Moral Event Horizon: Esteban García repeatedly rapes Alba. Not only rapes her, but does so while mocking her for being a Trueba.
Pragmatic Adaptation: The movie faithfully presents the main storyline, personalities and motivations, but compresses a lot of the plot and removes about half of the characters. Events on the book unfold for about 50 years, but the movie storyline lasts 30 at most. The most noticeable changes are that Nicolás and Jaime are removed, and the plots of Blanca and Alba are compressed on the former. Alba still appears, but only as a small girl instead of her young adult incarnation.
Squick: Quite a bit of it, but almost nothing can top the description of Esteban's mother Ester's putrefied legs when Esteban returns to her. It's so horrible that it's Esteban, normally a super stoic and macho Jerk Ass, pretty much collapses in Berserker Tears when he leaves the room, launching into an angry and frustrated rant about how he's powerless to do anything for his mother's sake even after ten years of working himself sick to finally pull the Truebas out of poverty.
Nearly all of the graphic sex scenes. Mostly due to the fact that almost all of them are nonconsensual.