Navigating sexual health, fertility, and adult wellness in individuals with Duchenne muscular dystrophy: Current standards of care and future directions.

Ultra-processed foods (UPFs) are industrial formulations designed to enhance food palatability, convenience, and shelf life. In the US, they account for more than half of total energy intake among children aged 1–5 years. Infancy and early childhood represent a period of heightened neuroplasticity, during which diet quality may influence neurodevelopment. Early dietary patterns, including higher UPF consumption, tend to persist across development, suggesting that exposure initiated during this sensitive period may be sustained over time. Observational studies have reported associations between higher UPF exposure and poorer physical and mental health, though causality remains unestablished, and it is unclear whether these associations reflect nutritional composition or food processing per se. As neurodevelopment may represent a pathway linking early diet to later health outcomes, these gaps support examining whether early-life UPF exposure is associated with neurodevelopment. Higher UPF intake has been associated with adverse cognitive and brain-related outcomes. In adults, higher intake has been linked to cognitive impairment and dementia, while in children and adolescents, inverse associations between UPF-subtypes (e.g., fast foods) and attention, inhibitory control, and working memory have been reported. Neuroimaging evidence, however, remains limited and inconsistent: higher UPF intake has been associated with lower intracellular volume fraction in subcortical regions in adults, whereas in children, higher intake of added sugars, common in UPFs, has been linked to greater hippocampal volumes. While mechanisms remain unclear, animal studies suggest roles for altered neuroplasticity and neuroimmune signaling. Longitudinal studies further note that early variation in subcortical regions is associated with poorer later physical and mental health. Together, these findings motivate investigation of associations between early UPF intake and brain development. Interpretation of existing evidence is limited by methodological constraints. UPFs overlap with foods high in added sugars, sodium, and unhealthy fats, and many studies rely on restricted definitions (e.g., SSBs, snacks), complicating the separation of nutritional composition from processing. As a result, observed associations may reflect underlying nutritional content rather than processing per se, and there is no clear consensus on whether processing alone has adverse health effects. In addition, most pediatric studies rely on single dietary assessments, limiting characterization of cumulative exposure and critical windows of susceptibility Consequently, it remains unclear when neurocognitive associations with UPF first emerge.