The Impact Of Ultra-Processed Food Consumption On Gut Health, Executive Functioning, Sleep, And Mental Wellbeing Among School-Going Adolescents In Delhi

Abstract

Ultra-processed food (UPF) consumption has surged among adolescents, correlating with gastrointestinal (GI) symptoms, poor sleep, and psychological distress. As adolescence is a critical window for neurocognitive and emotional development, understanding dietary impacts is vital. This study investigates the associations between UPF intake and GI symptoms, sleep quality, executive functioning, anxiety, depression, and overall quality of life (QOL) in a cohort of school-going adolescents in Delhi, India.

A cross-sectional study was conducted among 200 adolescents aged 10–19 years attending schools in Delhi. UPF consumption was assessed using an India-adapted NOVA-based food-frequency assessment. Gastrointestinal symptoms, sleep quality, executive functioning, anxiety, depressive symptoms, and quality of life were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), Pittsburgh Sleep Quality Index (PSQI), a Stroop task, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and a quality-of-life measure, respectively. Pearson correlations and PROCESS Model 4 mediation analyses were conducted. Indirect effects were evaluated using 5,000 bootstrap samples and 95% confidence intervals.

Findings reveal that higher UPF consumption significantly correlates with increased GI symptoms, heightened anxiety and depression, poorer sleep quality, and diminished executive function. Mediation analyses identified GI symptoms as a consistent mediator, particularly in the pathways linking UPF to anxiety and reduced QOL. These results underscore the importance of the gut-brain axis in adolescent health and highlight diet as a modifiable target for intervention, though the cross-sectional design limits causal inference.