Ultra-Processed Food Linked to a Chemical That Could Be Dangerous in Pregnancy, Study Says

These foods increase exposure to phthalates. Experts weigh in on what pregnant people can do.

Fact checked by Sarah Scott

What an expecting parent should and shouldn’t consume during pregnancy can sometimes feel overwhelming. A new study is now highlighting why ultra-processed and fast foods should be on the list of what to avoid.

The focus isn’t on the nutrition though, but the fact that these foods may increase exposure to phthalates, a group of chemicals that make plastics more durable, according to a recent study published in the journal Environment International.

The research found phthalates may be released from the wrapping and packaging of ultra-processed foods, as well as the plastic gloves used by fast food workers handling them. The phthalates can in turn get into the bloodstream and travel into the placenta, which may cause negative outcomes for both the fetus and the pregnant person.

The idea that phthalates can cause harm isn’t new. These are known endocrine disruptors and can be a cause for concern whether one is pregnant or not.

“They can interfere in normal hormonal functioning, causing an increased risk of conditions, such as obesity, diabetes, high blood pressure, and infertility,” explains Sameera Mokkarala, MD, MPH, an OB-GYN practicing in Pennsylvania and a Fellow with Physicians for Reproductive Health. “In pregnancy, as noted in the study, high exposure to phthalates can be associated with increased risk of low infant birth weight, preterm birth, and other child health outcomes.”

It can be concerning, but experts say there are ways to avoid phthalates during pregnancy.

Breaking down the Study on Phthalates and Pregnancy

The study looked at 1,031 socioeconomically diverse pregnant women in the urban South. Metabolites of phthalates were measured through their urine in the second trimester. Researchers found higher phthalate exposure in those who consumed ultra-processed foods, which accounted for between about 10% to 59% of participants.

What are ultra-processed foods, anyway? These have chemicals and preservatives meant to increase shelf life and appearance. These packaged foods along with fast foods include hamburgers, French fries, soda, and cake mixes, among others, as the study points out.

The study says low-income households may be disproportionately impacted by food-associated chemical exposures—they are more likely to live in food deserts or areas without proper access to affordable and nutritious food. More than 18 million people in the U.S. live more than a mile or 10 miles from a supermarket, according to the U.S. Department of Agriculture.

On top of that, healthy food can be expensive. Research in 2017 found healthier foods were twice as expensive as unhealthier foods. That’s only escalated since the pandemic with 2023 research showing the recommended diet cost increased by nearly 18% as prices of healthy foods shot up by almost 13%.

Policies to help limit phthalate exposures from food packaging and processing need to be implemented, the study concludes. Socioeconomic barriers, it explains, can make it impossible to reduce phthalate exposure through dietary recommendations.

The study has some limitations, though. “What the study can’t tell us is how much of these foods a person would need to consume in order to be at significantly higher risk for an abnormal pregnancy outcome,” says Dr. Mokkarala.

Alexander Kucherov, MD, a fertility specialist at Illume Fertility who is board-certified in Obstetrics & Gynecology and Reproductive Endocrinology & Infertility, also points out, “It does not make any conclusions regarding the pregnancy outcomes of the patients involved and was not evaluating those outcomes either.”

Why Phthalate Exposure During Pregnancy Can Be Harmful

Phthalate exposure during pregnancy—and exposure at any point in life for anyone—can cause issues.

Exposure can occur through skin absorption, inhalation, and ingestion. Aside from plastics, phthalates are found in hundreds of products, including vinyl flooring, lubricating oils, and personal-care products, according to the Centers for Disease Control and Prevention (CDC). Phthalates have also been found in children's clothing.

During pregnancy, research has found phthalate exposure can lead to preterm birth, low birth weight, pregnancy loss, and gestational diabetes. Another study found it can increase blood pressure in late pregnancy. But it’s not so black and white.

“It is difficult to say exactly what level of exposure is likely to be problematic,” says Dr. Mokkarala.

The reality is “we can't reduce every toxin from our bodies,” says James Nodler, MD, a physician with CCRM Fertility Clinic in Houston, who is board-certified in Reproductive Endocrinology and Infertility. 

How To Avoid Phthalate Exposure During Pregnancy

Phthalates are so widely used in today’s society making total elimination nearly impossible. There is some good news, though. “Since phthalates do not stay in our bodies long-term, however, behavioral changes to limit exposure can be impactful,” says Dr. Mokkarala.

Experts say the best way to minimize phthalate exposure during pregnancy is by focusing on the foods we eat. That means consuming more whole foods—aka ones that have not been processed. Think fruits and vegetables (avoid pre-peeled or cut produce packed in plastic) and plant-based proteins.

You'll want to stay away from red meats, or limit those to once a month, says Dr. Nodler, since they have "been shown to be incredibly pro-inflammatory, [and can cause an] increased risk of miscarriage, increased risk of gestational diabetes, and hypertension problems in pregnancy.”

Dr. Nodler points out that ultra-processed foods in general can be a health risk. New research published in the medical journal BMJ linked ultra-processed foods to 32 health issues, including cancer, as well as cardiovascular, gastrointestinal, and metabolic problems.

But don’t stress if you enjoy chowing down on cheeseburgers or other fast and processed foods. All the experts emphasize that having these foods from time to time is OK.

“It is important to note that eating a cheeseburger and French fries once in a while will not cause any major issues,” says Dr. Kucherov. “The repeated exposure is the main concern.”

Dr. Mokkarala agrees: “Nearly all foods are reasonably safe to eat in pregnancy if eaten in moderation. The foods commented on in the study—fast foods and pre-prepared or packaged foods made outside the home—don’t need to be eliminated from a pregnant person’s diet entirely, but it’s reasonable for all people to strive to limit their intake whether they’re pregnant or not.”

It all sounds simple enough, right? Not always.

“Due to structural factors such as the locations of grocery stores with non-processed food and the increased cost of those foods relative to processed foods, which tend to be cheaper, this is not a choice that is available to all or even most people,” says Dr. Mokkarala. “Additionally, the ability to make a meal out of purchased ingredients (rather than buying a pre-prepared meal) relies on time that many people simply do not have due to their work schedules.”

Again, changes need to be made on a policy level to ensure nutritious and safe foods make their way to all neighborhoods and households, the experts point out. But aside from pressuring local politicians to make change, here’s what else you can do at home to minimize exposure during pregnancy and beyond.

• Seek out local organizations. Dr. Nodler says trying to cook at home with healthy ingredients is important. If you live in a food desert, local resources can help. Dr. Nodler points to community gardens, as well as Community Supported Agriculture where you can find local farms. You can also scan the Environmental Working Group’s Dirty Dozen—an annual list of the fruits and vegetables with the most pesticides—to avoid other chemicals too.

• Don’t heat your food in plastic containers. “This can increase the chance of phthalates leaching into the food,” says Dr. Mokkarala. Opt for storing items in glass containers, paper or cloth bags, or other non-plastics. But if you do have to buy plastics at home, look for ones that are #2, #4, and #5, which are less likely to contain phthalates.

• Avoid household items with fragrances. “Phthalates can be used as solvents in perfumes, air fresheners, and other consumer scents,” explains Dr. Mokkarala.

• Pay attention to what products you come in contact with. “Pregnant people should buy personal care products that are labeled phthalate-free,” says Andrei Rebarber, MD, Director of the Division of Maternal-Fetal Medicine at Mount Sinai West and President of Maternal-Fetal Medicine Associates, PLLC. Plus, avoid paper receipts from stores since those “contain phthalate and BPA (another chemical) in far greater amounts than even some highly processed foods,” adds Dr. Mokkarala.

• Have good home ventilation. “Phthalates can adhere to dust particles and be consumed off surfaces,” says Dr. Mokkarala. Open your windows and use fans or an air filtration system whenever you can.
  

If you have any concerns about phthalates during pregnancy and beyond, make sure to also speak with your health care provider. 

“While it may be impossible to avoid phthalates and other endocrine disruptors entirely," confirms Dr. Mokkarala, "there are certainly ways to limit exposure."

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