Project 456688

Healthy eating during pregnancy has favorable effects on markers related to diabetes (glucose tolerance) and is associated with lower gestational diabetes mellitus (GDM) risk. The cornerstone of GDM treatment is nutrition therapy but the latter often starts late in pregnancy and thus may not have the expected effects on glucose tolerance. What if an intervention promoting healthy eating was initiated at the beginning of pregnancy in all women at risk, would it improve glucose homeostasis? To answer this important question, we will perform a randomized controlled trial in 120 pregnant women. Women receiving the nutritional intervention will be compared to a control group receiving standard care. Women will be included in the study if they are 18 years or older, at 12 gestational weeks or less and if they have at least one GDM risk factor. The nutritional intervention, which will start in the first trimester, is based on the 2019 Canada's Food Guide and is composed of 4 individual sessions with a registered dietitian (12, 18, 24 and 30 weeks). Between those follow-ups, informative nutritional web capsules and phone calls with the registered dietitian will be provided. To ensure that the women remain motivated and receive social support, a private Facebook group will be used. Change in fasting plasma glucose from the 1st to the 3rd trimester (primary outcome) will be compared between groups. Changes in other indices of glucose homeostasis will also be compared between both groups (secondary outcomes) as well as GDM incidence and gestational weight gain (exploratory outcomes). We hypothesize that the nutritional intervention will be effective at improving glucose homeostasis. We expect the results will show the importance of nutritional care starting early in pregnancy in women at risk of GDM. On a larger scale, this will emphasize the need of reallocating human resources in nutrition to support pregnant women at risk of GDM.