This double-blind clinical trial aims to determine the effect of physical activity and diet on the outcome of pregnancy among 122 pregnant women with metabolic syndrome who are referred to Ayatullah Rouhani Center for pregnancy care in the first trimester of pregnancy. The IDF scale is used to diagnose metabolic syndrome. Women with 3 out of 5 signs (based on BP, weight, height, W.C., HDL, TG, FBS before intervention) will be included in the study. Also written consent should be obtained from patients. Patients will be randomly divided into two groups using a computerized program. The intervention group receives the physical activity program three one-hour sessions a week in combination with Mediterranean diet with key components including high intake of fruit and vegetables, non-refined grains, legumes, moderate to high consumption of fish, small to moderate intake of poultry and dairy products such as yoghurt and cheese, low consumption of red meat and processed meat and avoidance of sugary drinks, fast food and food rich in animal fat until the end of pregnancy. The control group will receive routine pregnancy care until the end of pregnancy. After the end of pregnancy, The maternal ( pre-eclampsia,Gestational Diabetes,Extreme weight gain during pregnancy,Pregnancy-induced hypertension) and neonatal (Preterm labor,Apgar Score,IUGR, LGA) outcomes of pregnancy will be measured among two groups using a questionnaire.