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Dads get plenty of attention on Father's Day, but they've sometimes been overlooked in research about how they affect their children's health.

But from the start, fathers shape their children's health in significant ways, said James Muchira, an assistant professor at the Vanderbilt University School of Nursing in Nashville, Tennessee.

"Fathers, especially on Father's Day, need to know that they have a big part to play in modeling healthy behaviors," said Muchira, who studies how heart disease risks are transmitted across generations. "Their involvement is key."

A father's influence is unique, complementing but not being redundant with a mother's role, said pediatrician Dr. Michael Yogman, an assistant professor of pediatrics at Harvard Medical School in Boston.

Yogman was lead author of a on fathers' roles that said although mothers still handle most child care, fathers are more involved than ever before and are big influences on how their children eat, exercise and play.

Here's what Yogman and Muchira said about how fathers shape the health of their offspring.

It goes beyond biology

When discussing fathers, "we're talking about a pretty diverse set of male caregivers, not all of whom are biological fathers," Yogman said.

Adoptive fathers, foster fathers and nonresident fathers all count. "We also shouldn't neglect grandfathers," said Yogman, who has two daughters and two granddaughters.

Muchira said the way children pick up behaviors from their parents is complex. But overall, most of the risk of chronic disease, including cardiovascular disease, is not genetic. The bulk of the risk comes from factors such as where a child is growing and what they are eating, along with education and other socioeconomic factors.

"All these combined would have a higher impact to cardiovascular disease than just inheritance," Muchira said.

It starts early

Mothers-to-be have a dominant influence before birth, when her body is sustaining the developing child. But the earlier that fathers get involved, the better the pregnancy outcome, Yogman said.

A he co-wrote in 2021 cited research that has correlated a father's involvement during pregnancy with a greater likelihood of prenatal care and less smoking by the mother.

A father's style of play with infants may differ from a mother's, he said. Dads may do more tapping games and more bicycling of the legs, and they're likely to toss their babies in the air more. When children are 18 to 24 months old, fathers engage in more rough-and-tumble play, which might help children become more independent, develop better emotional control and reduce behavioral problems, studies say.

Being a role model matters

Yogman said that when a father engages in healthy behaviors related to fitness, or even staying off the phone at the dinner table, the model can permeate through the family. "A lot of these lifestyle issues are really critical for good health," he said.

Muchira's research has looked at how parents' lifestyles can affect cardiovascular health risk factors – such as cholesterol, blood pressure, blood glucose, smoking and body mass index – over a lifetime. Because of mothers' influence during pregnancy, they have a stronger effect than fathers over the years, he said. But his also suggests that the better a father's cardiovascular health is, the lower the risk of heart disease and stroke for his children.

Muchira said the connections between what a parent is doing and their child's health aren't immediately obvious. But problems such as stiffening of the arteries can begin even before birth, and in his work, he's shown that a parent's lifestyle is more than 50 years later.

Parents have that long-lasting influence because of how they model behavior, healthy and unhealthy, Muchira said. If a father takes a child for a walk, that child may learn to enjoy walks. If a father encourages healthy eating, a child may learn from that as well. that children of fathers who are active are more likely to be active themselves.

As the father of a 4-year-old daughter and 8-month-old son, Muchira is aware that his own modeling and guidance affect his children in ways he can't always see, and he knows there will be times as they grow up when they might ignore his advice. But he thinks of an older friend who vividly remembers when their parents taught them to avoid sugary foods and still thinks about that lesson when making choices today.

A child or teenager might not always eat the way a well-informed adult would, Muchira said. "But the point is, they know. And once they know, it is very different from someone who doesn't know."

Muchira emphasized, however, that some things are out of a father's control. A father can't model healthy eating if the family can't afford food, and he can't take kids on a walk if there is no safe place to do so.

Fathers can buffer against toxic stress

Childhood adversity and prolonged stress can lead to multiple health and psychological problems. But even one supportive, trusting relationship can go a long way toward buffering against it, Yogman said. Researchers have shown, for example, that a "can be enormously adaptive and protective for the child" when a mother has postpartum depression, he said.

Other research done among low-income Hispanic immigrant families showed that when a father was involved in caring for an infant, the lower levels of a stress-related hormone and performed better on memory tests as 8- or 9-year-olds.

Muchira said fathers can help kids manage their stress through exercise or just spending time together. "These kinds of habits release the healthful chemicals in the body that will reduce some of these mechanisms of transmission of disease risk to their kids," he said.

What a father has to understand

It's not enough to just tell a child what to do, Muchira said. "They also need to know why they are doing what they're doing. If the parents are just doing things without the kids knowing, then the kids will not see the point of doing it."

Which means a father has to understand his own heart-related numbers – BMI, blood pressure and cholesterol – and other risk factors. "The father will have to know those things so that he can communicate them to the kids," Muchira said.

Fathers also should be aware that they, too, can suffer from postpartum depression that can affect the whole family, Yogman said. And they should be active participants in their child's pediatric visits. (The AAP report says that pediatricians, who traditionally have emphasized communication with moms, need to be more welcoming to dads.)

Dads, it's OK if you don't always know best

"There's no such thing as perfect parenting," Yogman said. "All of us are guilty of all kinds of weaknesses and infractions."

Guilt and impossible standards don't help anybody, he said. But a father's goal, he said, is simply to do what he can. "You want your kids to do better than you did."

It may not be possible to prevent a child from ever having heart disease, Muchira said. But instilling healthy values can lengthen the time they live without it. "We want them to be able to enjoy life longer."