GDM and maternal obesity are independently associated with adverse pregnancy outcomes, and children born to mothers with GDM and overweight/obesity are more likely to be macrosomic and large for their gestational age [9][10][11]. In addition to short-term complications, they also have an increased risk of long-term complications similar to those in their mothers [12,13]. Studies indicate that offspring exposed to maternal diabetes or GDM in utero are at a higher risk of developing childhood obesity and glucose intolerance in early adulthood than offspring not exposed to maternal diabetes [12,14]. Moreover, if the offspring is female, she is more likely to develop GDM herself and thereby create a vicious circle. Prevention of GDM and fetal over-nutrition in pregnancy could therefore be important strategies to interrupt this trans-generational cycle of obesity and diabetes (Fig. 1).To date, several studies have demonstrated the effectiveness of lifestyle interventions in the prevention of type 2 diabetes [15]. A beneficial effect on the risk of diabetes was also found in the Diabetes Prevention Program in women with a history of GDM, which was sustained during a 10-year follow-up period [16]. Since obesity is one of the most powerful modifiable risk factors for GDM in pregnant women [12,17], many intervention studies have focused on reducing weight or on reducing gestational weight gain in pregnancy, most often by changes in diet and physical activity. The effects of combined diet and exercise interventions during pregnancy were recently reviewed by Cochrane [18]. No clear evidence for the prevention of GDM was found. In contrast, a newly published meta-analysis concluded that moderate exercise programmes initiated early during pregnancy reduce the risk of GDM and excessive gestational weight gain [19]. Ideally, interventions aimed at improving metabolic conditions and placental function in obese women should take place before pregnancy, prior to conception [20]. Interestingly, Zhang et al recently reported that adherence to a healthy lifestyle in the Diabetologia