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Active, not recruitingNCT04585581Updated Apr 8, 2026

Preconception Lifestyle Interventions to Improve Future Metabolic Health (Before the Beginning)

An interventional study of time-restricted eating and high intensity exercise in Gestational Diabetes, sponsored by Norwegian University of Science and Technology. Active, not recruiting at 1 site in Norway. Open to female participants aged 18 Years to 39 Years. Per ClinicalTrials.gov, last updated 2026-04-08.

Sponsored by Norwegian University of Science and Technology · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
167
Allocation
Randomized
Ages
18 Years to 39 Years
Sex
Female
01

Study summary

The aim of this study is to investigate whether the combination of high intensity exercise and time restricted eating before and during pregnancy can reduce the risk of hyperglycaemia during pregnancy.

Read the detailed description

Women who are planning a pregnancy will be recruited into a parallel groups randomised controlled trial where the intervention will consist of high intensity training and time-restricted eating. The intervention will continue throughout pregnancy. The investigators will assess whether this lifestyle intervention can effect maternal and offspring cardiometabolic health.

02

Conditions studied

  • Gestational Diabetes

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Keywords

  • Diet therapy
  • Exercise therapy
03

In context

Diabetes, Gestational

842 studies on the registry are indexed under Diabetes, Gestational; 198 are open to participants now.

This study's enrollment of 167 is above the median of 110 across 550 interventional studies indexed under Diabetes, Gestational.

Browse Diabetes, Gestational studies →

Lead sponsor

Norwegian University of Science and Technology is the lead sponsor of 487 studies on the registry; 52 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 39 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • contemplating pregnancy within the next six months
  • At least one of the following criteria: BMI ≥ 25 \< 40 kg/m2, gestational diabetes in a previous pregnancy, previous infant > 4.5 kg, fasting plasma glucose > 5.3 mmol/L, or Non-European ethnicity

Exclusion criteria

Exclusion Criteria:

  • On-going pregnancy
  • Trying to conceive ≥ 6 cycles at study entry
  • Known diabetes (type 1 or 2)
  • Shift work that includes night shifts > 2 days per week
  • Previous hyperemesis
  • Known cardiovascular diseases
  • High intensity exercise ≥ 2 hours/week the last 3 months
  • Habitual eating window ≤ 12 hours
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
167 participants (actual)

Study arms

  • Experimental
    diet + training

    Behavioral: time-restricted eating · Behavioral: high intensity exercise · Other: Standard Care

  • Active comparator
    controls

    Other: Standard Care

Interventions

  • Behavioraltime-restricted eating

    Participants will be asked to limit the time-window for their daily energy intake to a maximum of 10 hours.

  • Behavioralhigh intensity exercise

    Participants will be encouraged to exercise with high intensity 2-3 times per week

  • OtherStandard Care

    Standard clinical care

06

What researchers measure

Primary outcomes

  1. Plasma glucose concentration

    Plasma glucose concentration after 2 h oral glucose tolerance testing (75 g glucose)

    Time frame: Gestational week 28

Secondary outcomes

  1. Plasma glucose concentration

    Plasma glucose concentration after 2 h oral glucose tolerance testing (75 g glucose)

    Time frame: Gestational week 12

  2. HbA1c

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  3. Total cholesterol

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  4. Triglycerides

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  5. High density lipoprotein cholesterol

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  6. Low density lipoprotein cholesterol

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  7. Low density cholesterol

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  8. Glucose

    Measured in the blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

  9. Insulin

    Measured in the blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

  10. Cytokines

    Measured in the blood, a panel of 27 cytokines of relevance for inflammatory status (Bio-Plex Pro Human Cytokine 27-plex Assay)

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

  11. Adipokines (Adiponectin, Leptin, Ghrelin)

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

  12. Homocysteine

    Measured in the maternal blood

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  13. Insulin sensitivity

    Insulin sensitivity estimated by homeostatic model assessment for insulin resistance (fasting serum insulin concentration (μU/mL) x fasting plasma glucose levels (mmol/L)/22.5)

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and in cord blood (delivery)

  14. Total body mass

    Estimated using InBody720 bioimpedance scale.

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  15. Fat mass

    Estimated using InBody720 bioimpedance scale.

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  16. Muscle mass

    Estimated using InBody720 bioimpedance scale.

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  17. Visceral fat area

    Estimated using InBody720 bioimpedance scale.

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  18. Continuous glucose monitoring

    Continuous glucose monitoring using Freestyle Libre (Abbott Diabetes Care), worn for 14 days.

    Time frame: Baseline and 8 weeks intervention

  19. Cardiorespiratory fitness

    Peak oxygen uptake at a maximum effort exercise test, measured in L/min using Metalyzer.

    Time frame: Baseline and intervention week 8

  20. Blood pressure

    Systolic - and diastolic blood pressure (in mmHg) will be measured in the seated position after 15 minutes of rest with an automatic blood pressure device (Welch Allyn, Germany) three times with one minute intervals, in left arm (average of three measurement).

    Time frame: Baseline, intervention week 8, gestational week 12 and 28

  21. Measured physical activity

    Measured by SenseWear activity monitor, worn for 7 days.

    Time frame: Baseline

  22. Measured physical activity

    Measured by Amazfit GTS smartwatch

    Time frame: From baseline and throughout the study period.

  23. Diet intake

    Online food diary (Lifesum app), 4-day registration (one weekend day and three weekdays=

    Time frame: Every 8 week throughout the trial.

  24. Self-reported physical activity

    International Physical Activity Questionnaire

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

  25. Sleep

    Self-reported: Pittsburgh Sleep Quality Index

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

  26. Chronotype

    Self-reported: Hornestberg Morningness Eveningness Questionnaire

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

  27. Psychological general well being

    Psychological general well being index (PGWBI)

    Time frame: Baseline, intervention week 8, gestational week 12 and 28, and every 8 week until delivery or until the participant is excluded from the trial due to not conceiving within 6 months from baseline

  28. Time to pregnancy

    Self-reported

    Time frame: From baseline to pregnancy (up to 36 weeks from enrollment)

  29. Psychological well-being

    Self-reported: Psychological General Well Being Index

    Time frame: Baseline, intervention week 8, gestational week 12 and 28 and every 8 week throughout the trial.

  30. Birth weight (infant)

    From hospital record

    Time frame: Delivery

  31. Birth length (infant)

    From hospital record

    Time frame: Delivery

  32. Head circumference of infant

    From hospital record

    Time frame: Delivery

  33. Apgar score

    From hospital record

    Time frame: Delivery, after 1, 5 and 10 minutes

  34. ICU admission

    From hospital record

    Time frame: Delivery

  35. Congenital malformation

    From hospital record

    Time frame: Delivery

  36. Gestational age at birth

    From hospital record

    Time frame: Delivery

  37. Length of stay at hospital

    From hospital record

    Time frame: Delivery

  38. Blood pressure (Infant)

    Blood pressure (systolic - and diastolic)

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

  39. Cardiac function (Infant)

    Ultrasound echocardiography Blood flow and myocardial function will be measured using mechanical wave imaging (MWI).

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

  40. Infant total body mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

  41. Infant muscle mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

  42. Infant fat mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

  43. Infant hydration status

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

  44. Infant bone mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: Within 72 hours of birth and after 6 weeks post delivery

Other outcomes

  1. Infant gut microbiome

    Sequencing of faecal samples

    Time frame: Within one week of birth, after 6 weeks and after 6 months

  2. Maternal gut microbiome

    Sequencing of faecal samples

    Time frame: After 6 weeks after delivery and after 6 months

  3. Breastmilk composition

    Breastmilk sampling, for storage (outcomes will be exploratory, not yet specified)

    Time frame: After 6 weeks after delivery and after 6 months

  4. Infant total body mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: At age of 6 months

  5. Infant fat mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: At age of 6 months

  6. Infant muscle mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: At age of 6 months

  7. Infant hydration status

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: At age of 6 months

  8. Infant bone mass

    Estimated using impedance measurements (BioScan tough i8-nano)

    Time frame: At age of 6 months

07

Study locations

1 site
  • St Olavs Hospital
    Trondheim, Norway
08

References and documents

Publications

  • Sujan MJ, Skarstad HM, Rosvold G, Fougner SL, Follestad T, Salvesen KA, Moholdt T. Time restricted eating and exercise training before and during pregnancy for people with increased risk of gestational diabetes: single centre randomised controlled trial (BEFORE THE BEGINNING). BMJ. 2025 Sep 9;390:e083398. doi: 10.1136/bmj-2024-083398. PubMed 40925657 ↗
  • Sujan MAJ, Skarstad HMS, Rosvold G, Fougner SL, Nyrnes SA, Iversen AC, Follestad T, Salvesen KA, Moholdt T. Randomised controlled trial of preconception lifestyle intervention on maternal and offspring health in people with increased risk of gestational diabetes: study protocol for the BEFORE THE BEGINNING trial. BMJ Open. 2023 Oct 4;13(10):e073572. doi: 10.1136/bmjopen-2023-073572. PubMed 37793933 ↗

Individual participant data

Plan to share: Yes — We will share individual participant data that underlie the results in publications, after deidentification (text, tables, figures, and appendices).

Supporting information: Study protocol, Sap, Icf, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04585581
Lead sponsor
Norwegian University of Science and Technology
Collaborators
St. Olavs Hospital
Responsible party
Sponsor
First posted
Oct 14, 2020
Start date
Nov 6, 2020
Primary completion
Feb 5, 2024
Completion
Dec 2026 (estimated)
Last update
Apr 8, 2026

Study contacts

Øystein Risa
study director · Norwegian University of Science and Technology, Fac MH ISB
Kjell Å Salvesen, md prof
study director · St Olavs Hospital, Dept Obstetrics & Gynecology

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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