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Explore The Atlantic Archive Play The Atlantic crossword. The Print Edition Latest Issue Past Issues. Search The Atlantic. Quick Links. Sign In Subscribe. Olga Khazan is a staff writer at The Atlantic. She is the author of Weird: The Power of Being an Outsider in an Insider World.

She has also written for The New York Times , the Los Angeles Times , The Washington Post , and other publications. She writes a Substack on personality change. Among them, a total of 97 children were excluded which included 4 children who did not complete the food consumption survey and 93 children who did not finish the cognitive function assessment.

Finally, children were included for the further analysis. Ethical approval was granted by Guangxi Medical University, China No. The specific cognitive function domains included Verbal Comprehension Index VCI, a measure of the ability to understand, learn, and retain verbal information, as well as to use language to solve novel problems , Visual Spatial Index VSI, a measure of the ability to understand visual information and to solve novel abstract visual problems , Fluid Reasoning Index FRI, the test measures fluid intelligence, non-verbal concept formation, analysis, and problem-solving, and integration ability, etc.

The Full-Scale Intelligence Quotient FSIQ is a composite score of the above five domains scores VCI, VSI, FRI, WMI, and PSI , which represents the general intellectual ability of the subject.

The FSIQ and single index was standardized to have a mean of and a standard deviation of 15, ranging from 40 to Higher values of the FSIQ or the single index represent a better test performance, and therefore stronger cognitive abilities.

In addition, an FSIQ of less than 80 scores were defined as having a cognitive deficit 8 , 32 , Regarding assessments, all examiners were trained professionally and certified before the test. The assessments were administered by well-trained examiners one-on-one, without any guidance from teachers or guardians in a standard and quiet assessment room.

The ultraprocessed foods in the present study included chocolate, biscuits, candy, fast-food French fries or hamburgers , ice cream, sugar-sweetened beverage SSB , and sweet bakery products. Sociodemographic and family characteristics were collected via a face-to-face interview questionnaire, including child sex male or female , child age years , residence area rural or urban , siblings 0.

Categorical variables were described in frequencies and proportions, while continuous variables were described in terms of means and standardized deviations. They were assumed to be missing at random and imputed with the multivariate imputation by chained equations MICE method for five times.

Continuous variables were imputed using predictive mean matching, and categorical variables using logistic regression factor 2 levels The Chi-square test and Wilcoxon rank sum test was used to determine whether there were any statistically significant differences of the covariates between cognitive deficits and non-cognitive deficits.

The multiple linear regression and logistic regression models were applied to analyze the relationship between ultraprocessed food consumption and cognitive function and the risk of cognitive deficit, respectively.

Specifically, two models were constructed. Crude model did not adjust any factors. Adjusted model adjusted the potential confounders. A Directed Acyclic Graph 1 was used to inspect possible pathways for confounders In addition, covariates were selected a priori based on the previous literature Finally, the following variables were selected as confounders: child age, residence area, siblings, parental education levels, annual household incomes, outdoor exercise time, parental accompaniment time, daily sleeping time, breastfeeding duration, and secondhand smoke Figure 1.

All statistical analyses were performed using R 4. Forest plots were produced using the GraphPad Prism 8. Figure 1. Directed acyclic graph DAG for the relationship of ultraprocessed foods consumption with cognitive function of children at age 4—7 years.

Of the children, Most of the children were from urban environments Among them, A total of 83 Especially, higher incidence of cognitive deficit was observed among children who were from urban environments, had siblings, had parents with junior high school or below education level, and had lower annual household incomes.

Table 1. First, we applied a multiple linear regression model to assess the association between frequent ultraprocessed food consumption independent variables and FSIQ scores dependent variables Table 2. Table 2. Associations between frequent ultraprocessed foods consumption and FSIQ scores among children aged 4—7 years.

Second, we applied logistic regression models, including all children, to examine the association between frequent consumption of ultraprocessed foods independent variables and risk of cognitive deficit dependent variables Table 3.

Table 3. Associations between frequent ultraprocessed foods consumption and the risk of cognitive deficit among children aged 4—7 years.

The associations between frequent ultraprocessed food consumption and the specific cognitive domains, including VCI, VSI, FRI, WMI, and PSI scores, are also shown in Figure 2.

Figure 2. Associations between frequent consumption of ultraprocessed foods and different domain scores of the Wechsler Preschool and Primary Scale of Intelligence test among children aged 4—7 years. Crude model A was not adjusted for any variables. Adjusted model B was adjusted for child age, residence area, siblings, parental education levels, annual household incomes, outdoor exercise time, parental accompaniment time, daily sleeping time, breastfeeding duration, and secondhand smoke.

SSB, sugar-sweetened beverage; VCI, Verbal Comprehension Index; VSI, Visual Spatial Index; FRI, Fluid Reasoning Index; WMI, Working Memory Index; PSI, Processing Speed Index. In order to analyze the combined effects of frequent consumption of the seven ultraprocessed foods on the cognitive function of children, we calculated the number 0—7 of frequent consumption of ultraprocessed foods and divided the children into frequent consumption of 0—1 and 2—7 ultraprocessed foods.

Table 4 shows the multiple linear regression analysis of the associations between the numbers of ultraprocessed foods types of frequent consumption and specific cognitive function domains. In the crude models, we did not find any significant associations.

Furthermore, we also analyzed the association between the numbers of ultraprocessed food types of frequent consumption and cognitive function and found there were no significant associations no matter FSIQ scores or risk of cognitive deficit Table 5.

Table 4. Associations between the numbers of ultraprocessed foods types of frequent consumption and specific cognitive function domains among children aged 4—7 years.

Table 5. Associations between the numbers of ultraprocessed foods types of frequent consumption and cognitive function among children aged 4—7 years.

In the present study, we employed a cross-sectional data from the Guangxi Zhuang birth cohort to assess seven common ultraprocessed foods in the cognitive function of Chinese children aged 4—7.

We found children who frequently consumed candy and sweet bakery products had a significant decrease in both VCI and FSIQ scores. However, only frequent consumption of candy was significantly associated with an increased risk of cognitive deficit.

Furthermore, frequently consuming more than two kinds of ultraprocessed food showed a significant association with decreased VCI scores. These findings suggested the individual and combined effects of the seven ultraprocessed foods on cognitive function among children aged 4—7 years, providing new evidence from China on the association between ultraprocessed food consumption and child cognitive development.

The ultraprocessed foods in this survey are mainly those high in saturated fat and added sugar. We showed a combined effects of these ultraprocessed food intake on children cognitive function in VCI domain, which was in line with findings of several prior epidemiology studies that ultraprocessed diet patterns with high fat and sugar content impact cognitive function 17 , 18 , 20 , 21 , Animal evidence also supports the findings that these ultraprocessed food intakes may adversely influence cognitive development.

For example, added sugars, especially high-fructose corn syrup, may adversely influence hippocampal function during critical periods of development in adolescent rats However, we found only frequent consumption of candy and sweet bakery products was associated with decreased cognitive scores.

Results from SSB consumption were different from previous research, in which the authors suggested SSB consumption was negatively associated with executive function 26 , Executive function is a generic term for a range of interrelated, higher-level of cognitive abilities that are necessary for complex reasoning, goal-oriented activity, and self-regulatory behavior.

The inconsistent findings may be due to the difference of population e. The latest studies have shown that that candy is the most common sources of added sugar among children and adolescent 42 , Recently, animal studies have shown that the potentially harmful effects of long-term candy consumption on memory deficits and hippocampal neurogenesis were sufficient to reduce hippocampal levels of brain-derived neurotrophic factor BDNF and spatial learning performance Given these finding together with the impact of candy on cognitive function, we should pay much more attention to the regulation of these food sources.

In the present study, we observed that individually the categories candy and sweet bakery products and combined effects of the seven ultraprocessed foods on cognitive function were mainly associated with decreasing VCI scores, which represented the ability to understand, learn, and retain verbal information, as well as to use language to solve novel problems.

Our findings are also in line with two previous studies 20 showing that ultraprocessed dietary pattern snack pattern was negatively associated with lower cognitive ability, especially in verbal ability.

During childhood, parenting and the family environment significantly impact verbal skills more than other performance abilities Evidence shows that the prefrontal cortex and hippocampus region are critical role in verbal communication and comprehension 46 , Animal studies have shown that sugar could induce increases in inflammation mediators in the hippocampal such as IL-6 and IL-1β , as well as decrease antioxidant enzymes in the frontal cortex These findings lend some support to the results of the present study potentially suggesting that ultraprocessed food consumption may impact regions of the brain associated with verbal function.

However, more sensitive measures such as functional magnetic resonance imaging fMRI techniques should be employed to assess this potential relationship further. The present study provides new evidence of the association between ultraprocessed foods consumption and cognitive performance among children aged 4—7 years.

However, the following limitations should be taken into consideration when interpreting the results. First, the study relies on a cross-sectional data, which could not infer the causal relationship between ultraprocessed food consumption and cognitive development.

Second, the questionnaire method in this study may cause recall bias, so we measured the frequency of consumption of ultraprocessed foods on a weekly basis, rather than monthly or yearly, mainly to reduce the influence of recall bias. Finally, assessing the cognitive performance at a single point in time may influence misclassification bias.

However, in order to avoid the risk of bias as much as possible, we required testers to undergo strict training and obtain official certification. We ensured that all testers followed the evaluation procedures strictly, such as evaluating children individually in a standardized testing room.

Future studies are needed to establish the causal relationship between ultraprocessed food consumption and cognitive development perhaps using more sensitive techniques such as brain imaging.

It is necessary for scientists and policymakers to make targeted efforts to reduce ultraprocessed food consumption in children due to their potentially harmful effects on both physical and brain health including cognitive and emotional function.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. This study was approved by the Ethical Committee of Guangxi Medical University No.

The studies were conducted in accordance with the local legislation and institutional requirements. SL: Data curation, Funding acquisition, Project administration, Resources, Supervision, Writing-review and editing, Writing—original draft.

CM: Investigation, Methodology, Visualization, Writing—original draft. LL: Formal analysis, Methodology, Software, Writing—review and editing. JL: Supervision, Writing—review and editing.

Nick Bellissimo School of Nutrition, Ryerson University. Cognition is an overall term used to describe the mental skills people use to acquire, process, store, and transform information to carry out everyday tasks.

Cognition is an outcome of brain function, and is composed of multiple elements, including perception, attention, memory, executive functions i. The effects of overall diet and specific dietary components on cognition have been assessed in many animal studies, and in some human studies.

Research in both humans and animals has included cognitive outcomes on one hand like performance on tasks, and on the other hand molecular and chemical changes in brain regions. The information reviewed and discussed below are related to human studies.

The human brain uses a large amount of energy, and typically uses glucose a component of sucrose sugar as its sole source of energy for functioning. Glucose can be derived from dietary carbohydrate, synthesized in the body from other substrates such as amino acid, or released from glycogen storage in the liver and muscle.

The brain can also use ketones as an alternative source of energy when carbohydrate glucose supply is low; ketones are generated from metabolizing fatty acids. Interestingly, the adult brain uses glucose at the same rate that skeletal muscles use glucose during exercise 4.

Low-carbohydrate ketogenic diets have become popular over the years, however research has shown conflicting results on cognition, with a majority of data coming from animal models rather than humans, making translation into recommendations more difficult. Convincing evidence associates the ketogenic diet low carbohydrate, high fat and adequate protein and the treatment of epilepsy 5 , but it is beyond the scope of this article on cognition.

Glucose is the most common circulating sugar in the bloodstream, is the main fuel source for cells in the body, and is the primary sugar used by the brain for energy 6. Specifically, the human body requires a minimum of g of glucose per day 7 , which is based on the amount the brain needs to function.

The brain uses glucose from stores in the body, or uses glucose from the foods that people eat by breaking down carbohydrates starches and sugars into sucrose, which is then further broken down into glucose and fructose as shown in the diagram below.

Fructose is metabolized in the liver, and the metabolic pathways between glucose and fructose differ 6. Figure 1. The brain relies primarily on glucose to function. Restricting the brain's glucose supply can impair memory and ability to focus.

The body does not require fructose for energy, and there has been considerable speculation about the role of fructose and excess fructose consumption and health.

Some studies evaluating fructose and cognition were reviewed 8 , and the totality of evidence suggests there is a significant confounding effect of total energy intake, which makes it difficult to isolate the effect of fructose 9.

Overall, authors summarize that there is currently a lack of high quality evidence directly assessing the role of fructose and cognition 9. The consumption of sugars have different short minutes to hours and long-term months and years cognition-related outcomes.

Available evidence from studies with humans suggests that sugars have positive short-term effects for memory and learning processes 10,