The Mediterranean Diet is a set of dietary recommendations that follow the traditional eating patterns of people along the European coast of the mediterranean sea (southern France, southern Italy, Crete, Greece, etc). The diet is touted as one of the healthiest in the world based on research confirming it's positive effects on a laundry list of health concerns; cardiovascular disease, diabetes, weight loss, depression, cognitive function... the list goes on. Now, we can add fertility to the list!
Compared to our typical North American diets, the Mediterranean diet is different in these ways. It emphasizes:
high consumption of plant foods, mainly fruits and veggies. With fresh and varied fruits as both the main and desert.
opts for whole grain carbs, rather than white/processed ones. This means more homemade and whole grain breads and sides, and less pasta/white bread than you might initially think.
a low intake of red meat (beef and pork), in favour of cold water fish and poultry instead. (Although, I believe animal fats/meat can and should be a big part of a fertility promoting diet. The published mediterranean diet research came out around a time of famine along the mediterranean coast, so it's likely the actual diet of these populations contains more red meat than the research would reflect. Prosciutto anyone?)
a much higher focus on healthy unsaturated fats. Generally, fat makes up 25-35% of total calories, with olive oil being the main source.
moderate consumption of wine, with meals only.
low to moderate consumption of dairy products.
Very low sugar/sweets. Basically none at once or twice per week or less being the usual recommendation.
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Here are two well designed studies that look at the impact of the Mediterranean Diet on Fertility.
Toledo et al published a study in 2011 that observed a total of 2154 Spanish women to investigate the association between the Mediterranean type diet and Western type diets and their ability to conceive. 485 of the women reported difficulty conceiving and had no children, the rest had at least one child. Difficulty of conceiving was judged by questionnaire. The data revealed that those who had the least difficulty getting pregnant were most likely to eat a mediterranean type diet.
A 2009 study by Vujkovic, et al and published in Fertility and Sterility followed 161 Dutch couples undergoing in-vitro fertilization (IVF) or in-vitro fertilization with intracytoplasmic sperm injection (IVF with ICSI) found that when couples stuck to a Mediterranean diet, they increased their probability of pregnancy by 40%!!!! That's HUGE! (For reference, we almost never see that magnitude of effect in drug trials. Something is considered a success at 5-10% improvement.) Admittedly, this study is small, it would be nice to see the number of couples in thousands to be sure the 40% is accurate. That said... the stats on this small study worked out to say that the increase in pregnancy rates was definitely due to the dietary changes. The only question I have is if the 40% increase is the correct increase, which we just need a bigger study for. Of interest as well, is that in the study, adherence to the Mediterranean diet was associated with higher folate and vitamin B6 levels in red blood cells and in follicular fluid. It speaks to a mechanism of action for the increase in pregnancy rates as a small sign that the nutrients in the diet were getting into the bloodstream and then onward to the eggs/follicles, where they could do their good work.
Of course, there are other benefits to the mediterranean diet to consider that we know have an indirect on fertility... the diet is well known to be able to help you to reduce your weight – obesity is connected to lower pregnancy rates. So, why not address this risk factor and kill two birds with one stone?
Some of the biggest learnings you can pull from the Mediterranean Diet that I integrate into the dietary recommendations I give my patients are:
Flood your diet with colorful plants- these should be the foundation of your diet! I recommend 50% of every meal and snack be made up of fruits and veggies.
When it comes to animal proteins, focus on cold water fish and poultry/eggs. These choices are more likely to be higher in unsaturated, healthy omega 3 fats.
Add some good quality olive oil to everything. (Read here about cooking with olive oil healthfully.)
Quit sweets & refined sugars if you can. Or at least reduce them to once or twice per week. If you need help with this, I offer the 30-Day ZERO Sugar Challenge to help you wean yourself off the sugar in 30 days.
Making these few changes will get you started on your path toward a healthy body that can support a healthy pregnancy, but if you want more info, click here and enter your email and I'll send you my 8 Simple and Easy Strategies to a Lifetime of Healthy Eating, right now!
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