Li J, Yang Q, An R, et al. - Findings revealed that the impacts of an adverse developmental environment through famine in early life on body mass index (BMI) and blood pressure (BP) later in life could persist beyond one generation.

• In this study, the transgenerational link of early-life exposure to the Chinese famine of 1959 to 1962 with the trajectories of BMI, waist circumference (WC), and BP in 2 consecutive generations was investigated.

• This analysis comprised 21,106 F1 observations born between 1954 and 1967 (median age: 45 years) and 1926 F2 observations (median age: 23 years) from the longitudinal household-based China Health and Nutrition Survey from 1993 to 2015.

• Early-life exposure to famine was found to be related to elevated BMI, WC, and BP in 2 consecutive generations with gender and age differences.

• In F1, an association of famine with elevated BMI, WC, systolic BP, and diastolic BP was evident, particularly in males or those aged older than 50 years.

• In F2 males but not females, the parental exposure to famine was shown to be linked with 0.59 kg/m ² ([95% CI, 0.10–1.08], P=0.02) increase in BMI.

• Parental exposure to famine was noted to be related to elevated BMI (0.83 kg/m ² ), systolic BP (2.04 mm Hg), and diastolic BP (1.73 mm Hg), in F2 aged ≥25 years but not those younger ones.