The issue of gestational diabetes mellitus within disadvantaged communities is being addressed by Healthy Start for Mom & Me, a highly collaborative and multi-faceted prenatal nutrition program targeting at-risk women and teens in Winnipeg, Manitoba. The program s kitchen table approach focuses on the core concepts of education, community participation, and capacity-building to develop effective methods for community-based practice in this population. A qualitative case study of the program was conducted in 1999. This study showed that health education practices in the program are sensitive to marginalized women s needs and enhance service providers understanding of the context of participants lives. Community dietitians roles in this prenatal program are evolving, and are significant for other dietitians charting a new course of community-based practice.