Ultraprocessed foods consumption, inflammatory index levels, and risk of suicide attempt: findings from a prospective cohort study

Yichun Wu; Mengtong Sun; Yuheng Yuan; Shanshan Zhang; Linzhou Zhu; Zexin Lou; Yujie Shi; Jianing Li; Ziqing Sun; Lichao Yang; Linyan Li; Yueping Shen

doi:10.1016/j.ajcnut.2025.06.019

Ultraprocessed foods consumption, inflammatory index levels, and risk of suicide attempt: findings from a prospective cohort study

Yichun Wu (Co-first Author)
, Mengtong Sun (Co-first Author)
, Yuheng Yuan
, Shanshan Zhang
, Linzhou Zhu
, Zexin Lou
, Yujie Shi
, Jianing Li
, Ziqing Sun
, Lichao Yang
, Linyan Li^*
, Yueping Shen^*

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

4 Citations (Scopus)

Abstract

Background
Suicide attempts (SAs) are a major public health issue, with many cases being preventable. However, the impact of dietary patterns remains inadequately studied. Currently, the rising consumption of ultraprocessed foods (UPFs) has been linked to various health issues, including mental health disorders that may increase risk of SA.
Objectives
This study aimed to investigate the association between UPF consumption and SA, and explore the mediating role of SA-related inflammatory index levels.
Methods
This study included 208,938 participants from the UK Biobank cohort, recruited from 2006 to 2010. Cox proportional hazards models were used to assess the association between the weight proportion of UPF intake and incident SA. Substitution analyses were conducted to evaluate risk of SA when replacing UPF with unprocessed or minimally processed foods (UNPFs). Causal mediation analyses were further conducted to estimate the mediating effects of inflammatory index levels in this association.
Results
Over a median follow-up of 13.1 y, 545 SA events were identified. Compared with participants in the lowest quintile of UPF consumption, those in the highest quintile had a 1.63 times higher risk of developing SA [hazard ratio (HR): 1.63, 95% confidence interval (CI): 1.23, 2.15]. Additionally, each SD increase in UPF consumption was associated with a 20% higher risk of SA (HR: 1.20, 95% CI: 1.11, 1.29). Notably, replacing 20% of UPF weight with UNPF was linked to a 23% reduction in SA risk (HR: 0.77, 95% CI: 0.69, 0.85). Furthermore, in causal mediation analyses, inflammatory index levels mediated 0.7%–1.5% of the association between UPF consumption and SA.
Conclusions
Higher UPF consumption is associated with an increased risk of SA, partially mediated by inflammatory index levels. Replacing UPF with UNPF significantly reduces SA incidence, highlighting potential benefits of transitioning to a diet with higher UNPF consumption.
© 2025 American Society for Nutrition.

Original language	English
Pages (from-to)	1042-1051
Journal	American Journal of Clinical Nutrition
Volume	122
Issue number	4
Online published	26 Aug 2025
DOIs	https://doi.org/10.1016/j.ajcnut.2025.06.019
Publication status	Published - Oct 2025

Funding

This work was supported by the National Natural Science Foundation of China (project number 81973143), the Liyang Chronic Disease Risk Factor Monitoring Cohort Study (project number P113911618), and the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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@article{6f45ad6f83f84d65a928e8569d8d5621,

title = "Ultraprocessed foods consumption, inflammatory index levels, and risk of suicide attempt: findings from a prospective cohort study",

abstract = "Background Suicide attempts (SAs) are a major public health issue, with many cases being preventable. However, the impact of dietary patterns remains inadequately studied. Currently, the rising consumption of ultraprocessed foods (UPFs) has been linked to various health issues, including mental health disorders that may increase risk of SA. Objectives This study aimed to investigate the association between UPF consumption and SA, and explore the mediating role of SA-related inflammatory index levels. Methods This study included 208,938 participants from the UK Biobank cohort, recruited from 2006 to 2010. Cox proportional hazards models were used to assess the association between the weight proportion of UPF intake and incident SA. Substitution analyses were conducted to evaluate risk of SA when replacing UPF with unprocessed or minimally processed foods (UNPFs). Causal mediation analyses were further conducted to estimate the mediating effects of inflammatory index levels in this association. Results Over a median follow-up of 13.1 y, 545 SA events were identified. Compared with participants in the lowest quintile of UPF consumption, those in the highest quintile had a 1.63 times higher risk of developing SA [hazard ratio (HR): 1.63, 95\% confidence interval (CI): 1.23, 2.15]. Additionally, each SD increase in UPF consumption was associated with a 20\% higher risk of SA (HR: 1.20, 95\% CI: 1.11, 1.29). Notably, replacing 20\% of UPF weight with UNPF was linked to a 23\% reduction in SA risk (HR: 0.77, 95\% CI: 0.69, 0.85). Furthermore, in causal mediation analyses, inflammatory index levels mediated 0.7\%–1.5\% of the association between UPF consumption and SA. Conclusions Higher UPF consumption is associated with an increased risk of SA, partially mediated by inflammatory index levels. Replacing UPF with UNPF significantly reduces SA incidence, highlighting potential benefits of transitioning to a diet with higher UNPF consumption. {\textcopyright} 2025 American Society for Nutrition.",

author = "Yichun Wu and Mengtong Sun and Yuheng Yuan and Shanshan Zhang and Linzhou Zhu and Zexin Lou and Yujie Shi and Jianing Li and Ziqing Sun and Lichao Yang and Linyan Li and Yueping Shen",

year = "2025",

month = oct,

doi = "10.1016/j.ajcnut.2025.06.019",

language = "English",

volume = "122",

pages = "1042--1051",

journal = "American Journal of Clinical Nutrition",

issn = "0002-9165",

publisher = "Elsevier B.V.",

number = "4",

}

Ultraprocessed foods consumption, inflammatory index levels, and risk of suicide attempt: findings from a prospective cohort study. / Wu, Yichun (Co-first Author); Sun, Mengtong (Co-first Author); Yuan, Yuheng et al.
In: American Journal of Clinical Nutrition, Vol. 122, No. 4, 10.2025, p. 1042-1051.

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

TY - JOUR

T1 - Ultraprocessed foods consumption, inflammatory index levels, and risk of suicide attempt

T2 - findings from a prospective cohort study

AU - Wu, Yichun

AU - Sun, Mengtong

AU - Yuan, Yuheng

AU - Zhang, Shanshan

AU - Zhu, Linzhou

AU - Lou, Zexin

AU - Shi, Yujie

AU - Li, Jianing

AU - Sun, Ziqing

AU - Yang, Lichao

AU - Li, Linyan

AU - Shen, Yueping

PY - 2025/10

Y1 - 2025/10

N2 - Background Suicide attempts (SAs) are a major public health issue, with many cases being preventable. However, the impact of dietary patterns remains inadequately studied. Currently, the rising consumption of ultraprocessed foods (UPFs) has been linked to various health issues, including mental health disorders that may increase risk of SA. Objectives This study aimed to investigate the association between UPF consumption and SA, and explore the mediating role of SA-related inflammatory index levels. Methods This study included 208,938 participants from the UK Biobank cohort, recruited from 2006 to 2010. Cox proportional hazards models were used to assess the association between the weight proportion of UPF intake and incident SA. Substitution analyses were conducted to evaluate risk of SA when replacing UPF with unprocessed or minimally processed foods (UNPFs). Causal mediation analyses were further conducted to estimate the mediating effects of inflammatory index levels in this association. Results Over a median follow-up of 13.1 y, 545 SA events were identified. Compared with participants in the lowest quintile of UPF consumption, those in the highest quintile had a 1.63 times higher risk of developing SA [hazard ratio (HR): 1.63, 95% confidence interval (CI): 1.23, 2.15]. Additionally, each SD increase in UPF consumption was associated with a 20% higher risk of SA (HR: 1.20, 95% CI: 1.11, 1.29). Notably, replacing 20% of UPF weight with UNPF was linked to a 23% reduction in SA risk (HR: 0.77, 95% CI: 0.69, 0.85). Furthermore, in causal mediation analyses, inflammatory index levels mediated 0.7%–1.5% of the association between UPF consumption and SA. Conclusions Higher UPF consumption is associated with an increased risk of SA, partially mediated by inflammatory index levels. Replacing UPF with UNPF significantly reduces SA incidence, highlighting potential benefits of transitioning to a diet with higher UNPF consumption. © 2025 American Society for Nutrition.

AB - Background Suicide attempts (SAs) are a major public health issue, with many cases being preventable. However, the impact of dietary patterns remains inadequately studied. Currently, the rising consumption of ultraprocessed foods (UPFs) has been linked to various health issues, including mental health disorders that may increase risk of SA. Objectives This study aimed to investigate the association between UPF consumption and SA, and explore the mediating role of SA-related inflammatory index levels. Methods This study included 208,938 participants from the UK Biobank cohort, recruited from 2006 to 2010. Cox proportional hazards models were used to assess the association between the weight proportion of UPF intake and incident SA. Substitution analyses were conducted to evaluate risk of SA when replacing UPF with unprocessed or minimally processed foods (UNPFs). Causal mediation analyses were further conducted to estimate the mediating effects of inflammatory index levels in this association. Results Over a median follow-up of 13.1 y, 545 SA events were identified. Compared with participants in the lowest quintile of UPF consumption, those in the highest quintile had a 1.63 times higher risk of developing SA [hazard ratio (HR): 1.63, 95% confidence interval (CI): 1.23, 2.15]. Additionally, each SD increase in UPF consumption was associated with a 20% higher risk of SA (HR: 1.20, 95% CI: 1.11, 1.29). Notably, replacing 20% of UPF weight with UNPF was linked to a 23% reduction in SA risk (HR: 0.77, 95% CI: 0.69, 0.85). Furthermore, in causal mediation analyses, inflammatory index levels mediated 0.7%–1.5% of the association between UPF consumption and SA. Conclusions Higher UPF consumption is associated with an increased risk of SA, partially mediated by inflammatory index levels. Replacing UPF with UNPF significantly reduces SA incidence, highlighting potential benefits of transitioning to a diet with higher UNPF consumption. © 2025 American Society for Nutrition.

UR - https://www.scopus.com/pages/publications/105016874552#tab=impact

UR - https://www.scopus.com/pages/publications/105016874552

U2 - 10.1016/j.ajcnut.2025.06.019

DO - 10.1016/j.ajcnut.2025.06.019

M3 - RGC 21 - Publication in refereed journal

C2 - 41043871

SN - 0002-9165

VL - 122

SP - 1042

EP - 1051

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - 4

ER -

Ultraprocessed foods consumption, inflammatory index levels, and risk of suicide attempt: findings from a prospective cohort study

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