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

Abstract

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. Results In 46 children of healthy weight (mean [SD] age, 8.7 [1.1] years; 26 [57%] female; baseline BMI range, 13.8-19.9; body fat percentage range, 12.7%-32.2%), higher habitual UPF consumption was associated with greater BOLD responses to food cues in the dorsal striatum (β = 0.34; 95% CI, 0.07-0.61) but not the ventral striatum (β = 0.16; 95% CI, −0.14 to 0.46). Greater dorsal striatal food cue responsivity was associated with 1-year increases in BMI (β = 0.32; 95% CI, 0.02-0.62) and body fat percentage (β = 0.44; 95% CI, 0.15-0.72). Baseline UPF intake was associated with a 1-year increase in waist circumference (β = 0.38; 95% CI, 0.11-0.66). Point estimates for associations between UPF intake and increases in BMI (β = 0.28; 95% CI, 0.00-0.57) and body fat percentage (β = 0.29; 95% CI, 0.00-0.57) were positive. Inclusion of dorsal striatal responsivity attenuated the UPF associations with 1-year change in BMI by 31% and with body fat percentage by 44%. Conclusions and Relevance In this cohort study of children of healthy weight, higher habitual UPF intake was associated with greater dorsal striatal responses to food cues and prospective increases in adiposity. These findings suggest that reward-related brain responses may be involved in associations between UPF consumption and adiposity gain during childhood.

The authors' abstract, as published at the source. JAMA Network Open, 2026 · DOI ↗