Higher ultra-processed food intake in young children is associated with adverse early behavioural outcomes

1. Higher ultra-processed food consumption in children at age 3 was associated with adverse behavioural and emotional symptoms at age 5.

Evidence Rating Level: 2 (Good)

UPF has been linked to adverse health outcomes, behaviour, and mental health outcomes in adults and adolescents. The relationship between UPF intake and behavioural development during early childhood is unclear. This study thus examined the associations between preschool UPF intake and behavioural outcomes. This prospective cohort study analyzed data from the CHILD Cohort Study between September 2011 to April 2018. Canadian children from singleton births, gestational age of at least 34 weeks and 4 days, and who had no congenital abnormalities were included. UPF uptake was assessed at age 3 years by a 112-item food frequency questionnaire. The primary outcome, behaviour, was assessed at age 5 years using the Child Behaviour Checklist (CBCL; range 0-100; higher scores indicating more adverse symptoms). The total behaviour scale included questions from the internalizing scale that captured inward-focused behaviour (e.g., anxiety, fearfulness, and depression), and the externalizing scale that captured outward-directed behaviour (e.g., aggression, hyperactivity). In total, 2,077 participants were included (1,0921 male [52.6%]; 1,376 White [66.2%], 480 multiracial [23.1%], 221 another ethnic group [10.7%]). At age 3 years, UPF accounted for a mean (SD) of 45.5% (11.6%) of total energy intake. The main UPF subgroups contributing to energy were sweets and desserts (12.5%), breads and cereals (11.9%), animal-based products (7.9%), and ready-to-eat or ready-to-heat mixed dishes (6.1%). At age 5 years, every 10% increase in energy contribution from UPF was independently associated with higher CBCL internalizing (β = 0.81 [95% CI, 0.43 to 1.19]), externalizing (β = 0.47 [95% CI, 0.08 to 0.87]), and total (β = 0.64 [95% CI, 0.27 to 1.01]) scores. Overall, this study found that higher UPF intake at age 3 years was associated with adverse behavioural and emotional symptoms at age 5 years, highlighting the importance of early-life dietary interventions and policies to support healthy behavioural development.

Click here to read this study in JAMA Network Open

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