Assessing the influence of preconception paternal nutrition on offspring health: an evidence gap map

The Developmental Origins of Health and Disease (DOHaD) framework recognizes that preconception exposures influence offspring health, yet paternal nutrition has received little attention compared to maternal diet. To better understand this emerging area, we undertook a systematic evidence mapping exercise in accordance with the PRISMA 2020 guidelines to develop an evidence gap map (EGM). Seventy-five studies examining paternal preconception diet and offspring health outcomes were identified, including sixty animal experiments and fifteen human observational studies. Animal studies consistently showed that paternal high-fat or low-protein diets impaired offspring metabolism, and that targeted dietary interventions such as omega-3 fatty acids or methyl donors, mitigated these effects. Human studies were fewer, narrower in scope, and largely focused on famine exposure or single food group intakes, with no randomized trials and only half of the studies accounting for maternal diet. Offspring outcomes were limited to birthweight and adiposity, with little investigation of cardiometabolic, neurodevelopmental, mental health, or other chronic disease-related outcomes. The current evidence therefore suggests that paternal diet may influence offspring health, but highlights major methodological and conceptual gaps in human research. By mapping the scope and limitations of the existing evidence, this study provides a roadmap for future Paternal Origins of Health and Disease research, and underscores the need to develop paternal-inclusive preconception nutrition strategies and public health interventions to improve intergenerational health.