Parental obesity and offspring cardiometabolic trajectories from childhood to adulthood
Abstract
Parental obesity is a strong risk factor for childhood adiposity. However, evidence regarding its association with longitudinal cardiometabolic disease progression in offspring remains limited. We aimed to examine whether parental obesity is associated with adverse cardiometabolic trajectories in offspring from childhood to adulthood. We analyzed prospective data from the China Health and Nutrition Survey (1989–2015). Offspring aged ≥2 years were categorized according to parental overweight/obesity status: neither parent affected (Group 1, reference), only father affected (Group 2), only mother affected (Group 3), and both parents affected (Group 4). We used linear mixed-effects models with polynomial age terms to estimate longitudinal trajectories and annual changes in body mass index, waist circumference, and blood pressure. Cox proportional hazards models were used to assess hazard ratios for incident overweight/obesity, central obesity, and hypertension. Among 4,982 offspring, those with both parents affected (group 4) had the highest baseline levels; however, annual rates of increase were not consistently higher. Male offspring in group 4 had the highest risks for incident overweight/obesity (HR = 3.72; 95% CI, 1.73–7.99) and central obesity (HR = 2.46; 95% CI, 1.31–4.62); the association with hypertension was elevated but did not reach statistical significance (HR = 1.55; 95% CI, 0.86–2.77). Female offspring in group 4 had the highest risk for incident overweight/obesity (HR = 4.60; 95% CI, 1.93–10.94). Formal interaction tests for sex × parental obesity were not significant for any outcome (all P interaction > 0.05). Parental obesity, particularly when both parents are affected, is associated with higher baseline cardiometabolic risk levels and substantially higher disease risk in offspring, though the annual rates of increase do not consistently differ across groups. These findings underscore the family unit as a critical target for early preventive strategies.