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Preconception Lifestyle Interventions to Improve Future Metabolic Health (Before the Beginning)

Not Applicable
Active, not recruiting
Conditions
Gestational Diabetes
Interventions
Behavioral: time-restricted eating
Behavioral: high intensity exercise
Other: Standard Care
Registration Number
NCT04585581
Lead Sponsor
Norwegian University of Science and Technology
Brief Summary

The aim of this study is to investigate whether the combination of high intensity exercise and time restricted eating before and during pregnancy can reduce the risk of hyperglycaemia during pregnancy.

Detailed Description

Women who are planning a pregnancy will be recruited into a parallel groups randomised controlled trial where the intervention will consist of high intensity training and time-restricted eating. The intervention will continue throughout pregnancy. The investigators will assess whether this lifestyle intervention can effect maternal and offspring cardiometabolic health.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
167
Inclusion Criteria
  • contemplating pregnancy within the next six months
  • At least one of the following criteria: BMI ≥ 25 < 40 kg/m2, gestational diabetes in a previous pregnancy, previous infant > 4.5 kg, fasting plasma glucose > 5.3 mmol/L, or Non-European ethnicity
Exclusion Criteria
  • On-going pregnancy
  • Trying to conceive ≥ 6 cycles at study entry
  • Known diabetes (type 1 or 2)
  • Shift work that includes night shifts > 2 days per week
  • Previous hyperemesis
  • Known cardiovascular diseases
  • High intensity exercise ≥ 2 hours/week the last 3 months
  • Habitual eating window ≤ 12 hours

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
diet + trainingStandard Care-
diet + trainingtime-restricted eating-
controlsStandard Care-
diet + traininghigh intensity exercise-
Primary Outcome Measures
NameTimeMethod
Plasma glucose concentrationGestational week 28

Plasma glucose concentration after 2 h oral glucose tolerance testing (75 g glucose)

Secondary Outcome Measures
NameTimeMethod
Plasma glucose concentrationGestational week 12

Plasma glucose concentration after 2 h oral glucose tolerance testing (75 g glucose)

HbA1cBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

GlucoseBaseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

Measured in the blood

InsulinBaseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

Measured in the blood

CytokinesBaseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

Measured in the blood, a panel of 27 cytokines of relevance for inflammatory status (Bio-Plex Pro Human Cytokine 27-plex Assay)

Total cholesterolBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

TriglyceridesBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

Fat massBaseline, intervention week 8, gestational week 12 and 28

Estimated using InBody720 bioimpedance scale.

Measured physical activityFrom baseline and throughout the study period.

Measured by Amazfit GTS smartwatch

Diet intakeEvery 8 week throughout the trial.

Online food diary (Lifesum app), 4-day registration (one weekend day and three weekdays=

High density lipoprotein cholesterolBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

Low density lipoprotein cholesterolBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

Low density cholesterolBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

Psychological general well beingBaseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

Psychological general well being index (PGWBI)

Time to pregnancyFrom baseline to pregnancy (up to 36 weeks from enrollment)

Self-reported

Birth weight (infant)Delivery

From hospital record

Blood pressure (Infant)Within 72 hours of birth and after 6 weeks post delivery

Blood pressure (systolic - and diastolic)

HomocysteineBaseline, intervention week 8, gestational week 12 and 28

Measured in the maternal blood

Continuous glucose monitoringBaseline and 8 weeks intervention

Continuous glucose monitoring using Freestyle Libre (Abbott Diabetes Care), worn for 14 days.

ChronotypeBaseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

Self-reported: Hornestberg Morningness Eveningness Questionnaire

Apgar scoreDelivery, after 1, 5 and 10 minutes

From hospital record

ICU admissionDelivery

From hospital record

Infant muscle massWithin 72 hours of birth and after 6 weeks post delivery

Estimated using impedance measurements (BioScan tough i8-nano)

Infant bone massWithin 72 hours of birth and after 6 weeks post delivery

Estimated using impedance measurements (BioScan tough i8-nano)

Insulin sensitivityBaseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

Insulin sensitivity estimated by homeostatic model assessment for insulin resistance (fasting serum insulin concentration (μU/mL) x fasting plasma glucose levels (mmol/L)/22.5)

Muscle massBaseline, intervention week 8, gestational week 12 and 28

Estimated using InBody720 bioimpedance scale.

Psychological well-beingBaseline, intervention week 8, gestational week 12 and 28 and every 8 week throughout the trial.

Self-reported: Psychological General Well Being Index

Head circumference of infantDelivery

From hospital record

Cardiac function (Infant)Within 72 hours of birth and after 6 weeks post delivery

Ultrasound echocardiography

Blood flow and myocardial function will be measured using mechanical wave imaging (MWI).

Adipokines (Adiponectin, Leptin, Ghrelin)Baseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

Measured in the maternal blood

Blood pressureBaseline, intervention week 8, gestational week 12 and 28

Systolic - and diastolic blood pressure (in mmHg) will be measured in the seated position after 15 minutes of rest with an automatic blood pressure device (Welch Allyn, Germany) three times with one minute intervals, in left arm (average of three measurement).

Birth length (infant)Delivery

From hospital record

Congenital malformationDelivery

From hospital record

Gestational age at birthDelivery

From hospital record

Length of stay at hospitalDelivery

From hospital record

Infant total body massWithin 72 hours of birth and after 6 weeks post delivery

Estimated using impedance measurements (BioScan tough i8-nano)

Infant fat massWithin 72 hours of birth and after 6 weeks post delivery

Estimated using impedance measurements (BioScan tough i8-nano)

Infant hydration statusWithin 72 hours of birth and after 6 weeks post delivery

Estimated using impedance measurements (BioScan tough i8-nano)

Total body massBaseline, intervention week 8, gestational week 12 and 28

Estimated using InBody720 bioimpedance scale.

Visceral fat areaBaseline, intervention week 8, gestational week 12 and 28

Estimated using InBody720 bioimpedance scale.

Cardiorespiratory fitnessBaseline and intervention week 8

Peak oxygen uptake at a maximum effort exercise test, measured in L/min using Metalyzer.

Self-reported physical activityBaseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

International Physical Activity Questionnaire

SleepBaseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

Self-reported: Pittsburgh Sleep Quality Index

Trial Locations

Locations (1)

St Olavs Hospital

🇳🇴

Trondheim, Norway

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