{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:33:18Z","timestamp":1785393198855,"version":"3.55.0"},"reference-count":85,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260032-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Ultraprocessed foods (UPF) contribute to nearly half of energy intake among preschool-aged children in Canada, yet their impact on behavioral and emotional functioning remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260032-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations between UPF intake at age 3 years and behavioral outcomes at age 5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260032-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cohort study included children with dietary and behavioral data from September 2011 to April 2018 in the CHILD Cohort Study, a prospective Canadian pregnancy cohort. Data analysis was done between February to July 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260032-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>UPF intake at age 3 years was assessed by a 112-item food frequency questionnaire and categorized using the NOVA system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260032-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Behavior was measured using the validated Child Behavior Checklist (CBCL; range 0-100; higher scores indicating more adverse symptoms). UPF intake measured as a continuous percentage of energy was examined using multivariable-adjusted linear regression models accounting for maternal diet, birth factors, infant feeding, and sociodemographic and early-childhood characteristics. A multivariable-adjusted substitution model estimated the association of statistically replacing 10% energy from UPF with minimally processed foods (MPF) among all children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260032-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2077 participants, 1092 (52.6%) were male; 1376 children (66.2%) were White, 480 children (23.1%) were multiracial, and 221 children (10.7%) were identified as another ethnic group. At age 3 years, UPF contributed a mean (SD) of 45.5% (11.6%) of total energy intake. At age 5 years, the mean (SD) CBCL scores were 44.6 (9.1) for internalizing, 39.6 (9.4) for externalizing, and 41.2 (9.0) for total behavior. Each 10% increase in energy from UPF was associated with higher CBCL internalizing (\u03b2\u2009=\u20090.81 [95% CI, 0.43 to 1.19]), externalizing (\u03b2\u2009=\u20090.47 [95% CI, 0.08 to 0.87]), and total (\u03b2\u2009=\u20090.64 [95% CI, 0.27 to 1.01]) scores. Substitution of 10% energy from UPF with MPF was associated with lower internalizing (\u03b2\u2009=\u2009\u20130.91 [95% CI, \u20131.33 to \u20130.49]), externalizing (\u03b2\u2009=\u2009\u20130.49 [95% CI, \u20130.93 to \u20130.06]), and total (\u03b2\u2009=\u2009\u20130.70 [95% CI, \u20131.12 to \u20130.29]) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260032-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cohort study of preschoolers in Canada, higher UPF intake was associated with adverse behavioral and emotional symptoms by age 5 years. These findings suggest that replacing UPF with MPF during the preschool years may support healthier behavioral development, with potential benefits for long-term mental health. These findings also support ongoing policy actions that promote MPF and underscore the need for early-life dietary interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.0434","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:00:20Z","timestamp":1772553620000},"page":"e260434","source":"Crossref","is-referenced-by-count":4,"title":["Ultraprocessed Food Consumption and Behavioral Outcomes in Canadian Children"],"prefix":"10.1001","volume":"9","author":[{"given":"Meaghan E.","family":"Kavanagh","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Nutrition, Harvard T.H. 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