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Protein intake and ovulatory infertility
Abstract
The objective of the study was to evaluate whether intake of protein from animal and vegetable origin is associated with ovulatory infertility.
A total of 18,555 married women without a history of infertility were followed up as they attempted a pregnancy or became pregnant during an 8 year period. Dietary assessments were related to the incidence of ovulatory infertility.
During follow-up, 438 women reported ovulatory infertility. The multivariate-adjusted relative risk (RR) (95% confidence interval [CI]; P for trend) of ovulatory infertility comparing the highest to the lowest quintile of animal protein intake was 1.39 (1.01 to 1.90; 0.03). The corresponding RR (95% CI; P for trend) for vegetable protein intake was 0.78 (0.54 to 1.12; 0.07). Furthermore, consuming 5% of total energy intake as vegetable protein rather than as animal protein was associated with a more than 50% lower risk of ovulatory infertility (P =.007).
Replacing animal sources of protein with vegetable sources of protein may reduce ovulatory infertility risk.
... It is well-documented that a higher total protein intake is also associated with a positive effect on insulin secretion and blood glucose levels [25,26]. On the other hand, according to Chavarro et al. [27], a high dietary protein intake was associated with a higher risk of ovulatory infertility. In the mentioned study, women with the highest protein intake had a 41% higher risk of ovulatory infertility than women with the lowest protein intake. ...
... In the previously mentioned study of Chavarro et al. [27], a similar relationship occurred between the amount of animal protein consumption and the risk of ovulatory infertility. For the highest animal protein intake, the risk of ovulatory infertility was 39% greater than for the lowest. ...
... In the study by Chavarro et al. [32], a 2% higher trans fatty acid (TFA) intake resulted in a 94% increase in the risk of ovulatory infertility. In our study, the groups did not differ significantly in the intake of SFA, MUFA, or polyunsaturated fatty acids (PUFA), but similar to the Chavarro et al. study [27], the consumption of animal protein correlated positively with saturated fatty acids intake. Research shows that high consumption of these fatty acids, in comparison to polyunsaturated fatty acids, is related to a greater increase of total and visceral fat mass, which, as we know from the literature, can promote fertility impairment [33,34]. ...
Background and objectives: We aimed to assess the body composition and dietary intake of female patients attending one of the Polish infertility clinics. Additionally, we evaluated if there were any relationships between dietary intake and body composition parameters. Methods: The study involved 51 women who met the inclusion criteria. For the nutritional assessment, we used 3-day dietary records. Weight, height, waist and hip circumferences, and body composition were assessed. The participants were divided into three groups, with low (I, n = 12), normal (II, n = 27), and high (III, n = 12) fat tissue content, and then compared in terms of dietary intake. Results: The lowest protein intake per kilogram of body weight was observed in group III (p < 0.001). In group I, we reported the highest consumption of plant protein in general (p = 0.03) and per kg of body weight (p < 0.001). Higher protein intake per kg body mass was associated with lower values of BMI (r = −0.681; p < 0.001), fat mass (r = −0.641; p < 0.001), waist–hip ratio (r = −0.391; p = 0.005), and abdominal fat index (r = −0.653; p < 0.001). Conclusions: Our findings suggest that targeted nutritional counseling focused on optimizing protein intake and emphasizing plant-based sources may improve body composition and potentially support fertility outcomes in women undergoing infertility treatment.
... Consumption of increased amounts of animal protein has been related to ovulatory infertility. On the other hand, consumption of plant-derived protein confers protection against ovulatory dysfunction, probably due to improved insulin sensitivity [20]. Furthermore, among 2145 women in Spain, the greatest adherence to Mediterranean diet was associated with a 44% decrease of impaired conception risk, compared to lowest adherence to the diet [21]. ...
... • Residential proximity to high voltage electromagnetic radiation [6] • Air pollutants (SO 2, residential proximity to major roads) [16] • Increased consumption of animal protein, trans fatty acids and AGEs [19,20,22] • Excessive exercise [18] • Female obesity [17] • Long working hours [23] • Exposure to EDCs: ...
... • Humidity and high altitude at the time of birth [15] • Increased intake of plant-derived protein [20] • Mediterranean diet [21] • Weight loss and moderate exercise in obese women [18] • Mediterranean diet [62][63][64] • Seasonality (spring) [60] Endocrine Regarding Pb, Cd, As, and Cr, animal studies indicate an increased incidence of follicular atresia and gut microbiota alterations. In humans, heavy metals are related to increased risk for infertility in spontaneous pregnancies and decreased oocyte retrieval in assisted pregnancies. ...
Introduction
Over the recent years, scientific community has increased its interest on solving problems of female fertility pathology. Many factors acting separately or in combination affect significantly the reproductive life of a woman. This review summarizes current evidence regarding the direct and/or indirect action of environmental factors and endocrine disrupting chemicals (EDCs; i.e. heavy metals, plasticizers, parabens, industrial chemicals, pesticides, or medications, by-products, anti-bacterial agents, perfluorochemicals) upon assisted and non-assisted female fertility, extracted from in vivo and in vitro animal and human published data. Transgenerational effects which could have been caused epigenetically by the action of EDCs have been raised.
Methods
This narrative review englobes and describes data from in vitro and in vivo animal and human studies with regard to the action of environmental factors, which include EDCs, on female fertility following the questions for narrative reviews of the SANRA (a scale for the quality assessment of narrative review articles). The identification of the studies was done: through the PubMed Central and the PubMed of the MEDLINE, the Google Scholar database and the Cochrane Library database until December 2023 combining appropriate keywords (“specific environmental factors” including “EDCs” AND “specific negative fertility outcomes”); by manual scanning of references from selected articles and reviews focusing on these subjects. It includes references to EDCs-induced transgenerational effects.
Results
From the reported evidence emerge negative or positive associations between specific environmental factors or EDCs and infertility outcomes such as infertility indices, disrupted maturation of the oocytes, anovulation, deranged transportation of the embryo and failure of implantation.
Conclusion
The revealed adverse outcomes related to female fertility could be attributed to exposure to specific environmental factors such as temperature, climate, radiation, air pollutants, nutrition, toxic substances and EDCs. The recognition of fertility hazards related to the environment will permit the limitation of exposure to them, will improve female fertility and protect the health potential of future generations.
... For example, an extensive study by Gaskins and colleagues, which tracked over 18,000 females for 8 y, discovered that 1 additional serving of meat led to a 32% higher risk of ovulatory infertility. This correlation remained even after accounting for other factors such as age, parity, smoking history, oral contraceptive use, and physical activity [29]. Likewise, increased red meat consumption has been linked to an increased risk of developing endometriosis, a condition where the endometrial lining grows outside of the uterus, which can lead to infertility [30,31]. ...
... Although the amount of dietary protein consumed affects fertility and IVF success, with low amounts affecting activation of the primordial follicle in animal studies, the quality of protein consumed also affects female fertility [70,71]. Animal protein intake among healthy participants in the Nurses Health Study (NHS) II was associated with ovulatory disorders compared with plant protein intake [29]. Substituting 5% of energy intake for plant proteins was associated with a 50% reduction in ovulatory infertility risk among females aged >32 y [29]. ...
... Animal protein intake among healthy participants in the Nurses Health Study (NHS) II was associated with ovulatory disorders compared with plant protein intake [29]. Substituting 5% of energy intake for plant proteins was associated with a 50% reduction in ovulatory infertility risk among females aged >32 y [29]. Another study investigating the effects of a pulse-based diet on cardio-metabolic effects in reproductive-aged females with polycystic ovarian syndrome in Canada found improved insulin response, blood pressure, and lipid profiles among the intervention pulse-based diet group compared with the group on an isocaloric diet without pulses [72]. ...
Female cancer survivors have a higher chance of experiencing infertility than females without a history of cancer diagnosis. This risk remains high despite advances in fertility treatments. There is a need to augment fertility treatments with cost-effective methods such as nutritional guidance to improve fertility chances. The aim of this review article is to connect the current literature on cancer survivorship nutrition and fertility nutrition, focusing on the importance of integrating nutritional guidance into fertility counseling, assessment, and treatment for female cancer survivors. Consuming a healthful diet comprising whole grains, soy, fruits, vegetables, seafood, and unsaturated fats has improved both female fertility and cancer survivorship. Similarly, maintaining a healthy body weight also improves female fertility and cancer survivorship. Therefore, dietary interventions to support female cancer survivors with fertility challenges are of immense importance. The period of follow-up fertility counseling and assessment after cancer treatment may provide a unique opportunity for implementing nutritional guidance for female cancer survivors. Dietary interventions are a promising strategy to improve pregnancy chances and overall quality of life among female cancer survivors; thus, researchers should investigate perceptions regarding fertility, barriers, and challenges to changing nutrition-related behaviors, and preferences for nutritional guidance to support fertility treatments in this population.
... Depending on the protein source, dietary protein intake appears to have opposite effects on fertility; while animal proteins seem to be associated with an increased risk of infertility, plant proteins seem to improve fertility [19]. ...
... The MedDiet includes the regular consumption of vegetal protein and a reduced intake of animal protein, preferring dairy products, fish, and poultry. In one study, women who replaced 5% of their animal protein intake with vegetable protein had a 50% reduced risk of ovulatory infertility, while another study reported no association between vegetable sources of protein (beans, nuts, and soy) and implantation, clinical pregnancy, and live birth rate after ART [19,46]. In a cohort study, a higher intake of food enriched in fish and white meat was positively associated with the chance of blastocyst formation versus a negative correlation with red meat [47]. ...
... The effects of milk products on fertility depend on the various fat contents [102]. On the contrary, the consumption of plant proteins improves insulin sensitivity, reduces IGF-1 levels, and has a positive effect on ovulation [19]. ...
Diet has a key role in the reproductive axis both in males and females. This review aims to analyze the impacts of different dietary patterns on fertility. It appears that the Mediterranean diet has a predominantly protective role against infertility, while the Western diet seems to be a risk factor for infertility. Moreover, we focus attention also on dietary patterns in different countries of the World (Middle Eastern diet, Asian diet). In particular, when analyzing single nutrients, a diet rich in saturated fatty acids, cholesterol, animal proteins, and carbohydrates with high glycemic index is highly associated with male and female infertility. Finally, we evaluate the effects of vegetarian, vegan, and ketogenic diets on fertility, which seem to be still unclear. We believe that comprehension of the molecular mechanisms involved in infertility will lead to more effective and targeted treatments for infertile couples.
... Two prospective cohort studies assessed protein intake, one focussing on either the source of protein (vegetable or animal source) in 18 555 spontaneously reproducing women (Chavarro et al., 2008), and one focussing on protein-rich foods in 351 women undergoing ART (Nassan et al., 2018). Replacing 5% of animal protein with vegetable protein was associated with a 50% reduced risk of ovulatory infertility (Chavarro et al., 2008). ...
... Two prospective cohort studies assessed protein intake, one focussing on either the source of protein (vegetable or animal source) in 18 555 spontaneously reproducing women (Chavarro et al., 2008), and one focussing on protein-rich foods in 351 women undergoing ART (Nassan et al., 2018). Replacing 5% of animal protein with vegetable protein was associated with a 50% reduced risk of ovulatory infertility (Chavarro et al., 2008). However, Nassan et al. (2018) reported no association between vegetable sources of protein (beans, nuts, and soy) and ART outcomes, including implantation, clinical pregnancy, and live birth (Table 2). ...
... Moreover, whilst the Fertility Diet was associated with a reduced risk of ovulatory infertility (Chavarro et al., 2007), there was no reported associations with early pregnancy loss, spontaneous abortion, and stillbirth (Gaskins et al., 2014), or live birth, clinical pregnancy or implantation among ART populations (Gaskins et al., 2019). This was unexpected, considering that many of the components of the Fertility Diet, including multivitamins (Czeizel et al., 1996), vegetable protein (Chavarro et al., 2008), and the amount and quality of carbohydrates, have been observed to improve fertility when consumed on their own (Douglas et al., 2006;Shishehgar et al., 2016). Since this food pattern favours low-glycemic foods while limiting intake of TFAs, potential mechanisms could include improved glucose homeostasis and insulin sensitivity, which are crucial for ovulatory function and fertility (Chavarro et al., 2007). ...
Background:
Preconception diet is a proposed modifiable risk factor for infertility. However, there is no official guidance for women in the preconception period as to which dietary approaches may improve fertility.
Objective and rationale:
A comprehensive synthesis of the relevant evidence is key to determine the potentially effective dietary patterns and components as well as evidence gaps, and to provide information for nutritional recommendations for couples planning a pregnancy.
Search methods:
In this systematic scoping review, four electronic databases (Medline and EMBASE via Ovid processing, CAB Direct, and CINAHL via EBSCO) were searched for observational studies (prospective and retrospective cohort, cross-sectional, and case-control studies) from inception to 27 September 2021. Eligible studies included women of reproductive age during the preconception period, and evaluated exposures related to preconception diet and outcomes related to fertility. Results were synthesized using a descriptive approach.
Outcomes:
A total of 36 studies were eligible for inclusion (31 prospective, 3 cross-sectional, and 2 case-control studies) and were published between 2007 and 2022. Of the assessed dietary exposures, increased adherence to the Mediterranean diet displayed the strongest and most consistent association with improved clinical pregnancy rates. Reducing trans fatty acids (TFAs), saturated fatty acids, and discretionary food intake (fast food and sugar-sweetened beverages) were associated with improvements in live birth, clinical pregnancy rates, and related ART outcomes. The dietary components of seafood, dairy, and soy demonstrated inconsistent findings across the few included studies.
Wider implications:
Due to heterogeneity and the limited available literature on most exposures, there is insufficient evidence to support any specific dietary approach for improving fertility. However, following some of the dietary approaches outlined in this review (anti-inflammatory diets, reducing TFA, and discretionary food intake) are consistent with broad healthy eating guidelines, have little to no associated risk, and offer a plausible set of possible benefits. This warrants further exploration in randomized controlled trials.
... A growing interest, noticed in the scientific evidence, suggests that increased consumption of plant-based protein, rich in antioxidants, fiber, and low-glucose-index (GI) carbohydrates have an equally important effect on fertility. This aspect indicates that the plant-based nutritional model can lead to a positive effect on couples' fertility [15,16,[18][19][20]. ...
... Furthermore, the exchange of carbohydrates with vegetable protein also has a positive effect. Substituting 5% of the energy requirements of carbohydrates with vegetable protein can reduce the risk of ovulation disorders by up to 43% [20]. Taking the above-mentioned facts into consideration, it can be confirmed that the consumption of plant protein has a positive influence on fertility. ...
... Interestingly, replacing carbohydrates with vegetable protein can have a positive effect. Replacing 5% of the energy requirement of carbohydrates with vegetable protein was associated with a reduction in the risk of ovulation disorders by as much as 43% [20]. ...
Infertility is a disease globally affecting 20-30% of the reproductive age female population. However, in up to 50% on recorded cases, problems with infertility are ascribed to men; therefore, it is important to popularize healthy eating also in this group. During the last decade, it has been observed that society's lifestyle changed drastically: reduced energy expenditure in physical activity per day, increased consumption of hypercaloric and high-glycemic-index foods with high content of trans fats, and reduced consumption of dietary fiber, which negatively affects fertility. Increasing evidence points to a link between diet and fertility. It is becoming clear that well-planned nutrition can also contribute to the effectiveness of ART. The low-GI plant-based diet appears to have a positive effect, especially when it is based on Mediterranean dietary patterns: rich in antioxidants, vegetable protein, fiber, MUFA fatty acids, omega-3, vitamins, and minerals. Importantly, this diet has been shown to protect against chronic diseases associated with oxidative stress, which also translates into pregnancy success. As lifestyle and nutrition seem to be important factors affecting fertility, it is worth expanding knowledge in this regard among couples trying to conceive a child.
... Wholesome protein also constitutes a very important component in the "fertility diet". However, some studies showed that protein might have a negative effect on fertility, which is mainly related to its source [43,44]. Chavarro et al. [44] demonstrated that women from the highest quintile of total protein consumption were at a 41% higher risk of anovulatory infertility compared to women from lower quintiles of the consumption of this macronutrient. ...
... However, some studies showed that protein might have a negative effect on fertility, which is mainly related to its source [43,44]. Chavarro et al. [44] demonstrated that women from the highest quintile of total protein consumption were at a 41% higher risk of anovulatory infertility compared to women from lower quintiles of the consumption of this macronutrient. Furthermore, the addition of one portion of meat daily resulted in a 32% increase in the risk of ovulatory disorders. ...
... They were also less physically active. Therefore, the potential influence of both those factors needs to be considered, as they may intensify the correlation between animal protein consumption and ovulation disorders [44]. ...
Female infertility is commonly due to ovulation disorders. They are mostly related to polycystic ovary syndrome, which is currently viewed as one of the most common endocrine disorders in women of reproductive age. Ovulation-related female fertility is influenced by multiple factors which may include: age, smoking cigarettes, stress, use of psychoactive substances, and physical activity. Moreover, diet-related factors play an important role in the regulation of ovulation. Dietary components that exert a positive influence on ovulation include: carbohydrate products with low glycemic index, plant protein, monounsaturated and polyunsaturated fatty acids, folic acid, vitamin D, antioxidants, and iron. A diet based on the structure of the Mediterranean diet also seems beneficial. Components that have a negative influence mostly include high glycemic index carbohydrates, large amounts of animal protein, saturated fatty acids, and trans fatty acids, which are typically found in the Western model of nutrition. Due to the paucity of studies that presented a direct link between nutrition and the risk of anovulatory infertility, this study aimed to summarize the most recent research on the influence of dietary factors on ovulation disorders and indicate the possibilities of future research.
... Furthermore, the source of proteins appears to be an influential factor in female fertility. It has been observed that while animal protein intake seems to be linked to a higher risk of infertility, the consumption of plant-based proteins has positive effects on reproductive success (13). In a cohort study that included 18,555 women, it was found that consuming 5% of total energy intake as plant protein instead of animal protein was associated with a significantly reduced risk of ovulatory infertility (p = 0.007) (13). ...
... It has been observed that while animal protein intake seems to be linked to a higher risk of infertility, the consumption of plant-based proteins has positive effects on reproductive success (13). In a cohort study that included 18,555 women, it was found that consuming 5% of total energy intake as plant protein instead of animal protein was associated with a significantly reduced risk of ovulatory infertility (p = 0.007) (13). ...
Introduction
Female infertility is a multifactorial condition influenced by lifestyle and dietary factors. Understanding the relationship between nutritional status, dietary habits, and infertility could provide insights for targeted interventions.
Methods
A case-control study was conducted in health centers and hospitals in Alicante, Spain. The study included 60 infertile and 30 fertile women aged 18–40, selected through consecutive sampling. Data on body composition and dietary intake were collected and analyzed.
Results
Infertile women exhibited significantly lower muscle mass (p = 0.005) and larger hip circumference (p = 0.034) compared to fertile women. Additionally, a significant association was found between high red meat consumption and an increased risk of female infertility (p = 0.011).
Discussion
These results suggest that body composition and dietary habits, particularly muscle mass and red meat intake, play a key role in female fertility. Interventions aimed at improving muscle mass, reducing localized body fat, and limiting red meat consumption may enhance fertility outcomes. Further longitudinal research is needed to confirm these findings across diverse populations.
... As concerns protein intake, the consumption of plant-based proteins and the substitution of animal-derived protein with vegetable sources can boost fertility of women aged over 32 (88). However, there is no evidence to suggest that consuming dairy negatively impacts IVF outcomes; in fact, it may even be linked to increased likelihood of live birth (89). ...
... Moreover, increasing protein consumption, particularly plantbased sources over animal proteins, may restore carbohydrateinsulin balance, which, as stated above, is important in addressing anovulatory infertility in women (88,99). The chronic consumption of a HFD in women with obesity and T2DM may enhance IR, potentially impacting reproductive function through elevated serum insulin levels constantly stimulating insulin pathways in the ovaries and pituitary (100). ...
Infertility among women, particularly those living with obesity, presents a multifaceted challenge with implications for reproductive health worldwide. Lifestyle interventions, mainly focusing on weight loss, have emerged as promising strategies to improve fertility outcomes in this population. This review aims to explore the effectiveness of various lifestyle interventions, encompassing dietary modifications and exercise regimens, in enhancing fertility outcomes among women with obesity and associated conditions such as polycystic ovary syndrome, congenital adrenal hyperplasia, type 2 diabetes mellitus, premenopause, hypothyroidism and eating disorders. Methodology of study search encompass a broad spectrum, ranging from interventions targeting weight management through slow or rapid weight loss to dietary approaches emphasizing whole food groups, specific nutrients, and dietary patterns like low-carbohydrate or ketogenic diets, as well as the Mediterranean diet. By synthesizing existing findings and recommendations, this review contributes to the understanding of lifestyle interventions in addressing infertility, with an emphasis on the population of women of reproductive age with excess weight and known or unknown infertility issues, while promoting their integration into clinical practice to optimize reproductive health and overall well-being.
... -: not applicable glucose transporters type 4 (GLUT4) expression present over endometrium that leads to polycystic ovarian syndrome (PCOS) and may cause infertility in females [97]. A prospective study was conducted on 1,855 married, premenopausal women, during follow-up it was found that 438 women reported ovulatory infertility [98]. The study revealed that the total carbohydrate and dietary glycemic index was directly associated with ovulatory infertility among them. ...
... at 95% and the risk ratio for the glycemic load was 1.92 with a confidence interval of 1.26-2.92 at 95% [98]. ...
Infertility is a crucial and common health issue worldwide, that affects people both physiologically and psychosocially. The condition is described as the disease of the reproductive system of either male or female or both, incapability to instate a pregnancy after one year or more than twelve months of regular unprotected sexual intercourse or six months for women aged 35 years or more. Presently, the etiology of infertility is not well understood, many genetic factors, lifestyle factors, and environmental conditions such as stress work, oxidative stress, unbalanced nutrition, and unhealthy dietary patterns have been implicated to interfere with reproductive safety in both the sex. The nutritional factors are known to be amenable to normal and healthy reproductive function in both males and females. According to many studies, increased energy intake, dietary behavioral change, and low physical activity are responsible for epidemic disorders such as diabetes, heart disease, and obesity that affect reproductive health as well, and clear evidence indicates that there is a connection between inappropriate nutrition and sperm quality. Endocrinal disruption, occupational stress, and lifestyle behavior are positively linked with the pathophysiology of infecundity. Imbalance intake of both macro and micronutrients negatively affects normal reproductive function. Changes in eating behavior, and unhealthy dietary patterns such as a higher intake of food prepared with saturated and trans fats, spicy and salty foods, and a lower intake of antioxidants including fruit and vegetables are associated with reproductive life. This narrative review summarized that many studies with more consumption of fruit, vegetables, whole cereals, meat, poultry, skim milk, and seafood and less consumption of fried, spicy, salty, sugary, processed cereals and meats are linked with good sperm count.
... On the other hand, no relationship between the consumption of various fibers and the risk of ovulatory infertility has been discovered. As far as vegetable proteins are concerned, a beneficial influence on ovulation has been shown, i.e., when 5% of energy was sourced from vegetable instead of animal protein, the risk of anovulatory infertility more than halved [42]. ...
... Moreover, it has a negative impact on female fertility, i.e., obese women are more prone to ovulation disorders due to dysregulation of the hypothalamic-pituitary-ovarian axis [151]. It has also been shown that following the obesity-promoting Western diet, rich in saturated fats, animal protein, and simple sugars, is associated with an increased risk of ovulatory infertility [41][42][43]45]. Furthermore, it has been well established that obesity plays a key role in the onset of insulin resistance [150,152], which often co-occurs with ovulation disorders. ...
Ovulatory infertility is a serious clinical problem whose direct causes are still largely unknown. In addition to pathologies that make it impossible for a couple to establish a pregnancy, there are a number of other factors that have a bearing on fertility, including lifestyle factors, and particularly diet. Although numerous studies have been performed linking such factors to ovulatory infertility, most of them lack the necessary clinical significance, instead focusing on observational data and suggesting or establishing associative relationships. This article consists of a literature review focusing on connections between lifestyle factors such as diet, physical exercise, oxidative stress, sleep, and supplementation, and ovulatory infertility. Special emphasis was given to issues such as obesity and insulin resistance and their mutual relationship with other factors linked to ovulatory infertility. In addition, based on the conclusions of the literature review, the authors have proposed a classification of relationships between ovulation disorders and lifestyle factors in ovulatory infertility within the framework of the WHO classification of ovulation disorders. Furthermore, areas that merit further research have been indicated as well as those that do not. WHO Group II disorders gained prominence in the results of the study as the number of links with lifestyle factors and ovulatory infertility found in the course of the review greatly exceeded those for Groups I and III. The data presented in the article show that the issues of proper diet and physical exercise are those that could benefit from robust clinical studies focused specifically on ovulation infertility, while studies concerning the relationship between oxidative stress, sleep, and supplementation and ovulatory infertility do not seem to be promising directions as far as clinical significance is concerned.
... On the other hand, no relationship between consumption of various fibers and the risk of ovulatory infertility has been discovered. As far as vegetable proteins are concerned, a beneficial influence on ovulation has been shown: when 5% of energy was sourced from vegetable instead of animal protein, the risk of non-ovulatory infertility was more than halved [30]. ...
... Moreover, it has a negative impact on female fertility, i.e. obese women are more prone to ovulation disorders due to dysregulation of the hypothalamic-pituitary-ovarian axis [138]. It has also been shown that following the obesity-promoting Western diet, rich in saturated fats, animal protein, and simple sugars, is associated with a higher risk of ovulatory infertility [29][30][31]33]. Furthermore, it has been well established that obesity plays a key role in the onset of insulin resistance [139], which often co-occurs with ovulation disorders. ...
Ovulatory infertility is a serious clinical problem whose direct causes are still largely unknown. In addition to pathologies that make it impossible for a couple to establish a pregnancy, there are a number of other factors that have a bearing on fertility, including lifestyle factors, particularly diet. Although numerous studies have been performed linking such factors with ovulatory infertility, most of them lack the necessary clinical significance, focusing instead on observational data and establishing associative relationships. This paper includes a literature review focusing on connections between lifestyle factors such as diet, physical exercise, oxidative stress, sleep, and supplementation, and ovulatory infertility. Special emphasis was given to issues such as obesity and insulin resistance and their mutual relationship with other factors linked to ovulatory infertility. In addition, making use of the conclusions of literature review, the authors propose a classification of relationships between ovulation disorders and lifestyle factors in ovulatory infertility based on the WHO classification of ovulation disorders, and indicate areas that merit further research. The data presented in the paper shows that the issues of proper diet and physical exercise are those that would merit from robust clinical studies focused specifically on ovulation infertility, while studies concerning the relationship between oxidative stress, sleep, and supplementation and ovulatory infertility do not seem to be promising directions as far as clinical significance is concerned.
... The type of protein ingested also had a significant impact on the pathogenesis of fertility disorders. It has been demonstrated that replacing 5% of animal protein energy with plant protein energy reduces the risk of ovulatory infertility by half [3,29]. Sources of plant protein include legumes, which were less often eaten by male students. ...
... Fertility disorders are also related to the consumption of poultry. Chavarro et al. demonstrated that one additional serving of animal proteins a day (in the form of poultry or red meat, including processed meat) significantly reduces ovulatory fertility [29]. ...
... The consumption of vegetable proteins rather than carbohydrates or animal proteins shows a substantially lower risk of ovulatory infertility (Chavarro et al., 2008). Carbohydrates are important for carrying out various biological processes and producing energy. ...
... Carbohydrates, proteins, and healthy fats are macronutrients that are necessary for pregnant or lactating women. Few foods, which include animal proteins and transfats, should be avoided, as they cause infertility by different factors that induce production of reactive oxygen species infertility (Chavarro et al., 2008). The source and amount of protein in the diet have been reported to affect insulin sensitivity, which consequently stimulates ovulatory function (Layman et al., 2003). ...
Nutrition and lifestyle have a great impact on reproduction and infertility in humans, as they are essential for certain processes such as implantation, placental growth, angiogenesis, and the transfer of nutrients from the mother to the fetus. The aim of this review is to provide the interconnection between nutrition and reproductive health through the insight of omics approaches (including metabolomics and nutrigenomics). The effect of various macronutrients, micronutrients, and some food‐associated components on male and female reproduction was discussed. Recent research work was collected through database search from 2010 to 2020 to identify eligible studies. Alterations of metabolic pathways in pregnant women were deliberated with an emphasis on different strategies of lifestyle and dietary interventions. Several nutritional methods, which are important for embryonic and child neurological development, nutritional supplements to lactation, and improved gestational length along with birth weight have been emphasized. Considerable advances in omics strategies show potential technological development for improving human reproductive health. In this review, we clarify the importance of nutrition and dietary substrates in the reproductive health of humans. Omics (including metabolomics and nutrigenomics) have been employed to report the nutrients’ impact on physiological functions at the molecular level and to explain how diet and specific nutrients interact with genes, proteins, or metabolites to influence metabolic phenotypes and disease outcomes. Novel nutritional methods and compositions containing essential nutrients were explored to enhance embryonic, fetal, and child neurological development, afford nutritional supplementation to lactation, and improve gestational length and birth weight.
... p < 0.001), which is closely related to infertility. At the same time, the authors of the study draw attention to the fact that recommendations regarding the increase in consumption of fatrich dairy products should be considered very individually, in particular in people with risk factors for overweight, obesity, and atherosclerosis, due to the content of saturated fatty acids and their adverse effects, not only in terms of infertility, but also atherogenicity [4,5,21,22]. ...
... Chavarro et al. further proved that eating, in particular, chicken and turkey meat (most commonly consumed by the studied population animal protein form) was associated with an increased risk of ovulatory infertility. This study showed that one additional portion of animal protein per day, in particular in the form of poultry and red meat (including processed meat), significantly reduces (by 32%) ovulatory fertility (p = 0.01) [21]. ...
... In turn, 2 other studies conducted by Maldonado-Carceles [14,15] did not find relation between ovarian reserve and various dietary patterns. The Mediterranean nancy [20] farther substituting chicken and red meats with vegetable protein sources could potentially decrease the risk of infertility resulting from anovulation [21]. Soy and soy products can potentially affect reproductive health and fertility [22] but fruit and vegetables in some studies are high pesticide residue products which are associated with lower probability of clinical pregnancy and lower probability of live birth [23]. ...
Objectives: Research investigating the association between reproductive health and diet has predominantly focused on the antenatal and prenatal periods, as well as childbirth in women, and semen quality in men. There is a limited amount of research addressing female fertility assessed as ovarian reserve in relation to diet. The main aim of this study was to evaluate the association between dietary patterns and the parameters of ovarian reserve, such as antral follicle count (AFC), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) – predictors of reproductive health in women of childbearing age. Material and Methods: Women aged 24–39 years (N = 511) were enrolled from fertility clinic in central Poland. The count of antral follicles was determined using ultrasonography (USG), FSH and E2 levels were measured using a chemilumi- nescence method and for determination of AMH level, an enzyme-linked immunosorbent assay method was employed. Diet was assessed according to food frequency questionnaire and dietary patterns were identified by factor analysis. Women were classified into 3 groups according to scores of each dietary pattern: Western, mixed, prudent. Results: Higher adherence to the prudent dietary pattern in obese women was associated with significantly higher AFC (p = 0.03) and AMH (p = 0.05) as compared to participants with the Western dietary pattern. The results were adjusted for age, BMI, smoking and duration of fertility. Increased consumption of mixed dietary pattern was not statistically significant associated with any of examined ovarian reserve parameters. Conclusions: The prudent dietary pattern is positively associated with ovarian reserve in a cohort of women seeking fertility care. Continued research in this area will provide nutritional guidance for clinicians and their patients and provide novel insight on potential modifiable lifestyle factors which can be associated with ovarian reserve. Int J Occup Med Environ Health. 2024;37(4)
... In contrast, replacing 5% of energy requirements of carbohydrates with plant protein can reduce the risk of ovulatory disorders by up to 43%. 62 The anti-inflammatory effects of diets have been well proven. [63][64][65] Smoking, coffee and alcohol abuse: In women, smoking is associated with a decrease in ovarian reserves, delayed conception and an increased risk of spontaneous miscarriage. ...
Introduction and purpose Infertility is defined as a condition characterized by the inability to become clinically pregnant after 12 months of regular, unprotected sexual intercourse, or because a person's ability to reproduce, either as an individual or with his or her partner, is impaired. Infertility affects between 8% and 12% of couples of reproductive age worldwide. Fertility decline in women begins as early as age 25-30. The purpose of this article is to present the problem of infertility in women, possible diagnostic options, methods of prevention and treatment of infertility. We draw attention to the important role of a proper lifestyle, including diet in the fight against infertility. State of knowledge The article reviews the literature on infertility with special attention to the problem of infertility in women. Knowing the causes of infertility, it is possible to implement targeted diagnosis and then treatment. Attention is paid to the influence of proper diet on female fertility. Material and method A review of the literature available on PubMed and Google Schoolar was conducted. We focused on presenting different causes of infertility in women, diagnostic options, treatment methods depending on the cause of the problem. We paid special attention to proper diet and its impact on female fertility. Summary In our review, we presented how big a problem female infertility is. We managed to describe the current state of knowledge on the definition, epidemiology of fertility and infertility, and the main causes of female infertility. Based on a number of studies, we have proven the beneficial effects of a proper lifestyle with emphasis on a proper diet.
... There are many variants of protein diets such as the Zone diet [17], the CSIRO diet [18] and the Dukan diet [19]. An extensive study has shown an association between animal protein intake and an increased risk of ovulation infertility in a group of healthy women [20]. ...
To date, there is no comparative data on the effects of carbohydrates, fat, and proteins, which are macronutrients, on female reproductive functions. Therefore, in this study, we investigated the effects of diets enriched with carbohydrates, fats, and proteins on folliculogenesis and oocyte development in female rats. 21-day-old rats that were just weaned were divided into 4 groups: control, carbohydrate, fat, and protein. The control group was fed with standard chow and the carbohydrate, fat, and protein groups were fed diets enriched with 75% carbohydrate, 60% fat, and 50% protein for 11 weeks, respectively. It was found that high-fat and high-protein diets caused an increase in the estrous cycle length compared to carbohydrate group ( p < 0.05). Graafian follicle number decreased in the protein group compared to the control ( p < 0.05). However, the atretic follicle number was higher in the fat group compared to the control group ( p < 0.05). In the carbohydrate group, Zp1 was found to be lower than the control and protein groups, Zp2 was found to be lower than the control, and Zp3 was found to be lower than the fat group ( p < 0.05). While BMP15 was similar between groups ( p > 0.05), GDF9 was lower in all diet groups compared to the control ( p < 0.05). Foxo3a was lower in the protein group compared to carbohydrate and control ( p < 0.05). GAS2 was found to be higher in the control group than the fat group, and higher in the carbohydrate group than the fat and protein groups ( p < 0.05). FSH, LH, Progesterone, and E2 levels were higher in all three diet groups than in the control ( p < 0.05). Also, significant differences were observed between the groups regarding adiponectin, resistin, and leptin levels. Taken together, high carbohydrate, fat, and protein intake are associated with impairment of the menstrual cycle, depletion of the developing follicle types, and altered expression of folliculogenesis-specific genes and hormones. Therefore, long-term macronutrient diets may result in shortened reproductive periods and reduced fertilization potential in females in the long run.
... In this study, major source of staple consumed were roots and tubers (yam, potato and sweet potato); Cereals (rice, maize and maize products); protein (legume, sh and beef) but foods such as eggs, organ meats, fruits, vegetables and dairy food products which have been afrmed to be rich in micronutrients such as iron, folic acids and calcium among other nutrients were less consumed by the women in this study. Previous studies have established signicant roles of adequate intake of m i c r o n u t r i e n t s i n p r o m o t i n g w o m e n ' s reproductive health (51)(52). Majority of the overweight and obese women had high dietary diversity indicating that the quality of the women diet was good. ...
Background: Excess weight gain and poor dietary intake pose adverse effects on health and productivity of women of reproductive age. Objective: The study assessed association between nutritional status, dietary diversity and fertility. Methods: Study design was cross sectional, carried out among 210 among fertility-impaired women who attended gynaecological clinics A semi-structured interviewer administered questionnaire and adapted Dietary diversity Questionnaire was developed to determine respondents' socio-demographic characteristics and dietary diversification respectively. Height (m), weight (kg) and body fat (%) were measured. Data collected were analysed by Statistical Package for Social Science (SPSS) version 21.0. Descriptive and inferential statistics were performed. Association of variables was determined by chi-square having p<0.05. Results: More than half (53.3%) of respondents were within 30-39 years. Monthly average income was ₦30,000 ($187.5). Prevalence of overweight, obesity, secondary infertility, primary infertility and sexually transmitted infections (STI) was 40.5%, 32.8%, 55.5%, 44.5% and 28.5% respectively. Only 38.6% had experienced infertility beyond five years. Highly diverse diets were consumed by only 51.0% of respondents. Fruits and vegetable, organ meat, eggs, milk and milk products, meat and fish were not poorly consumed. Infertility was associated with increased Body Mass Index (p꞊0.042), Sexually Transmitted Infections (STI) (p꞊0.000), age (p꞊0.000), religion (p꞊0.020), occupation (p꞊0.003) and monthly income (p꞊0.036) were significantly associated with infertility. Conclusion: Majority of infertile women in this study were overweight, obese, and physically inactive, experienced abdominal adiposity and secondary infertility.
... p = 0.07). Substituting 5% of the total energy intake for vegetable protein instead of animal protein has been linked with a reduction in the ovulatory infertility risk [139]. Vegetal protein consumption also seems to have an impact on reproductive hormones. ...
Infertility affects 15% of the population in developed countries, and its prevalence is increasing. Fertility can be influenced by different factors. Although key factors like maternal age cannot be changed, there is growing evidence that other modifiable factors, such as diet, can have an impact on fertility. Diet has become increasingly important in recent years for a number of reasons: the new trend toward a healthy lifestyle, the higher prevalence of certain digestive disorders, a lack of time that leads people to consume more prepared and processed food, and personal choice to not eat meat, among others. To meet these needs, several diets have recently become popular, such as the Mediterranean diet, known as the gold standard of health; the DASH diet, known for preventing hypertension; the Western diet, characterized by processed food; the ketogenic diet, characterized by low carbohydrate intake; and the vegetarian diet, which is the choice for people who do not eat meat or animal by-products. Diets present a unique composition characterized by the presence or absence of specific nutrients, which have also been associated with male and female fertility individually. This review assesses the impact of these diets and of macro- and micronutrients on both female and male fertility.
... Chavaro et al claim that replacing animal protein diets with vegetable sources of protein may reduce ovulatory infertility risk. 10 This further implies that protein rich meals especially those from grains will likely be a remedy for infertility in females even though this fact has not been established for male genders. Tom brown, a diet rich in protein and Nitrogen might be beneficial in improving reproductive function in male animals. ...
Objectives/Background
Natural products are preferred over synthetic drug as fertility enhancers as they are cost effective. Infertility among men of reproductive age keeps rising. Synthetic drugs ameliorate the problem but leave adverse side effects as men advance in age, hence the need for alternative medicine. Tom brown weaning diet is a processed cereal-based powdery blend which is cooked into a semi-liquid food for children from 6 months and contains good nutrient levels. This work focused on the effects of Tom brown weaning diet on testes of Wistar rats.
Method
Fifteen Wistar rats were divided into 3 groups namely: Control group, 50% tom brown group and 100% tom brown group. Control received only rat chow, 50% Tom brown group received tom brown diet and normal rat chows at 12 h cycle per time. This cycle was repeated till the end of the experiment. 50% Tom brown group received only tom brown diet throughout the experimental period. The testes were excised, measured, and processed for morphological and histological analysis.
Results
Average testicular weight and relative weight in the 50% tom brown, 100% tom brown and control groups were not significant at alpha level of P ˂ .05. This was also supported by the normal histological features seen in sections of the testes of rats in all groups as there were no shrinking and denser spermatogenic cells in the seminiferous tubules. Hormonal analysis showed a non-significant difference in the level of FSH and LH at alpha levels of P˂0.05. However, testosterone level increased significantly in 100% group compared to 50% and the control group at P˂ .05. Also, GC-MS study on the diet revealed 30 compounds in the diet.
Conclusion
This study revealed that Tom brown diet has no detectable damaging effect(s) on the testes but could improve the cytoarchitecture and enhance fertility.
... It has been reported that integrating the diet with some nutritional supplements and antioxidants (Lipoic acid, Vitamin E, Vitamin C and CoQ10), can help improve fertility by reversing the bodily imbalance between the anti-oxidant protection and free radical (ROS) release [13,14]. Notably, several reports suggest that majority of infertility cases due to ovulation disorders may be preventable through modifications of diet and lifestyle, particularly by increased consumption of either proteins or low-glycemic index carbohydrates [14][15][16]. A systematic review by Shang et al. suggests that positive dietary changes improve fertility outcomes in women with polycystic ovary syndrome (PCOS) [17], one of the common causes of female infertility, affecting 6-12% of US women of reproductive age [18]. ...
Abstract Background Previous research suggests that some women are using integrative and complementary holistic approaches to optimize their own health and treat infertility. We aimed to determine patterns of integrative medicine use among those seeking fertility optimization by 1) Characterizing patterns of integrative medicine use to increase fertility; 2) Identifying demographic predictors associated with such integrative medicine use; and 3) Exploring cultural and religious influences on use of integrative medicine. Methods Cross-sectional self-reported survey data were collected from 1460 patients presenting to an academic fertility center in Chicago, Illinois. Variables were described with univariate frequencies and proportions, unadjusted bivariate comparisons were made between patient-level factors and reported integrative modality use, and multivariable logistic regression evaluated the strength of covariate-adjusted predictors of reported integrative medicine utilization. Results 80.4% of respondents reported using at least one integrative medicine modality to treat infertility (Acupuncture: 38.5%, Yoga: 27.6%, Massage: 25.8%, Meditation: 16.7%, and Herbal supplements: 18.5%). Diet therapy was the most frequently utilized modality (74.0%) followed by body therapy (45.2%), traditional alternative medicine (42.0%), mind therapy (32.1%), and senses therapy (23.0%). Any integrative medicine modality use was 4.03 times more likely among Hindu respondents compared to participants that identified as not religious (95% CI 1.2–13.7, p
... Although infertility therapeutic techniques have been developed, the high cost of these methods can lead individuals to come to alternative and inexpensive treatments [5]. Most recently, the recognition of modifiable factors in the treatment of infertility has been of interest in many studies [6][7][8][9]. ...
Background
In recent decades, more and more attention has been paid to the influence of nutrition on reproductive health. Nevertheless, the imminent association between diet-related inflammation and the risk of infertility has not yet been established. The aim of the current study was to investigate the ability of the Dietary Inflammatory Index (DII) to estimate infertility incidence in women.
Methods
This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 4437 participants. The DII was calculated based on the reported consumption of up to 31 food parameters measured via a validated and reproducible 118-item food-frequency questionnaire (FFQ). Multiple logistic regression analysis was applied to estimate the multivariable odds ratio (OR) adjusted for potential confounding variables.
Results
Out of all participants, 411 women (9.26%) were infertile. The mean ± SD age and weight of infertile women were 43.67 ± 7.47 years and 72.86 ± 13.02 kg, respectively. Statistical analyses showed the odds ratio of infertility in the fourth quartile (pro-inflammatory diet) was 1.76 times higher than in the first quartile (anti-inflammatory diet) of DII (95% CI: 1.57–2.02).
Conclusions
The findings of this study provide compelling evidence about the association between infertility and the quality of diet in women. Therefore, interventions and programs aimed at promoting a healthy lifestyle and using healthy diets can be considered as one of the effective approaches in the prevention and treatment of infertility in women.
... For example, obesity and being underweight are associated with gonad dysfunction and infertility, while certain vitamins (including vitamins B, C, and E) and food groups (including high-fat diets) have an important impact on reproductive health by influencing semen quality and ovulation [9][10][11][12][13]. Smoking, alcohol, and caffeine consumption can interfere with fertility and affect gonad function and reserve and influence endocrine function (FSH, LH, and testosterone in males) [1,[14][15][16][17][18][19]. ...
The survival of a species depends on its ability to reproduce [...]
... Já o consumo de carnes vermelhas ou processadas, pescado, ovos e leguminosas não foi significativamente associado a infertilidade. Novamente, a explicação da associação poderá dever-se à influência das proteínas de origem animal na resistência à insulina (28). Para além disso, as proteínas de origem animal estão associadas a menores níveis de testosterona, em mulheres saudáveis, e à redução do número de folículos antrais, realçando-se assim a sua potencial correlação com a síntese de androgénios e com a reserva ovariana (25,35). ...
Infertility has increased in the last years, affecting about 10% of the Portuguese population. The impact of medically assisted procreation treatments has enhanced the search for modifiable reproductive function factors. The aim of this review is to analyze the associations between diet, nutrition, and female fertility. Both Mediterranean and Fertility Diet improve reproductive parameters in women and proper intake of antioxidants seems to protect reproductive function. On the contrary, the consumption of trans fatty acids, proteins of animal origin, carbohydrates, white meats, lean dairy products, fast-food, alcoholic, sugary and caffeine-based beverages decrease fertility. Although woman’s age is a determinant of reproductive function and the associations are only partially understood, the change in diet remains one of the most promising interventions in fertility preservation.
... Alternatively, by influencing embryo implantation and development in the early stages of pregnancy, the source and quality of dietary amino acids may influence fertility outcomes [27,32]. A previous prospective study reported a 50% reduction in the risk of ovulatory infertility with the consumption of 5% total energy as vegetable versus animal protein [33]. Thus, although the mechanism is unknown at this time, results from the current study suggest that maternal YPPN consumption may be an effective strategy to improve adverse fertility issues that are commonly observed in high-fat-fed and obese rodent models [34,35]. ...
Increased consumption of dietary pulse protein has been shown to assist in body weight regulation and improve a range of metabolic health outcomes. We investigated if the exchange of casein for yellow pea protein (YPPN) in an obese-inducing maternal diet throughout pregnancy and lactation offered protection against obesity and dyslipidemia in offspring. Sixty female Sprague Dawley rats were fed a low-calorie control diet (CON), a high-caloric obesity-inducing diet (with casein protein (CP), HC-CP), or an isocaloric/macronutrient-matched HC diet supplemented with YPPN isolate (HC-PPN) in pre-pregnancy, gestation, and lactation. Body weight (BW) and metabolic outcomes were assessed in male and female offspring at weaning and in adulthood after consuming the CON diet in the postnatal period. Consumption of the HC-PPN diet did not protect against maternal obesity but did improve reproductive success compared with the HC-CP group (72.7% versus 43.7%) and reduced total energy, fat, and protein in maternal milk. Male, but not female, offspring from mothers fed the HC-CP diet demonstrated hyperphagia, obesity, dyslipidemia, and hepatic triglyceride (TG) accumulation as adults compared with CON offspring. Isocaloric exchange of CP for YPPN in a high-calorie obese-inducing diet did not protect against obesity but did improve several aspects of lipid metabolism in adult male offspring including serum total cholesterol, LDL/VLDL cholesterol, triglycerides (TGs), and hepatic TG concentration. Our results suggest that the exchange of CP for YPPN in a maternal obese-inducing diet selectively protects male offspring from the malprogramming of lipid metabolism in adulthood.
... Although infertility therapeutic techniques have been developed, the high cost of these methods can lead individuals to come to alternative and inexpensive treatments [5]. Most recently, the recognition of modi able factors in the treatment of infertility has been of interest in many studies [6][7][8][9]. ...
Background
In recent decades, more and more attention has been paid to the influence of nutrition on reproductive health. Nevertheless, the imminent association between diet-related inflammation and the risk of infertility has not yet been established. The aim of the current study was to investigate the ability of the Dietary Inflammatory Index (DII) to estimate infertility incidence in women.
Methods
This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 3,988 participants. The DII was calculated based on the reported consumption of up to 31 food parameters measured via a validated and reproducible 118-item food-frequency questionnaire (FFQ). Multiple logistic regression analysis was applied to estimate the multivariable odds ratio (OR) adjusted for potential confounding variables.
Results
Out of all participants, 397 women (9.95%) were infertile. The mean ± SD age of infertile women was 45.1 ± 7.58 years and the mean ± SD weight was 72 ± 13.69. Also, 957 (24%) of the participants had low physical activity and 3,374 (84.6%) used contraceptives. Statistical analyses showed the odds ratio of infertility in the fourth quartile (pro-inflammatory diet) was 1.48 times higher than in the first quartile (anti-inflammatory diet) of DII (95% CI: 1.10,2.03).
Conclusions
Based on the results that provide compelling evidence we concluded that infertility in women is related to dietary. Interventions and programs aimed at promoting a healthy diet and lifestyle could be helpful in solving the problem of infertility in women.
... L'hypertrophie des adipocytes dans le cas de l'obésité induit un niveau de sécrétion d'hormones stéroïdiennes plus élevé que la norme, ce qui affecte la Source: graphique reproduit de (Wise et al., 2010) a Ajusté sur l'âge, le tour de hanche, la régularité du cycle, l'âge du partenaire, l'IMC du partenaire, la pratique d'activité physique, le statut de consommation de tabac, la longueur du cycle, le statut de consommation d'alcool et la fréquence des rapports sexuels b nullipare ou multipare Des études évoquent une association entre l'alimentation et la fonction reproductive par exemple en lien avec la survenue de la puberté (De La Rochebrochard, 2000), ou en lien avec l'infertilité d'origine ovulatoire. Le régime alimentaire méditerranéen semble diminuer le risque d'infertilité, à contrario une alimentation trop riche en protéine et pauvre en nutriments semble augmenter le risque d'infertilité (Chavarro et al., 2008(Chavarro et al., , 2007Rossi et al., 2016;Silvestris et al., 2019). ...
Plus de 50 millions de couples souffrent d’infertilité dans le monde. Dans les pays développés, la progression de l’infertilité est due principalement au report de l’âge à la parentalité. La prise en charge de l’infertilité se décompose en deux grandes étapes : les traitements d’induction de l’ovulation et les techniques d’assistance médicale à la procréation (AMP), qui sont respectivement les traitements de première et de seconde intention. Les traitements d’AMP sont relativement bien connus alors que les inductions de l’ovulation restent peu explorées du fait de l’absence de sources de données pour les étudier. L’objectif est d’étudier les traitements de l’infertilité en considérant à la fois les traitements d’induction de l’ovulation et les traitements d’AMP. Pour cela, nous avons utilisé les données de l’assurance maladie française qui sont aujourd’hui accessibles à la recherche, notamment via l’échantillon généraliste des bénéficiaires (EGB) et le Datamart de Consommation Inter-Régime (DCIR). Notre objectif se décline en trois axes. Axe 1 : En France un couple 1 sur 4 ne parvient pas à obtenir une grossesse après 12 mois d’essai. Mais quelle est la proportion de femmes traitées pour infertilité ? Le recours global aux traitements de l’infertilité est méconnu en France et dans le monde. Nous avons mesuré le recours annuel aux traitements de l’infertilité. Chaque année, entre 2008 et 2017, 1,25% des femmes de 20-49 ans ont été traitées pour infertilité en France.Derrière un taux très stable sur la décennie, se cache une augmentation de 24% du recours chez les femmes de 34 ans et plus. Axe 2 : Les coûts des traitements de l’infertilité sont pris en charge à 100 % par l’assurance maladie en France. Cependant, la littérature internationale suggère l’existence possible d’un non-accès à l’AMP, même en cas de couverture des coûts. Dans notre étude, nous avons mis en évidence que 70% des femmes en échec d’induction de l’ovulation n’accédaient pas à la FIV. Le désavantage social, la défavorisation de la zone de résidence, les âges jeunes et les âges avancés augmentent le risque de non-accès à la FIV. Axe 3 : Le dernier axe aborde l’abandon précoce des traitements d’infertilité (durant le premier trimestre suivant l’initiation de l’induction de l’ovulation). Le taux d’abandon précoce de l’induction de l’ovulation a été estimé à 30%. Une analyse stratifiée sur le type d’inducteur et de prescripteur a mis en évidence qu’une bonne prise en charge ou suivi diminuent les risques d’abandon tandis que l’âge avancé augmente ce risque. Par ailleurs, il existe une forte interaction entre le type d’inducteur et de prescripteur et la prise charge. La question des inégalités sociales est souvent un angle mort de la prise en charge de l’infertilité qu’il apparaît essentiel d’investiguer dans de nouvelles recherches.
... We also observed some differences in food frequency intake between PCOS and CONTROL and between PCOS-MD and CONTROL-MD, which may result from women's awareness of the beneficial effects of PCOS treatment using diet therapy, though combined with the misconception that eliminating sweets and eating more wholemeal bread are sufficient for a low GI diet, which is recognized as the best diet for women with PCOS. Unfortunately, we also noticed an increase in the consumption of alcoholic beverages, products which are a source of animal fat and fruit juices, which reveals a need for educational activities for women with PCOS regarding the appropriate composition of a low GI diet (Banting et al. 2014;Chavarro et al. 2008). Moreover, the differences between PCOS-MD and PCOS-RC suggested that the key to maintaining a regular menstrual cycle in women with PCOS may be adequate hydration and limitation of alcohol consumption. ...
The aim of this study was to clarify the associations between menstrual cycle disorders, food frequency intake, dietary habits, and physical activity levels in women with and without Polycystic Ovary Syndrome (PCOS). 114 women with PCOS and 341 without PCOS (CONTROL) participated in the study. They were also divided into women with menstrual disorders(MD), and those with regular cycle (RC). Each of them completed a medical and Kompan questionnaires. In women with PCOS and menstrual disorders (PCOS-MD), intake of wholemeal products, meat and meat products, fats and alcoholic beverages was higher in comparison to those in the control group with menstrual disorders (CONTROL-MD). Women in the PCOS-MD group also reported significantly more frequent snacking between meals, higher Pro-Healthy Diet Index (pHDI-14), and a lower level of physical activity at leisure time than CONTROL-MD. Women with PCOS differed from those in CONTROL due to a higher consumption of meat and meat products, fats, fruits and vegetables, juices and alcoholic beverages, and a lower intake of whitemeal products, sweets, and fruits. Women with PCOS more frequently snacked, but the number of their meals was also lower. In women with PCOS, menstrual disorders may be related not only with diet quality and physical activity but also with snacking and skipping meals.
... The Nurses' Health Study II (NHS II) suggested that healthy women who consumed animal-based proteins were at increased risk of ovulatory disorders compared to those who received plant-based proteins (10), which indicates a putative effect of the source of dietary protein on female reproductive health. Diets enriched with proteins derived from plant sources could influence favorably insulin sensitivity and Insulin-like Growth factor (IGF-I) levels as observed in other conditions (88)(89)(90). ...
Female infertility is a major public health concern and a global challenge. It is a disorder of the reproductive system, defined as the inability to achieve a clinical pregnancy. Nutrition and other environmental factors are found to impact reproductive health in women as well as the outcome of assisted reproductive technologies (ART). Dietary factors, such as polyunsaturated fatty acids (PUFA), fiber as well as the intake of Mediterranean diet appear to exert beneficial effects on female reproductive outcomes. The exact mechanisms associating diet to female fertility are yet to be identified, although genomic, epigenomic, and microbial pathways may be implicated. This review aims to summarize the current knowledge on the impact of dietary components on female reproduction and ART outcomes, and to discuss the relevant interplay of diet with genome, epigenome and microbial composition.
... It was found that consuming vegetable protein instead of carbohydrates or animal protein was associated with a substantially lower risk of ovulatory infertility. 83 In a study considering 2696 embryos from 269 patients undergoing intracytoplasmic sperm injection cycles, red meat had a negative effect on blastocyst formation, implantation rates, and the probability of a live birth, 84 whereas a study of 351 women showed that fish intake was associated with a higher probability of live birth following assisted reproductive technology (ART), especially when fish replaced processed meat. 85 A differential effect of varying proteins on insulin sensitivity may explain these findings, in addition to the replacement of carbohydrate sources with vegetable protein, likely reducing the glycemic index (GI) of a meal. ...
Background:
One in seven couples are impacted by infertility in the UK, and female infertility is often associated with several health conditions impacted by nutrition. Despite many studies aimed at identifying the critical role of nutrition in infertility, there is currently no screening tool that identifies nutritional risk factors for infertility.
Aim:
To propose a self-administered screening tool to identify women who would benefit from nutritional intervention to promote fertility.
Methods:
A narrative review was carried out to identify and summarise modifiable nutritional risk factors that can influence female fertility, including comorbidities that can influence nutrition intake, absorption, and metabolism.
Key findings:
A nutrition screening tool outlining modifiable nutrition risk factors potentially improving female fertility has been proposed, comprising of BMI, medical history and quality of diet and lifestyle which would aid in designing evidence based dietetic services for female infertility.
... As a first constraint, the number of participants across the studies of this review is a matter of concern. In comparison with other trials conducted to investigate similar matters [10], the number of women included is limited. ...
Dietary intake of omega-3 polyunsaturated fats (PUFAs) may be associated with successful assisted reproductive techniques (ART). However, heterogeneous studies were conducted and opposing results were obtained. This systematic review aims to summarize the evidence on the effect of omega-3 dietary intake on oocyte and embryo quality for a positive ART outcome. The PRISMA 2020 statement was followed and the review protocol was registered with PROSPERO (CRD42021283881). Inclusion and exclusion criteria were: eligible studies examined women undergoing ART cycles whose diet was evaluated for omega-3 intake or experienced an increase in omega-3 compared with women who followed in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) but did not increase the omega-3 intake before the cycle. 5,412 records were identified and five studies were included in the analysis. Two studies focused on sub-fertile or infertile women specifically, yet all women in all studies went through IVF/ICSI procedures. All five studies demonstrated how omega-3 FAs may be beneficial by increasing the positive rate of ART outcomes and embryo quality evaluated according to morphology and morphokinetic parameters. More research focusing on comparable and/or equal outcomes is required to strengthen supporting evidence with the aim to provide valid recommendations for women seeking a pregnancy.
... Foods rich in antioxidants can reduce oxidative stress induced by various factors, damaging the structure and function of the sperm [10]. A diet involving chicken or turkey meat was unfavorable for ovulation and may lead to infertility in females [11]. Bodyweight is also known to play a crucial role infertility. ...
Living creatures, including humans, preserve their traits in this dynamic world after their demise. They reproduce to make better offspring, enabled to fight against the odds in nature to become the fittest survivor. Infertility, unable to give birth to a live child, is one of the burning problems in the present era worldwide; around 12% of women in the United States have difficulty getting pregnant or carrying a full-term pregnancy at their fertile age. The infertility issues with men are less in percentage among heterosexual couples, however, it is significant. Modern biomedical research and technology have improved significantly to diagnose the majority of infertility issues with fruitful remedies. Among them, the in vitro fertilization technique has been moderately successful in time (∼30% of individual attempts), but the success rate is still improving. Nevertheless, usage of ‘herbal medicines sometimes is ignorantly beneficial to improve the outcome of assisted reproduction, either by supplementing the conventional medical treatment and/or by mitigating the mental health of the futile patients under distress. Various herbal medicines have been utilized over the years as adjuvant therapies, depending on ethnicity and cultural diversity. Overall, the quality of evidence for herbal medicines in assisted reproduction is poor due to the lack of randomized controlled trials and scientific analyses; moreover, population-based qualitative studies are often misleading. This chapter is dedicated to discussing the pre-clinical and clinical evidence, underlying the potentiality of herbal medicines/phytochemicals to treat male and female infertility.
... The research carried out on 18,555 women and it was observed that dietary routine has some association with the occurrence of ovarian infertility. It was concluded that replacing animal source protein with plant source protein showed better results to cure ovarian infertility in women [13]. Research on obese and overweight women. ...
Infertility is one of the leading disorders and effecting large number of populations. Imbalanced dietary pattern can disturb fertility in women. The diet we consumed has huge input in the occurrence of fertility or infertility in women. Objective: To determine the role of dietary pattern in the occurrence of infertility among married women. Methods: Cross-sectional study was conducted in public sector hospital of Lahore on 100 infertile females from reproductive age to premenopausal years of life in married women. Results: Age group ranges from 27-32 years female were infertile. 56/100 females consumed refined carbohydrate and 89 out of 100 consumed sugar daily in diet. Several dietary factors were found to be involved in infertility among women. Conclusions: It has been concluded that imbalanced dietary routine can directly cause infertility in women of various age. Women who consumed refined carbs, high fat and low dairy items, thus results in failure to conceive or have a successful pregnancy.
... Foods rich in antioxidants can reduce oxidative stress induced by various factors, damaging the structure and function of the sperm [10]. A diet involving chicken or turkey meat was unfavorable for ovulation and may lead to infertility in females [11]. Bodyweight is also known to play a crucial role infertility. ...
... Foods rich in antioxidants can reduce oxidative stress induced by various factors, damaging the structure and function of the sperm [10]. A diet involving chicken or turkey meat was unfavorable for ovulation and may lead to infertility in females [11]. Bodyweight is also known to play a crucial role infertility. ...
Herbal Medicines: A Boon for Healthy Human Life provides a comprehensive overview of the role of herbal medicines for treating a broad variety of human diseases, from neurological disorders to cancer and major disorders such as infectious diseases, metabolic disorders, and more. Each chapter summarizes the current state and future direction of the use of herbal medicines against multiple diseases from a translational point-of-view, making this reference a valuable source of information for a large audience, including researchers and healthcare providers interested in the field of herbal remedies.
... During the follow up period, women who consumed higher amounts of trans fats as opposed to monounsaturated or polyunsaturated fats had a significantly higher risk of ovulatory infertility [40]. Additionally, women who consumed the highest glycemic load carbohydrates compared to the lowest amounts, had a 92% higher risk of ovulatory infertility, whereas women who prioritized intake of plant based proteins and took a daily multivitamin conversely had a 22 and 41% lower risk of ovulatory infertility respectively [41,42]. Our cohort differs from the NHSII in that women with PCOS were specifically excluded from our study. ...
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/m ² ) 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/m ² (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.
... In recent decades, increasing researches suggested a strong link between obesity and reproduction health [24], which indicated that obesity in women of childbearing age should be in great concern. Our findings revealed an increasing track of central obesity among women of childbearing age over time, the prevalence of high WC increased from 21.6 to 30.7% and so did the prevalence of high WHtR from 22.8 to 32.6%. ...
Background
Obesity among women of childbearing age has becoming an important public health concern. We aimed to describe the trends of central obesity among Chinese women of childbearing age from 2004 to 2011 and to examine its associations with nutrients intake and daily behaviors.
Methods
Longitudinal data were derived from the China Health and Nutrition Survey. Participants consisted of 2481 women aged 15–44 years old. WC (Waist circumference) and WHtR (Waist to height ratio) were adopted as indicators of central obesity. Generalized linear mixed model was performed to analyze the associations of nutrients intake and daily behaviors with central obesity.
Results
From 2004 to 2011, the prevalence of central obesity among Chinese women of childbearing age increased from 21.6 to 30.7% (WC as indice) or from 22.8 to 32.6% (WHtR as indice) (both p < 0.001). Protein intake above the AMDR (Acceptable macronutrient distribution range) (OR = 1.21, 95% CI 1.05–1.39, p < 0.01) and non-participation in LTPA (Leisure time physical activity) (OR = 1.45, 95% CI 1.17–1.80, p < 0.001) were risk factors for high WC, and the latter was also associated with high WHtR (OR = 1.36, 95% CI 1.10–1.67, p < 0.01). For those women who had high WC & high WHtR, the impacts of protein intake and LTPA became stronger, especial LTPA (OR = 1.53, 95% CI 1.21–1.94, p < 0.001). Age-stratified analyses found that non-participation in LTPA was key factor for central obesity in 15–34 age group, while protein intake above the AMDR was pronounced in the 35–44 age group.
Conclusions
Non-participation in LTPA and protein intake above the AMDR were significant contributors of central obesity, which could be intervention targets to deal with the growing trend of central obesity among women of childbearing age.
Introduction Women who want to get pregnant soon often ask their doctors how to prepare best. During such a visit, doctors usually mention folic acid supplementation, a check-up with the dentist and gynaecologist or vaccinations. However, it is also worth pointing out the importance of lifestyle factors that affect fertility and fetal development. Modifying daily habits can improve fertility naturally and make getting pregnant faster. An increasing number of studies are being published on the importance of nutrition, physical activity, sleep, stress, stimulants and other factors on women's reproductive health. This article is a summary of the current state of knowledge in this area. Aim of the study The aim of this study is to review the literature and summarize current state of knowledge on the association between lifestyle factors and female reproductive function. Material and methods of research This literature review based on researches from PubMed platform. We searched articles describing connection between potentially modifiable lifestyle factors and women’s fertility. Search terms included keywords: „lifestyle”, „female fertility”, „obesity”, „sleep”, „nutrition”, „diet”, „stress”, „physical activity”, „smoking”, „alcohol”, „weight loss”, „reproductive health”.
This review examines associations of nutrients and dietary preferences with recurrent pregnancy loss (RPL), miscarriage, and infertility. Research articles, reviews, and meta-analyses of RPL and infertility that focused on nutrition, meals, and lifestyle were reviewed, and associations of nutrients and dietary preferences with pregnancy are discussed in relation to recent research findings. Studies related to RPL were given the highest priority, followed by those dealing with miscarriage and infertility. Multivitamin supplements-even when lacking folic acid or vitamin A-reduced total fetal loss. High-dose folic acid supplementation before conception reduced the risk of miscarriage and stillbirth. A meta-analysis revealed a strong association of vitamin D deficiency/insufficiency with miscarriage. Another meta-analysis revealed that seafood and dairy products reduced the risk of miscarriage, whereas a caffeine intake of 300 mg/day or more was associated with miscarriage. A balanced diet that included nutrients with antioxidant properties helped prevent miscarriage, whereas a diet that included processed foods and nutrients with proinflammatory effects increased the risk of miscarriage. Associations of nutrients with RPL warrant further research.
Understanding the intricate relationship between nutrition, hormonal balance, and gender-specific factors is crucial for developing targeted interventions to mitigate obesity-related endocrine disruptions and improve metabolic health. This narrative review examines the impact of various dietary patterns on hormonal regulation in both men and women, focusing on their effects on hormonal balance and metabolic health in the context of obesity. Calorie restriction, the Western diet, high-fat diets, low-CHO diets, plant-based diets, and the Mediterranean diet are analyzed in relation to their influence on obesity-related endocrine disruptions and metabolic health. Future research directions include investigating the specific mechanisms underlying dietary influences on hormonal regulation, addressing the gender-specific metabolic differences and body fat distribution, and exploring the dietary needs of individuals undergoing gender transition. Personalized dietary interventions tailored to individual metabolic and hormonal profiles are essential for optimizing health outcomes across the gender spectrum. By integrating gender-specific considerations into dietary recommendations, healthcare professionals can better support individuals in achieving optimal metabolic health and hormonal balance.
Objective
To explore the association between the Diet Inflammatory Index (DII) and infertility.
Design
Multivariable logistic regression was performed to investigate the relationship between infertility and DII, and restricted cubic spline was utilized to test for nonlinear relationships in this cross‐sectional study.
Setting
Data of this study was collected from the 2013 ‐ 2020 National Health and Nutrition Examination Survey (NHANES) database.
Participants
A total of 2066 women aged 20‐45 years were enrolled in this study considering women's child‐bearing age.
Results
After adjusting for all covariates, a positive association was found between DII score and odds of infertility by multivariable logistic regression (odds ratio = 1.19, 95% confidence interval 1.03, 1.38; P = 0.027). Compared with participants with DII scores in the lowest quartile, those with DII scores in the highest quartile had significantly higher odds of infertility (odds ratio = 2.42, 95% confidence interval 1.09, 5.34; P = 0.034). The restricted cubic splines model suggested a linear relationship between DII and infertility (P for nonlinear = 0.1827).
Conclusions
A positive association between a pro‐inflammatory diet and self‐reported infertility was detected. Our study extends the application of the DII scoring system to infertility prevention.
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Breast cancer is a common and life-threatening disease that affects every aspect of women's lives worldwide. Early detection of breast abnormalities plays a critical role in improving patient outcomes. Deep learning techniques can be considered as promising approaches for automatic breast cancer detection using mammographic images based on the success rates of previous studies. This study aims to evaluate the performance of different deep learning architectures on the MIAS dataset for breast cancer detection. The architectures considered include VGGNet, DenseNet, ResNet, and MobileNet. Performance metrics such as accuracy, sensitivity, specificity, and precision are utilized to assess the effectiveness of each architecture. The results demonstrate the superior performance of VGGNet and DenseNet, achieving accuracy rates of 92.5% and 91.8%, respectively. ResNet and MobileNet also exhibit substantial potential with accuracies of 89.3% and 88.6%, respectively. These findings contribute to the growing body of knowledge in medical image analysis and highlight the effectiveness of deep learning architectures in breast cancer detection. Further investigations can focus on optimizing these architectures and exploring ensemble methods to enhance their performance.
Background
Previous research suggests that some women are using integrative and complementary holistic approaches to optimize their own health and treat infertility. We aimed to determine patterns of integrative medicine use among those seeking fertility optimization by 1) Characterizing patterns of integrative medicine use to increase fertility; 2) Identifying demographic predictors associated with such integrative medicine use; and 3) Exploring cultural and religious influences on use of integrative medicine.
Methods
Cross-sectional self-reported survey data were collected from 1460 patients presenting to an academic fertility center in Chicago, Illinois. Variables were described with univariate frequencies and proportions, unadjusted bivariate comparisons were made between patient-level factors and reported integrative modality use, and multivariable logistic regression evaluated the strength of covariate-adjusted predictors of reported integrative medicine utilization.
Results
80.4% of respondents reported using at least one integrative medicine modality to treat infertility (Acupuncture: 38.5%, Yoga: 27.6%, Massage: 25.8%, Meditation: 16.7%, and Herbal supplements: 18.5%). Diet therapy was the most frequently utilized modality (74.0%) followed by body therapy (45.2%), traditional alternative medicine (42.0%), mind therapy (32.1%), and senses therapy (23.0%). Any integrative medicine modality use was 4.03 times more likely among Hindu respondents compared to participants that identified as not religious (95% CI 1.2-13.7, p<0.026). Significant differences in specific modality use were observed by race, religious affiliation, age, income, and insurance coverage.
Conclusion
Most infertility patients in our study reported using at least one integrative medicine modality to help them conceive. Utilization was associated with age of participant, religious affiliation, annual income, and insurance coverage. Further research is needed to assess the impact of integrative medicine utilization on patient quality of life and outcomes.
The investigation of modifiable factors that may exert influences on female reproductive health and in vitro fertilization (IVF) outcomes is increasing. Growing attention is being paid to nutrition. The aim of the present review is to recapitulate the current understanding on the effects of nutrition on female fertility and IVF outcomes. In particular, the three main classes of macromolecules have been analysed i.e. carbohydrates, proteins and fatty acids. An increasing number of studies have focused on the potential benefit of whole grain, vegetables and omega-3 polynsatured fatty acids (ω-3 PUFAs) on reproductive outcomes. Controversial results exist regarding the consumption of omega-6 (ω-6) PUFAs and dairy. Overall, nutrition appears to represent a modifiable factor that may play a significant role in the context of female reproduction and IVF outcomes, but the limited number of studies and the discrepancies between the available data call for further research in the area.
Infertility is one of the leading disorder and effecting large number of population. Imbalanced dietary pattern can disturb fertility in women. The diet we consumed has huge input in the occurrence of fertility or infertility in women. Objective: To determine the role of dietary pattern in the occurrence of infertility among married women. Methods: Cross-sectional study was conducted in public sector hospital of Lahore on 100 infertile females from reproductive age to premenopausal years of life in married women. Results: Age group ranges from 27-32 years’ female were infertile. 56/100 females consumed refined carbohydrate and 89 out of 100 consumed sugar daily in diet. Several dietary factors were found to be involved in infertility among women. Conclusions: It has been concluded that imbalanced dietary routine can directly cause infertility in women of various age. Women who consumed refined carbs, high fat and low dairy items, thus results in failure to thrive a successful pregnancy.
Malnutrition is a major problem in developing countries, and obesity and eating disorders are increasingly common in developing as well as developed countries. The reproductive axis is closely linked to nutritional status, especially undernutrition in the female, and inhibitory pathways involving detectors in the hind brain suppress ovulation in subjects with weight loss. Recovery may occur after minimal reacquisition of weight because energy balance is more important than body fat mass. Anorexia nervosa and bulimia nervosa affect up to 5% of women of reproductive age causing amenorrhoea, infertility and, in those who do conceive, an increased likelihood of miscarriage. Obesity can affect reproduction through fat cell metabolism, steroids and secretion of proteins such as leptin and adiponectin and through changes induced at the level of important homeostatic factors such as pancreatic secretion of insulin, androgen synthesis by the ovary and sex hormone-binding globulin (SHBG) production by the liver. WHO estimates that 9 to 25% of women in developed countries are severely obese, and obese mothers are much more likely to have obese children, especially if they have gestational diabetes. Obesity-associated anovulation may lead to infertility and to a higher risk of miscarriage. Management of anovulation with obesity involves diet and exercise as well as standard approaches to ovulation induction. Many obese women conceive without assistance, but pregnancies in obese women have increased rates of pregnancy-associated hypertension, gestational diabetes, large babies, Cesarean section and perinatal mortality and morbidity. Among contraceptors, the fear of weight gain affects uptake and continuation of hormonal contraceptives, although existing trials indicate that any such effects are small. For all methods of hormonal contraception, weight above 70 kg is associated with increased failure rates.
The use of a mailed, self-administered, semiquantitative food frequency questionnaire to describe past dietary intake was evaluated in 1984 among a group of 150 Boston-area women who had completed four one-week diet records three to four years previously. Correlation coefficients comparing calorie-adjusted nutrient intakes computed from the questionnaire with those obtained from a compressed version of the questionnaire completed during diet record keeping ranged from 0.44 for total carbohydrate to 0.62 for vitamin C including supplements. Coefficients comparing calorie-adjusted nutrient intakes measured by questionnaire with those assessed by the diet records completed three to four years previously ranged from 0.28 for iron without supplements to 0.61 for total carbohydrate. An evaluation of the incremental contribution provided by several open-ended sections of the questionnaire to the estimation of nutrient intake suggested that in this population most of these items might be eliminated without material loss of information. These findings demonstrate that useful estimates of nutrient intake several years previously can be obtained by a relatively inexpensive, mailed, self-administered questionnaire.
Specialist infertility practice was studied in a group of 708 couples within a population of residents of a single health district in England. They represented an annual incidence of 1.2 couples for every 1000 of the population. At least one in six couples needed specialist help at some time in their lives because of an average of infertility of 21/2 years, 71% of whom were trying for their first baby. Those attending gynaecology clinics made up 10% of new and 22% of all attendances. Failure of ovulation (amenorrhoea or oligomenorrhoea) occurred in 21% of cases and was successfully treated (two year conception rates of 96% and 78%). Tubal damage (14%) had a poor outlook (19%) despite surgery. Endometriosis accounted for infertility in 6%, although seldom because of tubal damage, cervical mucus defects or dysfunction in 3%, and coital failure in up to 6%. Sperm defects or dysfunction were the commonest defined cause of infertility (24%) and led to a poor chance of pregnancy (0-27%) without donor insemination. Obstructive azoospermia or primary spermatogenic failure was uncommon (2%) and hormonal causes of male infertility rare. Infertility was unexplained in 28% and the chance of pregnancy (overall 72%) was mainly determined by duration of infertility. In vitro fertilisation could benefit 80% of cases of tubal damage and 25% of unexplained infertility--that is, 18% of all cases, representing up to 216 new cases each year per million of the total population.
Polycystic ovary syndrome (PCOS) is the most common cause of anovulation in women. Previous studies suggest that the pathogenesis of PCOS may involve interrelated abnormalities of the insulin-like growth factor (IGF) and ovarian steroidogenesis systems. We investigated this hypothesis in fasting serum samples from 140 women with PCOS (age, 27.4 +/- 0.4 yr; body mass index, 26.3 +/- 0.5 kg/m2; mean +/- SEM). IGF-related parameters were also studied in a group of normoovulatory women (n = 26; age, 26 +/- 4 yr; body mass index, 23.6 +/- 4.3 kg/m2). For the PCOS group, the mean testosterone (T) level was 2.5 +/- 0.1 nmol/L, and it was significantly correlated with LH (r = 0.41; P < 10(-6)), estrone (r = 0.33; P = 0.016), estradiol (r = 0.18; P = 0.04), and androstenedione (AD; P < 10(-6)), but not with dehydroepiandrosterone sulfate (P = 0.71), a marker of adrenal steroidogenesis. T and AD were also related to total ovarian follicle number and ovarian size, as previously found with normoovulatory women (1). There were no differences between the PCOS subjects and the normoovulatory group for total IGF-I, IGF-II, or IGF-binding protein-3 (IGFBP-3). However, IGFBP-1 levels were significantly decreased in the PCOS group (1.0 +/- 0.2 vs. 7.3 +/- 1.1 ng/mL; P < 0.001) and were inversely correlated with serum insulin levels (r = -0.50; P < 10(-8)). Serum levels of free IGF-I (fIGF-I) were elevated (5.9 +/- 0.3 vs. 2.7 +/- 0.3 ng/mL; P < 0.001) in inverse relation with IGFBP-1 (r = -0.31; P = 0.046). Serum fIGF-I levels were related to total follicle number (r = - 0.35; P < 10(-4)) and to the ratio of sex hormone-binding globulin to T (r = -0.23; P = 0.009). However, these relationships were not independent of other variables. Despite the more than 2-fold elevation in fIGF-I levels, significant relationships between fIGF-I and markers of ovarian steroidogenesis (T, AD, estradiol, and estrone) could not be demonstrated. In conclusion, although we confirmed correlations between LH and hyperandrogenemia and have found abnormalities in the IGF system in a large cohort of PCOS subjects, a direct relationship between hyperandrogenism and the IGF system could not be shown. Previous studies suggest that elevated LH and hyperinsulinemia lead to excess ovarian androgen synthesis in PCOS and that the intraovarian IGF system is important for normal follicle development and may be important in the arrested state of follicle development in PCOS. However, the data presented in this cross-sectional study suggest that insulin-related changes in circulating IGFBP-1 and subsequent elevation of fIGF-I reflect insulin resistance and have little enhancing effects on ovarian steroidogenesis in this disorder.
Plasma levels of insulin-like growth factor I (IGF-I) have been associated with risk of a number of cancers and other diseases. We examined the cross-sectional association of plasma IGF-I and IGF-binding protein 3 (IGFBP-3) levels with age, smoking, physical activity, and reproductive and menopausal factors in 1037 healthy women. Adjusted least-square mean hormone levels across categories of lifestyle factors were calculated by linear regression. Age was inversely associated with IGF-I levels. In multivariate analyses, a higher body mass index (BMI) was associated with higher IGFBP-3 levels (BMI <21 versus >/=29 kg/m(2), 3879 versus 4080 ng/ml; P for trend = 0.01). Current use of hormone replacement therapy (HRT) was associated with a lower IGF-I, with oral estrogen being associated with the lowest levels (non-use of HRT versus oral estrogen + progesterone versus oral estrogen: 181 versus 143 versus 116 ng/ml; P for all comparisons </= 0.005). Higher parity was also associated with lower levels of IGF-I (no pregnancies versus >/=4: 212 versus 180 ng/ml; P for trend = 0.003). We conclude that age and HRT use, particularly oral estrogen alone, were inversely associated with IGF-I levels. BMI was positively associated with IGFBP-3 levels. This is the first report of an inverse association of circulating IGF-I levels with parity. This association may represent one mechanism by which parity exerts its protective effect on some cancers.
Plasma levels of insulin-like growth factor I (IGF-I) have been associated with risk of several cancers. Although protein-calorie malnutrition is known to decrease IGF-I levels, few published studies have related diet to IGF-I levels in well-nourished humans. We examined the cross-sectional association of plasma IGF-I and IGF-binding protein 3 (IGFBP-3) levels with intakes of alcohol, energy, macronutrients, micronutrients, and specific foods in 1037 healthy women. Adjusted mean hormone levels across categories of dietary variables were calculated by linear regression. Results were adjusted for non-dietary factors found to be associated with IGF levels. Total energy intake was positively associated with IGF-I levels when adjusted for covariates. Adjusted mean levels of IGF-I (ng/ml) across increasing quintiles of energy intake were 181, 185, 191, 199, and 195 (P for the linear trend = 0.006). In other multivariate analyses, energy-adjusted fat and carbohydrate intake had no association with IGF-I levels. The most consistent finding was a positive association between protein intake with circulating IGF-I concentration (174, 188, 201, 192, and 196 ng/ml across quintiles of protein intake; P = 0.002), which was largely attributable to milk intake. Adjusted mean levels of IGF-I (ng/ml) across increasing quartiles of milk intake were 183, 189, 188, and 200 (P = 0.01). Higher fat intake, in particular saturated fat, was associated with lower levels of IGFBP-3. We conclude that higher energy, protein, and milk intakes were associated with higher levels of IGF-I. These associations raise the possibility that diet could affect cancer risk through influencing IGF-I level.
Thousands of cycles of in vitro fertilization (IVF) are performed each year. In the US, multiple births occur after 39% of IVF cycles, whereas in Europe, the figure is 26%. Indeed, multiple births are a major factor in the costs attributable to IVF. Reducing the multiple birth rate may reduce the overall costs of IVF, and providing insurance coverage of IVF may contribute to lowering multiple birth rates. The use of IVF is likely to expand in response to increases in infertility and scientific advances.
Low protein intake during lactation has been demonstrated to increase the loss of body protein and to reduce the reproductive performance of female pigs. The objectives of the current experiment were 1) to determine whether protein (lysine) restriction alters levels of somatotropic hormones, insulin, follicle-stimulating hormone, and leptin around weaning, and 2) to evaluate the relationships between these eventual alterations and postweaning reproductive performance. One day after farrowing, crossbred primiparous sows were randomly allocated to one of two diets containing 20% crude protein and 1.08% lysine (C, n = 12) or 10% crude protein and 0.50% lysine (L, n = 14) during a 28-d lactation. Diets provided similar amounts of metabolizable energy (3.1 Mcal/kg). Feed allowance was restricted to 4.2 kg/d throughout lactation, and litter size was standardized to 10 per sow within 5 d after farrowing. Catheters were fitted in the jugular vein of 21 sows around d 22 of lactation. Serial blood samples were collected 1 d before (day W - 1) and 1 d after (day W + 1) weaning, and single blood samples were collected daily from weaning until d 6 postweaning (day W + 6). Sows were monitored for estrus and inseminated. They were slaughtered at d 30 of gestation. During lactation, litter weight gain was similar among treatment groups. Reduced protein intake increased (P < 0.001) sow weight loss (-30 vs -19 kg) and estimated protein mobilization throughout lactation (-4.1 vs -2.0 kg). On day W - 1, L sows had higher (P < 0.02) plasma glutamine and alanine concentrations, but lower (P < 0.05) plasma tryptophan and urea than C sows. Mean and basal plasma GH were higher (P < 0.001), whereas plasma IGF-I and mean insulin were lower in L than in C sows on day W - 1. Preprandial leptin did not differ between treatments on day W - 1, but was higher (P < 0.01) in L sows than in C sows on day W + 1. Mean FSH concentrations were similar in both treatments on day W - 1 (1.3 ng/mL), but L sows had greater (P < 0.001) mean FSH on day W + 1 than C sows (1.6 vs 1.2 ng/mL). The weaning-to-estrus interval (5 +/- 1 d) was similar in both groups. Ovulation rate was lower in L than in C sows (20.0 +/- 1 vs 23.4 +/- 1, P < 0.05). No obvious relationships between reproductive traits and metabolic hormone data were observed. In conclusion, these results provide evidence that protein (lysine) restriction throughout lactation alters circulating concentrations of somatotropic hormones and insulin at the end of lactation and has a negative impact on postweaning ovulation rate.
In single-meal studies, dietary protein does not result in an increase in glucose concentrations in persons with or without type 2 diabetes, even though the resulting amino acids can be used for gluconeogenesis.
The metabolic effects of a high-protein diet were compared with those of the prototypical healthy (control) diet, which is currently recommended by several scientific organizations.
The metabolic effects of both diets, consumed for 5 wk each (separated by a 2-5-wk washout period), were studied in 12 subjects with untreated type 2 diabetes. The ratio of protein to carbohydrate to fat was 30:40:30 in the high-protein diet and 15:55:30 in the control diet. The subjects remained weight-stable during the study.
With the fasting glucose concentration used as a baseline from which to determine the area under the curve, the high-protein diet resulted in a 40% decrease in the mean 24-h integrated glucose area response. Glycated hemoglobin decreased 0.8% and 0.3% after 5 wk of the high-protein and control diets, respectively; the difference was significant (P < 0.05). The rate of change over time was also significantly greater after the high-protein diet than after the control diet (P < 0.001). Fasting triacylglycerol was significantly lower after the high-protein diet than after the control diet. Insulin, C-peptide, and free fatty acid concentrations were not significantly different after the 2 diets.
A high-protein diet lowers blood glucose postprandially in persons with type 2 diabetes and improves overall glucose control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse effects, and the long-term acceptability of the diet.
Overweight women with polycystic ovary syndrome (PCOS) were randomized to a high protein (HP; 40% carbohydrate and 30% protein; n = 14) or a low protein (LP; 55% carbohydrate and 15% protein) diet (n = 14). The intervention consisted of 12 wk of energy restriction (approximately 6000 kJ/d), followed by 4 wk of weight maintenance. Pregnancies (two HP and one LP); improvements in menstrual cyclicity, lipid profile, and insulin resistance (as measured by the homeostasis model); and decreases in weight (7.5%) and abdominal fat (12.5%) occurred independently of diet composition. Improvements in menstrual cyclicity were associated with greater decreases in insulin resistance and fasting insulin (P = 0.011). On the LP diet, high density lipoprotein cholesterol decreased 10% during energy restriction (P = 0.008), and the free androgen index increased 44% in weight maintenance stages (P = 0.027). Weight loss leads to improvements in cardiovascular and reproductive parameters potentially mediated by improvements in surrogate measures of insulin resistance. An HP weight loss diet may result in minor differential endocrine and metabolic improvements.
Insulin resistance and beta-cell dysfunction, two factors central to the pathogenesis of type 2 diabetes, were studied in relation to the development of diabetes in a group of participants with impaired glucose tolerance in the Diabetes Prevention Program (DPP) at baseline and after specific interventions designed to prevent diabetes. Participants were randomly assigned to placebo (n = 1,082), metformin (850 mg twice a day) (n = 1,073), or intensive lifestyle intervention (n = 1,079). The diabetes hazard rate was negatively associated with baseline insulin sensitivity (hazard rate ratio = 0.62-0.94 per SD difference, depending on treatment group and measure of sensitivity) and with baseline insulin secretion (hazard rate ratio = 0.57-0.76 per SD). Improvements in insulin secretion and insulin sensitivity were associated with lower hazard rates in all treatment arms (hazard rate ratio = 0.46-0.95 per SD increase and 0.29-0.79 per SD increase, respectively). In multivariate models that included the three metabolic variables (changes in body weight, insulin sensitivity, and insulin secretion) each significantly and independently predicted progression to diabetes when adjusted for the other two variables. The intensive lifestyle intervention, which elicited the greatest reduction in diabetes incidence, produced the greatest improvement in insulin sensitivity and the best preservation of beta-cell function after 1 year, whereas the placebo group, which had the highest diabetes incidence, had no significant change in insulin sensitivity and beta-cell function after 1 year. In the metformin group, diabetes risk, insulin sensitivity, and beta-cell function at 1 year were intermediate between those in the intensive lifestyle and placebo groups. In conclusion, higher insulin secretion and sensitivity at baseline and improvements in response to treatment were associated with lower diabetes risk in the DPP. The better preventive effectiveness of intensive lifestyle may be due to improved insulin sensitivity concomitant with preservation of beta-cell function.
Pharmacologic activation of the peroxisome proliferator-activated receptor gamma (PPAR-gamma) improves ovulatory function in women with polycystic ovary syndrome, and specific dietary fatty acids can affect PPAR-gamma activity.
The objective of the study was to assess whether the intakes of total fat, cholesterol, and major types of fatty acids affect the risk of ovulatory infertility.
We conducted a prospective cohort study of 18 555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant between 1991 and 1999. Diet was assessed twice during follow-up by using a food-frequency questionnaire.
During follow-up, 438 incidents of ovulatory infertility were reported. In logistic regression analyses, intakes of total fat, cholesterol, and most types of fatty acids were not related to ovulatory infertility. Each 2% increase in the intake of energy from trans unsaturated fats, as opposed to that from carbohydrates, was associated with a 73% greater risk of ovulatory infertility after adjustment for known and suspected risk factors for this condition [relative risk (RR) = 1.73; 95% CI: 1.09, 2.73]. Obtaining 2% of energy intake from trans fats rather than from n-6 polyunsaturated fats was associated with a similar increase in the risk of ovulatory infertility (RR = 1.79; 95% CI: 1.11, 2.89). In addition, obtaining 2% of energy from trans fats rather than from monounsaturated fats was associated with a more than doubled risk of ovulatory infertility (RR = 2.31; 95% CI: 1.09, 4.87).
trans Unsaturated fats may increase the risk of ovulatory infertility when consumed instead of carbohydrates or unsaturated fats commonly found in nonhydrogenated vegetable oils.
Thousands of cycles of in vitro fertilization (IVF) are performed each year. In the US, multiple births occur after 39% of IVF cycles, whereas in Europe, the figure is 26%. Indeed, multiple births are a major factor in the costs attributable to IVF. Reducing the multiple birth rate may reduce the overall costs of IVF, and providing insurance coverage of IVF may contribute to lowering multiple birth rates. The use of IVF is likely to expand in response to increases in infertility and scientific advances.
Associations between intake of specific nutrients and disease cannot be considered primary effects of diet if they are simply the result of differences between cases and noncases in body size, physical activity, and metabolic efficiency. Epidemiologic studies of diet and disease should therefore be directed at the effect of nutrient intakes independent of total caloric intake in most instances. This is not accomplished with nutrient density measures of dietary intake but can be achieved by employing nutrient intakes adjusted for caloric intake by regression analysis. While pitfalls in the manipulation and interpretation of energy intake data in epidemiologic studies have been emphasized, these considerations also highlight the usefulness of obtaining a measurement of total caloric intake. For instance, if a questionnaire obtained information on only cholesterol intake in a study of coronary heart disease, it is possible that no association with disease would be found even if a real positive effect of a high cholesterol diet existed, since the caloric intake of cases is likely to be less than that of noncases. Such a finding could be appropriately interpreted if an estimate of total caloric intake were available. The relationships between dietary factors and disease are complex. Even with carefully collected measures of intake, consideration of the biologic implications of various analytic approaches is needed to avoid misleading conclusions.
Insulin resistance and β-cell dysfunction, two factors central to the pathogenesis of type 2 diabetes, were studied in relation to the development of diabetes in a group of participants with impaired glucose tolerance in the Diabetes Prevention Program (DPP) at baseline and after specific interventions designed to prevent diabetes. Participants were randomly assigned to placebo (n = 1,082), metformin (850 mg twice a day) (n = 1,073), or intensive lifestyle intervention (n = 1,079). The diabetes hazard rate was negatively associated with baseline insulin sensitivity (hazard rate ratio = 0.62-0.94 per SD difference, depending on treatment group and measure of sensitivity) and with baseline insulin secretion (hazard rate ratio = 0.57-0.76 per SD). Improvements in insulin secretion and insulin sensitivity were associated with lower hazard rates in all treatment arms (hazard rate ratio = 0.46-0.95 per SD increase and 0.29-0.79 per SD increase, respectively). In multivariate models that included the three metabolic variables (changes in body weight, insulin sensitivity, and insulin secretion) each significantly and independently predicted progression to diabetes when adjusted for the other two variables. The intensive lifestyle intervention, which elicited the greatest reduction in diabetes incidence, produced the greatest improvement in insulin sensitivity and the best preservation of β-cell function after 1 year, whereas the placebo group, which had the highest diabetes incidence, had no significant change in insulin sensitivity and β-cell function after 1 year. In the metformin group, diabetes risk, insulin sensitivity, and β-cell function at 1 year were intermediate between those in the intensive lifestyle and placebo groups. In conclusion, higher insulin secretion and sensitivity at baseline and improvements in response to treatment were associated with lower diabetes risk in the DPP. The better preventive effectiveness of intensive lifestyle may be due to improved insulin sensitivity concomitant with preservation of β-cell function.
Total energy intake deserves special consideration in nutritional epidemiology for three reasons: firstly, the level of energy intake may be a primary determinant of disease; secondly, individual differences in total energy intake produce variation in intake of specific nutrients unrelated to dietary composition because the consumption of most nutrients is positively correlated with total energy intake; and, thirdly, when energy intake is associated with risk of disease but is not a direct cause, associations with specific nutrients may be distorted (confounded) by total energy intake. Before examining these three issues in detail, this chapter discusses the physiologic aspects of energy utilization and the determinants of variation in energy intake in epidemiologic studies.
We previously have shown that ingested beef protein is just as potent as glucose in stimulating a rise in insulin concentration in type II diabetic patients. A synergistic effect was seen when given with glucose. Therefore, we considered it important to determine if other common dietary proteins also strongly stimulate an increase in insulin concentration when given with glucose. Seventeen type II (non-insulin-dependent) untreated diabetic subjects were given single breakfast meals consisting of 50 g glucose, or 50 g glucose plus 25 g protein in the form of lean beef, turkey, gelatin, egg white, cottage cheese, fish, or soy. The peripheral plasma concentrations of glucose, insulin, glucagon, alpha amino nitrogen, urea nitrogen, free fatty acids, and triglycerides were measured. Following ingestion of the meals containing protein, the plasma insulin concentration was increased further and remained elevated longer compared with the meal containing glucose alone. The relative area under the insulin response curve was greatest following ingestion of the meal containing cottage cheese (360%) and was least with egg white (190%) compared with that following glucose alone (100%). The glucose response was diminished following ingestion of the meals containing protein with the exception of the egg white meals. The peripheral glucagon concentration was decreased following ingestion of glucose alone and increased following all the meals containing protein. The alpha amino nitrogen concentration varied considerably. It was decreased after glucose alone, was unchanged after egg white ingestion, and was greatest after ingestion of gelatin. The free fatty acid concentration decrease was 4- to 8-fold greater after the ingestion of protein with glucose compared with ingestion of glucose alone.
The reproducibility and validity of responses for 55 specific foods and beverages on a self-administered food frequency questionnaire were evaluated. One hundred and seventy three women from the Nurses' Health Study completed the questionnaire twice approximately 12 months apart and also recorded their food consumption for seven consecutive days, four times during the one-year interval. For the 55 foods, the mean of correlation coefficients between frequencies of intake for first versus second questionnaire was 0.57 (range = 0.24 for fruit punch to 0.93 for beer). The mean of correlation coefficients between the dietary records and first questionnaire was 0.44 (range = 0.09 for yellow squash to 0.83 for beer and tea) and between the dietary records and the second questionnaire was 0.52 (range = 0.08 for spinach to 0.90 for tea). Ratios of within- to between-person variance for the 55 foods were computed using the mean four one-week dietary records for each person as replicate measurements. For most foods this ratio was greater than 1.0 (geometric mean of ratios = 1.88), ranging from 0.25 (skimmed milk) to 14.76 (spinach). Correlation coefficients comparing questionnaire and dietary record for the 55 foods were corrected for the within-person variation (mean corrected value = 0.55 for dietary record versus first questionnaire and 0.66 versus the second). Mean daily amounts of each food calculated by the questionnaire and by the dietary record were also compared; the observed differences suggested that responses to the questionnaire tended to over-represent socially desirable foods. This analysis documents the validity and reproducibility of the questionnaire for measuring specific foods and beverages, as well as the large within-person variation for food intake measured by dietary records. Differences in the degree of validity for specific foods revealed in this type of analysis can be useful in improving questionnaire design and in interpreting findings from epidemiological studies that use the instrument.
This study was designed to test the effect of dietary protein on blood levels of insulin and glucagon. Twelve normocholesterolemic (less than 200 mg/dl) and 11 hypercholesterolemic greater than 240 mg/dl) healthy male subjects, 31-62 years of age, were randomly given 3 liquid test meals 1 week apart. Meals were identical except for the protein source (soybean, casein, or protein free). Blood was drawn at fasting, and 0.5 and 2 h postprandially. Insulin and glucagon levels were measured by radioimmunoassay. Hypercholesterolemic subjects had a higher (P less than 0.05) insulin/glucagon ratio (1.5) than normocholesterolemic subjects (0.7) 2 h post-prandially when fed the casein test meal. There was no significant difference following the soybean test meal. This implies that the post-prandial insulin/glucagon ratio was affected by the amino acid composition of the diet. There was a consistently higher insulin response to all test meals among hyper- versus normocholesterolemic subjects. These results are consistent with our hypothesis that the hypocholesterolemic effects of soybean protein and the hypercholesterolemic effects of casein were mediated by altered levels of insulin and glucagon.
To investigate the influence of dietary manipulation on in vivo glucose metabolism, we pair fed normal rats for 10 days with one of three diets: 1) high protein-low carbohydrate (Hi-PN) (n = 20); 2) intermediate protein (I-PN) (n = 11); and 3) low protein-high carbohydrate (Lo-PN) (n = 18). Fasting glucose, postmeal plasma glucose, and insulin concentrations were as follows: 118 +/- 2 mg/dl, 138 +/- 2 mg/dl, and 4.0 +/- 0.2 ng/ml in Hi-PN; 111 +/- 3 mg/dl, 147 +/- 3 mg/dl, and 5.1 +/- 0.3 ng/ml in I-PN; 102 +/- 2 mg/dl, 162 +/- 2 mg/dl, and 6.0 +/- 0.2 ng/ml in Lo-PN, respectively. Basic hepatic glucose production (HGP) was 6.6 +/- 0.2 in Hi-PN, 6.1 +/- 0.2 in I-PN, and 5.6 +/- 0.1 mg.kg-1.min-1 in Lo-PN. Insulin sensitivity was assessed with the euglycemic clamp using two insulin infusion rates: 2 and 4 mU.kg-1.min-1. The rate of glucose disappearance was 14.8 +/- 0.4 and 25.3 +/- 0.7 in Hi-PN, 15.3 +/- 0.4 and 26.9 +/- 0.5 in I-PN, and 16.1 +/- 0.6 and 31.5 +/- 0.5 mg.kg-1.min-1 in Lo-PN, respectively. HGP was suppressed by 86 in the 2- and by 90% in the 4-mU insulin clamp in the Lo-PN, whereas HGP was suppressed by 45 and by 79% in the two steps in the Hi-PN group.(ABSTRACT TRUNCATED AT 250 WORDS)
Associations between intake of specific nutrients and disease cannot be considered primary effects of diet if they are simply the result of differences between cases and noncases in body size, physical activity, and metabolic efficiency. Epidemiologic studies of diet and disease should therefore be directed at the effect of nutrient intakes independent of total caloric intake in most instances. This is not accomplished with nutrient density measures of dietary intake but can be achieved by employing nutrient intakes adjusted for caloric intake by regression analysis. While pitfalls in the manipulation and interpretation of energy intake data in epidemiologic studies have been emphasized, these considerations also highlight the usefulness of obtaining a measurement of total caloric intake. For instance, if a questionnaire obtained information on only cholesterol intake in a study of coronary heart disease, it is possible that no association with disease would be found even if a real positive effect of a high cholesterol diet existed, since the caloric intake of cases is likely to be less than that of noncases. Such a finding could be appropriately interpreted if an estimate of total caloric intake were available. The relationships between dietary factors and disease are complex. Even with carefully collected measures of intake, consideration of the biologic implications of various analytic approaches is needed to avoid misleading conclusions.
The aim of this study was to evaluate the reproducibility and validity of a 61-item semiquantitative food frequency questionnaire used in a large prospective study among women. This form was administered twice to 173 participants at an interval of approximately one year (1980-1981), and four one-week diet records for each subject were collected during that period. Intraclass correlation coefficients for nutrient intakes estimated by the one-week diet records (range = 0.41 for total vitamin A without supplements to 0.79 for vitamin B6 with supplements) were similar to those computed from the questionnaire (range = 0.49 for total vitamin A without supplements to 0.71 for sucrose), indicating that these methods were generally comparable with respect to reproducibility. With the exception of sucrose and total carbohydrate, nutrient intakes from the diet records tended to correlate more strongly with those computed from the questionnaire after adjustment for total caloric intake. Correlation coefficients between the mean calorie-adjusted intakes from the four one-week diet records and those from the questionnaire completed after the diet records ranged from 0.36 for vitamin A without supplements to 0.75 for vitamin C with supplements. Overall, 48% of subjects in the lowest quintile of calorie-adjusted intake computed from the diet records were also in the lowest questionnaire quintile, and 74% were in the lowest one of two questionnaire quintiles. Similarly, 49% of those in the highest diet record quintile were also in the highest questionnaire quintile, and 77% were in the highest one or two questionnaire quintiles. These data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.
Our aim was to examine the association between body mass index at age 18 and subsequent primary ovulatory infertility.
A nested case-control study was conducted within a cohort of 116,678 female registered nurses residing in 14 U.S. states. Cases comprised 2527 married nulliparous nurses unable to become pregnant for at least 1 year because of ovulatory disorder; controls comprised 46,718 married parous nurses with no history of infertility. The risk of ovulatory infertility for women at different levels of body mass index at age 18 was compared with that for women whose body mass index at age 18 was 20 to 21.9 (median for the cohort). Logistic regression was used to adjust for age at infertility or first birth, year of birth, age at menarche, physical activity during ages 18 to 22, smoking at ages 15 to 19, ethnicity, alcohol use at ages 18 to 22, use of oral contraceptives before age 22, and diagnosis of diabetes mellitus.
Multivariate relative risks for infertility were: 1.2 (body mass index < 16), 1.1 (body mass index 16 to 17.9), 1.0 (body mass index 18 to 19.9), 1.0 (referent body mass index 20 to 21.9), 1.1 (body mass index 22 to 23.9), 1.3 (body mass index 24 to 25.9), 1.7 (body mass index 26 to 27.9), 2.4 (body mass index 28 to 29.9), 2.7 (body mass index 30 to 31.9), and 2.7 (body mass index > or = 32). The relative risks for all categories of body mass index above 23.9 were statistically significantly elevated. Greater body mass index at age 18 was a predictor of ovulatory infertility in women with and without a diagnosis of polycystic ovary syndrome.
These findings suggest that elevated body mass index at age 18, even at levels lower than those considered to be obese, is a risk factor for subsequent ovulatory infertility.
To determine whether insulin and insulin-like growth factor I (IGF-I) affect the proliferation of human theca-interstitial cells.
In vitro assays.
University laboratory.
Premenopausal women undergoing oophorectomy for benign conditions.
Purified theca-interstitial cells were cultured in chemically defined media with or without insulin and IGF-I.
The proliferation of cells was evaluated by determination of [3H] thymidine incorporation and cell counting.
Insulin and IGF-I stimulated DNA synthesis by theca-interstitial cells in a dose-dependent fashion. Insulin-like growth factor I had a greater potency than did insulin. The effects of both approached, but did not reach, the level of DNA synthesis observed in cultures exposed to 10% fetal bovine serum. Direct counting of theca-interstitial cells revealed that IGF-I significantly increased the total number of cells (36% above control), whereas insulin induced a modest and statistically nonsignificant increase in the cell number (14% above control).
The present results support the hypothesis that insulin and IGF-I promote the mitotic activity of theca-interstitial cells. These effects may represent mechanisms that lead to hyperplasia of the thecal/stromal compartment in polycystic ovary syndrome.
We performed a follow-up study of time to pregnancy in a population of first-time pregnancy planners without previous reproductive
experience. The objective of this paper is to report and discuss a finding of a strong relationship between glycosylated haemoglobin
(HbA1C) and fertility. A total of 165 Danish couples without previous reproductive experience was followed from termination of birth
control until pregnancy for a maximum of six menstrual cycles. HbA1C and reproductive hormones were measured at entry. Questionnaire data were collected at entry and once in each cycle during
follow-up. The odds ratio (OR) for pregnancy per cycle decreased with increasing concentration of HbA1C (OR per percent HbA1C 0.4, 95% CI 0.2–0.9 for all six cycles and 0.2, 95% CI 0.1–0.5 in the first three cycles). A high concentration of HbA1C was associated with a high concentration of testosterone and a low concentration of inhibin A. No association was found between
HbA1C and psychosocial distress. The reduced fertility among women with high HbA1C may be due to an association with subclinical polycystic ovaries as indicated by the hormonal profile.
The aim of the present study was to determine the effects of feeding various dietary proteins on insulin sensitivity and glucose tolerance in rats. Male Wistar rats were fed for 28 days with isoenergetic diets containing either casein, soy protein, or cod protein. Cod protein-fed and soy protein-fed rats had lower fasting plasma glucose and insulin concentrations compared with casein-fed animals. After intravenous glucose bolus, cod protein- and soy protein-fed rats induced lower incremental areas under glucose curves compared with casein-fed animals. Improved peripheral insulin sensitivity was confirmed by higher glucose disposal rates in cod protein- and soy protein-fed rats (15.2 +/- 0.3 and 13.9 +/- 0.6 mg. kg(-1). min(-1), respectively) compared with casein-fed animals (6.5 +/- 0.7 mg. kg(-1). min(-1), P < 0.05). Moreover, test meal experiments revealed that, in the postprandial state, the lower plasma insulin concentrations in cod protein- and soy protein-fed animals could be also due to decreased pancreatic insulin release and increased hepatic insulin removal. In conclusion, the metabolic responses to three common dietary proteins indicate that cod and soy proteins, when compared with casein, improve fasting glucose tolerance and peripheral insulin sensitivity in rats.
We hypothesized that the administration of troglitazone, an insulin-sensitizing agent of the thiazolidinedione class, would improve the ovulatory dysfunction, hirsutism, hyperandrogenemia, and hyperinsulinemia of polycystic ovary syndrome (PCOS) patients. Four hundred and ten premenopausal women with PCOS in a multicenter, double blind trial were randomly assigned to 44 weeks of treatment with placebo (PBO) or troglitazone [150 mg/day (TGZ-150), 300 mg/day (TGZ-300), or 600 mg/day (TGZ-600)]. We compared changes in ovulatory function (by monitoring the urinary level of pregnanediol-3-glucuronide daily), hirsutism (by a modified Ferriman-Gallwey scoring method), hormonal levels (total and free testosterone, androstenedione, sex hormone-binding globulin, LH, FSH, and the LH/FSH ratio), and measures of glycemic parameters (fasting levels of glucose, insulin, hemoglobin A(1c), and the glucose and insulin areas under the curve during an oral glucose challenge) among study groups. Of the 410 patients recruited, 305 (74.4%) met evaluability criteria and were included in the analyses. The patients' baseline characteristics were similar across all treatment arms. Ovulatory rates were significantly greater for patients receiving TGZ-300 and TGZ-600 than for those receiving PBO (0.42 and 0.58 vs. 0.32; P < 0.05 and 0.0001, respectively). Of PCOS patients treated with TGZ-600, 57% ovulated over 50% of the time compared with 12% of placebo-treated patients. There was a significant decrease in the Ferriman-Gallwey score with TGZ-600 compared with PBO (0.22 +/- 0.53 vs. -2.21 +/- 0.49; P < 0.05, respectively). Free testosterone decreased and sex hormone-binding globulin increased in a dose-related fashion with troglitazone treatment, and all three troglitazone treatment groups were significantly different from placebo. Nearly all glycemic parameters showed dose-related decreases with troglitazone treatment. The total number and severity of adverse events (including elevations in liver enzymes) and the proportion of patients withdrawn from the study due to the development of adverse effects were similar between treatment groups. Troglitazone improves the ovulatory dysfunction, hirsutism, hyperandrogenemia, and insulin resistance of PCOS in a dose-related fashion, with a minimum of adverse effects.