You are asked to develop a short counseling script integrating nutrition and exercise rationale for pregnant patients at risk of GDM. Which message most effectively synthesizes evidence-based recommendations and their expected physiologic benefits?

• A. Recommend intensive anaerobic training five hours daily and severe caloric restriction to rapidly reduce maternal weight and therefore remove any future metabolic risks, even in pregnancy.
• B. Recommend complete avoidance of carbohydrates and prolonged bed rest to eliminate exercise-induced hypotension; this approach is universally advised because it guarantees elimination of GDM risk without need for monitoring.
• C. Advise taking only dietary supplements rather than changing food choices or activity because supplements alone have been proven to completely prevent GDM regardless of baseline lifestyle.
• D. Regular moderate aerobic activity and a balanced diet with controlled carbohydrate portions and increased fiber help improve insulin sensitivity, reduce post-meal glucose spikes, and lower the risk of excessive weight gain—actions that decrease the likelihood of gestational diabetes and its complications.

Answer: (D)