Ultra-processed food consumption during pregnancy and emotional and behavioral problems in offspring

Evidence on prenatal ultra-processed food (UPF) consumption and offspring psychopathological problems remains limited. Therefore, this study assessed the associations between UPF consumption during pregnancy and offspring emotional and behavioral problems. The potential impact of theoretically replacing UPFs with unprocessed or minimally processed foods was also examined using simulation models. The analyses included 201 mother-child pairs from the ECLIPSES study. Dietary intake was assessed using a validated food frequency questionnaire at 12, 24, and 36 weeks of gestation. UPF consumption (%grams/day) was estimated using the NOVA classification system. Children's behavior was assessed at age 4 using the parent-reported Child Behaviour Checklist (1.5 to 5 years), with outcomes defined as borderline/clinical scores. Multivariable-adjusted logistic regression models were fitted. Every 10% grams/day increase in prenatal UPF consumption was associated with higher odds of having children with borderline/clinical scores on several syndrome and broad-band scales: emotionally reactive (Odd ratios [OR]: 1.67; 95% Confidence interval [CI]: 1.06-2.63), aggressive behavior (OR 2.13; 95% CI: 1.18-3.84), internalizing problems (OR: 1.56 95%CI: 1.06-2.31), externalizing problems (OR: 2.00; 95% CI: 1.31-3.07) and total problems (OR: 1.68; 95%CI: 1.12-2.51). Associations were also observed with DSM-oriented scales, including depressive (OR: 2.08; 95%CI: 1.25-3.45), attention deficit/hyperactivity (OR: 1.71; 95%CI: 1.08-2.68) and oppositional defiant problems (OR: 1.85; 95%CI: 1.09-3.13). Replacing 10%grams/day of UPF with equal amounts of unprocessed or minimally processed foods was associated with lower likelihood of children presenting the aforementioned borderline/clinical scores. The findings suggest that prenatal UPF consumption might be associated with adverse emotional and behavioral outcomes in the offspring.