BackgroundThe family environment has a crucial role in the development of childhood obesity and related cardiometabolic disorders. This study aims to investigate the association of parental obesity and cardiometabolic risk factors in their children.MethodsThis multicentric cross-sectional study was performed on 14400 students (aged 7–18 years) and one of their parents. Students were recruited by multistage, stratified cluster sampling from urban and rural areas of 30 provinces of Iran. Fasting venous blood was obtained from a random sample of 4200 students. Demographic, anthropometric and clinical variables were collected.ResultsData of 14002 students and results of blood samples of 3483 of them were complete and included in the current study. The prevalence of obesity in children, fathers, and mothers was 11.4%, 10.6%, and 24.2%, respectively. In students, the most commonly observed metabolic abnormality was low HDL-C (29.5%); the prevalence of metabolic syndrome and dyslipidemia was 5% and 55.7%, respectively. Significant correlations were observed between the body mass index (BMI) and waist circumference of parents and weight, height, BMI, and waist circumference, as well as systolic and diastolic blood pressure (BP) of their children (P< 0.05). In the multivariate model, the risk of excess weight (OR: 1.30, 95%CI: 1.17–1.44), obesity (OR: 1.36, 95%CI: 1.18–1.59), abdominal obesity (OR: 1.16, 95%CI: 1.05–1.29) and elevated BP (OR: 1.17, 95%CI: 1.04–1.31) were higher in those students whose parents had excess weight compared with other students. Parental obesity did not have significant association with metabolic syndrome and dyslipidemia in their children.ConclusionsParental history of obesity could be used as a practical approach for the early preventive measures and identification of children at risk of cardiometabolic complications.