Pre-pregnancy fast food and fruit intake is associated with time to pregnancy

• Published in: Human reproduction (Oxford) 2018-06, Vol.33 (6), p.1063-1070
• Main Authors: Grieger, Jessica A, Grzeskowiak, Luke E, Bianco-Miotto, Tina, Jankovic-Karasoulos, Tanja, Moran, Lisa J, Wilson, Rebecca L, Leemaqz, Shalem Y, Poston, Lucilla, McCowan, Lesley, Kenny, Louise C, Myers, Jenny, Walker, James J, Norman, Robert J, Dekker, Gus A, Roberts, Claire T
• Format: Article
• Language: English
• Subjects: Adult; Fast Foods - adverse effects; Fast Foods - statistics & numerical data; Feeding Behavior; Female; Fruit; Humans; Infertility, Female - etiology; Pregnancy; Retrospective Studies; Risk Factors; Time-to-Pregnancy; Young Adult
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/dey079

Abstract STUDY QUESTION Is preconception dietary intake associated with reduced fecundity as measured by a longer time to pregnancy (TTP)? SUMMARY ANSWER Lower intake of fruit and higher intake of fast food in the preconception period were both associated with a longer TTP. WHAT IS KNOWN ALREADY Several lifestyle factors, such as smoking and obesity, have consistently been associated with a longer TTP or infertility, but the role of preconception diet in women remains poorly studied. Healthier foods or dietary patterns have been associated with improved fertility, however, these studies focused on women already diagnosed with or receiving treatments for infertility, rather than in the general population. STUDY DESIGN, SIZE, DURATION This was a multi-center pregnancy-based cohort study of 5628 nulliparous women with low-risk singleton pregnancies who participated in the Screening for Pregnancy Endpoints (SCOPE) study. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 5598 women were included. Data on retrospectively reported TTP and preconception dietary intake were collected during the first antenatal study visit (14-16 weeks' gestation). Dietary information for the 1 month prior to conception was obtained from food frequency questions for fruit, green leafy vegetables, fish and fast foods, by a research midwife. Use of any fertility treatments associated with the current pregnancy was documented (yes, n = 340, no, n = 5258). Accelerated failure time models with log normal distribution were conducted to estimate time ratios (TR) and 95% CIs. The impact of differences in dietary intake on infertility (TTP >12 months) was compared using a generalized linear model (Poisson distribution) with robust variance estimates, with resulting relative risks (RR) and 95% CIs. All analyses were controlled for a range of maternal and paternal confounders. Sensitivity analyses were conducted to explore potential biases common to TTP studies. MAIN RESULTS AND THE ROLE OF CHANCE Lower intakes of fruit and higher intakes of fast food were both associated with modest increases in TTP and infertility. Absolute differences between the lowest and highest categories of intake for fruit and fast food were in the order of 0.6-0.9 months for TTP and 4-8% for infertility. Compared with women who consumed fruit ≥3 times/day, the adjusted effects of consuming fruit ≥1-