Mixed

Intensive lifestyle counseling targeting physical activity, diet, and weight gain during pregnancy significantly reduces the proportion of large-for-gestational-age (LGA) newborns in high-risk women, but does not significantly reduce the incidence of gestational diabetes mellitus (GDM).

For high-risk pregnant women, intensive lifestyle counseling focusing on increasing physical activity (aiming for 800 MET minutes/week) and improving diet (more fiber, less saturated fat and sugar) can significantly reduce the risk of having a large-for-gestational-age baby. However, this approach may not be sufficient to prevent gestational diabetes itself. Adherence to these lifestyle changes is key to achieving better birthweight outcomes.