Overall body weight and weight gain during pregnancy have gone up among all women in the United States. Higher body weight of the mother at the time of the baby's conception and a greater weight gain during pregnancy are both associated with more fat in the infant and later overweight in children. Obesity in children has become a great public health problem. This study will use the new Institute of Medicine Guidelines for weight gain during pregnancy. These Guidelines are based on observations showing that women whose weight gain was within the recommended Guidelines had healthier pregnancies and better pregnancy outcomes than those who did not follow the Guidelines. It is important for researchers to understand whether a lifestyle intervention like LIFT can help women have healthier pregnancies and healthier babies. If the researchers find that a lifestyle intervention positively impacts the mothers and their babies, then the researchers can help other pregnant women have healthier pregnancies and babies as well.

This Study, The Lifestyle Intervention For Two (LIFT) Study, is part of the LIFE Moms consortium, a national project involving seven sites across the US. The purpose of the LIFE Moms consortium is to study different ways in which women who are overweight or obese can manage their body weight during pregnancy, and how this may affect them and their baby's health at birth and through the first year. As part of the LIFE Moms consortium, The LIFT Study will look how controlled weight gain during pregnancy will impact the health of the mother and her child. Researchers at Columbia University are investigating the effect of an intensive lifestyle intervention (i.e. diet and physical activity counseling). The researchers hope to positively impact not only body weight gain during pregnancy, but also positively impact infant body fatness and mother's weight loss after pregnancy. The LIFE Moms researchers are looking at whether too much weight gain in the mother will result in a leaner baby, and less retention of fat by the mother following pregnancy.

This study is a randomized controlled trial to study the effect, in a cohort of racially and ethnically diverse group of overweight and obese pregnant women, of an Intensive Lifestyle Intervention (ILI) compared to Usual Care (UC) on gestational weight gain (GWG), infant fatness, and mothers' post-delivery weight retention. Women in the ILI arm will receive intensive counseling during pregnancy and group counseling after delivery regarding behavior, nutrition, and physical activity change. Visits to counselors will occur semi-monthly and additional telephone and internet contacts will occur. The mothers' will be assessed at 14 and 36 weeks of pregnancy and at 14 weeks (range 13-15) and 52 (range 48-56) weeks post-delivery. The measurements will be anthropometry, whole body MRI, EchoMRI, and whole body plethysmography (BodPod). The infants' measurements will be anthropometry, whole body MRI, EchoMRI, and whole body plethysmography (PeaPod) for fatness 14 weeks (range 14-15) weeks and 52 (range 48-56) weeks. Mothers and children will have cardio-metabolic risk factors measured in plasma. Data will be collected regarding mothers' dietary intake and physical activity (questionnaires and accelerometry) to assist in counseling. Other data to be collected include questionnaires on quality of life, socio-economic status. Each mother will be followed during pregnancy and for a year post delivery. Each infant will be followed for a year after birth. The researchers have the ability to continue to follow these participants if further funding is forthcoming, as they are all local to the hospital's catchment area and to own physicians.