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.

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.