are with the Department of Nutrition, Federal University of Paraná, Curitiba, Paraná, Brazil.
Nutr Rev. 2023 Jun 9;81(7):775-789. doi: 10.1093/nutrit/nuac087.
The Mediterranean diet (MD) is a dietary pattern with evidence of positive health impact, and some nutrients in this diet have already been researched for their effectiveness in fertility. However, there are still questions about whether high adherence to the MD could be a factor that contributes to positive fertility outcomes in infertile men and women.
A systematic review and meta-analysis were conducted to determine whether a greater adherence to the MD can improve fertility markers and outcomes in infertile men and women.
The MEDLINE, BVS, SciELO, CENTRAL, and Embase databases and gray literature were searched from their inception to May 2022.
Data were included from cohort studies that addressed MD and outcomes.
Data searches, article selection, data extraction, and risk-of-bias assessments were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
A total of 11 studies met the inclusion criteria (n = 13 157 women and 1338 men). Greater adherence to the MD was associated with live births (I2 = 83.16%; odds ratio [OR], 0.652; 95%CI, 0.408-3.194), pregnancy rate (I2 = 93.83%; OR, 1.192; 95%CI, 0.349-4.325), sperm concentration >15 × 106/mL (I2 = 32.97%; OR 2.862; 95%CI, 1.583-5.174), and sperm count > 39 × 106/mL (I2 = 48.1%; OR, 2.543; 95%CI, 1.319-4.904); however, in an inconsistent scenario regarding the meta-analysis.
Current evidence of high adherence to MD and fertility markers is insufficient to support their clinical application, even though it indicates sperm improvement and a possibility of better pregnancy outcomes.
PROSPERO registration no. 169396.
地中海饮食（Mediterranean diet，MD）是一种具有积极健康影响的饮食模式，其某些营养成分已经过研究，以确定其对生育能力的有效性。然而，关于高 MD 依从性是否可能成为影响不孕男女生育结局的一个因素，仍存在疑问。
本系统评价和荟萃分析旨在确定 MD 更高的依从性是否可以改善不孕男女的生育标志物和结局。
从数据库建立到 2022 年 5 月，检索 MEDLINE、BVS、SciELO、CENTRAL 和 Embase 数据库及灰色文献。
纳入了探讨 MD 与结局的队列研究的数据。
根据系统评价和荟萃分析的首选报告项目指南，进行数据检索、文章选择、数据提取和偏倚风险评估。
共有 11 项研究符合纳入标准（n=13157 名女性和 1338 名男性）。更高的 MD 依从性与活产（I2=83.16%；比值比[OR]，0.652；95%CI，0.408-3.194）、妊娠率（I2=93.83%；OR，1.192；95%CI，0.349-4.325）、精子浓度>15×106/ml（I2=32.97%；OR，2.862；95%CI，1.583-5.174）和精子计数>39×106/ml（I2=48.1%；OR，2.543；95%CI，1.319-4.904）相关，但荟萃分析结果不一致。
目前关于 MD 高度依从性与生育标志物的证据不足以支持其临床应用，尽管这表明精子质量得到改善，并且可能有更好的妊娠结局。
PROSPERO 注册号为 169396。
