LIFT: Lifestyle Interventions For Two

• Infant Percent Fat at Birth [ Time Frame: Within 24 hours of birth ] [ Designated as safety issue: No ]
  Infant % fat at birth as a continuous variable. This will be ascertained from PeaPod within 24 hours after birth.
  
  

• Mother fat mass gain 35 Weeks [ Time Frame: 35,0-35,6 weeks of pregnancy ] [ Designated as safety issue: No ]
  Fat mass gain of mother at 35,0-35,6 weeks of pregnancy as a continuous variable.
  
  
• Mother fat mass gain one year postpartum [ Time Frame: 48-56 weeks postpartum ] [ Designated as safety issue: No ]
  Mother's fat mass at 52 (range 48-56) weeks postpartum
  
  
• Mother's weight one-year postpartum [ Time Frame: 48-56 weeks postpartum ] [ Designated as safety issue: No ]
  Weight of mother at 52 (range 48-56) weeks
  
  
• Infant % fat 14 weeks [ Time Frame: 13-15 weeks ] [ Designated as safety issue: No ]
  Infant %fat at 14 (range 13-15) weeks. This will be ascertained from PeaPod.
  
  
• Infant % fat 52 weeks [ Time Frame: 48-52 weeks ] [ Designated as safety issue: No ]
  Infant %fat 52 (range 48-56) weeks.
  
  
• Infant Weight 14 weeks [ Time Frame: 13-15 weeks ] [ Designated as safety issue: No ]
  Infant weight at 14 (range 13-15) weeks.
  
  
• Infant weight 52 weeks [ Time Frame: 48-56 weeks ] [ Designated as safety issue: No ]
  Infant weight at 52 (range 48-56) weeks.
  
  

A randomized controlled trial is proposed to study the effect, in a cohort of racially and ethnically diverse group of overweight and obese pregnant women, of an Intensive Lifestyle Intervention (ILI) compared to Usual Care (UC) on gestational weight gain (GWG), infant fatness, and mothers' post-delivery weight retention. Women in the ILI arm will receive intensive counseling during pregnancy and group counseling after delivery regarding behavior, nutrition, and physical activity change. Visits to counselors will occur weekly and additional telephone and internet contacts will occur. The mothers' will be assessed at 14 (9,0-14,6) and 36 (35,0-36,6) weeks of pregnancy and at 14 weeks (range 13-15) and 52 (range 48-56) weeks post-delivery. The measurements will be anthropometry, whole body MRI, EchoMRI, and whole body plethysmography (BodPod). The infants' measurements will be anthropometry, whole body MRI, EchoMRI, and whole body plethysmography (PeaPod) for fatness 14 weeks (range 13-15) weeks and 52 (range 48-56) weeks. Mothers and children will have cardio-metabolic risk factors measured in plasma. Data will be collected regarding mothers' dietary intake and physical activity (questionnaires and accelerometry) to assist in counseling. Other data to be collected include questionnaires on quality of life, socio-economic status. Careful record will be kept of expenses in providing the ILI, so that cost analysis of the intervention can be calculated. The study is powered on the primary outcome, fatness of the infants at birth. We require 180 participants to attain appropriate power. We will enroll 210 so as to allow for some dropouts along the way. Each mother will be followed during pregnancy and for a year post delivery. Each infant will be followed for a year after birth. We have the ability to continue to follow these participants if further funding is forthcoming, as they are all local to our hospital's catchment area and our own physicians.