Adherence to a modified DASH diet, intake of key food groups, and infertility in women and men: the Norwegian Mother, Father and Child Cohort Study
- 1Hospital del Mar Research Institute
Abstract
Background & AimsDiet is a modifiable exposure that may contribute to reproductive health. While most previous studies focused on selected nutrients in relation to fertility treatment outcomes or semen parameters, large cohort data addressing overall diet quality and clinical infertility in both women and men remain limited. We aimed to assess how adherence to a modified Dietary Approaches to Stop Hypertension (DASH) dietary pattern and intake of key food groups relate to infertility in women and men.
MethodsWe included 59,218 women and 26,866 men participating in the Norwegian Mother, Father and Child Cohort Study (MoBa). Diet was assessed using dietary questionnaires and summarized using a modified DASH score comprising fruits, vegetables, nuts/legumes, whole grains, low-fat dairy, sweet beverages, red and processed meat, and a snack/fast food proxy. Fish was also assessed. Infertility was defined as having tried to conceive for at least 12 months or using assisted reproductive technologies. Logistic regression models were fitted separately in women and men, adjusting for age, education, body mass index, smoking, and number of offspring. Food-group analyses were evaluated using a multiple-comparison threshold of p-value <0.0167, derived from Horns parallel analysis.
ResultsA higher modified DASH score was associated with lower odds of infertility in women (adjusted OR per 1-SD increment: 0.97, 95% CI 0.95 to 0.995) and men (OR: 0.91, 95% CI 0.87 to 0.94). In women, higher red and processed meat intake was associated with higher odds of infertility (adjusted OR per 1-SD increment: 1.04, 95% CI 1.02 to 1.07), and a nominal association was observed for the snack/fast food proxy (OR 1.03, 95% CI 1.01 to 1.05). Whole grains and fish showed evidence of non-linear associations: the lowest estimated odds of infertility were observed at approximately 5 servings/day for whole grains, and at approximately 0.4 serving/day for fish. In men, higher intakes of fruits, vegetables, whole grains, and fish were associated with lower odds of infertility (5-6% lower odds per 1-SD higher intake). Higher values of the snack/fast food proxy were associated with higher odds of infertility (7% higher odds per 1-SD higher intake). Associations were attenuated in women after adjustment for their partners modified DASH score, but not vice versa.
ConclusionGreater adherence to a modified DASH dietary pattern was associated with lower odds of infertility in both women and men, with stronger and more consistent associations in men and partly sex-specific food-group patterns, although maternal diet was assessed during pregnancy and may not reflect preconception intake. These findings support considering overall diet quality and both partners diets when studying infertility and highlight the need for preconception studies and dietary interventions using clinically relevant couple-level fertility outcomes.
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BibTeX
@misc{hernaez2026adherence,
title = {{Adherence to a modified DASH diet, intake of key food groups, and infertility in women and men: the Norwegian Mother, Father and Child Cohort Study}},
author = {A. Hernaez and I. H. Caspersen and T. Grindstad and M. M. Paulsen and S. Castro-Barquero and M. H. Hernandez and M. C. Magnus},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.21.26366136},
url = {https://www.medrxiv.org/content/10.64898/2026.10.21.26366136v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Adherence to a modified DASH diet, intake of key food groups, and infertility in women and men: the Norwegian Mother, Father and Child Cohort Study
AU - A. Hernaez
AU - I. H. Caspersen
AU - T. Grindstad
AU - M. M. Paulsen
AU - S. Castro-Barquero
AU - M. H. Hernandez
AU - M. C. Magnus
PY - 2026
DA - 2026/10/21
PB - medRxiv
DO - 10.64898/2026.10.21.26366136
UR - https://www.medrxiv.org/content/10.64898/2026.10.21.26366136v1
AB - Background & AimsDiet is a modifiable exposure that may contribute to reproductive health. While most previous studies focused on selected nutrients in relation to fertility treatment outcomes or semen parameters, large cohort data addressing overall diet quality and clinical infertility in both women and men remain limited. We aimed to assess how adherence to a modified Dietary Approaches to Stop Hypertension (DASH) dietary pattern and intake of key food groups relate to infertility in women and men. MethodsWe included 59,218 women and 26,866 men participating in the Norwegian Mother, Father and Child Cohort Study (MoBa). Diet was assessed using dietary questionnaires and summarized using a modified DASH score comprising fruits, vegetables, nuts/legumes, whole grains, low-fat dairy, sweet beverages, red and processed meat, and a snack/fast food proxy. Fish was also assessed. Infertility was defined as having tried to conceive for at least 12 months or using assisted reproductive technologies. Logistic regression models were fitted separately in women and men, adjusting for age, education, body mass index, smoking, and number of offspring. Food-group analyses were evaluated using a multiple-comparison threshold of p-value <0.0167, derived from Horns parallel analysis. ResultsA higher modified DASH score was associated with lower odds of infertility in women (adjusted OR per 1-SD increment: 0.97, 95% CI 0.95 to 0.995) and men (OR: 0.91, 95% CI 0.87 to 0.94). In women, higher red and processed meat intake was associated with higher odds of infertility (adjusted OR per 1-SD increment: 1.04, 95% CI 1.02 to 1.07), and a nominal association was observed for the snack/fast food proxy (OR 1.03, 95% CI 1.01 to 1.05). Whole grains and fish showed evidence of non-linear associations: the lowest estimated odds of infertility were observed at approximately 5 servings/day for whole grains, and at approximately 0.4 serving/day for fish. In men, higher intakes of fruits, vegetables, whole grains, and fish were associated with lower odds of infertility (5-6% lower odds per 1-SD higher intake). Higher values of the snack/fast food proxy were associated with higher odds of infertility (7% higher odds per 1-SD higher intake). Associations were attenuated in women after adjustment for their partners modified DASH score, but not vice versa. ConclusionGreater adherence to a modified DASH dietary pattern was associated with lower odds of infertility in both women and men, with stronger and more consistent associations in men and partly sex-specific food-group patterns, although maternal diet was assessed during pregnancy and may not reflect preconception intake. These findings support considering overall diet quality and both partners diets when studying infertility and highlight the need for preconception studies and dietary interventions using clinically relevant couple-level fertility outcomes.
ER -