A clinic must create a one-page take-home for patients summarizing lifestyle steps to lower pregnancy complication risks. Which synthesized statement best balances safety, evidence, and clarity?

• A. Recommend taking over-the-counter weight loss supplements and replacing meals with shakes without discussing exercise or prenatal screening because supplements are known to be sufficient prevention.
• B. Tell patients to avoid all fruits and vegetables to eliminate dietary carbohydrates and to stop attending prenatal visits because clinical monitoring is unnecessary if diet is strict.
• C. Encourage all patients to start high-intensity interval training daily and adopt a ketogenic diet immediately, as extreme measures are the only effective prevention strategy and are universally safe in pregnancy.
• D. Aim for regular moderate physical activity (e.g., 20–30 minutes most days), avoid rapid weight loss but target appropriate pregnancy weight gain based on pre-pregnancy BMI, prioritize fiber-rich carbohydrates with balanced meals to reduce glucose spikes, and attend routine prenatal visits for blood pressure and glucose screening—these actions together reduce risks of GDM and hypertensive disorders.

Answer: (D)