Be Healthy in Pregnancy (BHIP) With Nutrition and Exercise

NCT01689961 | Completed DMC

• 1 other identifier: 12-469
• Study Type: interventional
• Target: 242
• Locations: 1 country
• Sites: 4

Brief Summary

Excess weight gain in pregnancy is a major problem affecting 55-75% of Canadian women who enter pregnancy overweight or obese and about 40% of women who are normal weight. Excess weight gain puts mothers at risk for health problems such as diabetes and developing or sustaining obesity after pregnancy, and puts their babies at risk of being born too large or developing related health problems. Mothers will be randomized to a structured high dairy protein diet and walking program or the usual care by their care provider. The investigators research questions are: Will a structured nutrition and exercise program in pregnancy compared to usual prenatal care increase the chance that mothers will achieve pregnancy weight gain within the current recommendations; improve health measures, in mother and infant at six months post-partum; to evaluate the benefits of a high dairy intake in pregnancy on maintenance of bone status in the mother and bone health outcomes in the child in early life (6 months); and to investigate the interactions between genes associated with bone health and high dairy diet supplementation on bone status in mothers during pregnancy, and bone health in mothers post-delivery and children to 6 months of age. Mothers' weight, physical activity and adherence to the nutrition plan will be assessed until birth and at follow-up with their infants at 6 months after birth. The research team will ensure new information is quickly transferred to programs to assist women to have healthier pregnancies.

Conditions

Pregnancy Complications; Weight Gain

Keywords

Nutrition; Physical activity; Gestational weight gain; Pregnancy outcomes; Birth

Outcome Measures

Primary Outcomes (1)

• Gestational weight gain within IOM guidelines

  Among pregnant women (population), does introducing a structured and monitored nutrition and exercise program (treatment) in early pregnancy compared with Usual Prenatal Care (control) increase the likelihood of attaining gestational weight gain within the IOM guidelines (outcome) over the pregnancy period?

  Change from baseline at 38 weeks gestation

Secondary Outcomes (2)

• Maternal and infant outcomes

  6 months postpartum

• Bone health of mother and baby

  6 months post-partum

Study Arms (2)

Nutrition+Exercise Intervention

EXPERIMENTAL

Structured + monitored nutrition and exercise intervention: The exercise intervention includes a custom-designed pregnancy-specific group walking class of 30-60 min. 1x/week and a prescribed at-home walking program for 10,000 steps/day. The nutrition intervention is a high protein (25% energy) low-fat dairy food plan designed to meet energy needs and with individualized counselling. The intervention will include 2 x/month weight monitoring and records of nutrition and activity to ensure adherence

Behavioral: Structured + monitored nutrition and exercise intervention

Usual Prenatal Care

NO INTERVENTION

Mothers in the Control Group will be followed by their primary care provider and have usual access to public health services. In addition, they will be asked to attend 2 focus group sessions exploring women's experiences with exercise, nutrition, and weight gain in pregnancy. Women will receive information about healthy pregnancy from Health Canada.

Interventions

Structured + monitored nutrition and exercise intervention BEHAVIORAL

The exercise intervention includes a custom-designed pregnancy-specific group walking class of 30-60 min. 1x/week and a prescribed at-home walking program for 10,000 steps/day. The nutrition intervention is a high protein (25% energy) low-fat dairy food plan designed to meet energy needs and with individualized counselling. The intervention will include 2 x/month weight monitoring and records of nutrition and activity to ensure adherence.

Nutrition+Exercise Intervention

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Healthy pregnant females \> 18 years of age with singleton pregnancies (either nulliparous or multiparous);
• less than 17 weeks gestation;
• a pre pregnancy BMI \< 40 kg/m2 (owing to the fact that severe obesity with BMI\> 40 may have limitations with respect to physical activity);
• plans to deliver at a Hamilton or London regional hospital or by home birth and willing to attend research visits at the community site where they were recruited;
• able to tolerate dairy foods;
• approval of primary care provider;
• able to provide signed informed consent.

You may not qualify if:

• unable to understand some English;
• type 1 or type 2 diabetes;
• known contraindications to exercise as recommended by the Canadian clinical practice guidelines for pregnancy;
• severe gastrointestinal diseases or conditions;
• any significant heart, kidney, liver or pancreatic diseases;
• pre-existing diabetes;
• currently smoking;
• a depression score 12 or above on the validated Edinburgh depression questionnaire.

Sponsors & Collaborators

• McMaster University: lead
• Canadian Institutes of Health Research (CIHR): collaborator
• Agriculture and Agri-Food Canada: collaborator
• Dairy Farmers of Canada: collaborator

Study Sites (4)

Burlington Midwives Clinic

Burlington, Ontario, Canada

Location

McMaster Family Health Team

Hamilton, Ontario, L8S 1A4, Canada

Location

Hamilton Midwives Clinics

Hamilton, Ontario, Canada

Location

Exercise and Pregnancy Laboratory

London, Ontario, N6A 5C1, Canada

Location

Related Publications (8)

• Krzeczkowski JE, Mortaji N, Atkinson S, Schmidt LA, Van Lieshout RJ. Adaptive changes in multiple aspects of emotion regulation in the offspring of pregnant persons receiving a diet-and-exercise intervention relative to usual pregnancy care: a randomized controlled trial. Am J Clin Nutr. 2025 Jan;121(1):50-59. doi: 10.1016/j.ajcnut.2024.10.022. Epub 2024 Oct 30.

  PMID: 39486684 DERIVED

• Mortaji N, Krzeczkowski J, Atkinson S, Amani B, Schmidt LA, Van Lieshout RJ. Early neurodevelopment in the offspring of women enrolled in a randomized controlled trial assessing the effectiveness of a nutrition + exercise intervention on the cognitive development of 12-month-olds. J Dev Orig Health Dis. 2023 Aug;14(4):532-539. doi: 10.1017/S204017442300020X. Epub 2023 Jul 14.

  PMID: 37448202 DERIVED

• Dempsey K, Mottola MF, Atkinson SA. Comparative Assessment of Diet Quality and Adherence to a Structured Nutrition and Exercise Intervention Compared with Usual Care in Pregnancy in a Randomized Trial. Curr Dev Nutr. 2023 May 13;7(6):100097. doi: 10.1016/j.cdnut.2023.100097. eCollection 2023 Jun.

  PMID: 37441683 DERIVED

• Mortaji N, Krzeczkowski J, Atkinson S, Amani B, Schmidt LA, Van Lieshout R. Preliminary findings of emotion regulation in 12-month-old infants of mothers enrolled in a randomized controlled trial assessing a nutrition + exercise intervention. Dev Psychobiol. 2023 Mar;65(2):e22376. doi: 10.1002/dev.22376.

  PMID: 36811372 DERIVED

• Shanmuganathan M, Bogert M, Kroezen Z, Britz-McKibbin P, Atkinson SA. Dynamic Metabolic Signatures of Choline and Carnitine across Healthy Pregnancy and in Cord Blood: Association with Maternal Dietary Protein. J Nutr. 2023 Apr;153(4):999-1007. doi: 10.1016/j.tjnut.2023.02.013. Epub 2023 Feb 11.

  PMID: 36780943 DERIVED

• Perreault M, Mottola MF, Atkinson SA; BHIP study team. Individualized high dairy protein + walking program supports bone health in pregnancy: a randomized controlled trial. Am J Clin Nutr. 2022 Oct 6;116(4):887-896. doi: 10.1093/ajcn/nqac182.

  PMID: 35759368 DERIVED

• Murray-Davis B, Grenier L, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK. Experiences regarding nutrition and exercise among women during early postpartum: a qualitative grounded theory study. BMC Pregnancy Childbirth. 2019 Oct 21;19(1):368. doi: 10.1186/s12884-019-2508-z.

  PMID: 31638920 DERIVED

• Perreault M, Atkinson SA, Mottola MF, Phillips SM, Bracken K, Hutton EK, Xie F, Meyre D, Morassut RE, Prapavessis H, Thabane L; BHIP Study team. Structured diet and exercise guidance in pregnancy to improve health in women and their offspring: study protocol for the Be Healthy in Pregnancy (BHIP) randomized controlled trial. Trials. 2018 Dec 19;19(1):691. doi: 10.1186/s13063-018-3065-x.

  PMID: 30567604 DERIVED

MeSH Terms

Conditions

Pregnancy Complications; Weight Gain; Motor Activity; Gestational Weight Gain

Condition Hierarchy (Ancestors)

Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Body Weight Changes; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior

Study Officials

• Stephanie A Atkinson, PhD

  McMaster University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 13, 2012
• First Posted: September 21, 2012
• Study Start: November 1, 2012
• Primary Completion: October 30, 2018
• Study Completion: April 30, 2019
• Last Updated: October 1, 2020

Record last verified: 2019-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (4)