Title: ULTRA-PROCESSED FOOD CONSUMPTION AND CHILDHOOD OBESITY: A SCOPING REVIEW OF RECENT EVIDENCE AND RESEARCH GAPS (2021–2025)

Background and Objective: Childhood obesity is a global public health concern, and increasing consumption of ultra-processed foods (UPFs) may contribute to excess adiposity among children and adolescents. However, evidence varies in study design, dietary assessment, and outcomes. This scoping review aimed to map evidence on the association between UPF consumption and childhood obesity and identify dietary exposure measures and outcomes reported in studies.

Methods and Materials: We conducted a scoping review following PRISMA-ScR. We searched PubMed and Scopus for studies published from January 2021 to December 2025. Studies involving children and adolescents assessing UPF consumption and reporting at least one obesity-related outcome were eligible. In total, 11 studies met the eligibility criteria. Data were synthesised descriptively across study characteristics, exposures, and outcomes.

Results: The 11 studies represented settings in Europe, Latin America, the Middle East, and East Asia. Seven were cross-sectional, and four were cohort or longitudinal studies. UPF consumption was assessed using food diaries, food frequency questionnaires, and 24-hour dietary recalls, with NOVA classification used in most studies. BMI was the most frequently reported outcome (n=9), followed by BMI-for-age Z-score (n=5), fat mass index (n=3), body fat percentage (n=3), and waist circumference (n=2). Most studies reported positive associations between UPF consumption and adiposity, although some showed null, mixed, or inverse findings.

Conclusion: Higher UPF consumption was predominantly associated with adverse obesity-related outcomes, while evidence from LMICs remains limited. Longitudinal studies using standardised measures are needed to strengthen evidence and guide childhood obesity prevention.