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Life sciences · Journal article
eBioMedicine · September 23, 2026
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Background Ultra-processed food (UPF) consumption has increased substantially among children worldwide and has been associated with early cardiovascular alterations. We aimed to identify plasma metabolomic profiles associated with UPF consumption in children aged 3–6 years and to assess their association with cardiovascular risk factors. Methods This cross-sectional analysis used baseline data from the Childhood Obesity Risk Assessment Longitudinal Study (CORALS), with children recruited between March 2019 and June 2022 through primary schools and health-care centres in seven Spanish cities. 1148 children were included (mean age 5.0 years [SD 1.1]; 50.6% girls) after exclusions due to medical conditions and incomplete or implausible dietary or metabolomic data. Energy-adjusted UPF intake (g/d) was assessed using a validated food frequency questionnaire and categorised with NOVA classification. 249 metabolites were quantified by NMR-based metabolomics, and lipid-related and amino acid-related profiles/scores were derived. A composite cardiovascular risk score (CVRs) was constructed by summing sex-specific, age-adjusted z-scores for fat-mass index, HDL-and LDL-cholesterol, triglycerides, mean arterial pressure, and Homoeostatic Model Assessment for Insulin Resistance. Findings 19 metabolites were associated with UPF consumption after false discovery rate correction (FDR). A lipid-related score was positively associated with CVRs (β = 0.511; 95% CI: 0.413–0.610; FDR <0.001) and the amino acid–related score was associated with a lower CVRs (β = −0.494; 95% CI: −0.667 to −0.321; FDR <0.001). Discrimination of cardiovascular risk beyond covariates alone was higher after inclusion of metabolomic scores, particularly when both scores were considered jointly (ΔAUC 0.092, 95% CI: 0.013–0.172; p=0.020). Interpretation In Spanish pre-schoolers UPF-related metabolomic profiles were associated with different cardiovascular risk factors. These diet-related metabolomic scores capture biological correlates relevant to early cardiovascular health and align with early-life metabolic pattering, supporting future longitudinal studies and prevention strategies. Funding CIBEROBN; Instituto de Salud Carlos III (ISCIII–FIS; EU ERDF/ESF); ISCIII PFIS.