Parental Weight Before Pregnancy Linked to Higher Risk of Fatty Liver Disease in Adult Offspring, UK Study Finds
Key Takeaways:
- Pre-pregnancy overweight or obesity in either parent is associated with a significantly increased risk of metabolic dysfunction associated steatotic liver disease (MASLD) in their children by early adulthood.
- When both parents were living with overweight or obesity prior to conception, the likelihood of MASLD in offspring by age 24 was more than three times higher.
- Much of this increased risk appears to be mediated by excess weight accumulated during childhood and adolescence.
Rising concern over MASLD across generations
Parental weight status before pregnancy may play an important role in shaping long-term liver and metabolic health in the next generation, according to new research published online in Gut. The findings suggest that overweight and obesity in both mothers and fathers prior to conception are linked to a heightened risk of metabolic dysfunction associated steatotic liver disease (MASLD) in their children as young adults.
MASLD, previously known as non-alcoholic fatty liver disease, is now recognised as the most common chronic liver condition worldwide. Researchers note that the disease affects approximately 15% of children and more than 30% of adults globally. The condition is characterised by excess fat accumulation in the liver alongside cardiometabolic abnormalities and may progress to cirrhosis or liver failure in some individuals.
While earlier studies have primarily focused on maternal obesity, uncertainty has remained regarding the contribution of paternal weight and the role of childhood weight trajectories in determining future disease risk.
Large UK birth cohort provides long-term insight
To investigate these questions, researchers analysed data from 1,933 participants enrolled in the UK Avon Longitudinal Study of Parents and Children (ALSPAC), a long-running population study tracking health outcomes across generations.
The study examined associations between parental body mass index (BMI) before pregnancy and the likelihood that offspring would develop MASLD by the age of 24.
MASLD was defined as the presence of elevated liver fat together with at least one cardiometabolic risk factor, such as raised cholesterol levels or elevated fasting glucose.
Both parents provided information on height, weight, BMI and waist circumference before pregnancy. They also completed detailed questionnaires during pregnancy and following childbirth covering a wide range of potential influencing factors, including:
- Age at delivery
- Smoking during early pregnancy
- Weekly alcohol consumption prior to pregnancy
- Employment status
- Educational attainment
Mothers additionally reported physical activity levels and whether they had previously been diagnosed with diabetes or hypertension at study enrolment.
Tracking early life and adolescent risk factors
Extensive information was also collected about the children, allowing researchers to examine developmental influences across childhood and adolescence. Recorded factors included:
- Sex
- Mode of delivery
- Gestational age and birthweight
- Antibiotic exposure during the first six months of life
- Duration of breastfeeding
Participants underwent repeated measurements of BMI and waist circumference between the ages of 7–9, 10–12 and 13–17 years. Lifestyle factors in early adulthood, including alcohol and tobacco use, were also assessed.
One in ten young adults developed MASLD
By age 24, MASLD was identified in 201 participants, representing approximately one in ten individuals in the cohort. The remaining 1,732 participants had normal liver findings.
Those living with MASLD were more likely to be male and to have a higher BMI compared with peers without the condition.
After adjusting for multiple potential confounding factors, both maternal and paternal overweight or obesity before conception were independently associated with increased odds of MASLD in offspring.
Each additional kilogram per square metre of maternal BMI increased the likelihood of MASLD by 10%, while each equivalent increase in paternal BMI was associated with a 9% rise in risk.
Most notably, offspring whose parents were both living with overweight or obesity prior to pregnancy had more than three times the odds of developing MASLD compared with those whose parents had a normal BMI.
Childhood weight plays a central role
Further analysis suggested that much of this association operates through weight gain during childhood and adolescence. Researchers estimated that 67% of the increased risk linked to parental overweight or obesity was explained by cumulative excess BMI between the ages of 7 and 17.
Additional analyses incorporating maternal and offspring sugar intake, as well as genetic susceptibility to MASLD, produced similar results, strengthening confidence in the observed associations.
Observational findings with important limitations
The authors emphasise that the study was observational and therefore cannot establish direct causation. Several limitations were also acknowledged.
Parental weight data prior to pregnancy were self-reported, and information was unavailable regarding parental MASLD status or certain underlying health conditions before and during pregnancy. In addition, physical activity levels of offspring in early adulthood were not captured, which may have influenced outcomes.
Implications for preconception health
Despite these limitations, the researchers conclude that their findings highlight the potential importance of parental metabolic health before conception in shaping long-term outcomes for future generations.
They state that the results “lend support to an early life influence of biparental obesity on offspring metabolic health, suggesting efforts to mitigate excess adiposity of both mothers and fathers before conceiving may confer longitudinal benefits to the metabolic outcomes of their future offspring.“
The study adds to growing evidence that prevention of metabolic disease may need to begin not only in childhood, but even before pregnancy, with both parents playing a meaningful role in influencing lifelong health trajectories.
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Childhood Obesity in England Reaches Highest Level Since Pandemic, New Data Reveal
Key Takeaways:
- One in ten children aged four to five in England are living with obesity, the highest rate since the COVID-19 pandemic.
- Teachers warn that poverty, limited access to nutritious food, and cuts to school sport funding are fuelling the crisis.
- Nearly all teachers agree that healthy eating improves pupil focus, energy, and behaviour, yet many report children arriving at school hungry.
Childhood obesity at record levels outside pandemic years
Newly released data from the National Child Measurement Programme (NCMP) show that 10.5% of children aged four to five (Reception year) in England are living with obesity – the highest prevalence recorded outside of the pandemic period.
The NCMP, which annually measures the height and weight of primary school pupils, also found that more than one in five pupils in Year 6 (aged 10–11) are living with obesity. The findings indicate that boys are more likely to be overweight or obese than girls.
In Reception year, 13% of children were classified as overweight, meaning that almost one in four children in this age group are either overweight or living with obesity.
Excluding the sharp increase seen during the first year of the COVID-19 pandemic, these figures represent the highest obesity prevalence in Reception year since records began in 2006–07 and mark a rise from 9.6% in 2023–24.
Schools feeling the strain
Lee Parkinson MBE, a primary school teacher from Manchester, said that systemic factors and funding cuts have worsened the situation.
“After the 2012 Olympics, school sport funding was cut, and the promise to ‘inspire a generation’ faded fast due to austerity measures,” he explained.
“Many primary schools lost specialist PE teachers and local competitions, and PE time is often squeezed as pressures on the timetable grow. You cannot separate childhood obesity from poverty either.
“Schools play their part through PE and lessons about healthy lifestyles, but they cannot solve this alone. We need to reinvest in early years support, rebuild affordable community sport, and make healthy choices realistic for all families, not just the privileged few.”
The link between nutrition, learning, and behaviour
A related report on children’s nutrition found that 94% of teachers believe healthy eating improves children’s behaviour. Teachers observed that better nutrition had tangible effects on classroom dynamics – with pupils demonstrating sharper focus, more energy, and improved behaviour.
The report underscored that nutritious food at school is not only essential for health and wellbeing but also for learning outcomes.
Hunger and food insecurity
Research from the Trussell Trust highlighted that around 9.3 million people in the UK, including three million children, experience food insecurity. Currently, one in four children under the age of five are at risk of needing to use a food bank.
Mr Parkinson reflected on the impact of poverty on pupils’ concentration: “Obviously with the poverty element, if children are coming into school hungry it will make it harder for them to concentrate.”
This problem is often exacerbated during school holidays, when free school meals are unavailable. Last summer, one in 12 parents reported that their children had to miss meals due to financial difficulties.
Mr Parkinson added: “I do not know if it is lack of knowledge or the fact that unhealthy food is easier to access or what families can afford. When parents are working long hours and struggling to make ends meet, healthy living becomes another impossible task.”
Teachers filling the gap
The majority of teachers (88%) said they had witnessed children arriving at school hungry, with 66% reporting that they had brought in food from home or purchased healthy food for pupils themselves.
Nearly all teachers surveyed (98%) agreed that nutrition forms a vital foundation for learning. However, 83% said it can be challenging to inspire children to make healthy eating choices, particularly when access to nutritious food is inconsistent outside of school.
Measuring the scale
In total, 1.1 million children across state-maintained schools were measured as part of the NCMP data collection for 2024–25.
Public health experts warn that the findings underline an urgent need for coordinated national action to address the intertwined challenges of obesity, poverty, and food insecurity among children in England.
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