Association of Ultra-processed Food Consumption With Cardiovascular Mortality in the US Population: Long-term Results From a Large Prospective Multicenter Study

Abstract Background Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods A population-based cohort of 91891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results After an average follow-up of 13.5 years (1236049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.52; 95% CI, 1.39–1.67) and heart disease (HRquintile 5 vs. 1, 1.70; 95% CI, 1.52–1.89) but not cerebrovascular disease (HRquintile 5 vs. 1, 1.00; 95% CI, 0.80–1.23). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity<0.05), with a threshold effect observed at ultra-processed food consumption of 2.5 servings/day and 2.4 servings/day, respectively; below the thresholds, no significant associations were observed for these two outcomes. Subgroup analyses showed that the increased risks of mortality from ultra-processed foods were significantly higher in women than in men (all Pinteraction<0.05). Conclusions High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings are needed to be confirmed in other populations and settings.

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Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study

10.21203/rs.3.rs-47440/v2 ◽

2020 ◽

Author(s):

Guo-Chao Zhong ◽

Hai-Tao Gu ◽

Yang Peng ◽

Kang Wang ◽

You-Qi-Le Wu ◽

...

Keyword(s):

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Long Term Results ◽

Processed Foods ◽

Processed Food ◽

Disease Mortality ◽

The Us ◽

Subgroup Analyses

Abstract Background: Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods: A population-based cohort of 91891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results: After an average follow-up of 13.5 years (1236049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.50; 95% CI, 1.36–1.64) and heart disease (HRquintile 5 vs. 1, 1.68; 95% CI, 1.50–1.87) but not cerebrovascular disease (HRquintile 5 vs. 1, 0.94; 95% CI, 0.76–1.17). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity<0.05), with a threshold effect observed at ultra-processed food consumption of 2.4 servings/day and 2.3 servings/day, respectively; below the thresholds, no significant associations were observed for these two outcomes. Subgroup analyses showed that the increased risks of mortality from ultra-processed foods were significantly higher in women than in men (all Pinteraction<0.05). Conclusions: High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.

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Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01081-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Guo-Chao Zhong ◽

Hai-Tao Gu ◽

Yang Peng ◽

Kang Wang ◽

You-Qi-Le Wu ◽

...

Keyword(s):

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Long Term Results ◽

Processed Foods ◽

Processed Food ◽

Disease Mortality ◽

The Us ◽

Subgroup Analyses

Abstract Background Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods A population-based cohort of 91,891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results After an average follow-up of 13.5 years (1,236,049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.50; 95% CI, 1.36–1.64) and heart disease (HRquintile 5 vs. 1, 1.68; 95% CI, 1.50–1.87) but not cerebrovascular disease (HRquintile 5 vs. 1, 0.94; 95% CI, 0.76–1.17). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity < 0.05), with a threshold effect observed at ultra-processed food consumption of 2.4 servings/day and 2.3 servings/day, respectively; below the thresholds, no significant associations were observed for these two outcomes. Subgroup analyses showed that the increased risks of mortality from ultra-processed foods were significantly higher in women than in men (all Pinteraction < 0.05). Conclusions High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.

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Dietary Soy Consumption and Cardiovascular Mortality among Chinese People with Type 2 Diabetes

Nutrients ◽

10.3390/nu13082513 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2513

Author(s):

Xiaowen Wang ◽

Jun Lv ◽

Canqing Yu ◽

Liming Li ◽

Yonghua Hu ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

International Classification Of Diseases ◽

Cardiovascular Death ◽

Soy Foods ◽

Cox Proportional Hazard Regression

Randomized controlled trials showed that soy intervention significantly improved blood lipids in people with diabetes. We sought to prospectively examine the association of soy consumption with the risk of cardiovascular death among individuals with diabetes. A total of 26,139 participants with a history of diabetes were selected from the Chinese Kadoorie Biobank study. Soy food consumption was assessed by a food frequency questionnaire. Causes of death were coded by the 10th International Classification of Diseases. The Cox proportional hazard regression was used to compute the hazard ratios. During a median follow-up of 7.8 years, a total of 1626 deaths from cardiovascular disease (CVD) were recorded. Compared with individuals who never consumed soy foods, the multivariable-adjusted risks (95% confidence intervals) of CVD mortality were 0.92 (0.78, 1.09), 0.89 (0.75, 1.05), and 0.77 (0.62, 0.96) for those who consumed soy foods monthly, 1–3 days/week, and ≥4 days/week, respectively. For cause-specific cardiovascular mortality, significant inverse associations were observed for coronary heart disease and acute myocardial infarction. Higher soy food consumption was associated with a lower risk of cardiovascular death, especially death from coronary heart disease and acute myocardial infarction, in Chinese adults with diabetes.

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Changes of Physical Activity and Ultra-Processed Food Consumption in Adolescents from Different Countries during Covid-19 Pandemic: An Observational Study

Nutrients ◽

10.3390/nu12082289 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2289 ◽

Cited By ~ 5

Author(s):

María Belén Ruíz-Roso ◽

Patricia de Carvalho Padilha ◽

Diana C. Matilla-Escalante ◽

Paola Brun ◽

Natalia Ulloa ◽

...

Keyword(s):

Physical Activity ◽

Latin America ◽

Food Consumption ◽

Healthy Lifestyle ◽

Cross Sectional Study ◽

Processed Foods ◽

Processed Food ◽

Cross Sectional ◽

Consumption Data ◽

Food Consumption Data

Aim: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. Methods: Cross-sectional study via web survey. International Physical Activity Questionnaire (IPAQ) and weekly ultra-processed food consumption data were used. To compare the frequencies of physical activity status with sociodemographic variables, a multinomial logistic and a multiple logistic regression for habitual ultra-processed foods was performed. In final models, p < 0.05 was considered significant. Results: Sample of 726 adolescents, mostly females (59.6%) aged 16–19 years old (54.3%). Adolescents from Latin America presented odds ratio (OR) 2.98 (CI 95% 1.80–4.94) of being inactive and those whose mothers had higher level of education were less active during lockdown [OR 0.40 (CI 95% 0.20–0.84)]. The habitual ultra-processed consumption was also high during this period in all countries, and more prevalent in Latin America. Conclusion: A higher prevalence of inactivity was observed in this population, but reductions of physical activity and habitual ultra-processed consumption during the pandemic were more pronounced in Latin America. Our findings reinforce the importance of promoting a healthy lifestyle, i.e., exercise and diet, during periods of social isolation.

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Consumption of ultra-processed foods and the risk of overweight and obesity, and weight trajectories in the French cohort NutriNet-Santé

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003559 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Bernard Srour ◽

Marie Beslay ◽

Caroline Méjean ◽

Benjamin Allès ◽

Thibault Fiolet ◽

...

Keyword(s):

Food Intake ◽

Confidence Interval ◽

Prospective Study ◽

Food Consumption ◽

Overweight And Obesity ◽

Processed Foods ◽

Processed Food ◽

Weight Trajectories ◽

Incident Cases

AbstractIntroductionPrevious epidemiological studies have found associations between the consumption of ultra-processed foods and the risk of obesity-related outcomes, such as post-menopausal breast cancer, cardiovascular diseases, hypertension and mortality. However, only one Spanish prospective study has explored the associations between the consumption of ultra-processed foods and the risk of overweight and obesity. The aim of this study is to investigate the associations between ultra-processed food consumption and the risk of overweight and obesity, as well as the associations between ultra-processed food consumption and weight trajectories, in middle-aged adults included in the French large scale NutriNet-Santé cohort.MethodsOverall, 110260 participants aged at least 18 years from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records, merged with a food composition database of 3300 different products. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risks of overweight and obesity were assessed using multivariable Cox proportional hazard models. Associations between ultra-processed food intake and weight trajectories were assessed using multivariable linear mixed models for repeated measures with random slope and intercept. Models were adjusted for known risk factors (sociodemographic, lifestyle, and nutritional factors).ResultsUltra-processed food intake was associated with a higher risk of overweight (n = 7063 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.11 (95% confidence interval 1.08 to 1.14); P < 0.0001, median follow-up: 4.1y, 260304 person-years) and obesity (n = 3066 incident cases; HR = 1.09 (95% confidence interval 1.05 to 1.13); P < 0.0001, median follow-up: 8.0y 365344 person-years). Higher consumers of ultra-processed foods (4th quartile) were more likely to present an increase in body mass index over time (change of BMI/time-unit in Q4 vs Q1 = 0.04, P < 0.0001). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (fruits and vegetables and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.ConclusionIn this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

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Ultra-processed foods and early childhood caries in 0–3‐year‐olds enrolled at Primary Healthcare Centers in Southern Brazil

Public Health Nutrition ◽

10.1017/s1368980020002839 ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Maurício Santos de Souza ◽

Juliana dos Santos Vaz ◽

Thais Martins-Silva ◽

Rafael Aiello Bomfim ◽

Andreia Morales Cascaes

Keyword(s):

Early Childhood ◽

Food Consumption ◽

Primary Healthcare ◽

Early Childhood Caries ◽

Controlled Study ◽

Processed Foods ◽

Processed Food ◽

Southern Brazil ◽

Primary Healthcare Centers ◽

Childhood Caries

Abstract Objective: To investigate the relationship between ultra-processed food consumption and early childhood caries. Design: Cross-sectional analysis of baseline data from a cluster randomised controlled study. Outcomes included the prevalence of children with non-cavitated and cavitated caries. The main exposure was the total daily consumption of ultra-processed foods (up to three times and four times or more), assessed through a FFQ. Potential confounders were socio-demographic characteristics of the child and caregiver/family, child breast-feeding, oral hygiene and use of dental services. Poisson regression using robust variance adjustment was used to estimate prevalence ratios (PR) and their respective 95 % CI. Setting: Primary Healthcare Centers in an urban area of Pelotas, Southern Brazil. Participants: Children aged 0–3 years (n 309). Results: Consumption of ultra-processed foods four times or more a day was found in 67·6 % of children; 24·4 and 12·0 % presented non-cavitated and cavitated caries, respectively. After adjustment, children who consumed ultra-processed foods four times or more a day were more likely to present both non-cavitated caries (PR 2·25, 95 % CI 1·19, 4·27, P = 0·013) and cavitated caries (PR 3·48, 95 % CI 1·18, 10·30, P = 0·024) compared with those who have consumed them up to three times a day. Conclusions: Consumption of ultra-processed foods is associated with early childhood caries. Interventions aiming at reducing ultra-processed food consumption should be implemented to improve children’s oral health.

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Trimethyllysine Predicts All-Cause and Cardiovascular Mortality in Community-Dwelling Adults and Patients With Coronary Heart Disease

European Heart Journal Open ◽

10.1093/ehjopen/oeab007 ◽

2021 ◽

Author(s):

Espen Ø Bjørnestad ◽

Indu Dhar ◽

Gard F T Svingen ◽

Eva R Pedersen ◽

Mads M Svenningsson ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Community Dwelling ◽

Health Study ◽

Community Based ◽

Increased Risk ◽

Established Coronary Heart Disease

Abstract Aims Trimethyllysine (TML) is involved in carnitine synthesis, serves as a precursor of trimethylamine N-oxide (TMAO) and is associated with cardiovascular events in patients with established coronary heart disease (CHD). We prospectively examined circulating TML as a predictor of all-cause and cardiovascular mortality in community-dwelling adults and patients with CHD. Methods and Results By Cox regression modelling, risk associations were examined in 6393 subjects in the community-based Hordaland Health Study (HUSK). A replication study was conducted among 4117 patients with suspected stable angina pectoris in the Western Norway Coronary Angiography Cohort (WECAC). During a mean follow-up of 10.5 years in the HUSK-cohort, 884 (13.8%) subjects died, of whom 287 from cardiovascular causes. After multivariable adjustments for traditional cardiovascular risk factors, the hazard ratio (HR) (95% CI) for all-cause mortality comparing the 4th vs. 1st TML-quartile was 1.66 (1.31-2.10, p < 0.001). Particularly strong associations were observed for cardiovascular mortality (HR [95% CI] 2.04 [1.32-3.15, p = 0.001]). Corresponding risk-estimates in the WECAC (mean follow-up of 9.8 years) were 1.35 [1.10-1.66, p = 0.004] for all-cause and 1.45 [1.06-1.98, p = 0.02] for cardiovascular mortality. Significant correlations between plasma TML and TMAO were observed in both cohorts (rs≥0.42, p < 0.001); however, additional adjustments for TMAO did not materially influence the risk associations, and no effect modification by TMAO was found. Conclusion Elevated TML-levels were associated with increased risk of all-cause and cardiovascular mortality both in subjects with and without established CHD.

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Ultra-processed Food Consumption and Incident Frailty: A Prospective Cohort Study of Older Adults (P01-012-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz028.p01-012-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Helena Sandoval-Insausti ◽

Ruth Blanco-Rojo ◽

Auxiliadora Graciani ◽

Esther Lopez-Garcia ◽

Belén Moreno-Franco ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Food Intake ◽

Food Consumption ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Community Dwelling ◽

Alcoholic Beverages ◽

Processed Foods ◽

Processed Food

Abstract Objectives Ultra-processed food intake has been associated with chronic conditions. The aim of this study was to assess the relationship between ultra-processed food intake and incident frailty in community-dwelling older adults. Methods Prospective cohort study with 1822 individuals aged ≥60 who were recruited during 2008–2010 in Spain. At baseline, food consumption was obtained using a validated computerized face-to-face dietary history. Ultra-processed foods were identified according to the nature and extent of their industrial processing (NOVA classification). In 2012, incident frailty was ascertained based on Fried's criteria. Statistical analyses were performed with logistic regression and adjusted for the main potential confounders. Results After a mean follow-up of 3.5 years, 132 cases of frailty were identified. The odds ratios (95% confidence interval) for frailty across increasing quartiles of the percentage of total energy intake from ultra-processed foods were: 1.00, 1.52 (0.78–2.96), 2.98 (1.62–5.50), and 3.67 (2.00–6.73); p for linear trend: <0.001. Results were similar when food consumption was expressed as gram per day/body weight. Regarding ultra-processed food groups, the highest versus the lowest tertiles of consumption of yogurts and fermented milks, cakes and pastries, as well as non-alcoholic beverages (instant coffee and cocoa, packaged juices, and other non-alcoholic drinks, excluding soft drinks) were also significantly related to incident frailty. Conclusions Consumption of ultra-processed foods is strongly associated with frailty risk in older adults. Funding Sources Data collection was funded by the following grants: FIS PI16/1512; PI16/1460; PI16/609; PI17/1709 (State Secretary of R + D and FEDER/FSE), the ATHLOS project (EU H2020-Project ID: 635316), the SALAMANDER project (PCIN-2016-145), and the CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.

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Abstract P052: Coronary Heart Disease Mortality Declines in the United States From 1980 through 2011: Evidence for Stagnation in Young Adults, Especially Women

Circulation ◽

10.1161/circ.131.suppl_1.p052 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Kobina A Wilmot ◽

Martin O’Flaherty ◽

Simon Capewell ◽

Earl S Ford ◽

Viola Vaccarino

Keyword(s):

Coronary Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Young Women ◽

Cardiovascular Mortality ◽

Young Men ◽

Mortality Rates ◽

Men And Women ◽

The Us ◽

Age And Sex

Background: Cardiovascular mortality rates have fallen dramatically over the past four decades. However, recent unfavorable trends in coronary heart disease (CHD) risk factors among young adults (obesity, diabetes, and tobacco use) raise concerns about their subsequent impact on CHD mortality. Furthermore, recent data from the US and other countries suggest a worsening of CHD incidence and mortality among young women. We therefore examined recent trends in CHD mortality rates in the US according to age and sex. Methods: We used mortality data between 1980 and 2011 from US adults ≥ 25 years. We calculated age-specific CHD mortality rates and estimated annual percentage change (EAPC) for US adults, and compared three decades of data (1980-1989, 1990-1999, and 2000-2011). We also used Joinpoint regression modeling to assess changes in trends over time, based on inflection points of the mortality distribution. Results: Young men and women (aged<55 years) showed a robust decline in CHD mortality from 1980 until 1989 (EAPC -5.5% in men and -4.6% in women). However, the two subsequent decades saw stagnation with minimal improvement (Table). This was particularly true for young women who had no improvements between 1990 and 1999 (EAPC +0.1%), and only -1% EAPC since 2000. In contrast, older adults (65+years) showed steep annual declines since 2000, approximately doubled compared with the previous period (women, -5.0% and men, -4.4%). Jointpoint analyses provided consistent results. Conclusions: The dramatic declines in cardiovascular mortality since 1980 conceals major heterogeneities. CHD death rates in older groups are now falling steeply. However, young men and women have enjoyed small decreases in CHD mortality rates since 1990. The drivers of these major differences in CHD mortality trends by age and sex needs urgent study.

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Unhealthy Food and Psychological Stress: The Association between Ultra-Processed Food Consumption and Perceived Stress in Working-Class Young Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083863 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3863

Author(s):

Matheus Lopes Cortes ◽

José Andrade Louzado ◽

Marcio Galvão Oliveira ◽

Vanessa Moraes Bezerra ◽

Sóstenes Mistro ◽

...

Keyword(s):

Food Consumption ◽

Perceived Stress ◽

High Stress ◽

Ordinal Regression ◽

Processed Meat ◽

Processed Foods ◽

Processed Food ◽

Cross Sectional ◽

Sugary Drinks ◽

Stress Levels

Background: Ultra-processed foods are industrial formulations made from food extracts or constituents with little or no intact food and often containing additives that confer hyper-palatability. The consumption of these products increases the risk of chronic non-communicable diseases. Stressed people may engage in unhealthy eating as a way to cope. This study aimed to verify whether ultra-processed food consumption was associated with perceived stress levels in industrial and retail workers from Vitoria da Conquista, Brazil. Methods: This was a cross-sectional study carried out between July 2017 and August 2018. During the study period, 1270 participants completed a survey administered by an interviewer. Stress levels were assessed using the Perceived Stress Scale. Information regarding weekly ultra-processed food consumption was collected. Ultra-processed foods were classified into four groups: sugary drinks; sugary foods; fast foods; and canned foods, frozen foods, or processed meat. The Student’s t-test or one-way analysis of variance was used to assess the differences in stress levels and ultra-processed food consumption. Ordinal regression was used to determine the association between the degrees of stress and ultra-processed food consumption levels. Results: Factors such as a young age, being unmarried, smoking, high-risk alcohol consumption, negative health perception, and high perceived stress level indicated higher rates of ultra-processed food consumption. Ordinal regression analysis showed that high stress levels were associated with increased odds of higher ultra-processed food consumption (odds ratio: 1.94; 95% CI: 1.54–2.45). Conclusions: These findings could help identify appropriate target areas for interventions aimed at mental health promotion and healthier food consumption.

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