) as part of the Barcelona Life Study Cohort. Diet was assessed from 20 weeks of pregnancy using a 114-item food frequency questionnaire. UPF consumption was defined by the Nova classification. The presence of PND symptoms was measured using the Edinburgh Postnatal Depression Scale (EPDS) at two months postpartum, with higher scores indicating greater depressive symptoms. Associations were assessed using linear regression and generalised additive models, adjusting for potential confounders including sociodemographic and lifestyle factors. Analyses were conducted both continuously and by UPF quartile expressed as a percentage of total food intake by weight.
Results
In 726 participants, the median share of the diet coming from UPF was 17.9%. Higher quartiles of UPF consumption showed higher EPDS scores at most levels of adjustment compared to the lowest quartile (Q1): EPDS scores were 0.79 (95% CI: 0.04, 1.55) and 0.83 (95% CI: 0.07, 1.59) points higher in Q3 and Q4 (respectively). UPF dairy products and sweet drinks appeared to drive the associations, with a non-linear J-shape association for dairy, while pre-packaged meals showed an inverse association with EPDS scores. Higher UPF intake was also associated with higher EPDS scores at 32 weeks gestation.
Conclusions
Higher UPF consumption during pregnancy was associated with greater PND symptoms. Differences by UPF subgroups were observed. These findings highlight the need for nutritional policy and population-level measures that support maternal perinatal mental health.
Key messages
• This research extends the evidence linking ultra-processed food intake to perinatal mental health, particularly important given rising global ultra-processed food consumption.
• This work suggests population-level policies and strategies for maternal health should account for ultra-processed food intake in relation to perinatal mental health.