Ultraprocessed Food Intake, Striatal Response to Food Cues, and Adiposity Gain in Children

Importance: Preclinical studies suggest that ultraprocessed foods (UPFs) are associated with increased dopaminergic signaling in the striatum, reinforcing intake. Whether habitual UPF consumption is associated with striatal responses to food cues and subsequent adiposity gain in children is unknown.

Objective

To examine associations between habitual UPF intake, striatal responses to food cues, and 1-year adiposity changes in children. Design, setting, and participants: This prospective cohort study included children of healthy weight who were participating in the longitudinal BrainChild study. Baseline assessments were completed between April 11, 2015, and June 28, 2024, and included brain magnetic resonance imaging (MRI), dietary recalls, and adiposity measurements. Additional follow-up assessments of adiposity were conducted 1 year later (April 18, 2016, to June 19, 2025). Exposure: Habitual UPF intake, defined as the percentage of total energy intake from UPFs based on multiple 24-hour dietary recalls using the NOVA classification system. Main outcomes and measures: Blood oxygenation level-dependent (BOLD) responses to food cues in the dorsal and ventral striatum during functional MRI and 1-year changes in body mass index (BMI), body fat percentage, and waist circumference. Associations were examined using linear regression models and adjusted for age, sex, baseline BMI, and total caloric intake, with regression coefficient (β) reported as per SD change in outcome with per SD change in the exposure variable.