Dietary patterns and Ovulatory infertility: A case-control study

  • Maryam Hajishafiee Mail Food Security Research Center and Department of Community Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
  • Reza Ghiasvand Food Security Research Center and Department of Community Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
  • Awat Feizi Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
  • Gholamreza Askari Food Security Research Center and Department of Community Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
Keywords:
dietary pattern, nutrition, infertility, polycystic ovarian syndrome.

Abstract

Objective: To investigate the relation between female ovulatory infertility and major dietary patterns among women attending fertility clinics.

Methods: This case-control study was conducted on 167 infertile women with PCOS and 251 controls. PCOS was determined by using 2003 Rotterdam criteria. Usual dietary intake was assessed using a validated 168-item semi-quantitative food frequency questionnaire. Major dietary patterns were identified using factor analysis.

Results: Two main dietary patterns, healthy dietary pattern and western dietary pattern, were identified. Cases were statistically more overweight and abdominally fat than controls (p<0.01). No statistical significant difference was seen in total energy intake, nutrient intakes and dietary fiber between the two groups. Lower adherence to western dietary pattern was associated with decreased chance of infertility (OR=0.61; 95% CI: 0.41-0.91, p=0.01). The association remained significant even after taking other confounders into account (OR=0.62, 95%CI: 0.41-0.96, p=0.03). However, after adjusting for energy and macronutrient intakes, the association altered to marginally significant relation (p=0.07). Associations between having healthy dietary pattern and infertility regarding PCOS was not statistically significant (p=0.45).

Conclusion: Lower adherence to western dietary pattern may protect women in reproductive age against infertility. Further studies are needed to confirm the role of different dietary patterns on fertility outcomes.

References

Boivin J, Bunting L, Collins JA, Nygren KG: International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod 2007, 22:1506-1512.

Gurunath S, Pandian Z, Anderson RA, Bhattacharya S: Defining infertility--a systematic review of prevalence studies. Hum Reprod Update 2011, 17:575-588.

Norman RJ, Davies MJ, Lord J, Moran LJ: The role of lifestyle modification in polycystic ovary syndrome. Trends Endocrinol Metab 2002, 13:251-257.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol 2007, 110:1050-1058.

Safarinejad MR: The effect of coenzyme Q(1)(0) supplementation on partner pregnancy rate in infertile men with idiopathic oligoasthenoteratozoospermia: an open-label prospective study. Int Urol Nephrol 2012, 44:689-700.

Safarinejad MR: Infertility among couples in a population-based study in Iran: prevalence and associated risk factors. Int J Androl 2008, 31:303-314.

Oakley L, Doyle P, Maconochie N: Lifetime prevalence of infertility and infertility treatment in the UK: results from a population-based survey of reproduction. Hum Reprod 2008, 23:447-450.

Norman RJ, Homan G, Moran L, Noakes M: Lifestyle choices, diet, and insulin sensitizers in polycystic ovary syndrome. Endocrine 2006, 30:35-43.

Tehrani FR, Simbar M, Tohidi M, Hosseinpanah F, Azizi F: The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. Reprod Biol Endocrinol 2011, 9:39.

Altieri P, Cavazza C, Pasqui F, Morselli AM, Gambineri A, Pasquali R: Dietary habits and their relationship with hormones and metabolism in overweight and obese women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2013, 78:52-59.

Jeanes YM, Barr S, Smith K, Hart KH: Dietary management of women with polycystic ovary syndrome in the United Kingdom: the role of dietitians. J Hum Nutr Diet 2009, 22:551-558.

Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO: The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004, 89:2745-2749.

Shaum KM, Polotsky AJ: Nutrition and reproduction: is there evidence to support a "Fertility Diet" to improve mitochondrial function? Maturitas 2013, 74:309-312.

Chavarro JE, Toth TL, Wright DL, Meeker JD, Hauser R: Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertil Steril 2010, 93:2222-2231.

Robker RL, Wu LL, Yang X: Inflammatory pathways linking obesity and ovarian dysfunction. J Reprod Immunol 2011, 88:142-148.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: Dietary fatty acid intakes and the risk of ovulatory infertility. Am J Clin Nutr 2007, 85:231-237.

Chavarro JE, Ehrlich S, Colaci DS, Wright DL, Toth TL, Petrozza JC, Hauser R: Body mass index and short-term weight change in relation to treatment outcomes in women undergoing assisted reproduction. Fertil Steril 2012, 98:109-116.

Chavarro JE, Rich-Edwards JW, Rosner B, Willett WC: A prospective study of dairy foods intake and anovulatory infertility. Hum Reprod 2007, 22:1340-1347.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: Iron intake and risk of ovulatory infertility. Obstet Gynecol 2006, 108:1145-1152.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: Protein intake and ovulatory infertility. Am J Obstet Gynecol 2008, 198:210 e211-217.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility. Fertil Steril 2008, 89:668-676.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: Caffeinated and alcoholic beverage intake in relation to ovulatory disorder infertility. Epidemiology 2009, 20:374-381.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC: A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. Eur J Clin Nutr 2009, 63:78-86.

Palomba S, Giallauria F, Falbo A, Russo T, Oppedisano R, Tolino A, Colao A, Vigorito C, Zullo F, Orio F: Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study. Human Reproduction 2008, 23:642-650.

Lash MM, Armstrong A: Impact of obesity on women's health. Fertil Steril 2009, 91:1712-1716.

Dodson WC, Kunselman AR, Legro RS: Association of obesity with treatment outcomes in ovulatory infertile women undergoing superovulation and intrauterine insemination. Fertil Steril 2006, 86:642-646.

Kasim-Karakas SE, Cunningham WM, Tsodikov A: Relation of nutrients and hormones in polycystic ovary syndrome. Am J Clin Nutr 2007, 85:688-694.

Mmbaga N, Luk J: The impact of preconceptual diet on the outcome of reproductive treatments. Current Opinion in Obstetrics & Gynecology 2012, 24:127-131.

Tortoriello DV, McMinn J, Chua SC: Dietary-induced obesity and hypothalamic infertility in female DBA/2J mice. Endocrinology 2004, 145:1238-1247.

Thomson RL, Brinkworth GD, Noakes M, Clifton PM, Norman RJ, Buckley JD: The effect of diet and exercise on markers of endothelial function in overweight and obese women with polycystic ovary syndrome. Hum Reprod 2012, 27:2169-2176.

Thomson RL, Buckley JD, Brinkworth GD: Exercise for the treatment and management of overweight women with polycystic ovary syndrome: a review of the literature. Obes Rev 2011, 12:e202-210.

Toledo E, Lopez-del Burgo C, Ruiz-Zambrana A, Donazar M, Navarro-Blasco I, Martinez-Gonzalez MA, de Irala J: Dietary patterns and difficulty conceiving: a nested case-control study. Fertil Steril 2011, 96:1149-1153.

Vujkovic M, de Vries JH, Lindemans J, Macklon NS, van der Spek PJ, Steegers EA, Steegers-Theunissen RP: The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy. Fertil Steril 2010, 94:2096-2101.

Asemi Z, Esmaillzadeh A: DASH Diet, Insulin Resistance, and Serum hs-CRP in Polycystic Ovary Syndrome: A Randomized Controlled Clinical Trial. Horm Metab Res 2014.

Asemi Z, Samimi M, Tabassi Z, Shakeri H, Sabihi SS, Esmaillzadeh A: Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: A randomized clinical trial. Nutrition 2014, 30:1287-1293.

Colombo O, Pinelli G, Comelli M, Marchetti P, Sieri S, Brighenti F, Nappi RE, Tagliabue A: Dietary intakes in infertile women a pilot study. Nutr J 2009, 8:53.

Kuzmanov A, Broughton KS: Role of marine omega-3 fatty acids in PCOS cancer risk.2010.

Oner G, Muderris, II: Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gynaecol 2013, 33:289-291.

Rafraf M, Mohammadi E, Asghari-Jafarabadi M, Farzadi L: Omega-3 fatty acids improve glucose metabolism without effects on obesity values and serum visfatin levels in women with polycystic ovary syndrome. J Am Coll Nutr 2012, 31:361-368.

Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC: PCOS according to the Rotterdam consensus criteria: Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG 2006, 113:1210-1217.

Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC: Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women. Am J Clin Nutr 2007, 85:910-918.

Ghaffarpour M, Houshiar-Rad A, Kianfar H: The manual for household measures, cooking yields factors and edible portion of food. Tehran: Keshaverzi Press 1999.

Weijs PJ, Vansant GA: Validity of predictive equations for resting energy expenditure in Belgian normal weight to morbid obese women. Clin Nutr 2010, 29:347-351.

Song T, Venkataraman K, Gluckman P, Seng CY, Meng KC, Khoo EY, Leow MK, Seng LY, Shyong TE: Validation of prediction equations for resting energy expenditure in Singaporean Chinese men. Obes Res Clin Pract 2014, 8:e201-298.

Mirmiran P, Esmaillzadeh A, Azizi F: Under-reporting of energy intake affects estimates of nutrient intakes. Asia Pac J Clin Nutr 2006, 15:459-464.

Black AE, Coward WA, Cole TJ, Prentice AM: Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr 1996, 50:72-92.

Shaneshin M, Jessri M, Rashidkhani B: Validity of energy intake reports in relation to dietary patterns. J Health Popul Nutr 2014, 32:36-45.

Zahedi M, Ghiasvand R, Feizi A, Asgari G, Darvish L: Does Quercetin Improve Cardiovascular Risk factors and Inflammatory Biomarkers in Women with Type 2 Diabetes: A Double-blind Randomized Controlled Clinical Trial. Int J Prev Med 2013, 4:777-785.

Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003, 35:1381-1395.

Douglas CC, Norris LE, Oster RA, Darnell BE, Azziz R, Gower BA: Difference in dietary intake between women with polycystic ovary syndrome and healthy controls. Fertil Steril 2006, 86:411-417.

Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008, 23:462-477.

Kasim-Karakas SE, Almario RU, Cunningham W: Effects of protein versus simple sugar intake on weight loss in polycystic ovary syndrome (according to the National Institutes of Health criteria). Fertil Steril 2009, 92:262-270.

Mehrabani HH, Salehpour S, Amiri Z, Farahani SJ, Meyer BJ, Tahbaz F: Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: a randomized controlled intervention study. J Am Coll Nutr 2012, 31:117-125.

Stamets K, Taylor DS, Kunselman A, Demers LM, Pelkman CL, Legro RS: A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. Fertil Steril 2004, 81:630-637.

Galletly C, Moran L, Noakes M, Clifton P, Tomlinson L, Norman R: Psychological benefits of a high-protein, low-carbohydrate diet in obese women with polycystic ovary syndrome--a pilot study. Appetite 2007, 49:590-593.

Douglas CC, Gower BA, Darnell BE, Ovalle F, Oster RA, Azziz R: Role of diet in the treatment of polycystic ovary syndrome. Fertil Steril 2006, 85:679-688.

Carmina E, Legro RS, Stamets K, Lowell J, Lobo RA: Difference in body weight between American and Italian women with polycystic ovary syndrome: influence of the diet. Hum Reprod 2003, 18:2289-2293.

Barr S, Hart K, Reeves S, Sharp K, Jeanes YM: Habitual dietary intake, eating pattern and physical activity of women with polycystic ovary syndrome. Eur J Clin Nutr 2011, 65:1126-1132.

Cetin I, Berti C, Calabrese S: Role of micronutrients in the periconceptional period. Hum Reprod Update 2010, 16:80-95.

Patra SK, Nasrat H, Goswami B, Jain A: Vitamin D as a predictor of insulin resistance in polycystic ovarian syndrome. Diabetes Metab Syndr 2012, 6:146-149.

Rashidi B, Haghollahi F, Shariat M, Zayerii F: The effects of calcium-vitamin D and metformin on polycystic ovary syndrome: a pilot study. Taiwan J Obstet Gynecol 2009, 48:142-147.

Selimoglu H, Duran C, Kiyici S, Ersoy C, Guclu M, Ozkaya G, Tuncel E, Erturk E, Imamoglu S: The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010, 33:234-238.

Hu FB: Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002, 13:3-9.

Fransen HP, May AM, Stricker MD, Boer JM, Hennig C, Rosseel Y, Ocke MC, Peeters PH, Beulens JW: A posteriori dietary patterns: how many patterns to retain? J Nutr 2014, 144:1274-1282.

Published
2017-02-28
How to Cite
1.
Hajishafiee M, Ghiasvand R, Feizi A, Askari G. Dietary patterns and Ovulatory infertility: A case-control study. J Nutr Sci & Diet. 3(1).
Section
Original Article(s)