PRE-Pregnancy Weight Loss And the Reducing Effect on CHILDhood Overweight - Copenhagen

The study is a single site parallel randomized controlled study.The study will be assessing the effect of a 10% weight loss intervention vs a control group among healthy couples where the prospective mother is overweight or obese (BMI 28-45 kg/m^2) and between 18-35 years. The investigators will recruit a total of 240 healthy couples who will be randomized 1:1 to either intervention or control, stratified according to maternal pre-pregnancy BMI.The overall objective is to test whether a comprehensive pre-conceptional parental weight loss intervention effectively reduces the risk of offspring overweight and adiposity and its complications compared to a control group. The investigators hypothesize that parental weight loss intervention, initiated before conception, will facilitate lower parental insulin resistance, inflammation, body weight and adiposity, incretin responses compared to usual care. For the offspring the investigators hypothesize that the intervention will reduce adverse pregnancy outcomes with a reduction in offspring neonatal adiposity, reduced risk of being born large for gestational age (LGA) and with lower BMI z-score at 18 months.

Maternal inclusion Criteria:Maternal pre-pregnancy BMI 28.0-44.9 kg/m^2Maternal age range 18-35 yearsConnected to Hvidovre Hospital as place of birthNot pregnant or breastfeedingPaternal Inclusion Criteria:Paternal pre-pregnancy BMI 18.5-44.9 kg/m^2Paternal age range 18-55 yearsParental Inclusion Criteria:Couples (male and female)Planning pregnancy within 1 yearProvided voluntary informed consentDanish or English speakingIntention to permit the planned offspring to participate in the follow-up studyAble to store biological samples from the offspring at home in the freezer in a box given by the study personnelParental Exclusion Criteria:Diabetes mellitus (Type 1 or 2)Previous or present eating disorderAllergy towards ingredients in the very low calorie diet productsSevere heart, liver or kidney diseaseConception by in vitro fertilization≥4 consecutive spontaneous pregnancy loss (female)Having tried to conceive or prior time to pregnancy of more than 12 monthsAny medical condition or concomitant medication as judged by the medical responsibleAdherence to vegan diets or other diets interfering with the dietary guidelines in the studyParticipation in other clinical trialEngagement in elite sports or similar strenuous exercise ≥5 h/weekBlood donation or transfusion within the past month before baselineBlood donation during the studyInability or unwillingness to follow the study protocol and instructions given by the study personnelPregnancy registered at baseline visit (urinary analysis with dipstick)A detailed description of the exclusion criteria is given below:Medical conditions as known by the participant:Diabetes mellitus (type 1 and 2)History or diagnosis of eating disorder (e.g. restrained eating, disinhibition, emotional eating)Any significant medical condition as assessed by the investigator (e.g. dysregulated thyroid disease or reproductive diseases)Any significant psychiatric disorder (i.e. schizophrenia, bipolar disease or depression) as assessed by the investigatorSevere chronic heart, liver and kidney diseasePolycystic ovary syndrome with irregular cycleAmenorrheaSeverely reduced semen quality incl. azoospermiaMedication:- Current use of medication or use within the previous three months with a potential to affect body weight or pregnancy as judged by the investigator (e.g. systemic corticoids)Personal/other:Having tried to conceive or prior time to pregnancy of more than 12 monthsWeight changes ± 5% three months prior to inclusionSevere food allergies, food intolerances or dislike expected to interfere with the study, including allergy towards ingredients in the VLCD productsEngagement in elite sports or similar strenuous exercise ≥5 h/weekBlood donation or transfusion within the past month before baselinePlanned blood donation for other purpose than this study during participationAlcohol abuse, as judged by the investigator, within the previous 12 monthsDrug abuse, as judged by the investigator, within the previous 12 monthsPsychological or behavioral problems which, in the judgement of the investigator, would lead to difficulty in complying with the study protocolParticipation in other clinical trials within the past three months or intention to do so during the study, which are judged by the investigator to affect the present studyUnable to consume the interventional product for religious reasons, swallowing disorders, other physiological reasons or any other reasons for not being able to follow the recommended dietInability or unwillingness to give written informed consent or communicate with study personnelInability or unwillingness to follow the study protocol and instructions given by the study personnelIlliteracy or inadequate understanding of Danish or English language.Any other condition that judged by the investigator may interfere with the adherence to the study protocol