Clinical nutrition ESPEN · 2025
The impact of ultra-processed food intake and genetic predisposition on psychological well-being in a general adult cohort with cancer subgroups: The KoGES study.
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Jang Bum-Sup, Chang Ji Hyun, Kim Hak Jae
Аннотация
BACKGROUND: Cancer significantly impacts patients' psychological well-being. While nutrition is crucial in cancer care, the specific role of ultra-processed food (UPF) consumption on mental health in this population is underexplored. This study aimed to investigate the associations between UPF intake, genetic predisposition to UPF intake, and psychological well-being in a general adult cohort, with effects varying by cancer subgroups.
METHODS: This study included 53,057 participants from the Korean Genome and Epidemiology Study (KoGES), with low rates of new (0.11 %-0.72 %) and persistent cancers (0.06 %-0.72 %) across thyroid, breast, lung, gastric, and colon types. UPF intake was assessed using a food frequency questionnaire and dichotomized. Through logistic regression, we identified 22 single nucleotide polymorphisms (SNPs) associated with UPF intake, which were used to construct a polygenic risk score (PRS). The primary outcome was the Psychological Well-being Index (PWI), derived from the CES-D scale. We used generalized linear models (GLM) to analyze the associations, adjusting for demographic, lifestyle, and cancer status changes (thyroid, breast, lung, stomach, colon).
RESULTS: High UPF intake was significantly associated with higher PWI scores, indicating poorer psychological well-being (β = 0.44, P < 0.001). A higher PRS, based on 22 SNPs primarily located in the MHC class II region and OAS gene cluster, was independently associated with increased PWI (β = 6.02, P = 0.005), suggesting a genetic link to inflammation and immune responses influencing mental health. New diagnoses of lung (β = 2.00, P = 0.007) and thyroid cancer (β = 0.67, P = 0.022), and persistent colon (β = 0.93, P = 0.040) and breast cancer (β = 0.65, P = 0.032), were associated with significantly higher PWI scores.
CONCLUSION: Both high UPF intake and a genetic predisposition to it are independently associated with increased psychological distress in a general adult cohort, with subgroup analyses for incident and persistent cancer cases. These associations vary by cancer type and status, highlighting the need for personalized nutritional and psycho-oncological interventions to improve quality of life in this vulnerable population.
METHODS: This study included 53,057 participants from the Korean Genome and Epidemiology Study (KoGES), with low rates of new (0.11 %-0.72 %) and persistent cancers (0.06 %-0.72 %) across thyroid, breast, lung, gastric, and colon types. UPF intake was assessed using a food frequency questionnaire and dichotomized. Through logistic regression, we identified 22 single nucleotide polymorphisms (SNPs) associated with UPF intake, which were used to construct a polygenic risk score (PRS). The primary outcome was the Psychological Well-being Index (PWI), derived from the CES-D scale. We used generalized linear models (GLM) to analyze the associations, adjusting for demographic, lifestyle, and cancer status changes (thyroid, breast, lung, stomach, colon).
RESULTS: High UPF intake was significantly associated with higher PWI scores, indicating poorer psychological well-being (β = 0.44, P < 0.001). A higher PRS, based on 22 SNPs primarily located in the MHC class II region and OAS gene cluster, was independently associated with increased PWI (β = 6.02, P = 0.005), suggesting a genetic link to inflammation and immune responses influencing mental health. New diagnoses of lung (β = 2.00, P = 0.007) and thyroid cancer (β = 0.67, P = 0.022), and persistent colon (β = 0.93, P = 0.040) and breast cancer (β = 0.65, P = 0.032), were associated with significantly higher PWI scores.
CONCLUSION: Both high UPF intake and a genetic predisposition to it are independently associated with increased psychological distress in a general adult cohort, with subgroup analyses for incident and persistent cancer cases. These associations vary by cancer type and status, highlighting the need for personalized nutritional and psycho-oncological interventions to improve quality of life in this vulnerable population.