ArticleEnvironment international2024
Ultra-processed and fast food consumption, exposure to phthalates during pregnancy, and socioeconomic disparities in phthalate exposures.
Article in Environment international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Ultra-processed Food Intake During Pregnancy and its Impact on Maternal Diet Quality and Weight Change: A Systematic Review of Observational Studies.Current nutrition reports · 2024Pooled it
- Prenatal exposure to nonpersistent endocrine disruptors and early childhood BMI: single pollutant and mixture analyses from the ECHO Program.Pediatric research · 2026Article
- Household food security and urinary phthalate metabolite concentrations among US adults: Evidence from NHANES 2003-2018.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Urinary phthalate metabolite concentrations and oxidative stress biomarkers in pre- and perimenopausal women from the Midlife Women's Health Study.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Hair-Based Biomonitoring of Phthalate Metabolites and Triclosan in Childhood: Links with Metabolic and Endocrine Disorders.Journal of xenobiotics · 2026Article
- Maternal Diet During Pregnancy and Offspring Health: Current Evidence on Dietary Patterns, Microbiota, and Developmental Programming.Nutrients · 2026Review
- Dietary guidelines adherence and pregnancy exposure to 10 classes of priority chemicals: an observational study in the Environmental influences on Child Health Outcomes Cohort.The American journal of clinical nutrition · 2026Observational
- Development and Exploratory Evaluation of the Dietary Plastic Exposure Score for Mexican Populations in University Students.Nutrients · 2026Article
- Longitudinal patterns of urinary biomarkers of placental and renal function in pregnancy and associations with early pregnancy exposure to phthalates and replacements.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Periconceptional ultra-processed food consumption in women and men, fertility, and early embryonic development.Human reproduction (Oxford, England) · 2026Article
- Association of umbilical cord blood phthalate levels with neonatal growth parameters in term pregnancies.BMC pediatrics · 2026Article
- Occupation and urinary phthalate metabolite concentrations in a national survey of adults in Canada.Environmental health : a global access science source · 2026Article
- Ultra-Processed Foods and the Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, and Translational Evidence.Nutrients · 2026Review
- Age-Specific Association Between Urinary Phthalate Metabolites and Diabetes Mellitus: Findings from the Korean National Environmental Health Survey Cycle 4 (2018-2020).Healthcare (Basel, Switzerland) · 2026Article
- Is obesity the missing link? Ultra-processed foods and metabolic and reproductive outcomes: a narrative review.Frontiers in nutrition · 2026Review
- Reverse-engineered exclusive enteral nutrition as induction therapy in pediatric Crohn's disease: Effects on environmental toxin exposure.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2026Article
- Association of ultra-processed food consumption with all-cause and cause-specific mortality: population-based cohort study.Frontiers in nutrition · 2026Article
- Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data.Annals of medicine · 2025Article
- Environmental Toxicants in the Hispanic Community Epigenetically Contributing to Preeclampsia.Cardiovascular toxicology · 2025Review
- Article
Corrections and comments
- Erratum issued
Authors and funding
13 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundConsuming ultra-processed foods may increase exposure to phthalates, a group of endocrine disruptors prevalent in food contact materials.
objectivesInvestigate associations between ultra-processed food intake and urinary phthalates during pregnancy, and evaluate whether ultra-processed foods mediate socioeconomic disparities in phthalate exposures.
methodsIn a socioeconomically diverse sample of 1031 pregnant women from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study in the urban South, the Block Food Frequency Questionnaire was administered and urinary phthalate metabolites were measured in the second trimester. Linear regressions modeled associations between phthalates and overall ultra-processed food consumption, individual ultra-processed foods, and exploratory factor analysis dietary patterns. Causal mediation analyses examined whether ultra-processed food intake mediates relationships between socioeconomic disparities and phthalate exposures.
resultsUltra-processed foods constituted 9.8-59.0 % (mean = 38.6 %) of participants' diets. 10 % higher dietary proportion of ultra-processed foods was associated with 13.1 % (95 %CI: 3.4 %-22.9 %) higher molar sum concentrations of di(2-ethylhexyl) phthalate metabolites (ΣDEHP). 10 % higher consumption of minimally-processed foods was associated with lower ΣDEHP (10.8 %: 3.4 %-22.9 %). Ultra- and minimally-processed food consumption were not associated with non-DEHP metabolites. Standard deviation higher consumptions of hamburger/cheeseburger, French fries, soda, and cake were associated with 10.5 % (4.2 %-17.1 %), 9.2 % (2.6 %-16.2 %), 7.4 % (1.4 %-13.6 %), and 6.0 % (0.0 %-12.4 %), respectively, higher ΣDEHP. Exploratory factor analysis corroborated positive associations of processed food with ΣDEHP, and uncovered a healthy dietary pattern associated with lower urinary ΣDEHP, mono(2-ethyl-5-hydroxyhexyl) (MEHHP), mono(2-ethyl-5-carboxypentyl) (MECPP), mono(2-carboxymethylhexyl) (MCMHP), and mono-isononyl (MINP) phthalates. Significant indirect effects indicated that lower income and education levels were associated with 1.9 % (0.2 %-4.2 %) and 1.4 % (0.1 %-3.3 %) higher ΣDEHP, respectively, mediated via increased ultra-processed food consumption.
conclusionsConsumption of ultra-processed foods may increase exposure to phthalates. Policies to reduce dietary phthalate exposures from food packaging and processing are needed, as socioeconomic barriers can preclude dietary recommendations as a sole means to reduce phthalate exposures.
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