Affective States and Ultra-Processed Food Intake in Youth With Overweight or Obesity: Evidence From Laboratory and Ecological Momentary Assessment Studies.

BACKGROUND: Ultra-processed foods (UPFs) are increasingly prevalent in children's diets and linked to adverse health outcomes, yet factors driving UPF intake in youth remain unclear. Negative affect may be one factor. OBJECTIVES: To examine associations between affective states and UPF intake in youth with overweight or obesity, using a laboratory study and a naturalistic study. METHODS: Study 1 included 46 girls (7-12 years) who completed counterbalanced negative and neutral mood inductions, followed by ad libitum access to a buffet of UPFs and minimally processed foods. Study 2 included 38 youth (8-14 years) who completed a 14-day ecological momentary assessment (EMA) protocol with repeated affect ratings and three 24-h dietary recalls. Foods were classified using NOVA; the outcome was percentage of energy from UPFs (%UPF). Study 1 used multilevel and regression models; Study 2 used lagged multilevel models. RESULTS: In Study 1, mood condition did not affect %UPF intake (F[1, 45] = 0.04, p = 0.843); however, within the negative mood condition, greater post-induction sadness predicted lower subsequent %UPF intake (b = -0.076, p = 0.015). In Study 2, affect did not prospectively predict subsequent %UPF intake, and %UPF intake did not predict subsequent affect (all p > 0.20). CONCLUSIONS: Acute sadness was associated with reduced, rather than increased, UPF intake in the laboratory, while naturalistic affect did not predict UPF intake. Given the modest sample sizes, these null and unexpected findings should be interpreted cautiously and require replication before informing intervention design.