Association between ultra-processed food consumption and odds of depression, stress, and anxiety in adolescent girls: a cross-sectional study

Mental disorders, including depression, anxiety, and stress, disproportionately affect adolescent girls, with dietary patterns emerging as modifiable risk factors. Ultra-processed food (UPF) consumption, prevalent among adolescents, may exacerbate these conditions. This study examines the association between UPF consumption and mental health outcomes in Iranian female adolescents. In this cross-sectional study, 263 female adolescents aged 15–18 years from Tehran, Iran, were assessed. Dietary intake was measured using a validated 168-item food frequency questionnaire, with UPFs classified per the NOVA system and expressed as a percentage of total energy intake. Depression, anxiety, and stress were evaluated using the DASS-21 questionnaire. Multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) across UPF consumption tertiles, adjusting for BMI and physical activity. Higher UPF consumption was significantly associated with increased odds of depression, stress, and anxiety. In fully adjusted models, participants in the highest UPF tertile had 3.69 times higher odds of depression (95% CI: 1.92–7.10, P trend < 0.001), 2.84 times higher odds of stress (95% CI: 1.49–5.41, P trend = 0.001), and 1.99 times higher odds of anxiety (95% CI: 1.10–3.66, P trend = 0.026) compared to the lowest tertile. Greater UPF consumption is associated with elevated odds of depression, stress, and anxiety in adolescent girls, underscoring the need for dietary interventions to mitigate mental health burdens in this vulnerable population.