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The preconception period is an optimal window to adapt the lifestyle for improved outcomes for both mother and child. Our aim is to determine the effect of a lifestyle intervention, initiated before and continued throughout pregnancy, on maternal glucose tolerance and other maternal and infant cardiometabolic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This ongoing randomised controlled trial has included 167 females aged 18\u201339 years old at increased risk for GDM who are contemplating pregnancy. The participants were randomly allocated 1:1 to an intervention or control group. The intervention consists of exercise (volume is set by a heart rate-based app and corresponds to \u2265 1\u2009hour of weekly exercise at \u2265 80% of individual heart rate maximum), and time-restricted eating (\u2264 10\u2009hours\/day window of energy intake). The primary outcome measure is glucose tolerance in gestational week 28. Maternal and offspring outcomes are measured before and during pregnancy, at delivery, and at 6\u20138 weeks post partum. Primary and secondary continuous outcome measures will be compared between groups based on the \u2018intention to treat\u2019 principle using linear mixed models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The Regional Committees for Medical and Health Research Ethics in Norway has approved the study (REK 143756). The anonymised results will be submitted for publication and posted in a publicly accessible database of clinical study results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Clinical trial gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04585581\">NCT04585581<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073572","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T20:51:36Z","timestamp":1696452696000},"page":"e073572","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["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"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct04585581","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5505-3623","authenticated-orcid":false,"given":"Md Abu Jafar","family":"Sujan","sequence":"first","affiliation":[{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Department of Women's Health, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna Margrethe Storheil","family":"Skarstad","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guro","family":"Rosvold","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Lyngvi","family":"Fougner","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway"},{"name":"Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri Ann","family":"Nyrnes","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Children's Clinic, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Charlotte","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turid","family":"Follestad","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Clinical Research Unit Central Norway, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell \u00c5","family":"Salvesen","sequence":"additional","affiliation":[{"name":"Department of Women's Health, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway"},{"name":"Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-8088","authenticated-orcid":false,"given":"Trine","family":"Moholdt","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Department of Women's Health, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"key":"2025121411311170000_13.10.e073572.1","unstructured":"International Diabetes Federation . 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