A study that looked at preconception health across three generations in the UK has found that some unhealthy behaviours such as smoking and soft drink consumption have decreased over time, while rates of obesity have increased.

The study led by King’s College London and the University of Southampton has uncovered generational health trends among adolescents and young adults in the UK. The researchers have said that the study, published in PLOS ONE, has broad implications for reducing health disparities and designing targeted public health interventions.

Improving overall health

Optimising health in women and men before conception can improve pregnancy outcomes, reduce the risk of non-communicable diseases in both parents, and improve childhood health. Previous research has shown that many women enter pregnancy with risk factors that put them at higher risk for complications – such as poor diet, smoking, diabetes, hypertension and obesity – that disproportionately affect those from disadvantaged backgrounds.

In the UK, initiatives have been put in place to optimise and reduce inequalities in preconception health, and while there have been studies on women’s health during prenatal visits, there hasn’t been a national picture of preconception health of men and women of reproductive age.

The study looked at health behaviours and indicators across adolescence and adulthood in three cohorts in the UK born approximately 10 years apart: up to 17,198 people born in 1970, 15,770 people born in 1989 to 1990, and 19,517 people born in 2000 to 2002. Data on various health indicators and behaviours were collected at age 16/17 years and 25/26 years.

The study found that some suboptimal health behaviours, such as low fruit consumption, persisted in both men and women across generations. Other unhealthy behaviours, such as alcohol and tobacco use and soft drink consumption, decreased in younger generations, though the prevalence of obesity increased.

Olivia Righton, PhD student at King’s College London and lead author of the paper, said, “Optimising the health of both women and men before pregnancy can greatly improve pregnancy outcomes and their children's long-term health. However, our findings reveal ongoing challenges in preconception health across generations in the UK, with suboptimal behaviours such as low fruit intake and rising obesity rates persisting despite progress in reducing alcohol, tobacco, and soft drink consumption. This highlights an urgent need for public health initiatives that address the root causes of these suboptimal behaviours, laying the foundation for healthier pregnancies and better outcomes for future generations.”

Trends for several key health indicators important for pregnancy health, such as folic acid supplementation, cervical screening, and mental health conditions, could not be identified, as these were not consistently reported across the three cohorts.

The researchers said the trends identified in the study could help to tailor public health interventions to reduce inequalities and improve the overall health and wellbeing of the preconception population.

Danielle Schoenaker, senior research fellow at the University of Southampton and senior author of the paper, said, “Our findings highlight slight reductions in smoking, alcohol and soft drink consumption across generations of adolescents and young adults in the UK.

"Despite this progress, these suboptimal health behaviours remain common, and the number of young people with obesity is rising. These trends call for further public health efforts to support adolescents and young adults to adopt healthy behaviours – not only for their own health but also to improve the health outcomes of future generations.”

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