THE MEDITERRANEAN DIET
The Mediterranean Diet or Mediterranean-style eating pattern (MEP) has been one of the most researched diets since the 1950s, where it was found that people living in the Mediterranean region of the world had lower rates of coronary heart disease. The MEP is based on what is traditionally eaten by people living in countries bordering the Mediterranean Sea such as Greece, Italy, Spain etc.
The characteristics of a MEP are:
• Plant-based: abundant in fruit and vegetables; wholegrain breads and other cereals; nuts & seeds
• Minimally processed: including locally grown and seasonally fresh foods
• Limiting sweets: having fresh fruit instead
• Highly-quality fats: olive oil is primarily used
• Low to moderate dairy intake
• Small amounts of red meat and eggs consumed and with low frequency
• Moderate amounts of fish and seafood
• Low to moderate amounts of alcohol with meals
• Herbs and spices used to add flavour to foods in place of salt
BENEFITS OF THE MEDITERRANEAN DIET
There are numerous health benefits to the Mediterranean Diet or MEP. These include improvements in glycaemic control, reductions in the incidence of Type 2 Diabetes, and improvements to heart disease. For ladies, the Mediterranean Diet can also assist with those who have PCOS, endometriosis, those trying to conceive and those going through IVF. So, what is the link between the Mediterranean Diet and Fertility? To answer this question, let’s take a look at the 4 main nutrients associated with the Mediterranean Diet, and its effects on fertility.
OMEGA 3 – Omega-3 fatty acids have anti-inflammatory and antioxidant properties. Adequate intake of omega-3 has many health benefits on the heart, joints, and mental health. Omega-3 plays a key role in the production of prostaglandins which affect the menstrual cycle, growth and development of eggs; as well as the initiation of ovulation. Prostaglandins also influence the fertilisation of the embryo in the uterus. In male fertility, Omega 3 can improve sperm count, and directly support proper functioning and structure of sperm. Eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), the main components of omega 3 have also been shown to increase sperm motility and DNA concentration in semen.
The Australian Dietary Guidelines recommend 2-3 serves of oily fish (e.g. salmon, mackeral, sardines and tuna) per week to ensure adequate omega 3 intake. Other dietary sources of omega 3 include eggs and nuts.
VITAMIN D – Vitamin D is derived from dietary oily fish and eggs and appears to impact IVF outcomes by boosting levels progesterone and oestrogen, hormones which regulates menstrual cycles, thus improving the chance of conception. Vitamin D has also been found to improve semen quality and count in males, and increase levels of testosterone thus boosting libido.
VITAMIN E – Vitamin E is a fat-soluble vitamin and antioxidant, commonly found in extra virgin olive oil, almonds, avocados and seeds. The function of Vitamin E is to protect against cell damage from free radicals, maintain the structure of our cell membranes and fight inflammation. It is also important in male fertility, with Vitamin E and selenium supplementation showing an improvement in sperm motility, morphology and or both within just 100 days.
B VITAMINS – Another benefit of the Mediterranean diet to fertility is its high Vitamin B content, namely vitamin B6, B12 and folate (B9). These vitamins are required to break down homocysteine (an amino acid found in blood plasma) and prevent homocysteine accumulation which is associated with adverse reproductive and pregnancy outcomes. Adequate intake of folate, B6 and B12 is recommended for women who are trying to conceive both spontaneously or via IVF.
MEDITERRANEAN DIET & IVF
In Vitro Fertilisation (IVF) is a procedure used to overcome a range of fertility issues, by which an egg and sperm are joined together outside the body, in a specialised laboratory.
A study published in 2018 found that women who followed the Mediterranean diet 6 months prior to receiving IVF had significantly higher chances of conceiving and giving birth compared to women who did not eat foods associated with a Mediterranean diet. Results of that study found that women eating little to no red meat, more fruit and vegetables, fish, wholegrains and vegetables oils had 65 to 68% better chance of falling pregnant and giving birth than those who did not adhere to the Mediterranean diet. The link between successful IVF treatment and eating according to the Mediterranean eating pattern was also particularly strong for women under 35 years who followed the MEP for 6 months before having fertility treatment. These findings were consistent with another study done by Greek researchers who found that women under 35 years who followed the Mediterranean diet were 2.7 more likely to achieve pregnancy and give birth.
A Dutch study in 2010 found couples who went on a Mediterranean style diet in preconception and who were undergoing Assistive Reproductive Technology (ART) treatment increased their chances of achieving pregnancy by 40%
A Spanish study in 2011 which looked at 485 women who had conception difficulties found that adherence to the Mediterranean-type dietary pattern improved their fertility and increased pregnancy rates.
There are so many research studies demonstrating that a Mediterranean diet is the best way to boost fertility, improve IVF and pregnancy outcomes. This is definitely attributed to the nutrient and antioxidant packed foods associated with the Mediterranean diet, such as good oils, plant-based protein such as legumes and lentils, nuts & seeds, fish, wholegrains and fruit & vegetables.
PRACTICAL TIPS ON HOW TO EAT ACCORDING TO THE MEP:
- Replace butter and margarine with extra virgin olive oil. – Use olive oil in cooking, over salad vegetables, or spread lightly on wholegrain bread. Extra virgin contains polyphenols and antioxidants, and can also withstand high heat – perfect for both cooking and as a dressing or dip.
- Swap out white for wholegrains – Choose wholegrain breads and cereals, as well as wholegrain pasta and rice products such as brown rice. Wholegrains contain much more fibre and Vitamin Bs as compared to white options.
- Have fruit and/or vegetables as snacks – Aim for 5 serves of vegetables per day. A serve of vegetables is equivalent to 1 cup of salad vegetables or 1/2 cup cooked vegetables. Aim for 2 serves of fruit per day and enjoy fruit as a dessert instead of sweets.
- Substitute red meat for fish at least twice per week – Fresh or canned fish such as salmon, water-packed tuna, trout, mackeral and herring are all great choices. Aim to have fish at least 2-3 times per week as a great source of protein and omega-3 fats. Other types of lean protein include skinless chicken, turkey, beans, nuts and other plant-based protein sources such as tofu. When having red meats, choose lean cuts and keep to small portions such as the size of a deck of cards.
- Limit full cream dairy by switching to fat reduced or skim – Reduce saturated fat intake by switching full cream milk to fat-reduced or skim milk, this also applies to other dairy products such as yoghurt and cheese.
- Limit alcohol intake – If you drink alcohol, limit it to moderate consumption with a meal (no more than a glass for women or two glasses for men).
TAKE HOME MESSAGE
The Mediterranean Diet or MEP has been widely researched and shown to improve fertility, IVF and pregnancy outcomes. There are also numerous health benefits from eating like a Mediterranean, as it is one of the healthiest ways of eating. Start by making some simple swaps using the practical tips suggested above!
Everyone’s fertility and preconception journey is different, to get individualised advice, get in touch with one of our Accredited Practising Dietitians to get a tailored, individualised approach.