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Body mass index in parents and their adult offspring: a systematic review and meta-analysis

Obesity may track across generations, due to genetics and family environmental factors, or possibly intrauterine programming. However, many studies only assess associations between maternal body mass index (BMI) on offspring obesity in childhood. To determine whether maternal and paternal associations with offspring BMI differ, and whether associations persist into adulthood, a systematic review and meta-analysis was done. MEDLINE, EMBASE and PubMed (to December 2019) were searched. Observational studies reporting associations between maternal or paternal BMI and adult offspring BMI were included. Offspring BMIs were reported as continuous or categorical measures. 46 studies were included in the systematic review. Meta-analyses were conducted using random effects models. Parental BMI was positively associated with offspring BMI in adulthood. The pooled mother-offspring standardized mean difference (SMD) was 0.23 (95% confidence interval (CI): 0.20, 0.26), and father-offspring SMD was similar: 0.22 (95%CI: 0.19, 0.25) in adjusted models. Maternal and paternal overweight and obesity were associated with higher offspring BMI with similar magnitudes. If these associations are causal, they support interventions targeting all family members, rather than focusing solely on mothers, to maintain a healthy weight.