Category: Uncategorized

• A conceptual paper published in the Journal of Metabolic Health proposes that there are five stages of addiction to ultra-processed foods.
• In the first, pre-addiction stage, consumption of sugar and fat leads to increased activity in the regions of the brain responsible for reward experiences, and people pay more attention to hyperpalatable foods.
• In the final stage, the functioning of these centers is severely disrupted with very low activity and depletion of key neuromodulators, while eating becomes compulsive, and all control is lost.

Substance addictions are a big problem in the modern world. Addiction to nicotine (most often in the form of tobacco) is the most common (Tobacco, 2025), but there are also large numbers of people addicted to alcohol and drugs. The thing in common for all these people is that they have started using those substances because their use gave them pleasure. However, in time, the pleasure faded away, but the craving for those substances increased. They needed more and more, and started experiencing serious discomfort when they could not use them. Many affected individuals started neglecting their major roles in life (e.g., jobs, significant others), focusing on obtaining and using the substance (taking drugs, being drunk, spending scarce money on tobacco…). Many repeatedly tried to quit but failed.

While these addictions are well-known, scientists recently proposed that people can also become addicted to specific types of food.

Food addiction

From the very start, the idea that food can be addictive has been seen as controversial by many (Tarman, 2024). On the one hand, humans need food to survive. Without food, our bodies would starve and die relatively quickly. Given this, it is entirely understandable that people attach great importance to having access to sufficient food and being able to eat regularly.

On the other hand, people also eat when their bodies do not need the intake of nutrients. This desire to eat that is not driven by the need for nutrients is referred to as hedonic hunger (Lowe & Butryn, 2007). Eating motivated by food cues and factors that do not represent the body’s need for nutrients is called external eating (Van Strien et al., 1986).

The rewarding effects of food and developing food addiction

Eating food can be a rewarding experience, particularly when the food tastes good. Studies have shown that our bodies have signaling pathways connecting the digestive system to the reward areas of the brain (McDougle et al., 2024). The presence of fat and sugar triggers the activity of these pathways. When they detect the presence of fat or sugar in the gut, they send signals to the reward areas of the brain, producing the experience of pleasure.

Our bodies have signaling pathways linking our digestive system to the reward areas of the brain. 

The pathways for sugar and fat are separate (McDougle et al., 2024). This means that when both fat and sugar enter our digestive system, both sets of pathways start signaling, greatly increasing the feelings of reward. That is the reason why we find foods rich in easily digestible fats and sugars so tasty.

However, research indicates that triggering these reward areas so intensely often tends to dysregulate them, disrupting the body’s control system for food intake and regulation. This will promote overeating and can lead to obesity (see Figure 1). Studies on rodents have shown that feeding them diets rich in easily digestible fats and sugars is a reliable way to induce obesity (Hedrih, 2024; Ikemoto et al., 1996; Loxton, 2018).

 

Figure 1. Implications of separate pathways for sugar and fat

 

Studies on rodents show that feeding them diets rich in easily digestible fats and sugars is a sure way to make them obese.

In the long term, disruptions created in this way can produce symptoms similar to those seen in substance addiction (Fletcher & Kenny, 2018; Gordon et al., 2018). Some scientists propose that this be called food addiction and classified as a serious mental health disorder. Estimates state that around 14% of people worldwide display symptoms of food addiction (Gearhardt et al., 2023). The development of food addiction is often attributed to ultra-processed foods, which are industrially produced and primarily composed of refined ingredients, additives, and flavors, with little to no intact whole foods (Monteiro et al., 2019).

The five stages of food addiction

Vera I. Torman is one of the authors who supports the idea that people can become addicted to certain types of food, particularly to ultraprocessed foods. She proposed a model of food addiction development that consists of 5 stages: (1) pre-addiction, (2) early addiction, (3) mid-addiction, (4) late-stage, and (5) end-stage food addiction (Tarman, 2024). The progression through these stages is marked by increasingly greater dysregulation of the brain systems involved in food intake control and corresponding deterioration in food intake behaviors.

According to this model, in the first stage (pre-addiction), consumption of sugar and fat (at the same time) leads to increased activity in the reward regions of the brain, such as the nucleus accumbens and the ventral tegmental area (VTA). Signaling in the brain, facilitated by the neurotransmitter dopamine, is increased, as is the release of opioids, substances that modulate the behavior of neural cells. This makes people value foods that produce these rewarding experiences more. People also start paying more attention to such food and to anything associated with it (places, people, brands…). Over time, receptors in neural cells in those areas begin to become less sensitive. People in this phase may engage in overeating episodes, but they do not lose control over their eating behavior.

In the early addiction stage, receptors in the reward areas of the brain become less sensitive to rewards stemming from the intake of highly palatable foods. The release of opioids starts to decrease. People need to eat more to feel the same amount of pleasure. Excessive eating starts, accompanied by strong cravings for food and a lack of control over consumption.

In the third, middle-stage addiction, the sensitivity of receptors (for the neurotransmitter dopamine) in the reward areas is clearly reduced. Release of the neurotransmitter dopamine and opioids is also reduced. Individuals start losing control over their eating behaviors. Binge eating episodes become frequent, individuals experience intense food cravings, and show signs of compulsive eating behaviors.

In a late-stage addiction, the fourth stage, sensitivity of receptors in the reward areas of the brain is further reduced, and so is the release of the neurotransmitter dopamine and brain opioids. Tolerance develops as individuals require more food to achieve the same level of pleasurable experiences. Binge eating escalates, and cognitive control over eating behaviors is mostly lost. Affected individuals experience metabolic disturbances. Withdrawal symptoms become more intense when they try to reduce food intake. It is at this point that affected individuals lose their jobs, their relationships become strained, and their health issues become prominent.

In the final, end-stage addiction, the brain reward system deficits are very pronounced, and the release of dopamine and opioids in these areas is extremely low due to depletion (see Figure 2). Metabolic derangements are significant, and the executive functions of affected individuals are grossly impaired. Food consumption is compulsive despite minimal pleasure or rewards from eating. It occurs completely without control. The person cannot abstain from overeating and binge eating without experiencing severe withdrawal symptoms.

 

Figure 2. Five-stage model of ultraprocessed food addiction

 

Conclusion

The five-stage model of ultraprocessed food addiction describes the changes in behaviors and brain physiology of affected individuals as food addiction progresses. This model can be used in treating food addiction to tailor interventions to the stage of addiction the person is in.

The author of this model believes that in the early stages, interventions aimed at increasing inhibitory control and addressing any hormonal imbalances may be sufficient. However, more intensive interventions might be necessary in the middle and later stages of food addiction.

The paper “One size does not fit all: Understanding the five stages of ultra-processed food addiction” was authored by Vera I. Tarman.

Find out more about ultra-processed foods and their effect on psychological health and eating behavior in the Nutritional Psychology Research Library “Sugar, Ultra-processed Foods and Mental Health” Research Category. CNP is developing the field of nutritional psychology, one study at a time.

 

References

Fletcher, P. C., & Kenny, P. J. (2018). Food addiction: A valid concept? Neuropsychopharmacology, 43(13), 2506–2513. https://doi.org/10.1038/s41386-018-0203-9

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

Gordon, E. L., Ariel-Donges, A. H., Bauman, V., & Merlo, L. J. (2018). What Is the Evidence for “Food Addiction?” A Systematic Review. Nutrients, 10(4), 477. https://doi.org/10.3390/nu10040477

Hedrih, V. (2024, 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/

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

Lowe, M. R., & Butryn, M. L. (2007). Hedonic hunger: A new dimension of appetite? Physiology & Behavior, 91(4), 432–439. https://doi.org/10.1016/j.physbeh.2007.04.006

Loxton, N. J. (2018). The Role of Reward Sensitivity and Impulsivity in Overeating and Food Addiction. Current Addiction Reports, 5(2), 212–222. https://doi.org/10.1007/s40429-018-0206-y

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

Tarman, V. I. (2024). One size does not fit all: Understanding the five stages of ultra-processed food addiction. Journal of Metabolic Health, 7(1). https://doi.org/10.4102/jmh.v7i1.90

Tobacco. (2025). https://www.who.int/news-room/fact-sheets/detail/tobacco

Van Strien, T., Frijters, J. E. R., Bergers, G. P. A., & Defares, P. B. (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders, 5(2), 295–315. https://doi.org/10.1002/1098-108X(198602)5:2%253C295::AID-EAT2260050209%253E3.0.CO;2-T

• A study on mice published in Cell Metabolism found that daily oscillations in gut microbiota composition regulate natural daily patterns of corticosterone release.
• Depletion of gut microbiota results in impairments in stress responsivity that are specific to certain times of day and in disruptions in the rhythmicity of stress pathways in the brain.
• In this way, gut microbiota regulate the body’s responsivity to stress.

Introduction: Gut Microbiota and Stress

A new study published in Cell Metabolism reveals that daily oscillations in gut microbiota composition influence how the body regulates stress. The research shows that gut bacteria directly affect corticosterone release, which plays a central role in the stress response system.

This finding highlights the importance of the gut–brain axis and its connection to stress, circadian rhythm, and overall mental health.

We have all experienced situations that upset us. There are situations where we feel threatened or are afraid of something, or situations that require us to exert ourselves to prevent undesirable things from happening to us. Most often, we noticed our heart starting to beat faster, and a whole range of changes in our bodies became noticeable. In such situations, we experience stress.

What is Stress?

Stress is the body’s natural response to a perceived threat or challenge. Physiologically, it activates the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis (also known as the HPA axis), triggering the “fight-or-flight” response. The hypothalamus releases corticotropin-releasing hormone, which stimulates the pituitary gland to secrete adrenocorticotropic hormone, leading the adrenal cortex to release cortisol, the main stress hormone.  At the same time, the adrenal medulla releases adrenaline. Adrenaline and cortisol increase heart rate, blood pressure, and glucose availability for quick energy. Breathing becomes faster, muscles tense, and digestion slows to redirect resources toward immediate survival (Chrousos, 2000; Herman et al., 2016; Russell & Lightman, 2019).

Once the stressor passes, the parasympathetic nervous system helps restore balance and normal function. Chronic activation of this stress response can harm the immune system, cardiovascular health, and overall well-being.

Acute vs. Chronic Stress

The process described above refers to acute stress. However, stress can also be chronic. While acute stress is the body’s immediate reaction to a sudden challenge or threat, chronic stress occurs when stressors (situations that cause the stress reaction) persist over a long period. For example, such stressors could include ongoing financial worries, relationship difficulties, demanding jobs, or life in a war zone.

Prolonged activation of the stress response keeps cortisol levels elevated, which can suppress immunity, disrupt sleep, increase risk of depression, eating disorders, and other mental health disorders, make the body more responsive to future acute stress, create adverse changes in the brain affecting memory, contribute to cardiovascular and metabolic diseases, and is associated with a wide range of other adverse health outcomes (Adell et al., 1988; Dallman et al., 2005; Gouin, 2011, 2011; Khan et al., 2020; Torpy et al., 2007).

The Current Study: Gut Microbiota and Circadian Rhythms

Study author Gabriel S.S. Tofani and his colleagues note that systems in our body regulating stress are intertwined with those regulating circadian rhythms (Tofani et al., 2025). They consider this an evolutionary adaptation that enables the organism to adapt to environmental changes. Circadian rhythm is the body’s internal 24-hour biological clock that regulates cycles of sleep, wakefulness, hormone release, and other physiological processes in response to light and darkness.

Through evolution, there were times of day when dangerous and challenging situations were the most likely to occur and times of day when they were less likely. Before the invention of electric lighting, humans were primarily active during daylight hours, with most activities occurring in the morning. As a result, our bodies have adapted to being most responsive to stress at that time. The levels of the stress hormone cortisol peak in the morning (this is called the cortisol awakening response), and tend to decline in the evening, when the light fades (Steptoe & Serwinski, 2016).

The authors of this study investigated the role of the gut microbiota, the community of microorganisms residing in the gut, in the interplay between circadian rhythms and stress responsivity. More specifically, they aimed to investigate how this interplay operates when gut microbiota are removed from the gut.

The authors investigated the role of the gut microbiota in the interplay between circadian rhythms and stress responsivity. 

Methods: Mouse Model Experiments

The study was conducted on 7–14-week-old C57BL/6 mice, an inbred strain of laboratory mice widely used in research due to their genetic uniformity and well-established physiological characteristics.

Some of these mice were given drinking water containing a cocktail of antibiotics: ampicillin sodium salt (1 g/L), gentamicin sulfate (1 g/L), vancomycin hydrochloride (0.5 g/L), and imipenem (0.25 g/L) for 14 days. The goal of this treatment was to eliminate their gut microbiota. After this was achieved, some of the mice received a transfer of gut microbiota from feces in the form of two injections 72 hours apart. This resulted in the treated mice acquiring a new gut microbiota. Some other mice received a probiotic – Limosilactobacillus reuteri bacterium, allowing researchers to see whether this would reverse the effects of gut microbiota depletion on stress-related physiological parameters.

Some mice were controls and did not undergo treatments. After the treatments, the mice were exposed to a situation that induces stress (immobilization), and the study authors examined their behavioral reactions and physiological parameters, as well as tissues (see Figure 1).

 

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

 

Results: Gut Microbiota Oscillations and Stress Regulation

Gut microbiota composition oscillates across the day and modulates rhythms of corticosterone

Results showed that gut microbiota composition oscillates across the day and modulates the daily rhythm of change in corticosterone levels. Corticosterone is a hormone in mice that plays the same role as cortisol in humans. In mice with destroyed gut microbiota, the rhythm of corticosterone change was disrupted. A detailed analysis (RNA sequencing) revealed that the absence of gut microbiota affected the structure of the brain, specifically the suprachiasmatic nucleus (SCN), which is crucial for maintaining circadian rhythms.

The absence of gut microbiota affected the structure of the brain that is central for maintaining the circadian rhythms, called the suprachiasmatic nucleus

In mice with destroyed gut microbiota, the functioning of the HPA axis, and thus stress responsiveness, was also disrupted. Their reactions to stress, social interaction, and anxiety-like behaviors were changed, and this depended on the time of day. The blood-brain barrier in the hypothalamus was also impaired in these mice. Restoring gut microbiota through fecal microbiota transfer and administering the probiotic bacterium Limosilactobacillus reuteri normalized certain aspects of stress reactivity (see Figure 2).

 

Figure 2. Gut microbiota, Circadian rhythm, and stress regulation

 

In mice with destroyed gut microbiota, the functioning of the HPA axis, and thus stress responsiveness, was also disrupted.

Conclusions and Implications

The study revealed that gut microbiota composition fluctuates throughout the day and regulates the activity of brain areas responsible for circadian rhythms and stress responses. In this way, gut microbiota regulate the daily rhythms of the body’s system responsible for stress.

Although the study was conducted on mice and not humans, humans and mice share many physiological similarities, so it is reasonably expected that the findings in humans would not differ significantly from those in mice. This potentially opens ways through which individual responsivity to stress could be affected by using probiotics and other ways to modulate gut microbiota composition.

The paper “Gut microbiota regulates stress responsivity via the circadian system” was authored by Gabriel S.S. Tofani, Sarah-Jane Leigh, Cassandra E. Gheorghe, Paromita Sen, Gerard Clarke, and John F. Cryan.

To learn more about the microbiota-gut-brain axis and mental health, visit the Nutritional Psychology Research Library, the world’s largest online library of research connecting nutrition and mental health, or take our evidence-based continuing education courses for professionals. Visit www.nutritional-psychology.org. CNP is a non-profit educational organization building the way to a healthier future. Join us!

 

References

Adell, A., Garcia-Marquez, C., Armario, A., & Gelpi, E. (1988). Chronic Stress Increases Serotonin and Noradrenaline in Rat Brain and Sensitizes Their Responses to a Further Acute Stress. Journal of Neurochemistry, 50(6), 1678–1681. https://doi.org/10.1111/j.1471-4159.1988.tb02462.x

Chrousos, G. P. (2000). The Hpa Axis and the Stress Response. Endocrine Research, 26(4), 513–514. https://doi.org/10.3109/07435800009048562

Dallman, M. F., Pecoraro, N. C., & La Fleur, S. E. (2005). Chronic stress and comfort foods: Self-medication and abdominal obesity. Brain, Behavior, and Immunity, 19(4), 275–280. https://doi.org/10.1016/J.BBI.2004.11.004

Gouin, J.-P. (2011). Chronic Stress, Immune Dysregulation, and Health. American Journal of Lifestyle Medicine, 5(6), 476–485. https://doi.org/10.1177/1559827610395467

Herman, J. P., McKlveen, J. M., Ghosal, S., Kopp, B., Wulsin, A., Makinson, R., Scheimann, J., & Myers, B. (2016). Regulation of the hypothalamic-pituitary-adrenocortical stress response. Comprehensive Physiology, 6(2), 603–621. https://doi.org/10.1002/cphy.c150015

Khan, A. R., Geiger, L., Wiborg, O., & Czéh, B. (2020). Stress-Induced Morphological, Cellular and Molecular Changes in the Brain—Lessons Learned from the Chronic Mild Stress Model of Depression. Cells, 9(4), 1026. https://doi.org/10.3390/cells9041026

Russell, G., & Lightman, S. (2019). The human stress response. Nature Reviews Endocrinology, 15(9), 525–534. https://doi.org/10.1038/s41574-019-0228-0

Steptoe, A., & Serwinski, B. (2016). Chapter 34—Cortisol Awakening Response. In G. Fink (Ed.), Stress: Concepts, Cognition, Emotion, and Behavior (pp. 277–283). Academic Press. https://doi.org/10.1016/B978-0-12-800951-2.00034-0

Tofani, G. S. S., Leigh, S.-J., Gheorghe, C. E., Bastiaanssen, T. F. S., Wilmes, L., Sen, P., Clarke, G., & Cryan, J. F. (2025). Gut microbiota regulates stress responsivity via the circadian system. Cell Metabolism, 37(1), 138-153.e5. https://doi.org/10.1016/j.cmet.2024.10.003

Torpy, J. M., Lynm, C., & Glass, R. M. (2007). Chronic Stress and the Heart. JAMA, 298(14), 1722. https://doi.org/10.1001/jama.298.14.1722

 

• 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.

Why Sleep Quality Matters for Health

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 Saudi Study on Sugar Intake and Sleep Quality

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).

 

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

 

Findings: Higher Sugar, Lower 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).

 

Figure 2. Association of added sugar intake and sleep quality

 

Conclusion: Why Cutting Sugar May Improve Sleep

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

• 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).

 

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).

 

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

• 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).

 

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).

 

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

 

 

• 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).

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).

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

 

 

 

 

• 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).

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).

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

• 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.

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).

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

360. 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

• 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).

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.

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

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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