Is the Mediterranean Diet good for fertility and pregnancy?

There is strong evidence that the Mediterranean Diet (MD), a primarily plant, whole food, egg, poultry and fish based diet, has many health benefits. Early research has found that the diet has a protective effect for cardiovascular diseases and certain cancers.

Dr Joo Teoh, Obstetrician, Gynaecologist & Fertility Specialist
Dr Joo Teoh, Obstetrician, Gynaecologist & Fertility Specialist

A healthy diet enhances the fertility potential by improving the quality of the gametes and optimising the intrauterine environment for nurturing the embryos. It improves the overall health of individuals and perhaps helps fight against adverse impacts from the environment

Recent evidence suggests this diet improves fertility potential for both men and women. The beneficial effect is seen not only in groups with metabolic syndrome, but also in the general population. For instance, using a MD scoring system, females who have the highest adherence to the diet have been found to have a 66% lower chance of having ovulation problems and a lower risk, by 27%, of having other factors affecting their fertility.

Women with a higher MD score have a better chance of conceiving in IVF (29.1% vs 50%) and successfully giving birth (26.6% vs 48.8%).  Likewise, men with a high MD score have the best semen quality in all measured parameters. ‘Western’ diet and fast food high in carbohydrates, processed and red meats, and sweetened drinks are associated with longer time periods to conception, and lower semen quality.

Laboratory studies have shown that MD improves the immune response in certain systems in the body, e.g. the gut cells. In the current environment of a viral pandemic, a healthy diet may have a protective effect against the infection.

In the 1918 influenza pandemic, the birth rates were reported to be significantly reduced. A study in Taiwan stated that the birth reduction was due to reduced conceptions and embryonic loss during the first month of pregnancy, rather than through late-first-trimester loss. We are yet to learn the full picture of COVID-19. Reassuringly so far, there are no adverse outcomes being reported in early and mid-trimester pregnancies.

In pregnancies, adequate carotenoids intake has been shown to prevent pre-eclampsia and preterm delivery. A better diet quality, highly similar to MD, is associated with less likelihood of restricted growth. It is also beneficial for the development of intelligence of the babies. MD decreases the chance of gestational diabetes, macrosomia and emergency caesarean section.

In Singapore, a study has shown that vegetable and fruit-focused diet reduced likelihood of preterm-births. Like other environmental exposures, diet in pregnancy has also been shown to affect the epigenetic imprinting of the offspring, potentially affect their phenotypes for future generations.

Key messages

  • The Mediterranean diet has benefits in reproduction
  • A good diet can help prevent complications in pregnancy
  • Good nutrition provides the optimal nourishment for fetal development.

References available on request.

Questions? Contact the editor.

Author competing interests: The author has written a book on this subject

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