An upcoming four-year trial called the Healthy Moms study will attempt to keep obese women from gaining any weight during their pregnancies to determine whether restricting weight gain can improve pregnancy outcomes, the New York Times reports. According to the Times, one-fifth of pregnant women in the U.S. are obese. Researchers have questioned whether obesity in a woman can negatively affect the health of her fetus or increase the likelihood of childhood obesity. In addition, some observational studies have suggested that obese women who gain less have better pregnancies and deliveries. However, there also is concern that women who do not gain weight will burn fat for energy, producing acidic compounds called ketones that studies have linked to lower I.Q. scores in infants.

The Institute of Medicine in May released new guidelines that lowered the minimum recommended weight gain during pregnancy for obese women from 15 pounds to 11 pounds. Many experts say that women require only 300 to 400 additional calories per day to support a pregnancy. Kathleen Rasmussen, a professor of nutrition at Cornell University who led the IOM committee on weight gain during pregnancy, said, “Pregnancy is what we call a teachable moment, a time when women are willing to make positive behavioral changes, because it’s important for their own health and their babies’ health.” She said that while many women quit smoking or drinking during pregnancy, “three-quarters of pregnant women who are overweight and obese are gaining outside the recommended guidelines.” Rasmussen added that there is a need for experimental studies examining whether limited weight gain will improve pregnancy outcomes.

Researchers managing the Healthy Moms study are hoping that if participants do gain weight, the gain will be limited to 3% of their baseline weight, or about five pounds for a woman who weighs 170 pounds. Participants will meet twice on their own with a dietitian and also participate in weekly support groups with weight management specialists. They will be encouraged to follow a low-fat diet plan incorporating fruits, vegetables, whole grains, lean meat and low-fat dairy products. The women will aim to consume about 2,000 calories per day. The study will follow the participants during and after their pregnancies to track their weight gain, the size of their infants and their weight retention one year after birth. Researchers also will analyze any complications, the infant’s growth and feeding practices, and whether the woman continues with a healthier lifestyle after the birth (Rabin, New York Times, 12/15).

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