A lifestyle intervention to prevent gestational weight gain: will it effect infant obesity?

Clients that have consented to participate will be randomly allocated to the Intervention or the Control group. There will be 282 participants in each group. Women randomised to the Intervention group will complete questionnaires including questions from the NSW Population Health Survey (2105), 24h food recall, an Active Australia Questionnaire and Edinburgh Depression scale. Initial dietetic consultations for each of the participants is educational and advice based, and lasts for 45 approximately minutes. This is with a senior clinical dietitian with more than 10 years experience. It includes the rational for the concern over excessive gestational weight gain. It is personalised and involves information on culturally appropriate meal planning, healthy weight gain targets during pregnancy, nutritional requirements for pregnancy, strategies to limit sugar and saturated fat consumption, and how to approach non–hungry eating. Participants will be given exercise-related advice, specifically on the importance of how to incorporate 30-45min of moderate-intensity physical activity into their day. Moderate intensity means being able to hold a conversation while exercising without being short of breath, such as brisk walking, swimming or yoga/pilates. This will be provided by the dietitian and or midwife. Individualised dietary and exercise advice will be tailored by identifying gaps in the participant's dietary knowledge and exercise regimen, and optimised by providing appropriate advice to address these issues during initial and review consultations as required. Participants in the Intervention group will also receive regular monthly follow-up consultations with a midwife and dietitian until 28 weeks gestation, biweekly consultations from 28-36 weeks gestation, and weekly consultations until delivery. Review consultations are approximately 30 minutes. Should Participants not attend these consultations, they will be contacted by the Senior Clinical Dietitian or Midwife for a telephone consultation. Dietary and exercise will be review and discussed during face to face consultations or telephone interactions and once again will be tailored to the needs of the individual participant and their personal circumstances. During these consultations, participants can ask for advice, and clarify any issues with eating or exercise behaviours. Adherence to the program will be monitored via a food diary, using a 24h recall, GWG and clinic attendance. Participants will also receive fortnightly SMS messages in between face to face or telephone consultations, encouraging healthy eating and appropriate physical activity. Postpartum follow up includes a 15-30min telephone call by the dietitian at 3m postpartum, reinforcing dietary and lifestyle advice, targeting weight loss goals, and revisiting healthy eating and exercise strategies. This will culminate at 26 weeks post-partum, in participants attending WH or their Early Childhood Centres, or being telephoned for maternal and infant weight and referral to transition to Get Healthy NSW for continuity of care.