Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease, with the global prevalence rising from 25% to 38% in the past two decades.1 Paralleling global trends in obesity, MASLD onset is shifting towards younger ages with increasing prevalence in children and young adults.2 While environmental and lifestyle factors, such as unhealthy foods, a sedentary lifestyle and socioeconomic factors are important causal factors, there is accumulating evidence that obesity risk is in part inherited from parents through diverse mechanisms.3 Conversely, it is less clear to what extent parental obesity increases offspring risk to develop MASLD. While it is well described that maternal obesity is associated with the prevalence and severity of MASLD in offspring,4 there is scarce evidence to support that paternal obesity contributes to this risk.

Tica et al. analysed data from the UK Avon Longitudinal Study of…