Eating a healthy, calorie-controlled diet during pregnancy can help prevent excessive weight gain and cut the risk of obstetric complications, researchers report. In Europe and the United States, up to 40 percent of women gain more than the recommended weight during pregnancy and this excess weight is associated with a number of major health problems, according to background information in the study published online May 17 in the BMJ. In the report, an international team of researchers reviewed the findings of 44 studies that included more than 7,200 women and found that dietary intervention resulted in an average reduction in weight gain during pregnancy of nearly 8.8 pounds, compared with 1.5 pounds for exercise, and 2.2 pounds for exercise and diet combined. Dietary intervention alone also provided the most benefit in preventing serious pregnancy complications such as preeclampsia (a sudden spike in the mother's blood pressure after the 20th week of pregnancy), diabetes and premature birth, according to lead researcher Dr. Shakila Thangaratinam from Queen Mary, University of London, and colleagues. The study authors concluded that dietary and lifestyle interventions in pregnancy improve outcomes for both mother and baby. However, an accompanying editorial suggested that there is not enough evidence to support dietary or any other type of intervention.

Dawn Josephson could barely believe it when she found health insurance that would actually cover the cost of treating her young son’s eye condition.

Josephson, a freelance editor, wife and mother of two in Jacksonville, Fla., had been spending as much as $1,000 a month of her family’s budget on surgery, doctor visits, tests, and treatments in the seven months since 2-year-old Wesley awoke one morning with his eyes pointed toward each other, a condition called strabismus. That was on top of the $807 in monthly premiums the family spent on an insurance plan that excluded anything related to her son’s eyes.

A few weeks after President Barack Obama signed a sweeping health care reform law in March 2010, Josephson got a call from another insurance company telling her the family had been accepted into a new plan. “What about Wesley’s eye? If he needs another surgery, another test, another something, is it covered?” she asked the customer service representative. She pressed the point again: What’s the catch? “Nothing. Your family’s fully covered,” she was told.

Josephson's change in fortune was the result of the new law's provision that prohibits insurance companies from refusing to cover children with pre-existing medical conditions. The family's new insurer decided to change its rules before the law required it, giving Josephson, her husband Dave, Wesley, and his little sister Margo some relief. A few months later, Josephson got to meet Obama at a health care reform event in Falls Church, Va.

Even with that relief, Josephson can't rest easy. The Supreme Court is scheduled to hear arguments next week in a case challenging the constitutionality of health reform. The court, or a Republican president next year, could reverse the family's fortunes again, with Josephson's son, now 6, still struggling to gain control of his right eye. He sometimes wears an eye patch, and might need more surgery, Josephson said.

The fate of millions of other Americans also hangs on the Supreme Court's ruling. Repealing health care reform would squash the hopes of uninsured people struggling to pay for health care.

“I definitely think I’d have to worry about it,” Josephson said. “It’s scary because you see the before and after.”