Can weight loss before pregnancy prevent childhood overweight?

Children of mothers who are overweight have three times the increased risk of becoming overweight as adolescents and adults. Overweight is often the precursor of type 2 diabetes and cardiovascular disease.

A new research project at the Steno Diabetes Center Copenhagen (SDCC) will, in collaboration with the Department of Biomedical Sciences, help women achieve healthy weight loss and will thus show whether a weight loss of ten per cent or more before pregnancy and a healthy weight during pregnancy can benefit both the mother and the child.

Mother's overweight also increases the risk of fertility problems, abortion, and complications with pregnancy and birth. What the mother weighs when she becomes pregnant also seems to determine the child's weight, not just at the time of birth, but for the rest of the child's life.

It is not trivial matters that the mother's weight can be taken into account for, and which can contribute to the worry of many expectant mothers.

In addition to the role of the mother, we also know that their partner’s health plays a significant role. Both for the future child's health, his own fertility and as support for the woman to succeed with her weight loss. With this project, we wish not only to improve the coming family’s lifestyle before and during pregnancy, but we hope to provide the future parents with tools and help to ensure a lifestyle change that will benefit the family later on as well.

"Our hope is that when mom loses her weight before her pregnancy, she will have fewer complications during pregnancy and childbirth and give birth to a child with a healthier distribution of fat on the body compared to women who are overweight and who do not lose weight. If this turns out to be the case, we believe it can provide tools for women who are overweight and who want to be mothers to achieve a healthy weight," says Professor and Chief Physician at SDCC, Tina Vilsbøll, who is Research Director for the project known as PRE-STORK.

Professor Signe Sørensen Torekov from Department of Biomedical Sciences at the University of Copenhagen also participates in the project. She is researching how to achieve healthy and persistent weight loss and obesity during childhood.

"In this study, women who have obesity and who want a healthy weight before pregnancy will be offered to lose 10% of their body weight, which is subsequently maintained with a training programme, a healthy diet, and conversations with which we have had a good experience in the past. Our expectation is that the mother's healthy weight before and during pregnancy will lead to a healthy weight development in the children with less of the unhealthy fat," says Professor Signe Torekov.

"From previous studies, we know that obesity and high blood sugar during pregnancy are associated with an increased risk of later development of obesity and type 2 diabetes in the children. At the same time, previous studies also indicate that it is too late to start lifestyle interventions during pregnancy if they are to have a beneficial effect on children's health later in life, and therefore this study is particularly interesting as we start the intervention before the pregnancy and sustain it until the women have given birth," says Louise Groth Grunnet, Senior Researcher at SDCC,  For many years, she has focused on health during pregnancy and childhood and is jointly responsible for the project.

The project, which will run for a five-year period, has just received a grant of DKK 24 million from the Novo Nordisk Foundation. The Foundation has awarded a total of DKK 60 million to research projects which, in their own way, will seek to identify whether overweight in parents up to and during pregnancy are linked to the development of overweight in children and adolescents.

In the PRE-STORK project, the children are followed until they are six months. This applies to both the children born of mothers who have lost weight before their pregnancy, and the children born of mothers who are overweight in the control group who do not lose weight beforehand.

Last year, the Scientific Council for Preventative Measures concluded in a survey that the previous initiatives to prevent and reduce overweight among children and adolescents do not seem to have an effect in the long term, and that overweight is a complex interplay between physical, psychological, and social factors.

The report "Prevention of obesity among children and adolescents" from the Scientific Council also states that 15-20 per cent of the children in Denmark are overweight. 3-4 per cent are obese.

In the PRE-STORK project, the future mothers will receive support for changing dietary habits, exercising, as well as coaching and support from either a dietician, a nurse, or a sports physiologist. The future mother’s partners will also be involved throughout the process.

If parents and families change their lifestyles and lose weight, will fewer children, adolescents, and adults become overweight?

"It must be a joint effort for both the mother and their partner. We know this is difficult – just as it is difficult to achieve permanent weight loss. But even though it is difficult it should not be a pretext for doing nothing for us as researchers or for the families. We believe that we can make a difference for the women and their children with this project”. "We hope that the women, who will participate are ready to spend six months getting some good habits into their daily lives to bring their body and mind into the best possible condition before the pregnancy. Our expectation is that they will find it easier to complete an uncomplicated pregnancy and most importantly: That they give birth to a healthy baby who gets a really good start in life," says Tina Vilsbøll, Louise Grunnet, and Signe Torekov who are jointly responsible for the project.