APPROACH - An optimized programming of healthy children

– The most favourable dietary protein:carbohydrate ratio during pregnancy in the context of New Nordic Diet

Overweight and excessive gestational weight gain (GWG) is associated with increased risk of high birth weight; furthermore, there is an increased risk of the child developing overweight, diabetes and other metabolic diseases in childhood or adulthood. Increased knowledge to the possibility and efficacy of preventing overweight and related diseases is necessary. The effect of reducing GWG while supplying optimized amount and sources of nutrients is not well investigated. Modification of protein source and increase in ratio of protein in relation to amount of carbohydrate and reduction of glycaemic index (GI) has in observational studies individually been linked to improved foetal body composition, metabolism and weight control later in life, and less weight gain and weight retention for the mother. 

The overall aim of APPROACH is to investigate how an optimal diet during pregnancy influences the programming of the offspring. This study will increase the knowledge of the effect of a specific nutrient composition and weight retention during pregnancy on growth and development during the foetal stage and until nine years of age, risk markers later metabolic diseases, especially diabetes and metabolic syndrome.

APPROACH will be a dietary intervention investigating differences in responds to a high-protein, especially marine and dairy protein and low-GI diet versus a diet according to the Nordic Nutritional Recommendations. All visits and assessment will be performed by trained staff at Copenhagen University Hospital Herlev. Subjects will be women with expected delivery at Department of Gynaecology and Obstetrics and examinations of gestational development, foetal and child growth and development will take place at Copenhagen University Hospital Herlev. A total of 390 obese (body mass index (BMI) ≥ 30 kg/m2) pregnant women will be randomized to intervention or control and engage in the program from late first trimester or early second trimester to birth. After birth the 390 children will be included in a prospective cohort according to maternal randomization and examined six times from delivery until the age of nine years.

In addition to support given from the Copenhagen University Hospital Herlev financial support has been obtained from the Danish Dairy Research Foundation and OPUS project - Optimal well-being, development, and health for Danish children through a healthy New Nordic Diet (supported by a grant from the Nordea Foundation). Furthermore support has been granted from LEGO Charity, Pharma Nord and PharmoVital. 

APPROACH is registered on identified as NCT01894139, by 31st October 2013 approved by the Ethical Committee, journal number: H-3-2013-119 and declared to the Danish data protection agency, journal number is HEH-2013-046 / 02414.