Study Finds Added Sugar Linked to Poor Sleep in Young People

  • A survey of Saudi Arabian female students published in the American Journal of Lifestyle Medicine examined the links between eating habits and sleep quality
  • Results showed that students consuming higher quantities of foods with added sugars tended to have worse sleep quality
  • Study authors report that only 17% of study participants had good sleep quality

We all know that many factors can prevent us from sleeping well. Worrying about something can keep us awake for a long time. Similarly, when we are doing something exciting, we may forget to get enough sleep. However, if we chronically lack sufficient sleep, it will become increasingly difficult to function properly until we have had proper rest.

The importance of sleep

Sleep is a natural state of rest in which the body and mind become less responsive to external stimuli and engage in essential recovery processes. It plays a vital role in physical health, emotional well-being, and cognitive functioning, such as memory consolidation and learning. During sleep, the body repairs tissues, balances hormones, and strengthens the immune system.

However, many people experience sleep problems. This includes young people and adolescents. Estimates state that the prevalence of insomnia, one of the most common sleep disturbances, is comparable to that of depression and anxiety (Roberts et al., 2008).

The prevalence of insomnia, one of the most common sleep disturbances, is comparable to that of depression and anxiety 

Sleep can also be nonrestorative. This is a situation where a person sleeps but does not feel refreshed and rested afterward (Stone et al., 2008). Many individuals experience insufficient sleep, poor sleep quality, or trouble falling asleep (Wang et al., 2023). While acute lack of sleep can be compensated by longer sleep later, studies clearly link chronic poor sleep quality or insufficient sleep with serious adverse health outcomes, such as type 2 diabetes or cardiovascular disease (Sofi et al., 2014; Vgontzas et al., 2009).

Sleep, diet, and eating disorders

Studies also link poor sleep quality with changes in food-related behaviors. For example, insufficient sleep is one of the key determinants of excess body weight (Bacaro et al., 2020; Cappuccio et al., 2008). More specifically, eating during the night, i.e., the time when one should be sleeping, is an important predictor of weight gain. A 2008 study found that individuals who eat at night consume 15% of their daily calories during nighttime eating episodes. In this study, they gained several kilograms more weight during the study period compared to participants who did not eat at night (Gluck et al., 2008).

Insufficient sleep is one of the key determinants of excess body weight

When night eating is accompanied by increased food intake in the evening, avoidance of eating in the morning, a declining mood that worsens in the evening, and emotional distress, it becomes a type of eating disorder called night eating syndrome (Tzischinsky et al., 2021).

Studies also indicate that people increase their food intake when they are acutely deprived of sleep, even in the absence of chronic sleep problems (Brondel et al., 2010). Researchers have found that individuals with shorter sleep durations consume fewer fruits and vegetables, while those suffering from chronic insomnia tend to eat more ultraprocessed foods (Duquenne et al., 2024; Thapa et al., 2024).

People increase their food intake when they are acutely deprived of sleep, even in the absence of chronic sleep problems

The current study

Study author Sarah A. Alahmary and her colleagues sought to investigate the relationship between the consumption of foods high in added sugars and sleep quality among female university students at Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia (Alahmary et al., 2022). They note that previous studies have shown that consuming high amounts of added sugar increases the risk of heart disease, diabetes, and even some forms of cancer. But what about sleep?

The study participants were 100 female students from the College of Applied Studies and Community Service at Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia. They were between 19 and 23 years of age, with the mean age being 20 years.

The students completed a Food Frequency Questionnaire (FFQ), which asked them about their consumption of 57 different types of food. For each of these items, the study authors estimated the quantity of added sugar. Participants also completed a 24-hour dietary recall for two different days – one weekday and one weekend day. Based on this, the study authors divided participants into four groups according to the contribution of added sugars and total carbohydrates to their total daily energy intake. Participants also completed the Sleep Quality Questionnaire (see Figure 1).

 

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Figure 1. Procedure (Alahmary et al., 2019)

 

Higher intake of added sugar was associated with worse sleep quality

Results showed that only 17% of students reported good sleep quality. This means that they slept from 7 to 8.5 hours continuously at night, needed less than 15 minutes to fall asleep, did not use any sleeping pills, and were not suffering from insomnia.

Higher intake of added sugar (as estimated through 24-hour dietary recall) was associated with poorer sleep quality. Seventy-seven percent of students in the poor sleep quality group had more than 10% of added sugar in their diet, whereas this was the case with only 47% of students who had good sleep quality. Further analysis revealed that this association was stronger among students who were consuming food items containing caffeine.

On the other hand, the link between added sugar intake and sleep quality was not so clear when added sugar intake was estimated using the Food Frequency Questionnaire (see Figure 2).

 

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Figure 2. Association of added sugar intake and sleep quality

 

Conclusion

The study shows that a higher intake of added sugars was associated with poorer sleep quality. Although the design of this study does not allow for causal inferences to be drawn from these results, the findings suggest that limiting added sugar intake may help improve sleep quality. Given the existing findings on the links between added sugar intake and other adverse health outcomes, reducing added sugar intake may have a broader beneficial effect on overall health as well.

The paper “Relationship Between Added Sugar Intake and Sleep Quality Among University Students: A Cross-sectional Study” was authored by Sarah A. Alahmary, Sakinah A. Alduhaylib, Hibah A. Alkawii, Mashail M. Olwani, Reem A. Shablan, Hala M. Ayoub, Tunny S. Purayidathil, Omar I. Abuzaid, and Rabie Y. Khattab.

 

References

Alahmary, S. A., Alduhaylib, S. A., Alkawii, H. A., Olwani, M. M., Shablan, R. A., Ayoub, H. M., Purayidathil, T. S., Abuzaid, O. I., & Khattab, R. Y. (2022). Relationship Between Added Sugar Intake and Sleep Quality Among University Students: A Cross-sectional Study. American Journal of Lifestyle Medicine, 16(1), 122–129. https://doi.org/10.1177/1559827619870476

Bacaro, V., Ballesio, A., Cerolini, S., Vacca, M., Poggiogalle, E., Donini, L. M., Lucidi, F., & Lombardo, C. (2020). Sleep duration and obesity in adulthood: An updated systematic review and meta-analysis. Obesity Research & Clinical Practice, 14(4), 301–309. https://doi.org/10.1016/j.orcp.2020.03.004

Brondel, L., Romer, M. A., Nougues, P. M., Touyarou, P., & Davenne, D. (2010). Acute partial sleep deprivation increases food intake in healthy men. The American Journal of Clinical Nutrition, 91(6), 1550–1559. https://doi.org/10.3945/ajcn.2009.28523

Cappuccio, F. P., Taggart, F. M., Kandala, N.-B., Currie, A., ChB, M., Peile, E., & Miller, M. A. (2008). Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults. 31(5).

Duquenne, P., Capperella, J., Fezeu, L. K., Srour, B., Benasi, G., Hercberg, S., Touvier, M., Andreeva, V. A., & St-Onge, M.-P. (2024). The association between ultra-processed food consumption and chronic insomnia in the NutriNet-Santé Study. Journal of the Academy of Nutrition and Dietetics, S2212267224000947. https://doi.org/10.1016/j.jand.2024.02.015

Gluck, M. E., Venti, C. A., Salbe, A. D., & Krakoff, J. (2008). Nighttime eating: Commonly observed and related to weight gain in an inpatient food intake study. The American Journal of Clinical Nutrition, 88(4), 900–905. https://doi.org/10.1093/ajcn/88.4.900

Roberts, R. E., Roberts, C. R., & Duong, H. T. (2008). Chronic Insomnia and Its Negative Consequences for Health and Functioning of Adolescents: A 12-Month Prospective Study. Journal of Adolescent Health, 42(3), 294–302. https://doi.org/10.1016/j.jadohealth.2007.09.016

Sofi, F., Cesari, F., Casini, A., Macchi, C., Abbate, R., & Gensini, G. (2014). Insomnia and risk of cardiovascular disease: A meta-analysis. European Journal of Preventive Cardiology, 21, 57–64. https://doi.org/10.1177/2047487312460020

Stone, K. C., Taylor, D. J., McCrae, C. S., Kalsekar, A., & Lichstein, K. L. (2008). Nonrestorative sleep. Sleep Medicine Reviews, 12(4), 275–288. https://doi.org/10.1016/j.smrv.2007.12.002

Thapa, A., Lahti, T., Maukonen, M., & Partonen, T. (2024). Consumption of fruits and vegetables and its association with sleep duration among Finnish adult population: A nationwide cross-sectional study. Frontiers in Nutrition, 11, 1319821. https://doi.org/10.3389/fnut.2024.1319821

Tzischinsky, O., Latzer, I. T., Alon, S., & Latzer, Y. (2021). Sleep quality and eating disorder-related psychopathologies in patients with night eating syndrome and binge eating disorders. Journal of Clinical Medicine, 10(19). https://doi.org/10.3390/jcm10194613

Vgontzas, A. N., Liao, D., Pejovic, S., Calhoun, S., Karataraki, M., & Bixler, E. O. (2009). Insomnia With Objective Short Sleep Duration Is Associated With Type 2 Diabetes. Diabetes Care, 32(11), 1980–1985. https://doi.org/10.2337/dc09-0284

Wang, S., Rossheim, M. E., & Nandy, R. R. (2023). Trends in prevalence of short sleep duration and trouble sleeping among US adults, 2005–2018. Sleep, 46(1), zsac231. https://doi.org/10.1093/sleep/zsac231

How Expectations Change Our Body’s Response to Food, Study Finds

  • A study published in Health Psychology found that one’s expectations affect physiological responses to food
  • Participants who believed that the milkshake they consumed was high-calorie showed a much steeper decline in ghrelin level compared to participants who believed that the same shake was low-calorie.
  • Participants’ feelings of satiety were consistent with what they believed they were consuming rather than with what they actually consumed

We have all experienced situations when our expectations shaped our reactions and perceptions of events more than the actual developments. Attending a party and expecting to have a good time can significantly contribute to the overall experience of that party. Similarly, coming to an exam with the expectation that we will do well will easily motivate us to put in more effort in our work and actually perform better than if we came expecting to fail.

Expectations are important!

Scientists have long recognized that expectations play a crucial role in determining behavior. In his classic experiment from the 1950s, Curt Richter observed that rats initially placed in a water container where they must keep swimming to survive, as they cannot escape, tend to drown quickly. This was particularly true of wild rats. However, if rescued once, they would swim for much longer periods upon subsequent immersions (expecting that they will be rescued) (Richter, 1957). Although this experiment lacked the stringency of modern scientific experiments, it yielded a powerful finding that demonstrated the significant role of expectations in shaping behavior.

Since that time, numerous scientific findings have confirmed that expectations can significantly influence human perceptions. This includes the area of nutrition and food behavior. For example, a 2022 study found that people perceive food as tastier when it is eaten in an aesthetically pleasing environment (Hedrih, 2023; Wu et al., 2022). Another study showed that increasing the price of a wine makes people report its flavor as more pleasant, while also increasing activity in the medial orbitofrontal cortex of the brain (an area thought to be responsible for experienced pleasantness) during wine consumption (Plassmann et al., 2008).  On the opposite pole of expectations, a study found that people tend to give lower liking ratings to foods if they were labeled as low-fat (Wardle & Solomons, 1994).

Expectations and physiological changes

The effects of expectations seem to go beyond psychological experiences. They can affect physiological parameters of the body as well. Studies have shown that people learn to expect meals at a certain time of day, and their bodies adjust blood sugar levels accordingly (Isherwood et al., 2023).

Similarly, numerous studies demonstrate that the body responds with fluctuating hormone levels, including insulin, ghrelin, pancreatic polypeptide, and glucagon, when a person sees or smells food, thereby initiating meal anticipation (Skvortsova et al., 2021).

The current study

Study author Alia J. Crum and her colleagues sought to determine whether subtle changes in mindset regarding the characteristics of what people eat might influence the release of ghrelin in response to food consumption (Crum et al., 2011). Ghrelin is a hormone primarily produced in the stomach that stimulates hunger by signaling the brain to increase appetite. Its levels rise before meals and fall sharply after eating begins.

Study participants were recruited through fliers presenting an opportunity to participate in a “Shake Tasting Study” at the Yale Center for Clinical Investigation in exchange for $75 for two 2.5-hour sessions. In this way, the study authors recruited 46 participants who completed all components of the study. These sessions were exactly one week apart and took place in the morning after an overnight fast.

The study authors informed participants that their institution’s kitchen was preparing two different milkshakes for them to test. In one session, participants were to test one of the milkshakes, while they would taste the other in the second session. In reality, both milkshakes were identical. However, the label on the milkshake in one session said that it is a high-fat, high-calorie “indulgent” milkshake (aiming to induce an indulgent mindset about it). In contrast, in the other session, the label read that it is a low-fat, low-calorie “sensible” milkshake.

At the start of each session, participants had an intravenous catheter inserted for blood drawing. After a 20-minute rest, the study authors drew the first blood sample. New blood samples were taken at 60 and 90 minutes after the start of the procedure. Study authors used these blood samples to determine ghrelin levels.

During the first interval, participants were asked to view and rate the label of the shake. During the interval between the second and the third blood drawing, participants were asked to drink and rate the milkshake. Participants rated the taste, smell, appearance, enjoyment, and overall healthiness of the milkshake on a visual analogue scale. They rated their own hunger levels 10 minutes prior to each blood drawing. Participants also completed an assessment of restrained eating (the Dutch Eating Behavior Questionnaire) (see Figure 1).

 

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Figure 1. Study Procedure (Crum et al., 2011)

 

Ghrelin levels drop sharply when participants believe they drank a high-calorie milkshake

Results showed that participants rated the milkshake they believed to be low-calorie as much healthier than the same milkshake when they believed it was high-calorie. After reading the milkshake label, participants exhibited a steeper rise in ghrelin levels when the label indicated that the milkshake was a high-calorie shake than when it stated that it was low-calorie. After consuming the milkshake, the reduction in ghrelin levels was much steeper when participants believed that the milkshake was high-calorie.

In contrast, anticipation of a low-calorie milkshake resulted in either flat or only slightly increased ghrelin levels. After drinking it, ghrelin levels either remained similar or declined slightly, suggesting that participants were not physiologically satisfied, despite consuming the same nutrient contents. Participants’ satiety was consistent with what they believed they were consuming, rather than with the actual nutritional value of what they consumed  (see Figure 2).

 

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Figure 2. Influence of expectation on physiological response.

Conclusion

The results of this study indicate that expectations and the mindset with which one approaches food can influence the physiological responses to consuming it. In this case, ghrelin levels in participants’ blood were more affected by their expectations than by the nutrient content of the milkshake they consumed.

This suggests that policies aimed at promoting healthy dietary habits and meal plans in general should consider people’s expectations about food and the mindset with which they approach it, rather than focusing solely on the nutritional content of food. The same goes for research studies examining the physiological and psychological effects of consuming specific foods.

The paper “Mind Over Milkshakes: Mindsets, Not Just Nutrients, Determine Ghrelin Response” was authored by Alia J. Crum, William R. Corbin, Kelly D. Brownell, and Peter Salovey.

 

References

Crum, A. J., Corbin, W. R., Brownell, K. D., & Salovey, P. (2011). Mind over milkshakes: Mindsets, not just nutrients, determine ghrelin response. Health Psychology, 30(4), 424–429. https://doi.org/10.1037/a0023467

Hedrih, V. (2023, June 12). Is Food Tastier When Consumed in Aesthetically Pleasing Environments? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/is-food-tastier-when-consumed-in-aesthetically-pleasing-environments/

Isherwood, C. M., van der Veen, D. R., Hassanin, H., Skene, D. J., & Johnston, J. D. (2023). Human glucose rhythms and subjective hunger anticipate meal timing. Current Biology, 33(7), 1321-1326.e3. https://doi.org/10.1016/j.cub.2023.02.005

Plassmann, H., O’Doherty, J., Shiv, B., & Rangel, A. (2008). Marketing actions can modulate neural representations of experienced pleasantness. Proceedings of the National Academy of Sciences, 105(3), 1050–1054. https://doi.org/10.1073/pnas.0706929105

Richter, C. P. (1957). On the Phenomenon of Sudden Death in Animals and Man. Psychosomatic Medicine, 19(3).

Skvortsova, A., Veldhuijzen, D. S., Kloosterman, I. E. M., Pacheco-López, G., & Evers, A. W. M. (2021). Food anticipatory hormonal responses: A systematic review of animal and human studies. Neuroscience & Biobehavioral Reviews, 126, 447–464. https://doi.org/10.1016/j.neubiorev.2021.03.030

Wardle, J., & Solomons, W. (1994). Naughty but nice: A laboratory study of health information and food preferences in a community sample. Health Psychology, 13(2), 180–183. https://doi.org/10.1037/0278-6133.13.2.180

Wu, C., Zhu, H., Huang, C., Liang, X., Zhao, K., Zhang, S., He, M., Zhang, W., & He, X. (2022). Does a beautiful environment make food better—The effect of environmental aesthetics on food perception and eating intention. Appetite, 175(April), 106076. https://doi.org/10.1016/j.appet.2022.106076

Does the Availability of Palatable Food Influence Eating Behavior and Health?

  • A study published in Foods examined the relationship between the availability of palatable food and three aspects of eating behavior —cognitive restraint, uncontrolled eating, and emotional eating.
  • Where palatable foods were widely available, people were more prone to uncontrolled eating and emotional eating
  • Individuals currently on a diet exhibited higher levels of cognitive restraint and emotional eating.

Although people have different food preferences, they cannot always act on them. An important limitation is often availability – no matter how much we want certain food, we can eat it only if it is available to us. If the food we want is not available, we usually settle for foods that are, even though they are not our first choice.

What affects our food choices?

Our food choices are influenced by a combination of biological factors (such as hunger, taste preferences, and nutritional needs), psychological and social influences (including mood, habits, culture, and peer pressure), and environmental factors (including availability, cost, advertising, and time). Our cultural background and upbringing have a significant influence on our long-term food preferences and habits. They can influence our preferences for or aversions to certain foods. Similarly, humans can use food choice as an expression of their values, attitudes, and identity (Hedrih, 2023; Jayasinghe et al., 2025).

Studies suggest that we learn to interpret sensations coming from our body as signals of hunger and how to respond to them. Moreover, humans (as well as animals) can learn to expect food at specific locations and at certain times. We can even learn to expect a certain number of meals per day and what their contents will be (Hedrih, 2023; Isherwood et al., 2023).

Humans (as well as animals) can learn to expect food at specific locations and at certain times. 


Two processes of hunger

Some authors propose that there are two different processes responsible for hunger and thus two different processes that motivate us to eat. One of those processes is homeostatic hunger. A lack of specific nutrients in the body triggers specific signals, resulting in the sensation of hunger. This experience then motivates the person to seek and eat foods containing the nutrients the body needs.

The second process of hunger is called appetite. It arises from the learned associations between various cues for food and their consequences. For example, a person may remember how eating a chocolate cake resulted in a pleasant experience coming from the taste of the cake. Because of this, when the person sees a chocolate cake again, he/she will expect the same pleasant experience from eating it, which will increase that person’s motivation to eat the cake (Hedrih, 2023).

However, the learned associations need not be only with taste. People may learn that choosing and eating certain foods can communicate endorsement of certain values, prestige, or even contribute to their overall health and well-being. This can make the person choose or avoid specific food items, regardless of their taste (Folwarczny et al., 2024).

The current study

Study author Natália d’Ottaviano Medina and her colleagues sought to investigate the relationship between the availability of palatable food in one’s environment and three aspects of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating (Medina et al., 2023). These authors believed that these aspects of eating behaviors would be associated with how rich a person’s environment is in palatable foods and whether the person is dieting. They also believed that individuals practicing these behaviors more often would have a higher body mass index.

Restrained eating, uncontrolled eating, and emotional eating

Cognitive restraint, also known as restrained eating, refers to the conscious restriction of food intake to control body weight or shape, often by deliberately limiting calories or avoiding specific foods. Although people practice restrained eating with the aim of reducing their food intake, previous studies suggest that this approach can actually increase food cravings and hunger, ultimately leading to overeating later (Dicker-Oren et al., 2022).

Uncontrolled eating is the tendency to eat excessively in response to external cues or emotions, often without awareness or the ability to stop despite feeling full. Emotional eating is a behavior in which individuals eat in response to their emotions rather than to satisfy physical hunger. It involves using food as a means of coping with or soothing emotional distress, such as stress, sadness, or anxiety (Encyclopedia of Nutritional Psychology, 2025).

Study design

Study participants were 413 adults between 18 and 60 years of age. 76% of them were between 18 and 30 years old. 50% of them were women. They were all Brazilian, and 91% of them were from São Paulo. 69% of them completed or engaged in higher education, and 21% in postgraduate programs.

They completed the Power of Food Scale, a self-report questionnaire intended to measure the psychological impact of living in food-rich environments. It considers changes in participants’ appetitive responses based on three levels of proximity to food (food available, food present, and food tasted). Participants also completed the Three-Factor Eating Questionnaire, designed to assess the three previously mentioned aspects of eating behavior (see Figure 1).

 

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Figure 1. Study procedure (Medina et al., 2025)

 

Where palatable foods were widely available, people were more prone to engage in emotional and uncontrolled eating

Results showed that the presence and availability of palatable foods were associated with higher levels of uncontrolled eating and emotional eating. Individuals who reported palatable foods as more available tended to report higher levels of cognitive restraint.

Those who reported practicing all three types of eating behaviors more tended to have a higher body mass index. Additionally, individuals who reported currently dieting were more prone to engaging in both cognitive restraint and emotional eating (see Figure 2).

 

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Figure 2. Association of palatable food availability with uncontrolled and emotional eating

 

Conclusion

The results of this study suggest that the presence of food and its general availability are important determinants of eating behavior, particularly in cases of uncontrolled and emotional eating. Additionally, the results confirmed the link between dieting and a higher proneness to emotional eating.


Health protection strategies should consider the impact of people’s food environment when designing interventions to prevent and manage eating behavior impairments.

This suggests that health protection strategies should consider the impact of people’s food environment when designing interventions to prevent and manage eating behavior impairments. They should also take into account the vulnerability of individuals practicing restrictive diets to emotional eating.

The paper “The Psychological Impact of the Widespread Availability of Palatable Foods Predicts Uncontrolled and Emotional Eating in Adults” was authored by Natália d’Ottaviano Medina, Joana Pereira de Carvalho-Ferreira, Julia Beghini, and Diogo Thimoteo da Cunha.

 

References

Dicker-Oren, S. D., Gelkopf, M., & Greene, T. (2022). The dynamic network associations of food craving, restrained eating, hunger and negative emotions. Appetite, 175(March), 106019. https://doi.org/10.1016/j.appet.2022.106019

Encyclopedia of Nutritional Psychology. (2025). The Center for Nutritional Psychology. https://www.nutritional-psychology.org/encyclopedia/

Folwarczny, M., Menon, R. G. V., & Otterbring, T. (2024). Plate, glass, and social class: How dominance and prestige orientation shape food preferences. Personality and Individual Differences, 225, 112666. https://doi.org/10.1016/j.paid.2024.112666

Hedrih, V. (2023). Are Hunger Cues Learned in Childhood? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/are-hunger-cues-learned-in-childhood/

Isherwood, C. M., van der Veen, D. R., Hassanin, H., Skene, D. J., & Johnston, J. D. (2023). Human glucose rhythms and subjective hunger anticipate meal timing. Current Biology, 33(7), 1321-1326.e3. https://doi.org/10.1016/j.cub.2023.02.005

Jayasinghe, S., Byrne, N. M., & Hills, A. P. (2025). Cultural influences on dietary choices. Progress in Cardiovascular Diseases, In press, S0033062025000209. https://doi.org/10.1016/j.pcad.2025.02.003

Medina, N. d’Ottaviano, De Carvalho-Ferreira, J. P., Beghini, J., & Da Cunha, D. T. (2023). The Psychological Impact of the Widespread Availability of Palatable Foods Predicts Uncontrolled and Emotional Eating in Adults. Foods, 13(1), 52. https://doi.org/10.3390/foods13010052

 

 

Do Children Who Eat Healthier Diets See Themselves as More Capable and Worthy?

  • A survey of children and their caregivers in China, published in Frontiers in Nutrition, found that children who eat more fruits and vegetables tend to have better self-concepts.
  • In other words, they tend to see themselves as more capable, worthy, and valuable compared to children who eat fruits and vegetables less often.
  • Children who frequently ate sweet foods and street foods tended to have lower self-concepts as well.
  • Children consuming unhealthy sugar-sweetened beverages had an increased risk of having emotional and behavioral issues.

We probably all know that food intake and food choice are not solely driven by hunger or biological needs, such as metabolic demands or neurobiological processes related to reward and emotion. For most people, food choice is determined by what is available where they live, what they can afford, what they are able to prepare, as well as their attitudes, cultural norms, and many other factors. Having a freshly cooked meal prepared from healthy ingredients is not just a matter of choice, but more often a matter of being able to obtain the needed ingredients, store them, have a place and facilities to prepare the meal, as well as time and knowledge to do it, or funds to buy the meal someone else has prepared. On the other hand, when this is not available, people may opt for industrially processed food with a long shelf life, or another convenient option, even if it is less healthy.

How does culture drive food choice?

Food choice is an expression of people’s identity, values, and lifestyle (Enriquez & Archila-Godinez, 2022). Some foods and methods of preparing them are deeply rooted in culture, transmitted through generations, and are thus considered traditional. Some foods are considered taboo in certain cultures. Individuals embracing norms of those cultures are expected to avoid eating such foods (Jayasinghe et al., 2025).

Researchers use the term cultural food to refer to specific foods associated with a particular culture, region, or ethnicity. These foods are prepared using recipes and ingredients that have been passed down through generations, carrying historical and symbolic significance as part of the shared identity of specific cultural groups. Examples include sushi in Japan, pasta in Italy, tamales in Mexico, or fermented herring in Sweden. Cultural groups also have their own food cultures, which encompass rituals, values, and social norms surrounding food. Food culture refers to the way food is grown, prepared, shared, and consumed, along with the customs that influence these activities (Jayasinghe et al., 2025; Nygaard, 2019).

A recent survey including 16 different countries found that broad cultural dimensions are associated with specific food-related attitudes and behaviors. For example, this study showed that individuals with higher tolerance for ambiguity were more likely to choose foods that are trendy, cheap, and convenient. People from less indulgent cultures were more likely to eat foods similar to those they had eaten as children. In contrast, individuals with a short-term orientation were more often inclined to eat foods that others expected them to consume (Djekic et al., 2021).

Food choice and mental health

Studies have also shown that some food choices are associated with mental health. For example, a 2024 meta-analysis indicated that more frequent consumption of junk food was associated with an increased odds of depression and psychological stress (Ejtahed et al., 2024; Hedrih, 2025). Higher intake of added sugars is associated with poorer sleep quality (Alahmary et al., 2022). Additionally, some individuals use food consumption as a means of coping with stress and intense emotions. This behavior is referred to as emotional eating (Ljubičić et al., 2023)

The current study

Study author Dong Zhao and his colleagues aimed to investigate the relationship between the dietary habits of children on one side, and their self-concept and emotional and behavioral problems on the other (Zhao et al., 2025). Self-concept is a person’s overall understanding of themselves, indicating how capable, worthy, and confident they see themselves to be. Emotional and behavioral problems in children are difficulties in managing emotions, behaviors, or social interactions that significantly interfere with their daily functioning, learning, or relationships.

These authors conducted a survey. Study participants were recruited from Zhejiang province in China, using a stratified sampling procedure that divided the province into 3 economic groups. Researchers then randomly selected two primary schools from each economic group and surveyed all third-grade children and their caregivers in those schools.

In total, they surveyed 1126 children-caregiver pairs. The average age of children was 9-10 years. 302 were classified as having emotional and behavioral problems. 71% of participants lived in cities. 67% of participating caregivers were mothers.

Study participants answered 10 questions about children’s consumption of 3 healthy foods – fresh fruit, fresh vegetables, and milk/soymilk, and seven unhealthy foods – sugar-sweetened beverages, fried food, sweet food, puffed food, pickled vegetables, Western fast food, and street food in the preceding week. They also completed assessments of self-concept (using the Piers-Harris Children’s Self-Concept Scale) and emotional and behavioral problems (using the Rutter’s Child Behavior Questionnaire) (see Figure 1).

%learn about nutrition mental health %The Center for Nutritional Psychology
Figure 1. Study Procedure (Zhao et al., 2025)

Children who eat more fruit and vegetables tend to have better self-concepts

Results showed that children eating lots of fresh fruit and vegetables had half the odds of having low self-concept compared to their peers who ate less of these foods. Children who ate sweet foods and street foods more than three times a week were also more likely to have a low self-concept. On the other hand, children who drank lots of sugar-sweetened beverages had higher odds of displaying emotional and behavioral problems.

Overall, children with healthy dietary habits tended to have better self-concept and were less likely to display emotional and behavioral problems, particularly anti-social behaviors. The study authors tested a statistical model proposing that healthy dietary habits lead to a better self-concept and that a better self-concept reduces the risk of emotional and behavioral problems. The results showed that this state of relationships is indeed possible (see Figure 2).

%learn about nutrition mental health %The Center for Nutritional Psychology
Figure 2. Study Findings (Zhao et al., 2025)

Conclusion

Overall, the study revealed a slight association between healthy dietary habits, specifically the consumption of fresh fruits and vegetables, and mental health. Children with healthier diets tended to have slightly better self-concepts and were less likely to display emotional and behavioral problems.

Although the design of this study does not allow for any causal inferences to be drawn from the results, it is possible that improving children’s diets by ensuring they have access to fresh fruits and vegetables may be protective of their mental health, aside from conferring other health benefits.

The paper “Association between dietary habits and emotional and behavioral problems in children: the mediating role of self-concept” was authored by Dong Zhao, Wenhan Xiao, Boren Tan, Ye Zeng, Shuting Li, Jiali Zhou, Shiyi Shan, Jing Wu, Qian Yi, Ronghua Zhang, Danting Su, and Peige Song.

 

References

Alahmary, S. A., Alduhaylib, S. A., Alkawii, H. A., Olwani, M. M., Shablan, R. A., Ayoub, H. M., Purayidathil, T. S., Abuzaid, O. I., & Khattab, R. Y. (2022). Relationship Between Added Sugar Intake and Sleep Quality Among University Students: A Cross-sectional Study. American Journal of Lifestyle Medicine, 16(1), 122–129. https://doi.org/10.1177/1559827619870476

Djekic, I., Bartkiene, E., Szűcs, V., Tarcea, M., Klarin, I., Černelić-Bizjak, M., Isoldi, K., EL-Kenawy, A., Ferreira, V., Klava, D., Korzeniowska, M., Vittadini, E., Leal, M., Frez-Muñoz, L., Papageorgiou, M., & Guiné, R. P. F. (2021). Cultural dimensions associated with food choice: A survey based multi-country study. International Journal of Gastronomy and Food Science, 26, 100414. https://doi.org/10.1016/j.ijgfs.2021.100414

Ejtahed, H.-S., Mardi, P., Hejrani, B., Mahdavi, F. S., Ghoreshi, B., Gohari, K., Heidari-Beni, M., & Qorbani, M. (2024). Association between junk food consumption and mental health problems in adults: A systematic review and meta-analysis. BMC Psychiatry, 24(1), 438. https://doi.org/10.1186/s12888-024-05889-8

Enriquez, J. P., & and Archila-Godinez, J. C. (2022). Social and cultural influences on food choices: A review. Critical Reviews in Food Science and Nutrition, 62(13), 3698–3704. https://doi.org/10.1080/10408398.2020.1870434

Hedrih, V. (2025). Does Eating Lots of Junk Food Lead to Poor Mental Health? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/does-eating-lots-of-junk-food-lead-to-poor-mental-health/

Jayasinghe, S., Byrne, N. M., & Hills, A. P. (2025). Cultural influences on dietary choices. Progress in Cardiovascular Diseases, In press, S0033062025000209. https://doi.org/10.1016/j.pcad.2025.02.003

Ljubičić, M., Matek Sarić, M., Klarin, I., Rumbak, I., Colić Barić, I., Ranilović, J., Dželalija, B., Sarić, A., Nakić, D., Djekic, I., Korzeniowska, M., Bartkiene, E., Papageorgiou, M., Tarcea, M., Černelič-Bizjak, M., Klava, D., Szűcs, V., Vittadini, E., Bolhuis, D., & Guiné, R. P. F. (2023). Emotions and Food Consumption: Emotional Eating Behavior in a European Population. Foods, 12(4), Article 4. https://doi.org/10.3390/foods12040872

Nygaard, M. E. (2019). Swedish fermented herring as a marker of rural identity: The Alfta surströmmingsskiva. Food, Culture & Society, 22(4), 407–422. https://doi.org/10.1080/15528014.2019.1620585

Zhao, D., Xiao, W., Tan, B., Zeng, Y., Li, S., Zhou, J., Shan, S., Wu, J., Yi, Q., Zhang, R., Su, D., & Song, P. (2025). Association between dietary habits and emotional and behavioral problems in children: The mediating role of self-concept. Frontiers in Nutrition, 12, 1426485. https://doi.org/10.3389/fnut.2025.1426485

 

 

 

 

People Consuming Lots of Ultra-Processed Foods Tend to Have Slightly Worse Mental Health Indicators

  • The results of a survey of Turkish adults published in Food Science & Nutrition showed that individuals consuming more ultraprocessed food tended to self-report slightly more severe symptoms of food addiction.
  • These individuals also tended to report slightly greater symptoms of depression, anxiety, and stress.
  • Younger participants, women, those unemployed, and single individuals tended to consume more ultraprocessed foods.

We all know that consuming nutritious meals made from healthy ingredients is beneficial for our health. However, we have all been in situations where we don’t have the time or energy to invest in preparing such a meal, but we opt for something readily available instead. There are likely also times when we are drawn by the taste or smell of some industrially prepared food item, and times when such meals were the only available option.

While such ready-made foods were relatively rare in earlier times, studies indicate that the consumption of industrially processed foods has been increasing rapidly in recent decades. This is particularly true for ultra-processed foods (Baker et al., 2020; Juul et al., 2022; Juul & Hemmingsson, 2015).

The consumption of industrially processed foods has increased rapidly in recent decades.

Ultraprocessed foods

Ultra-processed foods are industrially manufactured food products that contain ingredients not typically used in home cooking. These include artificial flavors, preservatives, emulsifiers, and colorings. They are typically made from industrial formulations of substances extracted from foods (like oils, sugars, starches, and proteins) with little to no intact whole food content. Ultra-processed foods are designed to be convenient, palatable, and long-lasting (Hedrih, 2024; Monteiro et al., 2019).

Common examples include sugary cereals, instant noodles, soft drinks, packaged snacks, and ready-to-eat meals. Unlike minimally processed foods, ultra-processed products tend to be low in essential nutrients and high in salt, sugar, and unhealthy fats.

Ultraprocessed foods and health

More and more studies link regular consumption of ultra-processed food to adverse health outcomes such as obesity, cardiovascular diseases, type II diabetes, depression, and even sleep problems (Duquenne et al., 2024; Hedrih, 2024a; Lane et al., 2024). Studies suggest that long-term consumption of foods rich in easily digestible fats and sugars can dysregulate the brain’s mechanisms for regulating food intake. This mechanism makes us feel satiated and prevents us from eating when we have eaten enough, thereby reducing the risk of obesity. This phenomenon is well-known from studies on rodents, where such diets are referred to as obesogenic diets because they are used to induce obesity in these animals (Ikemoto et al., 1996).

Ultra-processed foods are most often made to be rich in easily digestible fats and sugars, a combination that is rare in natural foods. Even when whole foods contain both fats and sugars in high quantities, such as in almonds, these nutrients are embedded in a fibrous matrix that slows digestion and absorption. Given that the central nervous system has separate neural pathways that react to fats and sugars and link into regions of the brain involved in reward processing, the consumption of ultra-processed foods triggers activity in both of these pathways, resulting in feelings of pleasure rarely experienced from eating natural foods (McDougle et al., 2024; Hedrih, 2024b).

Whole foods have nutrients embedded in a fibrous matrix that slows digestion and absorption.

There are also indications that some ultra-processed foods contain additives that can trigger reactions in the brain similar to those seen in various addictions. All of this makes some authors talk about food addiction and link ultra-processed foods to the development of this condition (Gearhardt et al., 2023; Hedrih, 2023).

Some ultra-processed foods contain additives that can trigger reactions in the brain similar to those seen in various addictions.

The current study

Study author Özge Mengi Çelik and her colleagues wanted to examine the associations between ultra-processed food consumption, hedonic hunger, food addiction symptoms, and mental health indicators (depression, anxiety, and stress). They conducted an online survey.

Study participants were 3,997 individuals between 18 and 65 years of age from Ankara Province, Türkiye. 63% of them were women. 39% were overweight or obese.

The survey contained assessments of ultra-processed food consumption (the Screening Questionnaire of Highly Processed Food Consumption), hedonic hunger (the Power of Food Scale), food addiction (the Yale Food Addiction Scale), and mental health symptoms (the DASS-21 scale). Participants also reported their body weight and height (see Figure 1).

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 1. Study procedure (Çelik et al., 2025)

Hedonic hunger refers to a strong desire or preoccupation with consuming food for the enjoyment and pleasure it brings rather than responding to actual physical hunger cues. It involves craving food based on the pleasurable eating experience rather than fulfilling a genuine nutritional need. Food addiction refers to a condition where individuals exhibit compulsive behaviors, cravings, and loss of control around food consumption, similar to patterns observed in substance addiction (Encyclopedia of Nutritional Psychology, 2025).

Individuals consuming lots of ultra-processed foods were more prone to hedonic hunger

Results showed that individuals reporting higher consumption of ultra-processed foods tended to be more prone to hedonic hunger. They also tended to show somewhat higher symptoms of food addiction. Similarly, these individuals tended to report higher levels of depressive symptoms, anxiety symptoms, and stress.

Individuals with higher levels of ultra-processed food consumption tended to be younger and were more likely to be women. Overall, 59% of women and 41% of men were classified as high consumers of ultra-processed foods. Individuals in the high ultra-processed food consumption category were also more likely to be single than married (69% vs. 31%) and were more likely to be unemployed. Ultra-processed food consumption was not associated with the number of meals or snacks consumed in a typical day (see Figure 2).

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 2. Processed food intake and hedonic hunger

Conclusion

Overall, the study results confirm a link between the consumption of ultra-processed foods and mental health. Individuals with high quantities of ultra-processed food in their diet tended to report experiencing hedonic hunger somewhat more often and having somewhat worse mental health symptoms.

While the study’s design does not allow for causal inferences to be drawn from the results, it does support the notion that promoting healthy eating habits can be a relatively simple way to support overall physical and mental health.

The paper “Factors Affecting Ultra-Processed Food Consumption: Hedonic Hunger, Food Addiction, and Mood” was authored by Özge Mengi Çelik, Ümmügülsüm Güler, and Emine Merve Ekici.

 

References

Baker, P., Machado, P., Santos, T., Sievert, K., Backholer, K., Hadjikakou, M., Russell, C., Huse, O., Bell, C., Scrinis, G., Worsley, A., Friel, S., & Lawrence, M. (2020). Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obesity Reviews, 21(12), e13126. https://doi.org/10.1111/obr.13126

Duquenne, P., Capperella, J., Fezeu, L. K., Srour, B., Benasi, G., Hercberg, S., Touvier, M., Andreeva, V. A., & St-Onge, M.-P. (2024). The association between ultra-processed food consumption and chronic insomnia in the NutriNet-Santé Study. Journal of the Academy of Nutrition and Dietetics, S2212267224000947. https://doi.org/10.1016/j.jand.2024.02.015

Encyclopedia of Nutritional Psychology. (2025). The Center for Nutritional Psychology. https://www.nutritional-psychology.org/encyclopedia/

Gearhardt, A. N., Bueno, N. B., DiFeliceantonio, A. G., Roberto, C. A., Jiménez-Murcia, S., & Fernandez-Aranda, F. (2023). Social, clinical, and policy implications of ultra-processed food addiction. BMJ, e075354. https://doi.org/10.1136/bmj-2023-075354

Hedrih, V. (2023). Scientists Propose that Ultra-Processed Foods be Classified as Addictive Substances. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/scientists-propose-that-ultra-processed-foods-be-classified-as-addictive-substances/

Hedrih, V. (2024a). What are Ultra-Processed Foods Doing to Your Mental and Physical Health? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/what-are-ultra-processed-foods-doing-to-your-mental-and-physical-health/

Hedrih, V. (2024b). Consuming Fat and Sugar (At The Same Time) Promotes Overeating, Study Finds. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/16563-2/

Ikemoto, S., Takahashi, M., Tsunoda, N., Maruyama, K., Itakura, H., & Ezaki, O. (1996). High-fat diet-induced hyperglycemia and obesity in mice: Differential effects of dietary oils. Metabolism, 45(12), 1539–1546. https://doi.org/10.1016/S0026-0495(96)90185-7

Juul, F., & Hemmingsson, E. (2015). Trends in consumption of ultra-processed foods and obesity in Sweden between 1960 and 2010. Public Health Nutrition, 18(17), 3096–3107. https://doi.org/10.1017/S1368980015000506

Juul, F., Parekh, N., Martinez-Steele, E., Monteiro, C. A., & Chang, V. W. (2022). Ultra-processed food consumption among US adults from 2001 to 2018. The American Journal of Clinical Nutrition, 115(1), 211–221. https://doi.org/10.1093/ajcn/nqab305

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, e077310. https://doi.org/10.1136/bmj-2023-077310

McDougle, M., de Araujo, A., Singh, A., Yang, M., Braga, I., Paille, V., Mendez-Hernandez, R., Vergara, M., Woodie, L. N., Gour, A., Sharma, A., Urs, N., Warren, B., & de Lartigue, G. (2024). Separate gut-brain circuits for fat and sugar reinforcement combine to promote overeating. Cell Metabolism. https://doi.org/10.1016/j.cmet.2023.12.014

Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J. C., Louzada, M. L. C., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez-Steele, E., Baraldi, L. G., & Jaime, P. C. (2019). Ultra-processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. https://doi.org/10.1017/S1368980018003762

Older Adults Who Eat More Ultra processed Foods Face Faster Cognitive Decline, Study Finds

  • A study of Brazilian public servants published in JAMA Neurology found an association between high ultraprocessed food consumption and the pace of age-related cognitive decline.
  • Compared to participants with the lowest ultraprocessed food intake (below 20% of calories), those with higher intake showed a 28% faster rate of global cognitive decline.
  • They also experienced a 25% faster rate of decline in executive function.

As people reach advanced age, their bodies start to change. Their muscle mass becomes smaller, metabolism slows, and bone density decreases. Many develop problems with their eyes and vision, and experience hearing loss. Their roles in society change. Many retire, changing their daily routines, social interaction patterns, and personal identity. They also experience psychological changes. Aging brings increased wisdom, emotional resilience, and a deeper sense of gratitude, often leading to greater happiness and life satisfaction. It also offers more time for meaningful relationships, personal passions, and the opportunity to leave a lasting legacy.

Cognitive changes in advanced age.

With advancing age, cognitive functions like memory and processing speed tend to decline. Some 20% of people experience dementia, a progressive neurological condition characterized by a decline in memory, thinking ability, and daily functioning so severe that it interferes with a person’s ability to live independently (Moon et al., 2019). Dementia is currently the most important cause of disability in high-income countries (Gomes Gonçalves et al., 2023)

However, cognitive decline does not affect all people equally. Some individuals start experiencing strong cognitive decline relatively early (e.g., in their 40s). In contrast, others retain much of their cognitive abilities well into very advanced age, such as their 80s (Mella et al., 2018). Also, cognitive decline does not affect all cognitive functions equally. For example, vocabulary knowledge seems to remain stable or even improve as people gain experience, even up to 91 years of age (Kavé, 2024).

Examining the factors that contribute to these individual differences in cognitive decline rates, researchers highlight cognitive reserve as a crucial protective factor against cognitive decline. Cognitive reserve refers to the brain’s ability to resist the effects of aging or neurological damage by efficiently reorganizing its neural networks or utilizing alternative neural pathways to achieve desired cognitive outcomes. It is believed to be created throughout one’s life through education, social engagement, cognitively stimulating leisure activities, and generally through engaging in activities that require intense cognitive processing (M. Tucker & Stern, 2011; Stern, 2002).

Ultraprocessed foods and cognition.

Ultraprocessed foods are industrially manufactured products made from refined ingredients, additives, and preservatives, with little to no whole food content. They are primarily designed for convenience and long shelf life (Hedrih, 2024; Monteiro et al., 2019). They are most often hyperpalatable, making them easy to overconsume. Common examples include sugary cereals, instant noodles, soft drinks, and packaged snacks.

Studies link frequent consumption of ultraprocessed foods with obesity, type 2 diabetes, depression, and other health conditions. 

Studies have linked frequent consumption of ultraprocessed foods with obesity, type 2 diabetes, depression, and various other adverse health conditions (Lane et al., 2024; Samuthpongtorn et al., 2023). Additionally, some studies indicate that ultraprocessed foods, and particularly those containing specific additives, activate processes in the brain similar to those found in substance use disorders, creating what is referred to as food addiction (Gearhardt et al., 2023; Hedrih, 2023).

The current study.

Study author Natalia Gomes Gonçalves and her colleagues note that the consumption of ultraprocessed foods increased drastically in the past 40 years. Currently, around 58% of calories consumed by U.S. citizens and 30% of total calories of Brazilians come from ultraprocessed foods. They conducted a study to investigate the association between the consumption of ultraprocessed foods and the cognitive decline among Brazilians (Gomes Gonçalves et al., 2023).

They analyzed data from the Brazilian Longitudinal Study of Adult Health, a longitudinal study that included public servants between 35 and 74 years of age (at the start of the study) from six Brazilian cities (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitória). Data were collected in three waves, approximately four years apart. The first wave occurred between 2008 and 2010, while the last wave spanned 2017 and 2019.

The analyzed data came from 10,775 participants in this study. Their average age at the start of the study was 52 years. Fifty-five percent of participants were women, and 57% held a college degree.

At the start of the study, participants reported their food and drink consumption patterns in the past 12 months using a validated food frequency questionnaire (FFQ). Study authors classified the foods reported in the questionnaire into four categories based on the Nova classification system (Monteiro et al., 2018). One of the categories was ultraprocessed foods. They also completed cognitive assessments up to three times during the study period, i.e., once in each wave. The cognitive assessments explored participants’ memory and executive functioning. The study authors also utilized data on participants’ sociodemographic characteristics and various clinical and lifestyle factors.

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 1. Study procedure (Gonçalves, 2022)

 

Individuals consuming ultraprocessed foods had a faster pace of cognitive decline

Participants’ mean daily calorie intake was 2856 kcal, and 27% came from ultraprocessed foods. The study authors divided participants into four equally sized groups based on the percentage of calories from ultraprocessed foods in their diets. Such groups are called quartiles.

Participants in the first quartile had the lowest share of calories from ultraprocessed foods in their daily diets, with an average of 15% of their calories coming from ultraprocessed foods. The 4th quartile comprised 25% of participants with the highest intake of ultraprocessed foods. They received 41% of their calories from ultraprocessed foods. Individuals in this 4th quartile also had the highest total energy intake, lower physical activity, lower frequency of other adverse health conditions, but a higher frequency of depression.

Individuals taking more than 20% of their daily calories from ultraprocessed foods (i.e., those in the 2nd, 3rd, and 4th quartile) had a 28% faster rate of cognitive decline with age than those taking below 20% of calories from ultraprocessed foods. These individuals also had a 25% faster rate of decline in executive function. However, there was no association between ultraprocessed food consumption and changes in memory scores (see Figure).

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 2. Ultra-processed food intake and cognitive decline

Conclusion

The study results indicate that frequent consumption of ultraprocessed food, i.e., taking more than 20% of daily calories from foods of this type, is associated with faster cognitive decline in Brazilian public servants.

Taking more than 20% of daily calories from foods of this type is associated with faster cognitive decline

While the mechanisms behind this association are being increasingly explored, these findings suggest that ultraprocessed food consumption may be an important topic to consider when planning interventions and policies to prevent or slow cognitive decline, or support the health of older individuals.

The paper “Association Between Consumption of Ultraprocessed Foods and Cognitive Decline” was authored by Natalia Gomes Gonçalves, Naomi Vidal Ferreira, Neha Khandpur, Euridice Martinez Steele, Renata Bertazzi Levy, Paulo Andrade Lotufo, Isabela M. Bensenor, Paulo Caramelli, Sheila Maria Alvim de Matos, Dirce M. Marchioni, Claudia Kimie Suemoto.

 

References

Gearhardt, A. N., Bueno, N. B., DiFeliceantonio, A. G., Roberto, C. A., Jiménez-Murcia, S., & Fernandez-Aranda, F. (2023). Social, clinical, and policy implications of ultra-processed food addiction. BMJ, e075354. https://doi.org/10.1136/bmj-2023-075354

Gomes Gonçalves, N., Vidal Ferreira, N., Khandpur, N., Martinez Steele, E., Bertazzi Levy, R., Andrade Lotufo, P., Bensenor, I. M., Caramelli, P., Alvim De Matos, S. M., Marchioni, D. M., & Suemoto, C. K. (2023). Association Between Consumption of Ultraprocessed Foods and Cognitive Decline. JAMA Neurology, 80(2), 142. https://doi.org/10.1001/jamaneurol.2022.4397

Hedrih, V. (2023). Scientists Propose that Ultra-Processed Foods be Classified as Addictive Substances. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/scientists-propose-that-ultra-processed-foods-be-classified-as-addictive-substances/

Hedrih, V. (2024). What are Ultra-Processed Foods Doing to Your Mental and Physical Health? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/what-are-ultra-processed-foods-doing-to-your-mental-and-physical-health/

Kavé, G. (2024). Vocabulary changes in adulthood: Main findings and methodological considerations. International Journal of Language & Communication Disorders, 59(1), 58–67. https://doi.org/10.1111/1460-6984.12820

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, e077310. https://doi.org/10.1136/bmj-2023-077310

  1. Tucker, A., & Stern, Y. (2011). Cognitive Reserve in Aging. Current Alzheimer Research, 8(4), 354–360. https://doi.org/10.2174/156720511795745320

Mella, N., Fagot, D., Renaud, O., Kliegel, M., & De Ribaupierre, A. (2018). Individual Differences in Developmental Change: Quantifying the Amplitude and Heterogeneity in Cognitive Change across Old Age. Journal of Intelligence, 6(1), Article 1. https://doi.org/10.3390/jintelligence6010010

Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J. C., Louzada, M. L. C., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez-Steele, E., Baraldi, L. G., & Jaime, P. C. (2019). Ultra-processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. https://doi.org/10.1017/S1368980018003762

Monteiro, C. A., Cannon, G., Moubarac, J.-C., Levy, R. B., Louzada, M. L. C., & Jaime, P. C. (2018). The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition, 21(1), 5–17. https://doi.org/10.1017/S1368980017000234

Moon, H., Badana, A. N. S., Hwang, S.-Y., Sears, J. S., & Haley, W. E. (2019). Dementia Prevalence in Older Adults: Variation by Race/Ethnicity and Immigrant Status. The American Journal of Geriatric Psychiatry, 27(3), 241–250. https://doi.org/10.1016/j.jagp.2018.11.003

Samuthpongtorn, C., Nguyen, L. H., Okereke, O. I., Wang, D. D., Song, M., Chan, A. T., & Mehta, R. S. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Network Open, 6(9), e2334770. https://doi.org/10.1001/jamanetworkopen.2023.34770

Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448–460. https://doi.org/10.1017/S1355617702813248

How Depression Changes What We Crave: New Study Insights

  • A study of individuals suffering from major depressive disorder published in Psychological Medicine found that their wanting for various food items is lower compared to their healthy peers
  • Looking at the macronutrient content of food, depressed participants had lower wants and likings for high-fat and high-protein foods if they were low in carbohydrates.
  • Their preferences for foods high in carbohydrates were the same as those of healthy participants, or sometimes even higher.
  • These alterations in liking and wanting of food dependent on macronutrient composition might indicate that there are disturbances in gut-brain signaling in depressed individuals

Most of us have experienced a lack of appetite when we are ill. When we have a fever (e.g., caused by some respiratory infection), we may completely forget about eating for prolonged periods and still not experience hunger. Similarly, certain physiological conditions, such as pregnancy, are well known to induce cravings for specific foods and alter an individual’s preference for certain food items (Orloff & Hormes, 2014). Changes in appetite and food preferences are also present in individuals suffering from depression.

Depression

Depression or major depressive disorder is a mental health disorder characterized by persistent sadness, loss of interest or pleasure in activities, and a range of emotional and physical symptoms. It can impact a person’s thoughts, behavior, sleep patterns, appetite, and overall ability to function in daily life.

Together with anxiety disorders, it is one of the most common mental health disorders worldwide (Baxter et al., 2014; Briley & Lépine, 2011). Although medications and psychotherapy treatments for depression exist and are widely used, they are not very effective, with up to 55% of individuals not achieving remission after antidepressant treatment. Combined with the fact that many individuals with depressive symptoms who seek help do not get diagnosed or do not receive adequate treatment, estimates are that only 5-7% of individuals with depression receive a treatment that results in remission of symptoms (McIntyre et al., 2023).

Only 5-7% of individuals with depression receive a treatment that results in remission of symptoms.

This is the reason why intense research into mechanisms underpinning depression and new ways to treat it is ongoing across the world. One stream of these studies looks into links between depression and eating behavior.

Depression and food

Many studies reported links between depression and specific behavior patterns. Individuals suffering from depression seem to be more prone to emotional eating (Dakanalis et al., 2023). In other words, they are more likely to use food intake as a method of coping with negative emotions and unclear, but distressing, mental states.

Another study found that consumption of fried foods can facilitate depression by affecting the metabolism of fats in the body and promoting neuroinflammation (inflammation of the nerve tissue) (Wang et al., 2023). Studies also note increased severity of depression symptoms in individuals eating lots of ultraprocessed foods (Samuthpongtorn et al., 2023). On the other hand, adherence to healthy diets such as the Nordic diet seems to be associated with lower severity of depression symptoms (Araste et al., 2024).

Consumption of fried foods can facilitate depression by affecting the metabolism of fats in the body and promoting neuroinflammation.

The current study

Study author Lilly Thurn and her colleagues note that anhedonia, the inability to feel pleasure from activities that are normally enjoyable and rewarding, is one of the hallmark symptoms of depression. This blunted sensitivity to rewards also affects eating. Depression and anhedonia seem to disrupt neural reward signaling pathways that respond differently to fats and carbohydrates, reducing the pleasure derived from food.

On the other hand, individuals with depression often have increased cravings for food items rich in sugar and carbohydrates. Depression seems to alter energy metabolism and gut-brain communication, creating neurochemical imbalances like reduced serotonin activity that drive these cravings.

To investigate the specificities of how depressed individuals perceive food, these authors conducted a study in which they compared a group of people suffering from major depressive disorder with a group of healthy individuals (Thurn et al., 2025).

The study participants were 54 people diagnosed with major depressive disorder and 63 healthy participants, who were used as controls. Their average age was 30, and their mean body mass index was 23.6 (i.e., they were of normal weight). To participate in the study, participants were required to be between 20 and 50 years of age and not suffer from serious mental disorders or neurological conditions.

As part of a larger study, participants completed several assessments of depression and anhedonia, provided blood samples, completed various reward-related tasks, and underwent body measurements.

They also completed a series of food cue reactivity tasks. In these tasks, researchers would show them pictures of various food items, and participants were to rate how much they liked and wanted the food item shown. Participants gave their ratings on a 0-100 visual analogue scale (see Figure 1).

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 1. Study procedure (Thurn et al., 2025)

 

Depressed participants had lower food wanting

Results showed that participants with major depressive disorder, on average, did not differ from their healthy peers in how much they liked food items they were shown. However, on average, they reported wanting them less. This lower wanting was particularly notable in participants with pronounced anhedonia.

Depressed participants had an increased desire for food rich in carbohydrates

Next, the study authors sought to investigate whether these differences in food preferences were related to the macronutrient composition of the food items. Macronutrients are the essential nutrients—carbohydrates, proteins, and fats—that the body requires in large amounts for energy, growth, and overall functioning. The study authors created and tested a statistical model that predicted participants’ responses based on the content of fats, proteins, and carbohydrates in the food items displayed.

Results showed that wanting and liking a food item depended on its carbohydrate content. Depressed participants tended to enjoy and like food items with more carbohydrates. They tended to report lower liking for foods rich in fats and proteins if they were low in carbohydrates.

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 2. Altered Food Wanting and Macronutrient Preferences in Depression

 

While, for example, healthy participants reported relatively similar levels of liking of foods rich in fats regardless of their carbohydrate contents, depressed participants showed similar levels of liking only for fat-rich foods that were also rich in carbohydrates, while displaying much lower average levels of liking and wanting for fat-rich foods that were low in carbohydrates. The situation was similar when protein and carbohydrate contents were compared – depressed participants liked protein-rich foods as much as healthy participants did (and wanted it just a bit less) if it was rich in carbohydrates. If carbohydrate content was low, depressed participants wanted it and liked it much less than healthy participants.

Conclusion

The study showed that individuals suffering from major depressive disorder tend to show lower overall wanting for food. This was particularly the case in individuals with pronounced anhedonia. More specifically, their preferences for foods rich in carbohydrates were either similar to those of healthy participants or slightly higher. In contrast, preferences for fat- and protein-rich foods that were low in carbohydrates were significantly lower compared to those of healthy participants.

These results correspond with findings of other studies linking depression with increased intake of high-calorie foods and obesity. However, this also confirms that food perception and food preferences change in depressed individuals, something that treatments for depression should take into account.

The paper “Altered food liking in depression is driven by macronutrient composition” was authored by Lilly Thurn, Corinna Schulz, Diba Borgmann, Johannes Klaus, Sabine Ellinger, Martin Walter, and Nils B. Kroemer.

 

References

Araste, A., Moghadam, M. R. S. F., Mohammadhasani, K., Fard, M. V., Khorasanchi, Z., Latifi, M., Hasanzadeh, E., Talkhi, N., Sharifan, P., Asadiyan-Sohan, P., Bidokhti, M. K., Ghassemi, A., Darban, R. A., Ferns, G., & Ghayour-Mobarhan, M. (2024). Adherence to the nordic diet is associated with anxiety, stress, and depression in recovered COVID-19 patients, a case-control study. BMC Nutrition, 10(1), 38. https://doi.org/10.1186/s40795-024-00845-x

Baxter, A. J., Vos, T., Scott, K. M., Ferrari, A. J., & Whiteford, H. A. (2014). The global burden of anxiety disorders in 2010. Psychological Medicine, 44(11), 2363–2374. https://doi.org/10.1017/S0033291713003243

Briley, M. & Lépine. (2011). The increasing burden of depression. Neuropsychiatric Disease and Treatment, 3. https://doi.org/10.2147/NDT.S19617

Dakanalis, A., Mentzelou, M., Papadopoulou, S. K., Papandreou, D., Spanoudaki, M., Vasios, G. K., Pavlidou, E., Mantzorou, M., & Giaginis, C. (2023). The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence. Nutrients, 15(5), 1173. https://doi.org/10.3390/nu15051173

McIntyre, R. S., Alsuwaidan, M., Baune, B. T., Berk, M., Demyttenaere, K., Goldberg, J. F., Gorwood, P., Ho, R., Kasper, S., Kennedy, S. H., Ly-Uson, J., Mansur, R. B., McAllister-Williams, R. H., Murrough, J. W., Nemeroff, C. B., Nierenberg, A. A., Rosenblat, J. D., Sanacora, G., Schatzberg, A. F., … Maj, M. (2023). Treatment-resistant depression: Definition, prevalence, detection, management, and investigational interventions. World Psychiatry, 22(3), 394–412. https://doi.org/10.1002/wps.21120

Orloff, N. C., & Hormes, J. M. (2014). Pickles and ice cream! Food cravings in pregnancy: Hypotheses, preliminary evidence, and directions for future research. Frontiers in Psychology, 5. https://doi.org/10.3389/fpsyg.2014.01076

Samuthpongtorn, C., Nguyen, L. H., Okereke, O. I., Wang, D. D., Song, M., Chan, A. T., & Mehta, R. S. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Network Open, 6(9), e2334770. https://doi.org/10.1001/jamanetworkopen.2023.34770

Thurn, L., Schulz, C., Borgmann, D., Klaus, J., Ellinger, S., Walter, M., & Kroemer, N. B. (2025). Altered food liking in depression is driven by macronutrient composition. Psychological Medicine, 55. https://doi.org/10.1017/s0033291724003581

Wang, A., Wan, X., Zhuang, P., Jia, W., Ao, Y., Liu, X., Tian, Y., Zhu, L., Huang, Y., Yao, J., Wang, B., Wu, Y., Xu, Z., Wang, J., Yao, W., Jiao, J., & Zhang, Y. (2023). High fried food consumption impacts anxiety and depression due to lipid metabolism disturbance and neuroinflammation. Proceedings of the National Academy of Sciences of the United States of America, 120(118). https://doi.org/10.1073/pnas.2221097120

Eating Junk Food Linked to Higher Risk of Depression, Study Finds

  • A meta-analysis published in BMC Psychiatry found that individuals consuming junk food frequently had 16% higher odds of having depression and 33% higher odds of experiencing increased stress.
  • Junk food consumption was also associated with 15% higher odds of developing mental health problems in general.
  • The meta-analysis included 17 studies with a total of 159,885 participants.

We all know that preparing nutritious and healthy meals can sometimes require quite a bit of work. We need to buy all the groceries, spend time cleaning and cutting them, cook them using various methods, season them, and finally serve them as a dish. This work becomes more challenging when we are ill, overworked, or not feeling well for various reasons. In such situations, many consider affordable, ready-made food or food that can be prepared for eating with minimal effort (e.g., by simply heating it) to be a good alternative, given its alluring taste. However, many such food items available in the market are junk food.

Junk food

“Junk food” (Hedrih, 2025) is food that is high in calories, sugar, salt, and unhealthy fats, but low in essential nutrients like fiber, vitamins, and minerals. It includes ultraprocessed foods, fast foods, unhealthy snacks, and sugar-sweetened beverages (Ejtahed et al., 2024). Ultraprocessed foods, a subcategory of junk foods, are industrially manufactured products made from refined ingredients, additives, and preservatives, with little to no whole food content. They are primarily designed for convenience and long shelf life (Hedrih, 2023, 2024a). Examples of junk Food include chips, candy, soda, fast food burgers, and pre-fried snacks (see Figure 1).

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Figure 1. Characterization of the term “junk food” used in research

 

Regular consumption of junk food is linked to obesity, type 2 diabetes, heart disease, and other chronic health conditions (Rajveer & Monika, 2012). These foods tend to be heavily processed and designed to be hyper-palatable, making them easy to overeat. Junk food is widely marketed, especially to children and adolescents, contributing to unhealthy eating habits (Harris & Graff, 2012).

Junk food and health

In recent decades, scientists have been paying increased attention to the relationship between food, eating habits, and health. The world is currently going through an obesity pandemic (Wong et al., 2022), with the percentage of overweight and obese individuals in double digits in most countries. Unlike in previous centuries, when humans struggled to produce enough calories for everyone and avoid recurring famines, modern human society’s challenge is maintaining food intake regulation that supports good health.

Studies have so far shown that a diet based on foods rich in easily digestible fats and sugar (such as junk food) can dysregulate the food intake regulation mechanisms in our brains, leading to obesity (Hedrih, 2024b; McDougle et al., 2024). This mechanism is well-known in studies on rodents, where such a diet is referred to as an obesogenic diet and is used to experimentally induce obesity (Ikemoto et al., 1996).

The world is currently going through an obesity pandemic
(Wong et al., 2022).

Some researchers propose that humans can develop patterns of behavior around food similar to those found in substance use disorders. They refer to it as food addiction, suggesting that ultraprocessed foods, along with additives found in such foods, lead to this addiction (Gearhardt et al., 2023; Hedrih, 2023).

Unlike in previous centuries, the primary challenge for modern human society is maintaining food intake regulation.

The current study

Study author Hanieh-Sadat Ejtahed wanted to integrate the findings of published scientific studies on the links between junk food consumption and mental health disorders in adults (Ejtahed et al., 2024). They conducted a systematic review and a meta-analysis.

These authors searched the databases of scientific publications PubMed/ Medline, ISI Web of Science, Scopus, Cochrane, Google Scholar, and EMBASE up to July 2023. They used keywords like “sweetened drink” or “sweetened beverage”, “processed food”, “junk food”, “fried food”, “instant food”, and several others, along with keywords for mental health conditions and concepts such as “sleep disorders”, “mental health”, “depression”, “stress”, “happiness”, and “well-being”. They sought scientific publications reporting the associations between junk food consumption and mental health.

The search initially returned 1745 records. However, after removing duplicates, publications that were not relevant to the study goal, and studies on children (the authors were interested in adults), the number of studies was reduced to 17. They involved 159,885 participants.

Junk food consumption is associated with a 15% increased risk of having depression

Analysis of these studies showed that all of them reported at least one link between junk food consumption and adverse psychological outcomes. Integration of results of 4 studies on stress suggested that individuals consuming high levels of junk food have 33% higher odds of being under increased stress. Junk food consumption was associated with 15% higher odds of mental health issues in general.

An analysis of studies looking into links with depression indicated that frequent junk food consumption was associated with 15% increased odds of depression (compared to individuals not consuming junk food or consuming it much less).

However, findings reported by various studies tended to be quite diverse. For example, studies looking into the links between depression and junk food consumption reported increased odds of depression for individuals consuming lots of junk food, ranging from 3% higher to 77% higher. Similarly, increased odds reported by cross-sectional studies looking into links between junk food and stress ranged from 5% higher to 73% higher (see Figure 2).

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 2. Procedure and findings (Ejtahed, 2024)

Conclusion

The study results indicate that frequent consumption of junk food, i.e., foods high in fat and sugar content and low in nutritive value, is associated with poorer mental health. This might mean that a diet based on junk food adversely affects mental health, but it could also mean that individuals in poor mental health, dealing with depression and increased stress, are less able to provide themselves with a healthy diet.

Future studies are needed to explore the mechanisms behind this relationship. However, the existence of this link indicates that interventions aimed at supporting mental health or treating mental health issues need to consider their patients’ nutrition habits and nutrition options.

The paper “Association between junk food consumption and mental health problems in adults: a systematic review and meta-analysis” was authored by Hanieh-Sadat Ejtahed, Parham Mardi, Bahram Hejrani, Fatemeh Sadat Mahdavi, Behnaz Ghoreshi, Kimia Gohari, Motahar Heidari-Beni, and Mostafa Qorbani.

 

References

Ejtahed, H.-S., Mardi, P., Hejrani, B., Mahdavi, F. S., Ghoreshi, B., Gohari, K., Heidari-Beni, M., & Qorbani, M. (2024). Association between junk food consumption and mental health problems in adults: A systematic review and meta-analysis. BMC Psychiatry, 24(1), 438. https://doi.org/10.1186/s12888-024-05889-8

Gearhardt, A. N., Bueno, N. B., DiFeliceantonio, A. G., Roberto, C. A., Jiménez-Murcia, S., & Fernandez-Aranda, F. (2023). Social, clinical, and policy implications of ultra-processed food addiction. BMJ, e075354. https://doi.org/10.1136/bmj-2023-075354

Harris, J. L., & Graff, S. K. (2012). Protecting Young People From Junk Food Advertising: Implications of Psychological Research for First Amendment Law. American Journal of Public Health, 102(2), 214–222. https://doi.org/10.2105/AJPH.2011.300328

Hedrih, V. (2023). Scientists Propose that Ultra-Processed Foods be Classified as Addictive Substances. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/scientists-propose-that-ultra-processed-foods-be-classified-as-addictive-substances/

Hedrih, V. (2024a). What are Ultra-Processed Foods Doing to Your Mental and Physical Health? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/what-are-ultra-processed-foods-doing-to-your-mental-and-physical-health/

Hedrih, V. (2024b, February 19). Consuming Fat and Sugar (At The Same Time) Promotes Overeating, Study Finds. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/16563-2/

Hedrih, V. (2025). Does Eating Lots of Junk Food Lead to Poor Mental Health? CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/does-eating-lots-of-junk-food-lead-to-poor-mental-health/

Ikemoto, S., Takahashi, M., Tsunoda, N., Maruyama, K., Itakura, H., & Ezaki, O. (1996). High-fat diet-induced hyperglycemia and obesity in mice: Differential effects of dietary oils. Metabolism, 45(12), 1539–1546. https://doi.org/10.1016/S0026-0495(96)90185-7

McDougle, M., de Araujo, A., Singh, A., Yang, M., Braga, I., Paille, V., Mendez-Hernandez, R., Vergara, M., Woodie, L. N., Gour, A., Sharma, A., Urs, N., Warren, B., & de Lartigue, G. (2024). Separate gut-brain circuits for fat and sugar reinforcement combine to promote overeating. Cell Metabolism. https://doi.org/10.1016/j.cmet.2023.12.014

Rajveer, B., & Monika, O. (2012). Junk Food: Impact on health. Journal of Drug Delivery & Therapeutics, 2(3), 67–73.

Wong, M. C., Mccarthy, C., Fearnbach, N., Yang, S., Shepherd, J., & Heymsfield, S. B. (2022). Emergence of the obesity epidemic: 6-decade visualization with humanoid avatars. The American Journal of Clinical Nutrition, 115(4), 1189–1193. https://doi.org/10.1093/AJCN/NQAC005

 

 

Integrating Nutrition into Mental Healthcare: Assessing Current Training, Beliefs, and Future Directions for Psychologists

  • Psychologists increasingly recognize the bidirectional relationship between diet and mental health, yet most report limited formal training in nutrition and a strong desire for further education in this area.
  • Interprofessional collaboration between psychologists and dietitians is gaining momentum. Evidence suggests it can improve clinical outcomes, and preliminary precedent exists in educating clinicians while maintaining clear professional boundaries.
  • Integrating nutrition into mental healthcare requires formalized education and training programs, interdisciplinary language connecting the two fields, and established pathways for interprofessional collaboration.

Introduction

In this article, we examine the current state of nutrition training among psychologists and identify perceived barriers to integrating nutrition into clinical mental health practice. While a growing body of evidence supports the link between dietary intake patterns and psychological processes, experiences, and outcomes, the systematic development of interprofessional education, skills, novel language, and training to close the gap between the psychological and nutritional sciences is in its infancy.

The use of nutrition among psychologists and mental health practitioners varies globally, and surveys indicate a consensus on the need for further systematic nutrition education within the field of psychological sciences and its applications in clinical mental health settings. This article examines various beliefs, perceptions, and barriers to incorporating nutrition into mental healthcare among psychologists, dietitians, nutritionists, and other related professionals.

Efforts to Connect Nutrition & Mental Health 

The connection between diet and physical health has been recognized for centuries, dating back to ancient civilizations. Although psychology as a science has formally been founded in the late 19th century (with Wilhelm Wundt founding the first psychology laboratory in Leipzig, Germany) (Titchener, 1921), the links between nutrition and psychology have only recently, in the last couple of decades, become a mainstream topic of psychological inquiry (JFKU, Introduction to Nutritional Psychology, 2009). As mental health treatments become more comprehensive, lifestyle factors, including nutrition, are increasingly recognized as important components in a broader understanding of well-being (Mrozek et al., 2023; O’Neil et al., 2024).

In parallel, a growing body of research has documented a global shift toward Westernized dietary patterns over the past two decades (Juul et al., 2021), characterized by high consumption of processed foods, added sugars, and unhealthy fats, which are associated not only with obesity and metabolic dysfunction but also with increased risk for common mental disorders such as depression and anxiety (Firth et al., 2019; Lane et al., 2024; Çelik et al., 2025). In addition, an umbrella review involving nearly 10 million participants found that ultra-processed dietary patterns were associated with 32 poor physical and mental health outcomes (Lane et al., 2024, as cited in Nilson, 2025).

Current obesity statistics indicate a global health crisis, with 16% of the worldwide adult population and 40.3% of U.S. adults living with obesity (National Center for Health Statistics, 2022). Statistics indicate a curvilinear increase in the body mass index of adult Americans over the last six decades, in both males and females (Wong et al., 2022). Among adolescents, obesity rates are projected to reach 1 in 6 by 2050 (Murdoch Children’s Research Institute, 2025). Concomitantly, 1 in 7 adolescents worldwide are diagnosed with a mental health disorder (World Health Organization, 2024), yet 80% of those affected are left without psychological care (CDC, as cited in Uzzell, 2024). Additionally, one out of every two people in the world will develop a mental health disorder in their lifetime (Harvard Medical School, 2023) (see Figure 1).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 1. The Global burden of obesity and mental health disorders

 

Depression and obesity often co-occur and studies have found that individuals with depression have a higher risk of becoming obese, and conversely, those who are obese have a higher risk of developing depression (Friedman, et al., 2025; Mannan, 2016, as cited in Benton & Young, 2020; Stenz, & Jansen, 2023; Lane et al., 2024). However, these data come from correlation studies, so the causal relationships between depression and obesity remain insufficiently clear. Further, there is a correlation between depression and the development of other metabolic syndromes, such as appetite dysregulation and insulin resistance (Zeng & Zhang, 2025).  Mechanisms underlying this bidirectional relationship involving dietary intake are being increasingly investigated, including shared pathways such as systemic inflammation, gut-brain signaling, gut microbiota, HPA axis dysregulation, and neurotransmitters (Sochacka, 2024; Mörkl, 2021).

Additionally, a meta-analysis by Firth et al. (2019) encompassing 16 randomized controlled trials found that dietary improvement significantly reduced depressive symptoms, with smaller but promising effects also noted for anxiety. These findings may support the inclusion of dietary intervention as a viable component of psychological care, reinforcing the relevance of nutrition in extending beyond physical health to encompass mood-related outcomes (Firth et al., 2019). Still, it can be challenging to isolate the specific effects of dietary change from other factors associated with participation in such programs, including increased support, motivation, or engagement.

Research in nutritional psychiatry has worked to identify the causal connection between diet and psychiatric disorders to support the development of nutrition-based clinical interventions in mental healthcare (Marx et al., 2017). The SMILES trial was the first randomized controlled trial to demonstrate that participants who followed a modified Mediterranean diet experienced significant reductions in depression symptoms, establishing a causal link between diet and mental health (Jacka, 2017).

Metabolic psychiatry is another emerging field that explores how metabolic processes, including increased ketone production, influence psychiatric disorders (Bostock et al., 2017; Barch, 2023; Laurent et al., 2024).

Beyond obesity and psychiatric disorders, ample research demonstrates the interconnections between nutrition and nearly every aspect of psychological, behavioral, cognitive, and psychosocial functioning, including mood, emotion, behavior, cognition, perception, interoceptive experience, and social well-being. Many of these interconnections are identified, cataloged, and summarized within the Nutritional Psychology Research Library (NPRL) through The Center for Nutritional Psychology (CNP) (Nutritional Psychology Research Library, 2025) and used to inform the development of a theoretical foundation situated within the psychological sciences, novel interdisciplinary language contained in the Encyclopedia of Nutritional Psychology (ENP), evidence-based curricula, and a global platform for supporting collaboration among clinicians, professionals, educators, and researchers. These efforts support the development of a new field of study that bridges the psychological and nutritional sciences, referred to as nutritional psychology.

Research demonstrates the interconnections between nutrition and nearly every aspect of psychological functioning.

There is a clear need to continue these efforts to expand our understanding of the interconnections between psychological and nutritional factors and their impact on psychological functioning and mental health. Beyond the need to continue solidifying a strong evidence base connecting the psychological and nutritional sciences, developing a theoretical framework to encompass these findings, creating novel language, and expanding conceptualization, understanding the current state of training, beliefs, and practices in both disciplines and professions is necessary to continue bridging the gap between the psychological and nutritional sciences.

Understanding the current state of training, beliefs, and practices in both disciplines and professions is necessary to continue bridging the gap between the psychological and nutritional sciences.

Nutrition Training & Use of Nutrition in Mental Health Practice

Psychologists and psychiatrists acknowledge the connection between nutrition and mental health, yet there is limited information on how they integrate it into practice or whether they receive formal training. To further understand this topic, the CNP team reviewed three published surveys that asked psychologists and psychiatrists if they received nutrition training, how they incorporate nutrition into clinical practice, and their interest in additional education.

The findings, summarized in Figure 2, reveal that despite having limited nutrition education, many psychologists still discuss nutrition with their clients. Additionally, professionals have a consensus on the need for further research and training in this area. Psychologists and psychiatrists are interested in nutrition courses that align with the biopsychosocial model to enhance well-being (Litta, 2024). Findings consolidated from these three studies (Mörkl, Stromsnes, and Litta) are summarized and published in the Figure below.

 

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Figure 2. Nutrition in mental health practice: Insights from three studies

 

The Morkle study involved 1,056 mental health professionals. Regarding nutrition training, 66.3% of psychologists reported having received no nutrition training, while 74.2% of psychiatrists reported the same. Despite this, 56.8% of survey participants have recommended supplements, and 43% have recommended diet strategies in their clinical practice. In the Stromsnes study, which included 76 psychologists, 60.5% had no nutrition training. Still, 92.1% reported discussing nutrition with clients, and 39.5% incorporated nutrition counseling into their work.

The Litta study surveyed 110 psychologists and psychiatrists, revealing that 47.5% of psychologists and 63.3% of psychiatrists had no nutrition training. Of this group, 51.4% reported sometimes using a nutrition approach in practice. Interest in additional training was high, with 92.9% in the Mörkl study and 97% in the Litta study expressing a desire for more nutrition education.

These findings reveal a significant gap in nutrition training among psychologists and psychiatrists, despite their strong interest in additional training on the topic. Across three studies, a notable share of psychologists reported having no formal nutrition training, ranging from 47.5% to 66.3%.

These findings reveal a significant gap in nutrition training among psychologists and psychiatrists.

Nonetheless, many psychologists still address nutrition in their clinical practice: 92.1% reported discussing nutrition with clients, while a smaller, but still notable, proportion engaged in nutrition counseling (39.5%). In addition, a broader portion of mental health professionals recommended dietary supplements (56.8%) or suggested diet strategies (43.8%). Importantly, nearly all respondents (92.9%–97%) desired more nutrition training, underscoring a strong demand for integrating systematic, evidence-based nutritional knowledge into mental health care.

Nearly all respondents expressed a desire for more nutrition training, underscoring a strong demand for integrating nutritional knowledge into mental healthcare.

Barriers to Implementing Nutrition into Clinical Mental Health Care

Psychologists report several barriers to implementing nutrition into clinical mental health care practice, the most significant being a lack of training. Psychologists have concerns about overstepping professional boundaries without formal education or clear guidelines. Further, a lack of professional confidence is a barrier among professionals who avoid discussing nutrition in practice. They express feeling hypocritical if they are not in optimal shape themselves and raise concerns about body image and weight-related triggers in both therapists and clients (Stromsnes, 2024). Additionally, time and resource constraints contribute to the issue, as time-sensitive therapy sessions prevent in-depth conversations about diet (Aprifel, 2025). Figure 3 summarizes some identified barriers to implementing nutrition into clinical mental healthcare.

 

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Figure 3. Barriers to implementing nutrition into Clinical mental health care

 

Interprofessional Collaboration

Recent studies underscore the critical role of interprofessional collaboration between dietitians and mental health professionals, particularly in addressing depression and related conditions. Stenz and Jansen (2023) explored the collaborative dynamics between dietitians and psychologists, highlighting how both professions perceive and apply the growing body of research linking nutrition and depression.

Their findings, based on a survey of both groups, indicate that while there is universal recognition (100%) of the bidirectional relationship between diet and depression, differences emerge in practical application. For example, 81% of psychologists report discussing diet in relation to depression with clients, compared to only 47% of dietitians. Furthermore, all surveyed dietitians (100%) believe psychologists should refer diet-related issues to them (see Figure 4).

 

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Figure 4. Stenz and Jansen (2023), psychologists’ and dietitians’ perspectives on the practical application of nutrition and depression research

 

Both psychologists and dietitians recognize the bidirectional relationship between diet and depression.

However, limited training in each other’s respective fields remains a barrier. Less than 20% of psychologists reported having undergraduate coursework in nutrition, and only 2% received graduate-level training in this field. While 85% of dietitians had some psychology coursework, mostly at the introductory level, this limited exposure has not equipped professionals with the depth of knowledge needed to integrate both fields confidently. These gaps point to a broader need for structured training programs that bridge the divide between nutritional science and mental health practice.

The scope of practice for each type of professional remains another area of disconnect. While 63% of psychologists believe discussing diet is within their professional scope, only 12% of dietitians agree. Conversely, 69% of psychologists think mood falls within a dietitian’s scope, compared to just 44% of dietitians. Despite these discrepancies, nearly all participants (100% of psychologists and 94% of dietitians) agreed that improved collaboration would improve patient care.

Most psychologists and dietitians agree that collaboration between the two professions would improve patient care.

Complementing this, Teasdale et al. (2023) examined the roles of dietitians in mental health settings through a cross-sectional survey of 48 professionals, primarily from inpatient services. The study revealed that dietitians often face systemic barriers, including a lack of awareness about their role in mental health care and insufficient tools for nutrition screening specific to mental health populations. Dietitians reported providing individual consultations and group sessions and participating in multidisciplinary teams, but highlighted a need for additional mental health training to integrate fully into such teams. More training, resources, and an increased evidence base were identified as crucial for better service provision.

Dietitians highlighted a need for additional mental health training to integrate fully into multidisciplinary teams.

Both studies converge on a central message: interprofessional collaboration between psychologists and dietitians is essential but underdeveloped. Better integration requires increased awareness of each profession’s contributions, targeted training, and a stronger evidence base to support practice. Addressing these gaps would not only enhance collaborative care but also improve outcomes for individuals experiencing mental health challenges.

Facilitating Conversations: Partnership Between Dietitians and Mental Health Clinicians

Interprofessional collaboration between dietitians and psychologists may begin with facilitating conversations about food and nutrition. Beckman (2025a), a dietitian specializing in eating disorders, emphasizes that mental health clinicians play an important role in identifying whether clients are meeting basic nutritional needs, such as eating regularly and consuming nutrient-dense foods. She recommends ongoing communication between professionals to create a full picture of a client’s overall health. While Beckman specifically refers to psychiatrists, the same principles apply to psychologists, who likewise benefit from understanding how nutritional factors influence mood, medication effectiveness, and treatment outcomes (Beckman, 2025b).

While informal communication strategies can support collaboration, formalized models of interdisciplinary care may offer even greater benefits in complex clinical settings.

A recent initiative proposed an interprofessional model of care for eating disorders called Interprofessional Enhanced Cognitive Behaviour Therapy (CBT-IE). This model integrates psychologists and dietitians in co-delivering treatment with clearly defined, complementary roles (Bray et al., 2023). While CBT-IE exemplifies structured collaboration between psychologists and dietitians within the context of eating disorders, there is a clear lack of collaboration in addressing broader mental health issues, such as mood, emotion regulation, and cognitive functioning. Extending and adapting such structured models beyond the context of eating disorders presents an opportunity to expand collaboration and provide a more robust, evidence-based foundation for integrating nutrition into mental health care.  One of the core missions of The Center for Nutritional Psychology is to facilitate collaboration and communication between nutrition and psychology by addressing existing barriers and expanding integrated care to the broader field of mental health.

Barriers and Benefits to Interprofessional Collaboration

Role confusion often hinders interprofessional collaboration between psychologists and dietitians in the context of mental health care. Without clearly defined scopes of practice, psychologists may inadvertently offer nutritional advice, while dietitians may refrain from addressing mood-related concerns (Stenz & Jansen, 2023).

Other key barriers include challenges in interprofessional communication, such as differing professional terminology (due to a lack of formalized interdisciplinary language), differing client interaction styles, and practical issues like billing and financial feasibility (Rich et al., 2020; Stenz & Jansen, 2023). Notably, however, in the field of eating disorder treatment, many of these challenges have been overcome through the development of best practices and improved communication strategies (Jeffrey & Heruk, 2020; Yang et al., 2021; Stenz & Jansen, 2023; Bray et al., 2023). This success highlights the potential for similar interdisciplinary approaches to be applied effectively in the treatment of other mental health conditions, including depression.

When collaboration is thoughtfully and systematically implemented, clinicians can incorporate nutrition-informed mental healthcare without exceeding their scope of practice.

What Interdisciplinary Training Exists for Psychologists and Nutritionists?

Currently, psychologists’ scope of practice does not include nutrition-related diagnosis and intervention, while dietitians and nutritionists are not licensed to diagnose or treat psychological and mental health disorders. Systematic efforts, however, have been underway for quite some time to bridge the gap between the psychological and nutritional sciences, beginning with the development of the first university-level continuing education courses in Nutritional Psychology, taught to psychologists and mental health professionals at JFK University from 2008 through 2011 (see Figure 5).

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Figure 5. CNP’s history and development of Nutritional Psychology

 

Building on these courses, the American Psychological Association approved a seven-course Certificate in Nutritional Psychology for inclusion within JFK University’s Continuing Education program, which provided continuing education to licensed mental health professionals. This Certificate included initial scope of practice guidelines in nutritional psychology and was taught until 2020.

The Center for Nutritional Psychology was established to support the identification, consolidation, categorization, and synthesis of research at the intersection of the psychological and nutritional sciences. 

In 2015, the Center for Nutritional Psychology (CNP) was established to support the identification, consolidation, categorization, and synthesis of research at the intersection of the psychological and nutritional sciences. From these efforts came the development of methods, language, concepts, and the theoretical foundation necessary to establish a formalized, systematic, and empirically derived interconnection between the psychological and nutritional sciences, foster interdisciplinary communication, further delineate scope of practice criteria, and equip practitioners with practical tools to integrate psychological and nutritional education into professional practice.

CNP as an organization has strived to develop evidence-based continuing education for professionals in accordance with major licensing bodies within the psychological and nutritional sciences. Accordingly, CNP is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists, the California Association of Marriage and Family Therapists (CAMFT) to provide CE to Licensed Marriage and Family Therapists (LMFTs), Licensed Clinical Social Workers (LCSWs), Licensed Professional Clinical Counselors (LPCCs), and Licensed Educational Psychologists (LEPs), and by the National Board of Certified Counselors to sponsor CE for National Certified Counselors (NCCs). CNP is also approved to sponsor Continuing Professional Education Units (CPEUs) for Dietitians/Nutritionists and registered Dietetic Technicians (DTRs) through the Commission on Dietetic Registration (CDR).

Interdisciplinary Education Versus Clinical Intervention

The scope of practice for psychologists and other licensed mental health professionals does not include diagnosing, treating, and providing nutritional interventions. Similarly, dietitians and nutritionists are not licensed to diagnose or treat mental health issues. However, this does not mean professionals should not be trained on the psychological, behavioral, neurobiological, social, cognitive, and sensory-perceptual processes through which diet, nutrients, and psychological processes interconnect.

Mental health professionals benefit from expanding their knowledge to include evidence-based understanding of how dietary choices and patterns influence brain function, psychological processes, emotional regulation, mental health experience, and outcomes without stepping into clinical nutrition interventions. One way, for example, in which psychological processes inform our understanding of the connection between diet and mental health (the diet-mental health relationship) is through knowledge of how early relationships influence adolescent and adult eating behaviors. This influence, in turn, affects mental health outcomes and the mental health-obesity connection.

Research shows that insecure attachment to parents can set the stage for disordered eating during adolescence. A multiwave longitudinal study by Cortés-García et al. (2022) tracked over 900 youths and found that insecure attachment to mothers in late childhood significantly increased the risk of developing eating disorder symptoms by mid-adolescence, an effect not observed with paternal attachment. This relationship was mediated by depressive symptoms: insecure maternal attachment at ages 10–12 predicted increased depressive symptoms at 12–14, which then led to more disordered eating behaviors by ages 14–16. These findings highlight the particular influence of the mother-child bond on adolescent emotional health and eating behaviors (see Figure 6).

 

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Figure 6. Cortés-García et al. (2022)

In addition, dietitians and nutritionists trained in psychological, behavioral, and cognitive factors that influence food choices, habits, and dietary behaviors are better equipped to understand the barriers and motivations preventing clients from adopting nutrition interventions.

The “vicious cycle model,” for example (see Figure), shows how repeated consumption of hyperpalatable foods may impair hippocampal function, increasing sensitivity to food cues and promoting further overeating. Specifically, this model describes how the intake of hyperpalatable foods associated with the Western Diet impairs hippocampal-dependent memory and learning, increasing susceptibility to food cues and promoting further overeating, creating a self-perpetuating cycle of cognitive decline and obesity (see Figure 7).

 

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Figure 7. Vicious Cycle Model

 

These examples illustrate powerful concepts illuminating the relationship between psychological and nutritional factors, which are currently missing from academic education and clinical practice in both professions. These factors influence dietary intake behavior and the obesity-depression relationship. Together, these examples illustrate how psycho-nutritional education falls within the scope of practice for both Psychologists and Dietitians/Nutritionists; However, intervention and treatment must remain within each profession’s licensure boundaries. Professionals can use this knowledge to enhance their practice within their existing licensure and qualifications.

Preliminary Scope of Practice Guidelines

Preliminary Scope of Practice guidelines for licensed psychologists were introduced and taught in the Introductory Certificate in Nutritional Psychology through JFK University. This certificate included a 3-unit course devoted to practice guidelines for psychologists. This curriculum was retired in 2020 to make way for the vastly updated, fully evidence-based Introductory Certificate in Nutritional Psychology (called the NP-100 Series Certificate) now offered through the Center for Nutritional Psychology. All 124 hours of continuing education included in this CNP Certificate lie within the realm of psychoeducation, and accordingly, are designed to fit within the scope of practice for all psychologists, mental health professionals, nutritionists, and dietitians.

Mental Health Professionals (Psychologists, Licensed Counselors):

Mental health professionals (unless licensed to do so) may not provide clinically-based nutrition assessment, diagnosis, or intervention involving diets or supplements unless licensed in nutrition, dietetics, or a related area. Examples of how licensed psychologists and mental health professionals may provide psychonutritional education within scope include:

  • Using evidence-based NP knowledge to contextualize, educate, and support clients in understanding how their dietary intake could be influencing their mental health, and vice versa.
  • For example, discussing how childhood affective attachment patterns may influence an individual’s likelihood of engaging in disordered eating or using food intake as a coping mechanism.
  • Explaining how dietary intake patterns can influence neurological, cognitive, perceptual, social, behavioral, psychological, interoceptive, and brain-gut processes to shape psychological health, eating behavior, and well-being.
  • How psychological factors like motivation, food insecurity, social environments, and daily stressors influence dietary behavior.
  • Addressing challenges one may face when attempting to adopt healthier eating patterns and habits, and how certain dietary or environmental factors can affect their food choices and intake patterns.
  • How healthy eating patterns can benefit one’s relationship with food and their psychological health and well-being.

Dietitians & Nutritionists:

Dietitians (unless licensed to do so) may not provide mental health assessment, diagnosis, or intervention. Dietitians may provide clients with evidence-based education on the connection between nutrition, psychology, and mental health. This includes the cognitive, behavioral, and mood-based factors influencing eating behavior and dietary patterns. Dietitians can be trained to recognize how certain foods may lead to physiological neuroadaptive changes in brain regions that affect eating behavior, emotional regulation, and stress resilience. They also might explore how psychosocial factors in their environment, such as their family or community, influence their clients’ food choices or discuss how cognitive attention priorities and decision-making change when hungry or eating certain dietary patterns. This training and knowledge can powerfully supplement dietitians’ and nutritionists’ knowledge, enriching their understanding of how diet and human experience interconnect without overstepping professional limits.

Bridging the Gap and Expanding Education & Training

Bridging the gap between nutrition and mental healthcare is increasingly recognized as essential due to mounting evidence that diet directly and significantly impacts mental well-being. As programs like “Food is Medicine” gain traction, developing new language interconnecting these two fields (Stenz & Jansen, 2023), graduate-level coursework on evidence-based nutrition counseling and mental health (Stromsnes, 2024), and making nutritional education mandatory for mental health professionals at both undergraduate and graduate levels (Mörkl, 2021) can empower professionals to integrate nutrition into mental health care and enable more comprehensive patient care, while improving prevention and treatment outcomes, aligning practice with the latest scientific evidence, and alleviating practitioners’ hesitation about their respective scopes of practice.

Standing at the Crossroads of Solutions

The relationship between diet, psychological health, and well-being is complex, bidirectional, and requires interdisciplinary efforts. Consolidating emerging evidence in nutritional psychology provides a theoretical foundation connecting the psychological and nutritional sciences. These efforts support the development of shared language education, training, and collaboration across disciplines, lessening the barriers between them and their professionals, and improving interdisciplinary treatment approaches to address the obesity, depression, and mental health epidemic affecting global populations. In conclusion, the development of the interdisciplinary field of nutritional psychology expands mental health and nutrition professionals’ education and skills, deepening their understanding of the connection between diet and psychological processes, experiences, and outcomes, ultimately improving patient outcomes.

This CNP conceptual article is brought to you by The Center for Nutritional Psychology. Visit us at www.nutritional-psychology.org to find out more about future directions in the connection between diet and mental health and to join our mission to support the inclusion of nutrition within mental healthcare by 2030.

References

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Can Better Collaboration Between Dietitians and Psychologists Enhance Depression Treatment?

  • Results of an online survey published in Translational Issues in Psychological Science examined some of the benefits and barriers to collaboration between dietitians and psychologists in depression treatment
  • All participating clinicians agreed that there is a relationship between diet and depression
  • 50% of psychologists and 30% of dietitians stated that patient care would improve if psychologists and nutritionists collaborated
  • Career-specific jargon was the most frequently listed barrier to collaboration between these professions.

Although new mental health treatments are being developed every day, they are still not very effective. Large shares of individuals suffering from mental health issues do not respond to existing therapies or experience relapses not too long after remission (e.g., Bystritsky, 2006; McIntyre et al., 2023). This, at least partly, comes from the fact that mental health conditions are usually not caused by a single factor. They tend to have complex etiologies, and although many risk factors and changes associated with mental health disorders are well known, their causes are not fully understood.

Depression

One particularly common and serious mental health condition is depression. Depression is characterized by persistent sadness, hopelessness, and a loss of interest in activities once enjoyed. People with depression may experience persistent fatigue, sleep disturbances, appetite changes, difficulty concentrating, and feelings of worthlessness or guilt (see Figure 1).

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Figure 1: Depression and its common symptoms

Unlike temporary sadness, depression persists for weeks, months, or even years. If left untreated, depression can increase the risk of self-harm or suicidal thoughts. Depressive patients have a 20-fold greater risk of suicide compared to the general population (Brådvik, 2018; Briley & Lépine, 2011).

Causes of depression are not fully understood, but it is clear that depression is a complex disorder with many different contributing factors (Bembnowska & Jośko-Ochojska, 2015). Conversely, treatments for depression are also not very effective. One estimate states that at least 30% of depressed individuals with access to high-quality care for depression will not respond to treatment and will be considered to suffer from treatment-resistant depression (McIntyre et al., 2023). When we take into account that not all people suffering from depression receive high-quality care, the share of successful treatments is even lower. McIntyre et al. (2023) estimate that only 5-7% of persons with depression treated in the primary care setting would be expected to achieve remission.

Only 5-7% of persons with depression treated in the primary care setting would be expected to achieve remission.

These are the reasons why researchers are on a constant lookout for ways to improve depression treatment. One relatively novel point of interest in this regard is diet.

Diet and depression

Recent decades have seen a large number of studies reporting links between depressive symptoms and eating patterns. For example, an analysis of the U.S. National Health and Nutrition Examination Survey (NHANES) database found that for every additional 100 grams of sugar intake per day, the odds of a person suffering from depression increase by 28% (Zhang et al., 2024). Similarly, the consumption of artificially sweetened beverages was found to be associated with an increased risk of depression (Hedrih, 2023; Samuthpongtorn et al., 2023).

For every additional 100 grams of sugar intake per day, the odds of a person suffering from depression increase by 28%.

Studies reported that individuals with higher dietary fiber intake are less likely to suffer from depression or to contemplate suicide (a symptom common in severe depression) (Fatahi et al., 2021; Huang et al., 2024). And there are many more.

The current study

Study authors Colette F. H. Stenz and Kate L. Jansen wanted to investigate psychologists’ and dietitians’ views on the benefits and barriers to their collaboration in treating depressive patients. They recruited 32 psychologists and 34 dietitians through a professional organization in Arizona to complete an online survey.

The survey asked about participants’ views on the relationship between diet and depression (e.g., “I believe there is a relationship between diet and depression”) and about how much they discuss the relationship between diet and depression with clients (and if they feel confident in those discussions). It also contained two questions examining participants’ knowledge about the nutrition-depression relationship.

Next, the survey presented three case vignettes – one depicting a clinical psychologist giving suggestions about diet change to a client with depression, one about a dietitian in a similar situation, and one about a collaboration between a psychologist and a dietitian.

Participants reported whether such discussions were in the depicted clinician’s scope of practice, if the clinician should have referred the patient to someone else, and if the clinician in the vignette could give credible advice. The survey ended with open-ended questions about barriers and benefits to collaboration between dietitians and psychologists, and some more questions about participants’ educational background and whether they made referrals for diet or mood (see Figure 2).

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Figure 2. Study protocol (Stenz and Jansen, 2023)

 

Clinicians agree that there is a bidirectional relationship between diet and depression

Results showed that all participating clinicians agreed there is a bidirectional relationship between diet and depression. Dietitians and psychologists demonstrated similar levels of knowledge on the topic of the diet-depression relationship and displayed similar levels of confidence in discussing this topic with patients. 63% of psychologists believed that it is within their scope of practice to discuss diet with patients, but this was the case with only 12% of dietitians. 50% of psychologists, but only 3% of dietitians, believed that psychologists could give credible advice about diet.

84% of psychologists reported asking depressed patients about their diet, and a similar percentage referred them to dietitians, nutritionists, and physicians for this. Only 47% of dietitians indicated asking their clients about mood or mental health (see Figure 3).

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Figure 3. Clinicians’ Perspectives on the Diet-Depression Relationship

 

Psychologists and dietitians agree that care for depressed patients would improve if their professions collaborated

All psychologists and almost all dietitians believed that patient care would improve if their professions collaborated. Improved and more appropriate care was listed as the main benefit (50% of psychologists, 30% of dietitians). Career-specific jargon was listed as the main barrier to collaboration between these professions (16% of psychologists, 15% of dietitians), followed by differences in client communications, issues related to the scope of practice, and trust between professions (see Figure 4).

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Figure 4. Beliefs and barriers

Conclusion

Overall, psychologists and dietitians participating in this survey believed that there is a bidirectional relationship between depression and diet. Psychologists generally believed that depressed patients’ diet was within their scope of practice and that they could give credible advice on the topic, but dietitians did not share this view about psychologists’ competencies. Both professions agreed that patient care would improve if their professions collaborated, but they saw career-specific jargon as the main barrier to collaboration.

Overall, the study showed that both of the studied professions recognize diet as a pathway to helping individuals with depression. This might indicate that the results of novel studies on the relationship between diet and mental health are being applied in practice at least to some extent.

The 2023 paper “Nutrition and Depression: Collaboration Between Psychologists and Dietitians in Depression Treatment” was authored by Colette F. H. Stenz and Kate L. Jansen.

More studies on the collaboration between nutrition and psychology can be found in the Nutritional Psychology Research Library (NPRL) Towards Interdisciplinary Efforts research category.

References

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Brådvik, L. (2018). Suicide Risk and Mental Disorders. International Journal of Environmental Research and Public Health, 15(9), 2028. https://doi.org/10.3390/ijerph15092028

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