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Objective: To explore whether individuals who consume higher amounts of ultra-processed food have more adverse mental health symptoms. Design: Using a cross-sectional design, we measured the consumption of ultra-processed foods as a percentage of total energy intake in kilo-calories using the NOVA food classification system. We explored whether individuals who consume higher amounts of ultra-processed food were more likely to report mild depression, more mentally unhealthy days and more anxious days per month using multivariable analyses adjusting for potential confounding variables. Setting: Representative sample from the United States National Health and Nutrition Examination Survey between 2007 and 2012. Participants: 10,359 adults aged 18+ without a history of cocaine, methamphetamine, or heroin use. Results: After adjusting for covariates, individuals with the highest level of ultra-processed food consumption were significantly more likely to report at least mild depression (OR 1.81; 95% CI: 1.09-3.02), more mentally unhealthy (RR 1.22; 95% CI: 1.18-1.25), and more anxious days per month. (RR 1.19; 95% CI: 1.16-1.23). They were also significantly less likely to report zero mentally unhealthy (OR 0.60; 95% CI: 0.41-0.88) or anxious days (OR 0.65; 95% CI 0.47-0.90). Conclusions: Individuals reporting higher intakes of ultra-processed food were significantly more likely to report mild depression, more mentally unhealthy and more anxious days, and less likely to report zero mentally unhealthy or anxious days. These data add important information to a growing body of evidence concerning the potential adverse effects of ultra-processed food consumption on mental health.

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Nonalcoholic fatty liver disease (NAFLD) is common in overweight adolescents, and screening with serum alanine transaminase (ALT) levels is recommended by the American Academy of Pediatrics. We sought to determine if ALT is an accurate adolescent screening measure for NAFLD in a nationally representative sample of overweight adolescents. Diagnosis of NAFLD was determined using vibration-controlled transient elastography. Analyses were performed to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and Youden’s index at various serum ALT cutoff levels. Receiver operating curves were generated in order to determine ALT’s discrimination capability. Males and females were analyzed separately. While average measures (mean and median) of ALT were higher in subjects with NAFLD, ALT provided only minimal discrimination with AUROC (area under the receiver operating characteristic) values of .66 in males and .67 in females. In a nationally representative sample of overweight and obese adolescents, serum ALT level functioned inadequately as a screening test to detect NAFLD.