Early Prevention of Excessive Gestational Weight Gain Using Lifestyle Change

A randomized parallel groups design will be used as a pilot project. Each participant will be medically pre-screened using the PARmed-X for Pregnancy (2015) in early pregnancy (<18 weeks), stratified by pre-pregnancy BMI status (normal weight [18.5-24.9 kg/m2]; overweight [25.0-29.9 kg/m2], obese [=>30.0 kg/m2]) and randomized into one of 3 groups: Group A) NELIP (full intervention); Group B) Nutrition intervention given at study entry followed sequentially by the exercise intervention starting immediately after 24 week mid-way visit (N+E); or Group C) Exercise intervention started at study entry followed sequentially by the nutrition intervention starting immediately after 24 week mid-way visit (E+N). Infant sex, body weight, length, complications will be recorded at birth and the last known maternal body weight. Neonatal morphometrics will be assessed with diaper only (6 skinfold sites from umbilical, suprailiac, biceps, triceps, subscapular, and anterior thigh; circumferences from the head, chest, abdomen, hips, thigh, leg, arm, and arm, forearm, thigh and leg length measured to the nearest mm) and will be measured within 6-18 hours of delivery by a member of the research team visiting the woman either at hospital or home. Each maternal-infant pair will be asked to return to the lab at 2, 6 and 12 months post-delivery for follow-up and assessment of chronic disease risk.

Inclusion criteria

• single pregnancy (no twins);
• < 18 weeks, 0 days pregnant at time of entry to study;
• low-risk pregnancy, as determined by medical pre-screening via PARmed-X for Pregnancy by their health care provider;
• > 18 years of age;
• low physical activity defined as less than 3 intentional bouts of 30 minutes of moderately intense physical activity per week;
• non smokers.

Exclusion criteria

• multiple pregnancy (twins, etc);
• contraindication to exercise (includes chronic diseases such as cardiovascular diseases, thyroid diseases, uncontrolled Type 2 diabetes, peripheral vascular disease, hypertension);
• > 18 weeks, 0 days pregnant at time of entrance to study;
• <18 years of age;
• high physical activity defined as more than 3 intentional bouts of 30 minutes of moderately intense physical activity per week;
• smokers.