Association of the Dietary Approaches to Stop Hypertension, Physical Activity, and Their Combination with Semen Quality: A Cross-Sectional Study

Abstract

The influence of individual lifestyle factors is widely described in studies on semen quality. However, their synergistic effect is often neglected. The aim of the study was to examine the association between semen quality and dietary approaches to stop hypertension (DASH) diet, physical activity (PA), and the two separately and in combination. A cross-sectional study was carried out among 207 men aged 20-55. Dietary data were collected by a food frequency questionnaire (FFQ) and analysed according to the DASH scoring index. Physical activity was evaluated by the International Physical Activity Questionnaire. Semen parameters were assessed via the computer-aided semen analysis (CASA). Adherence to the DASH diet was associated with higher sperm count (∆ T3-T1 = 82.1 mln/ej) and concentration (∆ T3-T1 = 24.6 mln/mL). Higher PA was related to higher sperm count (∆ T3-T1 = 69.4 mln/ej), total (∆ T3-T1 = 11.9%), and progressive motility (∆ T3-T1 = 8.5%) and morphology (∆ T3-T1 = 2.8%) in the crude model and remained significant after adjustment. The combination of the DASH diet and PA, was significantly positively associated with sperm count (∆ T3-T1 = 98.1 mln/ej), sperm concentration (∆ T3-T1 = 17.5 mln/mL), total (∆ T3-T1 = 11.8%), and progressive motility (∆ T3-T1 = 10.0%) and morphology (∆ T3-T1 = 3.3%) in both models. Adherence to the DASH diet was related to higher sperm count and concentration, whereas after its combination with physical activity it was also positively correlated with sperm motility and morphology.Most of the epidemiological studies have assessed the effects of single foods, nutrients and other lifestyle factors on semen parameters [6-9], whereas their synergistic effect is neglected. Some lifestyle behaviours co-occur together and in combination are more beneficial to health than their cumulative individual effect. Moreover, interventions aimed at multiple-behaviour change may have a potentially greater impact on health than interventions based on a single risk factor [10].The easiest modifiable lifestyle factors, with the important impact on semen quality, are diet and physical activity. The dietary approaches to stop hypertension (DASH) diet is one of the most well-known dietary strategies, and its effect is often linked with prevention and treatment of hypertension, diabetes, obesity, and coronary artery disease [11]. Moreover, its effects were studied in the context of other diseases [12], including semen quality [13]. The DASH diet can be adapted to any variance in regional diet, which can make lifestyle-related health factors grow more sustainable [14]. The DASH diet reflects a healthy eating pattern holistically, promoting food such as food sources of vitamins, minerals, and antioxidants, and limiting food high in saturated fats, sugar, and sodium. Previous research has indicated that this dietary pattern may be important to maintain proper semen quality [6,13].Physical activity is one of the health promoting lifestyle factors. However, earlier studies describing a link between physica...

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