Counselling, lifestyle and physical activity in maternity care -study (NELLI)

Lifestyle trial during pregnancy – prevention of chronic diseases in mothers and their offspring


Physical activity and diet are both known to have favourable effects on insulin resistance during pregnancy.


In the NELLI study we aimed to investigate, whether gestational diabetes could be prevented by counseling on diet, physical activity and gestational weight gain during pregnancy.


A cluster-randomized controlled trial was conducted in 14 municipalities in the southern part of Finland. Pairwise randomization was performed in order to take into account socioeconomic differences.

Recruited women were at 8–12 weeks’ gestation and fulfilled at least one of the following criteria:
• body mass index ≥25 kg/m²
• history of earlier gestational glucose intolerance
• macrosomic newborn (> 4500 g), age ≥ 40 years
• first or second degree relative with history of type 1 or 2 diabetes.
Main exclusion criterion was pathological oral glucose tolerance test (OGTT) at 8–12 weeks’ gestation.

The trial included several counseling sessions:
• one on physical activity at 8–12 weeks’ gestation
• one for diet at 16–18 weeks’ gestation
• 3–4 booster sessions during other routine visits.

In the control clinics women received usual care. Information on height, weight gain and other gestational factors was obtained from maternity cards.
Physical activity, dietary intake and quality of life were followed by questionnaires during pregnancy and at 1-year postpartum. Blood samples for lipid status, hormones, insulin and OGTT were taken at 8–12 and 26–28 weeks’ gestation and 1 year postpartum.


In addition with diabetes prevention, the study has produced information on workability and return to work and cost-effectiveness of gestational physical activity and dietary counselling, prevalence of gestational diabetes and postpartum metabolic syndrome. Results on maintaining the possible health behaviour changes one or five years postpartum are important in order to prevent chronic diseases such as cardiovascular disease and diabetes.







Riitta Luoto, Research Director



For publications (international and Finnish) of this research see the Finnish description.
To find the list of publications (Julkaisuja), scroll the page down.

Last Modified: 27.11.2014


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