Dietary patterns are associated with improved ovarian reserve in overweight and obese women: a cross-sectional study of the Lifestyle and Ovarian Reserve (LORe) cohort

Abstract

Background Growing evidence suggests that adherence to certain dietary patterns is associated with improved fecundity and reproductive outcomes in the general population and infertile couples assisted reproductive treatments. The objective of this study was to assess if dietary patterns are associated with ovarian reserve in reproductive age women without a history of infertility. Methods This was a cross-sectional study of 185 women in the Lifestyle and Ovarian Reserve (LORe) cohort. Women aged 18–44 without a history of infertility were recruited from the local community at an academic medical center. Subjects completed validated food frequency and physical activity questionnaires to assess patterns over the year prior to presentation. Dietary patterns including a Western (including meat, refined carbohydrates, high-calorie drinks), prudent (including fruits, vegetables, olive oil and nuts), fertility (lower intake of trans fat with higher intake of monounsaturated fatty acids, increased intake of plant based protein, high-fat dairy, lower glycemic load carbohydrates and supplemental iron) and profertility diet (PFD) (characterize by whole grains, soy and seafood, low pesticide residue produce, supplemental folic acid, B12 and vitamin D) were identified through principal component analysis. Main outcome measures were serum antimullerian hormone concentration (AMH) (ng/mL) and antral follicle count (AFC) obtained by transvaginal ultrasound. Results After stratifying by BMI, adjusting for age, smoking and physical activity, dietary patterns were not associated with ovarian reserve in normal weight women. Increased adherence to a profertility diet in overweight and obese women (BMI ≥ 25 kg/m2) was associated with a significantly higher AMH. Women in the third and fourth quartiles of PFD adherence had a mean AMH concentration of 1.45 ng/mL (95%CI 0.33–2.56, p = 0.01) and 1.67 ng/mL (95%CI 0.60–2.74, p = 0.003) higher than women in the lowest quartile respectively. The highest adherence to PFD was also associated with a higher AFC in women with a BMI ≥ 25 kg/m2 (β = 7.8, 95%CI 0.003–15.34, p < 0.05). Other common dietary patterns were not significantly associated with ovarian reserve. Conclusions Increased adherence to a profertility diet is associated with improved markers of ovarian reserve in overweight and obese women. These findings provide novel insight on potential modifiable lifestyle factors associated with ovarian reserve.

The association between Diet Quality Index–International score and risk of diminished ovarian reserve: a case–control study

“…In a prospective study on the association between dietary intake and rate of AMH decline among eumenorrheic women from the Tehran Lipid and Glucose study, it was shown that the consumption of dairy food reduced the rate of AMH decline in these women (29). Eskew et al (8) conducted a cross-sectional study on 185 overweight and obese women without a history of infertility from the Lifestyle and Ovarian Reserve (LORe) cohort and found that greater adherence to a profertility diet, characterized by increased intake of whole grains, soy, seafood, dairy, low pesticide residue fruit and vegetables, and supplemental vitamin D, folic acid and B12, was associated with higher AMH level and AFC. Also, low preconception Mediterranean diet score (MDS) was reported to be a risk factor for poor ovarian response in a study on 296 women seeking infertility treatments (30).…”

“…We used analysis of covariance (ANCOVA) to compare adjusted (for FM, BMI, Physical activity and total energy) means of AMH and AFC across the DQI-I quartiles. Potential confounding variables included in the analyses were chosen based on prior literature (8,25) as well as Directed Acyclic Graph (DAG) (26). The multivariate logistic regression analysis was conducted to evaluate the association between quartiles of DQI-I score and the odds of DOR, as well as between one-unit increase in DQI-I score and DOR risk, after adjustment for multiple covariates in three models.…”

“…Females of the same age have various reproductive potential, which highlights the impact of environmental factors on ovarian reserve (6). Identifying modifiable lifestyle factors, such as diet, which could promote ovarian reserve and influence human fertility has been the focus of several recent observational studies (7,8). However, these studies mainly consider individual nutrients, food or food groups such as serum 25-hydroxyvitamin D, dietary fats, and soy products in the diet (9)(10)(11)(12).…”

Dietary acid load and risk of diminished ovarian reserve: a case-control study

“…The fact that females of the same age have various reproductive potential may indicate the impact of environmental factors on ovarian reserve [ 4 ]. Identifying potentially modifiable factors including nutritional factors which could promote ovarian reserve and thus beneficially affect fertility has been the focus of several recent observational studies [ 5 , 6 ].…”