There is evidence from epidemiological and animal studies supporting the concept of programming fetal, neonatal, and adult health in response to in utero exposures such as the achieved obesity and various lifestyle variables. Maternal physical activity, gestational weight gain, and sub-optimal and excess nutrition during pregnancy may result in risk of obesity for the offspring. Intake of dairy foods rich in high-quality proteins, calcium, and vitamin D, by the mother, may influence bone health status in the long term. Existing clinical practice guidelines for managing GWG are not founded on randomized trials and are bereft of specific active intervention ingredients. The Be Healthy in Pregnancy (BHIP) study is randomized controlled trial (RCT) designed to put to test the effectiveness of novel structured and monitored nutrition and exercise intervention in pregnant women of all pre-pregnancy weight categories, delivered via prenatal care in community settings, on the likelihood of women achieving recommended GWG and a benefit to bone status of offspring and the mother during birth time and six months postpartum.

Methodology
The BHIP study is a two-site RCT that will recruit up to 242 participants more than 18 years of age and at 12 to 17 weeks of gestation. Post baseline measures, participants are put through a structured and monitored nutrition and exercise, or usual care program for the duration of the pregnancy. The outcome of the study is the percent of women who achieve GWG within the Institute of Medicine (IOM) guidelines. Subsequent outcomes comprise of maternal bone status via blood bone biomarkers during pregnancy; infant bone status in cord blood; infant and mother bone status measured by dual-energy absorptiometry scanning (DXA scan) at six months postpartum; other measures including mother’s blood pressure, blood glucose measure, measure of lipid profiles, body fat, and postpartum weight retention; and finally infant weight z-scores and mass at the age of six months post birth.

Conversation
In reality this RCT is all set to generate high-quality proof to refine the nutrition guidelines during pregnancy to enhance the likelihood of women achieving recommended GWG. This is also going to demonstrate the importance of early nutrition on bone health of the infant.

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