Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Pediatrics

Determining the interplay of prenatal parental BMI in shaping child BMI trajectories: the CHILD Cohort Study

International Journal of Obesity volume 49, pages 1608–1615 (2025)Cite this article

Subjects

Abstract

Background

Obesity is a major public health concern affecting millions of people globally. Early identification of individuals susceptible to obesity is crucial for reducing the burden of obesity. Obesity is often defined based on body-mass-index (BMI), and tracking BMI trajectories from early childhood offers a valuable tool for risk stratification. Although the role of mothers in shaping these trajectories is well-recognized, the paternal influence on childhood obesity development remains a knowledge gap. We hypothesize that children of fathers with obesity have higher odds of being in the rapid BMI growth trajectory with stronger estimates when the mother is also with overweight or obesity.

Methods

We analyzed data from the Canadian CHILD Cohort Study, a pregnancy cohort in which both parents were enrolled in early pregnancy when BMI was assessed. The child’s BMI was repeatedly collected from birth to age five. We used group-based trajectory modeling to identify offspring BMI z-score (BMIz) trajectory groups (age-and-sex standardized) and weighted multinomial logistic regression analysis to determine the associations between prenatal paternal BMI and offspring growth trajectories, stratified by maternal weight categories.

Results

Among 2 238 participants, the mean prenatal paternal BMI was 27.44 (SD = 4.77), and 22.83% of fathers were with obesity. The four identified offspring BMIz trajectories were: low stable (n = 220, 9.83%), normative (n = 1 356, 60.59%), high stable (n = 572, 25.56%), and rapid BMIz growth trajectory (n = 90, 4.02%). Children of normal-weight mothers and fathers with obesity had 1.86 higher odds (OR: 1.86; 95%CI: 1.22–2.84) of being classified in the rapid growth BMIz trajectory, compared to children of normal-weight fathers. The odds of being in the rapid growth BMIz trajectory were higher when both mothers and fathers were with obesity (OR: 4.35; 95%CI: 2.65–7.14).

Conclusions

Children of fathers with obesity had higher odds of being in the rapid BMI growth trajectory, particularly when also the mother was with overweight or obesity. These results support the need for preconception advice and interventions for couples to optimize their offspring’s health.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Prenatal paternal BMI and offspring BMIz trajectories in the CHILD Cohort Study.
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

A list of variables available in the CHILD Cohort Study is available at https://childstudy.ca/for-researchers/study-data/. Researchers interested in collaborating on a project and accessing CHILD Cohort Study data should contact the Study’s National Coordinating Centre (NCC) to discuss their needs before initiating a formal request. To contact the NCC, please email child@mcmaster.ca. More information about data access for the CHILD Cohort Study can be found at https://childstudy.ca/for-researchers/data-access/.

References

  1. World Health Organization. Obesity and Overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (World Health Organization, 2024).

  2. Umer A, Kelley GA, Cottrell LE, Giacobbi P, Innes KE, Lilly CL. Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis. BMC Public Health. 2017;17:683.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev J Int Assoc Study Obes. 2016;17:56–67.

    Article  CAS  Google Scholar 

  4. Péneau S, Giudici KV, Gusto G, Goxe D, Lantieri O, Hercberg S, et al. Growth trajectories of body mass index during childhood: associated factors and health outcome at adulthood. J Pediatr. 2017;186:64–71.e1.

    Article  PubMed  Google Scholar 

  5. Araújo J, Severo M, Barros H, Mishra GD, Guimarães JT, Ramos E. Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors. Int J Obes 2005. 2015;39:1443–9.

    Google Scholar 

  6. Ahanchi NS, Ramezankhani A, Munthali RJ, Asgari S, Azizi F, Hadaegh F. Body mass index trajectories from adolescent to young adult for incident high blood pressure and high plasma glucose. PLOS ONE. 2019;14:e0213828.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Reyna ME, Petersen C, Dai DLY, Dai R, Becker AB, Azad MB, et al. Longitudinal body mass index trajectories at preschool age: children with rapid growth have differential composition of the gut microbiota in the first year of life. Int J Obes. 2022;46:1351–8.

    Article  Google Scholar 

  8. Barker DJ. The fetal and infant origins of adult disease. BMJ. 1990;301:1111.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Heslehurst N,Vieira R,Akhter Z,Bailey H, Slack E,Ngongalah L, et al. The association between maternal body mass index and child obesity: a systematic review and meta-analysis. PLOS Med. 2019;16:e1002817.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Baidal JAW, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk factors for childhood obesity in the first 1000 days: a systematic review. Am J Prev Med. 2016;50:761–79.

    Google Scholar 

  11. Hunt KJ, Ferguson PL, Neelon B, Commodore S, Bloom MS, Sciscione AC, et al. The association between maternal pre-pregnancy BMI, gestational weight gain and child adiposity: a racial-ethnically diverse cohort of children. Pediatr Obes. 2022;17:e12911.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gete DG, Waller M, Mishra GD. Pre-pregnancy diet quality is associated with lowering the risk of offspring obesity and underweight: finding from a prospective cohort study. Nutrients. 2021;13:1044.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Linabery AM, Nahhas RW, Johnson W, Choh AC, Towne B, Odegaard AO, et al. Stronger influence of maternal than paternal obesity on infant and early childhood body mass index: the Fels Longitudinal Study. Pediatr Obes. 2013;8:159–69.

    Article  CAS  PubMed  Google Scholar 

  14. Gaillard R, Steegers EAP, Duijts L, Felix JF, Hofman A, Franco OH, et al. Childhood cardiometabolic outcomes of maternal obesity during pregnancy: the Generation R Study. Hypertens Dallas Tex 1979. 2014;63:683–91.

    CAS  Google Scholar 

  15. Voerman E, Santos S, Patro Golab B, Amiano P, Ballester F, Barros H, et al. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis. PLoS Med. 2019;16:e1002744.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sharp GC, Lawlor DA. Paternal impact on the life course development of obesity and type 2 diabetes in the offspring. Diabetologia. 2019;62:1802–10.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Soubry A, Guo L, Huang Z, Hoyo C, Romanus S, Price T, et al. Obesity-related DNA methylation at imprinted genes in human sperm: results from the TIEGER study. Clin Epigenet. 2016;8:51.

    Article  Google Scholar 

  18. Soubry A, Murphy SK, Wang F, Huang Z, Vidal AC, Fuemmeler BF, et al. Newborns of obese parents have altered DNA methylation patterns at imprinted genes. Int J Obes 2005. 2015;39:650–7.

    CAS  Google Scholar 

  19. Potabattula R, Dittrich M, Schorsch M, Hahn T, Haaf T, El Hajj N. Male obesity effects on sperm and next-generation cord blood DNA methylation. PLoS ONE. 2019;14:e0218615.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Soubry A, Schildkraut JM, Murtha A, Wang F, Huang Z, Bernal A, et al. Paternal obesity is associated with IGF2hypomethylation in newborns: results from a Newborn Epigenetics Study (NEST) cohort. BMC Med. 2013;11:29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Billah MM, Khatiwada S, Morris MJ, Maloney CA. Effects of paternal overnutrition and interventions on future generations. Int J Obes 2005. 2022;46:901–17. May

    Google Scholar 

  22. Tomar A, Gomez-Velazquez M, Gerlini R, Comas-Armangué G, Makharadze L, Kolbe T, et al. Epigenetic inheritance of diet-induced and sperm-borne mitochondrial RNAs. Nature. 2024;630:1–8.

  23. Kaati G, Bygren LO, Edvinsson S. Cardiovascular and diabetes mortality determined by nutrition during parents’ and grandparents’ slow growth period. Eur J Hum Genet. 2002;10:682–8.

    Article  CAS  PubMed  Google Scholar 

  24. Li J, Yang Q, An R, Sesso HD, Zhong VW, Chan KHK, et al. Famine and trajectories of body mass index, waist circumference, and blood pressure in two generations: results from the CHNS from 1993-2015. Hypertension. 2022;79:518–31.

    Article  CAS  PubMed  Google Scholar 

  25. Yao WY, Li L, Jiang HR, Yu YF, Xu WH. Transgenerational associations of parental famine exposure in early life with offspring risk of adult obesity in China. Obesity. 2023;31:279–89.

    Article  CAS  PubMed  Google Scholar 

  26. Ng SF, Lin RCY, Laybutt DR, Barres R, Owens JA, Morris MJ. Chronic high-fat diet in fathers programs β-cell dysfunction in female rat offspring. Nature. 2010;467:963–6.

    Article  CAS  PubMed  Google Scholar 

  27. Carone BR, Fauquier L, Habib N, Shea JM, Hart CE, Li R, et al. Paternally induced transgenerational environmental reprogramming of metabolic gene expression in mammals. Cell. 2010;143:1084–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Watkins AJ, Dias I, Tsuro H, Allen D, Emes RD, Moreton J, et al. Paternal diet programs offspring health through sperm- and seminal plasma-specific pathways in mice. Proc Natl Acad Sci USA. 2018;115:10064–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Watkins AJ, Sinclair KD. Paternal low protein diet affects adult offspring cardiovascular and metabolic function in mice. Am J Physiol-Heart Circ Physiol. 2014;306:H1444–52.

    Article  CAS  PubMed  Google Scholar 

  30. de Castro Barbosa T, Ingerslev LR, Alm PS, Versteyhe S, Massart J, Rasmussen M, et al. High-fat diet reprograms the epigenome of rat spermatozoa and transgenerationally affects metabolism of the offspring. Mol Metab. 2016;5:184–97.

    Article  PubMed  Google Scholar 

  31. Northstone K, Golding J, Davey Smith G, Miller LL, Pembrey M. Prepubertal start of father’s smoking and increased body fat in his sons: further characterisation of paternal transgenerational responses. Eur J Hum Genet. 2014;22:1382–6.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Miliku K, Bergen NE, Bakker H, Hofman A, Steegers EAP, Gaillard R, et al. Associations of maternal and paternal blood pressure patterns and hypertensive disorders during pregnancy with childhood blood pressure. J Am Heart Assoc Cardiovasc Cerebrovasc Dis. 2016;5:e003884.

    Article  Google Scholar 

  33. Deveci AC, Keown-Stoneman CDG, Maguire JL, O’Connor DL, Anderson LN, Dennis CL, et al. Paternal BMI in the preconception period, and the association with child zBMI. Int J Obes. 2023;47:1–8.

  34. Subbarao P, Anand SS, Becker AB, Befus AD, Brauer M, Brook JR, et al. The Canadian Healthy Infant Longitudinal Development (CHILD) study: examining developmental origins of allergy and asthma. Thorax. 2015;70:998–1000.

    Article  PubMed  Google Scholar 

  35. World Health Organization. A Healthy Lifestyle—WHO Recommendations. https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations (World Health Organization, 2010).

  36. Bridgman SL, Azad MB, Persaud RR, Chari RS, Becker AB, Sears MR, et al. Impact of maternal pre‐pregnancy overweight on infant overweight at 1 year of age: associations and sex‐specific differences. Pediatr Obes. 2018;13:579–89.

    Article  CAS  PubMed  Google Scholar 

  37. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr. 2006;450:76–85.

    Article  Google Scholar 

  38. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Takaro TK, Scott JA, Allen RW, Anand SS, Becker AB, Befus AD, et al. The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study: assessment of environmental exposures. J Expo Sci Environ Epidemiol. 2015;25:580–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Kelemen LE, Anand SS, Vuksan V, Yi Q, Teo KK, Devanesen S, et al. Development and evaluation of cultural food frequency questionnaires for South Asians, Chinese, and Europeans in North America. J Am Diet Assoc. 2003;103:1178–84.

    Article  PubMed  Google Scholar 

  41. Buuren Svan, Groothuis-Oudshoorn K. mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45:1–67.

    Article  Google Scholar 

  42. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B Methodol. 1995;57:289–300.

    Article  Google Scholar 

  43. Simmonds M, Burch J, Llewellyn A, Griffiths C, Yang H, Owen C, et al. The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. NIHR J. Library; 2015.

  44. Regnault N, Botton J, Forhan A, Hankard R, Thiebaugeorges O, Hillier TA, et al. Determinants of early ponderal and statural growth in full-term infants in the EDEN mother-child cohort study. Am J Clin Nutr. 2010;92:594–602.

    Article  CAS  PubMed  Google Scholar 

  45. Fleten C, Nystad W, Stigum H, Skjaerven R, Lawlor DA, Davey Smith G, et al. Parent-offspring body mass index associations in the Norwegian mother and child cohort study: a family-based approach to studying the role of the intrauterine environment in childhood adiposity. Am J Epidemiol. 2012;176:83–92.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Murrin CM, Kelly GE, Tremblay RE, Kelleher CC. Body mass index and height over three generations: evidence from the lifeways cross-generational cohort study. BMC Public Health. 2012;12:81.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Durmuş B, Arends LR, Ay L, Hokken-Koelega AC, Raat H, Hofman A, et al. Parental anthropometrics, early growth and the risk of overweight in pre-school children: the generation R study: parental and childhood anthropometrics. Pediatr Obes. 2013;8:339–50.

    Article  PubMed  Google Scholar 

  48. Lawlor DA, Smith GD, O’Callaghan M, Alati R, Mamun AA, Williams GM, et al. Epidemiologic evidence for the fetal overnutrition hypothesis: findings from the mater-university study of pregnancy and its outcomes. Am J Epidemiol. 2007;165:418–24.

    Article  PubMed  Google Scholar 

  49. Petersen TL, Møller LB, Brønd JC, Jepsen R, Grøntved A. Association between parent and child physical activity: a systematic review. Int J Behav Nutr Phys Act. 2020;17:67.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Rhodes RE, Perdew M, Malli S. Correlates of parental support of child and youth physical activity: a systematic review. Int J Behav Med. 2020;27:636–46.

    Article  PubMed  Google Scholar 

  51. Matos R, Monteiro D, Amaro N, Antunes R, Coelho L, Mendes D, et al. Parents’ and children’s (6–12 years old) physical activity association: a systematic review from 2001 to 2020. Int J Environ Res Public Health. 2021;18:12651.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Su DLY, Tang TCW, Chung JSK, Lee ASY, Capio CM, Chan DKC. Parental influence on child and adolescent physical activity level: a meta-analysis. Int J Environ Res Public Health. 2022;19:16861.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Huang RC, de Klerk NH, Smith A, Kendall GE, Landau LI, Mori TA, et al. Lifecourse childhood adiposity trajectories associated with adolescent insulin resistance. Diabetes Care. 2011;34:1019–25.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Zhang T, Xu J, Li S, Bazzano LA, He J, Whelton PK, et al. Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study. Diabetologia. 2019;62:70–7.

    Article  PubMed  Google Scholar 

  55. Corder K, Winpenny EM, Foubister C, Guagliano JM, Hartwig XM, Love R, et al. Becoming a parent: a systematic review and meta-analysis of changes in BMI, diet, and physical activity. Obes Rev J Int Assoc Study Obes. 2020;21:e12959.

    Article  Google Scholar 

  56. Lo BK, Kang AW, Haneuse S, Yu X, Ash Tvon, Redline S, et al. Changes in fathers’ Body Mass Index, sleep, and diet from prebirth to 12 months postbirth: exploring the moderating roles of parenthood experience and coparenting support. Ann Behav Med. 2021;55:1211–9.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank the CHILD Cohort Study participant families for their dedication and commitment to advancing health research. CHILD was initially funded by CIHR and AllerGen NCE. Visit CHILD at www.childstudy.ca.

Funding

This work was funded from a CIHR Operating Grant; Ontario Regional Centre of the Canadian Statistical Sciences Institute, the Connaught New Investigator Award, and the University of Toronto Pathway Grants (KM). PS holds a Tier 1 Canada Research Chair in Pediatric Asthma and Lung Health. SET holds a Tier 1 Canada Research Chair in Pediatric Precision Health and the Aubrey J. Tingle Professor of Pediatric Immunology. ZL holds an Early Career Researcher Award in Asthma. The authors report no conflicts of interest related to the study.

Author information

Authors and Affiliations

  1. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada

    Antonio Rossi, Zheng Hao Chen, David Jenkins, Deborah O’Connor, Ahmed El-Sohemy & Kozeta Miliku

  2. Department of Public Health Sciences, Queens University, Kingston, ON, Canada

    Mojtaba Ahmadiankalati & Zihang Lu

  3. Nutrition and Dietetics Program, Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Susan C. Campisi

  4. Translational Medicine Program, Department of Pediatrics, The Hospital of Sick Children, Toronto, ON, Canada

    Myrtha E. Reyna, Theo J. Moraes & Padmaja Subbarao

  5. School of Medicine, University College Dublin, Belfield, Ireland

    Kendra Dempsey

  6. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Piushkumar J. Mandhane

  7. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada

    Elinor Simons

  8. Department of Pediatrics, BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada

    Stuart E. Turvey

  9. Department of Physiology, University of Toronto, Toronto, ON, Canada

    Padmaja Subbarao

  10. Department of Medicine, McMaster University, Hamilton, ON, Canada

    Padmaja Subbarao & Kozeta Miliku

Authors
  1. Antonio Rossi
    View author publications

    Search author on:PubMed Google Scholar

  2. Zheng Hao Chen
    View author publications

    Search author on:PubMed Google Scholar

  3. Mojtaba Ahmadiankalati
    View author publications

    Search author on:PubMed Google Scholar

  4. Susan C. Campisi
    View author publications

    Search author on:PubMed Google Scholar

  5. Myrtha E. Reyna
    View author publications

    Search author on:PubMed Google Scholar

  6. Kendra Dempsey
    View author publications

    Search author on:PubMed Google Scholar

  7. David Jenkins
    View author publications

    Search author on:PubMed Google Scholar

  8. Deborah O’Connor
    View author publications

    Search author on:PubMed Google Scholar

  9. Ahmed El-Sohemy
    View author publications

    Search author on:PubMed Google Scholar

  10. Piushkumar J. Mandhane
    View author publications

    Search author on:PubMed Google Scholar

  11. Elinor Simons
    View author publications

    Search author on:PubMed Google Scholar

  12. Stuart E. Turvey
    View author publications

    Search author on:PubMed Google Scholar

  13. Theo J. Moraes
    View author publications

    Search author on:PubMed Google Scholar

  14. Zihang Lu
    View author publications

    Search author on:PubMed Google Scholar

  15. Padmaja Subbarao
    View author publications

    Search author on:PubMed Google Scholar

  16. Kozeta Miliku
    View author publications

    Search author on:PubMed Google Scholar

Contributions

The authors’ responsibilities were as follows—KM designed and managed the project; PJM, ES, SET, TJM and PS conceived the CHILD cohort design, managed study recruitment, and oversaw clinical assessments of study participants; AR conducted all the statistical analyses, and ZHC, MA, MER, ZL and KM oversaw the statistical analyses; AR and KM interpreted the data and wrote the manuscript; all authors (AR, ZHC, MA, SSC, MER, KD, DJ, DO, AE, PJM, ES, SET, TJM, ZL, PS, and KM) provided feedback and read and approved the final manuscript. AR and ZHC have full access to the data in the study.

Corresponding author

Correspondence to Kozeta Miliku.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rossi, A., Chen, Z.H., Ahmadiankalati, M. et al. Determining the interplay of prenatal parental BMI in shaping child BMI trajectories: the CHILD Cohort Study. Int J Obes 49, 1608–1615 (2025). https://doi.org/10.1038/s41366-025-01792-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41366-025-01792-8

Search

Advanced search

Quick links