# Dietary Intake Patterns, Substance Use and Their Association with Anxiety and Depression Symptoms in Medical Students in Mexico: A Cross-Sectional Study

## TL;DR

This study found that medical students in Mexico who ate more ultra-processed foods had higher anxiety and depression symptoms, while those who ate more unprocessed foods had fewer symptoms.

## Contribution

The study identifies specific dietary patterns linked to emotional symptoms in medical students, emphasizing the role of ultra-processed foods.

## Key findings

- Higher intake of ultra-processed foods like pizza and sugary cereals was linked to increased anxiety and depression symptoms.
- Consuming more than three daily servings of cereals with added fat and sugar increased the risk of severe depressive symptoms by over sevenfold.
- Unprocessed foods like fruits and vegetables were consumed less by students with anxiety or depression.

## Abstract

Background/Objectives: The growing prevalence of mental health problems among medical students is a global concern, with dietary patterns emerging as potential modifiable factors. This study aimed to explore and evaluate whether higher consumption of ultra-processed foods may be associated with greater symptoms of anxiety and depression. Methods: This was an exploratory cross-sectional study integrated into a previous cohort of medical students, conducted based on the guidelines for Strengthening the Reporting of Observational Studies in Epidemiology. Sixty-seven medical students completed a Food Frequency Questionnaire-based index. Dietary patterns and the associations between these patterns and symptoms of anxiety and/or depression were assessed statistically. Results: There were differences in the consumption of unprocessed or minimally processed foods, including fruits, vegetables, legumes and unsweetened juices between groups with/without anxiety or depression (p < 0.05). A higher intake of ultra-processed foods such as pizza, hot dogs, cereals high in fat and sugar, processed beverages and sweets was linked to greater symptoms (p < 0.05; Cohen’s d = 0.3–0.7). Three to four dietary patterns were identified, explaining between 60% and 86% of the variance. High consumption of cereals with added fat and sugars increased the risk by 7.4 times (OR = 7.4, 95% CI 1.2–12.2, p < 0.05). Conclusions: Dietary intake was associated, but not causally linked, to emotional symptoms among medical students. Lower consumption of unprocessed foods and higher intake of ultra-processed foods formed consistent behavioral profiles associated with anxiety and depression. Consuming more than three daily servings of cereals with added fat and sugar increased the risk of severe depressive symptoms by more than sevenfold, highlighting a strong dietary determinant. Future research should assess nutritional interventions aimed to improve mental health and academic performance in medical students.