Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability

Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability

The American Journal of Clinical Nutrition

10.1093/ajcn/nqab344

http://dx.doi.org/10.1093/ajcn/nqab344

Shan Xuan Lim, See Ling Loy, Marjorelee T Colega, Jun Shi Lai, Keith M Godfrey, Yung Seng Lee, Kok Hian Tan, Fabian Yap, Lynette Pei-chi Shek, Yap Seng Chong, Johan G Eriksson, Jerry Kok Yen Chan, Shiao-Yng Chan, Mary Foong-Fong Chong

Nutrition and Dietetics, Medicine (miscellaneous)

04 December 2021

Lim, S. X., Loy, S. L., Colega, M. T., Lai, J. S., Godfrey, K. M., Lee, Y. S., Tan, K. H., Yap, F., Shek, L. P.-C., Chong, Y. S., Eriksson, J. G., Chan, J. K. Y., Chan, S.-Y., & Chong, M. F.-F. (2021). Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability. The American Journal of Clinical Nutrition, 115(2), 559–569. https://doi.org/10.1093/ajcn/nqab344

ABSTRACT Background Modest associations have been reported between specific food groups or nutrients and fecundability [measured by time to pregnancy (TTP)]. Examining overall diets provides a more holistic approach towards understanding their associations with fecundability. It is not known whether plant-based diets indices or exploratory dietary patterns are associated with fecundability. Objectives We examine the associations between adherence to 1) plant-based diet indices; and 2) exploratory dietary patterns and fecundability among women planning pregnancy. Methods Data were analyzed from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) study. Prepregnancy diet was assessed using a semi-quantitative FFQ from which the overall, healthful, and unhealthful plant-based diet indices (oPDI, hPDI, and uPDI, respectively) were calculated. Exploratory dietary patterns were derived using factor analysis based on 44 predefined food groups. Participants were categorized into quintiles based on their dietary pattern scores. TTP (expressed in menstrual cycles) was ascertained within a year from the prepregnancy dietary assessment. Discrete-time proportional hazard models, adjusted for confounders, were used to estimate fecundability ratios (FRs) and 95% CIs, with FR > 1 indicating a shorter TTP. Results Among 805 women, 383 pregnancies were confirmed by ultrasound scans. Compared with women in the lowest quintile, those in the highest quintile of the uPDI had reduced fecundability (FR of Q5 compared with Q1, 0.65; 95% CI, 0.46–0.91; P trend, 0.009). Conversely, greater adherence to the hPDI was associated with increased fecundability (1.46; 95% CI, 1.02–2.07; P trend, 0.036). The oPDI was not associated with fecundability. Among the 3 exploratory dietary patterns, only greater adherence to the Fast Food and Sweetened Beverages (FFSB) pattern was associated with reduced fecundability (0.61; 95% CI, 0.40–0.91; P trend, 0.018). Conclusions Greater adherence to the uPDI or the FFSB dietary pattern was associated with reduced fecundability among Asian women. Greater adherence to the hPDI may be beneficial for fecundability, though this requires confirmation by future studies.

Publisher Copyright

This research / project is supported by the National Medical Research Council (NMRC) / National University Singapore (NUS) - Translational and Clinical Research (TCR) Flagship Programme
Grant Reference no. : NMRC/TCR/004-NUS/2008

This research / project is supported by the National Medical Research Council (NMRC) / National University Hospital Singapore (NUHS) - Translational and Clinical Research (TCR) Flagship Programme
Grant Reference no. : NMRC/TCR/012-NUHS/2014

This research / project is supported by the Ministry of Health - Open Fund Large Collaborative Grant
Grant Reference no. : MOH-000504

This research is supported by core funding from: Singapore Institute for Clinical Sciences
Grant Reference no. : NA

Overseas Funding:- 1) UK Medical Research Council (MC_UU_12011/4) 2) National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) 3) NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004 4) European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) 5) British Heart Foundation (RG/15/17/3174).

This is a pre-copyedited, author-produced version of an article accepted for publication in The American Journal of Clinical Nutrition following peer review. The version of recordLim, S. X., Loy, S. L., Colega, M. T., Lai, J. S., Godfrey, K. M., Lee, Y. S., Tan, K. H., Yap, F., Shek, L. P.-C., Chong, Y. S., Eriksson, J. G., Chan, J. K. Y., Chan, S.-Y., & Chong, M. F.-F. (2021). Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability. The American Journal of Clinical Nutrition, 115(2), 559–569. https://doi.org/10.1093/ajcn/nqab344 is available online at: https://doi.org/10.1093/ajcn/nqab344

https://oar.a-star.edu.sg/communities-collections/articles/18190

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Singapore Institute for Clinical Sciences