Objective: We sought to identify modifiable risk factors for excessive gestational weight gain (GWG).
Study design: We assessed associations of diet and physical activity with excessive GWG among 1388 women from the Project Viva cohort study.
Results: Three hundred seventy-nine women (27%) were overweight (body mass index >or= 26 kg/m(2)) and 703 (51%) experienced excessive GWG, according to Institute of Medicine guidelines. In multivariable logistic regression models, we found that intake of total energy (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.00-1.22, per 500 kcal/d), dairy (OR, 1.08; 95% CI, 1.00-1.17, per serving per day), and fried foods (OR, 3.47; 95% CI, 0.91-13.24, per serving per day) were directly associated with excessive GWG. First trimester vegetarian diet (OR, 0.46; 95% CI, 0.28-0.78) and midpregnancy walking (OR, 0.92; 95% CI, 0.83-1.01, per 30 minutes per day) and vigorous physical activity (OR, 0.76; 95% CI, 0.60-0.97, per 30 minutes per day) were inversely associated with excessive GWG.
Conclusion: A healthful diet and greater physical activity are associated with reduced risk for excessive GWG.