Adherence to the Mediterranean Diet in Women and Reproductive Health across the Lifespan: A Narrative Review
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Study Selection and Data Extraction
2.4. Quality Assessment
3. Reproductive Health
3.1. Menarche
3.1.1. Observational Studies
3.1.2. Possible Mechanism
3.2. Menstrual Cycle
Observational Studies
3.3. Menopause
3.3.1. Age of Onset of Menopause
Authors (Country) | Type of Study | Number and Age of Participants | Assessment of Mediterranean Diet | Effect | Quality Assessment a |
---|---|---|---|---|---|
AGE OF MENARCHE | |||||
Szamreta et al. [18] (USA) | Longitudinal cohort study | n = 202 10.0 ± 0.58 years | Adapted MD score | No association | Low |
MENSTRUAL CYCLE | |||||
Onieva-Zafra et al. [30] (Spain) | Cross- sectional | n = 311 21.2 ± 2.6 years | KIDMED questionnaire | Women with low adherence had longer menstrual cycles. No association with regularity, amount of flow, duration of menses, or menstrual pain. | Medium |
AGE OF ONSET OF MENOPAUSE | |||||
No study was conducted |
3.3.2. The European Menopause and Andropause Society (EMAS) Position Statement
3.3.3. Symptoms and Health Problems Related to Perimenopausal Age
4. Reproductive Health Dysfunction
4.1. Premenstrual Syndrome
4.1.1. Observational Studies
4.1.2. Possible Mechanism
4.2. Dysmenorrhea
Observational Studies
4.3. Sexual Dysfunction
4.3.1. Experimental and Observational Studies
4.3.2. Possible Mechanism
4.4. Endometriosis
4.4.1. Experimental Studies
4.4.2. Possible Mechanism
4.5. Polycystic Ovary Syndrome
4.5.1. Randomized Controlled Trials
4.5.2. Case-Control Studies
4.5.3. Cross-Sectional Studies
4.5.4. Possible Mechanism
4.6. Infertility
4.6.1. Observational Studies
4.6.2. Possible Mechanism
Authors (Country) | Type of Study | Number and Age of Participants | Assessment of Mediterranean Diet | Effect | Quality Assessment a |
---|---|---|---|---|---|
PREMENSTRUAL SYNDROME | |||||
Kwon et al. [48] (South Korea) | Cross-sectional | Non-PMS: n = 91 33 (26–37) years PMS: n = 171 31 (26–37) years | Mediterranean Diet Adherence Screener | Low adherence to MD was associated with increased risk of PMS. | Medium |
DYSMENORRHEA | |||||
Onieva-Zafra et al. [30] (Spain) | Cross-sectional | n = 311 21.2 ± 2.6 years | KIDMED questionnaire | No association. | Medium |
SEXUAL DYSFUNCTION | |||||
Esposito et al. [76] (Italy) | Randomized controlled trial study Women with metabolic syndrome and FSD Intervention: MD for 2 years | MD n = 21 42.3 ± 4.5 years CD n = 28 41.5 ± 3.9 years | Evaluated by the nutritionist for 24 months (consultations every month) | Improved FSFI and reduced CRP levels in the intervention group. No single sexual domain (desire, arousal, lubrication, orgasm, satisfaction, pain) was significantly ameliorated. | Major limitations |
Maiorino et al. [77] (Italy) | Randomized clinical trial study Women with type 2 diabetes and FSD Intervention: MD for 8.1 years | MD n = 54 50.9 ± 9.2 years LFD n = 55 51.2 ± 9.3 years | MD score | Less deterioration in the sexual health of the intervention group. | Major limitations |
Giugliano et al. [78] (Italy) | Cross-sectional study Women with type 2 diabetes and FSD | n = 595 57.9 ± 6.7 years | MD score | Women with the highest MD score had lowest prevalence of sexual dysfunction. | Medium |
ENDOMETRIOSIS | |||||
Ott et al. [83] (Austria) | Experimental study Women with endometriosis Intervention: MD for 5 months | n = 68 35.3 ± 11.2 years | Self-reported by each patient | Significant relief of general pain and an improvement in the general condition. | Major limitations |
POLYCYSTIC OVARY SYNDROME | |||||
Cincione et al. [87] (Italy) | Randomized controlled trial Overweight and/or obese women with PCOS Intervention: hypocaloric MD vs. KD for 45 days | MD n = 71 33.6 ± 4.9 years KD n = 73 33.4 ± 5.7 years | Evaluated by the nutritionist through counseling every 2 weeks and reinforced by phone calls every 2–3 days | Both interventions were effective. The improvement in the anthropometric, metabolic, and endocrine parameters was significantly higher in the KD compared to the MD group. | Major limitations |
Mei et al. [88] (China) | Randomized controlled trial Overweight women with PCOS Intervention: MD/LC vs. LF for 12 weeks | MD/LC n = 30 28.0 ± 5.3 years LF n = 29 28.1 ± 7.1 years | Evaluated and monitored by the nutritionist | Both dietary models were effective. MED/LC effectiveness was higher than the LF. | Major limitations |
Wang et al. [89] (China) | Case-control study Cases: PCOS patients Controls: healthy women | PCOS n = 202 30.2 ± 3.4 years Controls n = 325 31.8 ± 3.8 years | MD pattern | Protective association with PCOS. | Medium |
Cutillas-Tolin et al. [90] (Spain) | Case-control study Cases: PCOS patients Controls: healthy women | PCOS n = 121 Controls n = 155 29.1 ± 5.7 years | Relative MD score Adapted MD score | No associations. | High |
Moran et al. [85] (Australia) | Population cross-sectional study Women with and without self-declared PCOS | PCOS n = 414 33.5 ± 0.1 years Non-PCOS n = 7155 33.7 ± 0.1 years | MD pattern | Protective association MD with PCOS. | High |
Barrea et al. [91] (Italy) | Cross-sectional study Women with and without diagnosed PCOS | PCOS n = 112 24.2 ± 5.5 years Non-PCOS n = 112 24.1 ± 5.1 years | PREDIMED questionnaire | PCOS vs. non-PCOS group had a lower adherence to the MD. | High |
Barrea et al. [92] (Italy) | Cross-sectional study Treatment-naïve women with PCOS and obesity | PCOS MHO n = 54 23.8 ± 3.7 years PCOS MUO n = 40 24.5 ± 3.7 years | PREDIMED questionnaire | MUO vs. MHO patients had a lower adherence to the MD. | High |
INFERTILITY | |||||
Sun et al. [106] (China) | Prospective cohort study Infertile women before IVF treatment | LMD n = 362 31.85 ± 3.68 years HMD n = 228 31.67 ± 3.80 years | MD score | Higher number of available embryos; positively correlated with the number of fertilized oocytes and embryo yielded. | High |
Karayiannis et al. [107] (Greece) | Prospective cohort study Women before first IVF treatment | T1 n = 79 35 (32–37) years T2 n = 79 36 (32–39) years T3 n = 86 36 (34–38) years | MD score | Higher rates of clinical pregnancy and live birth. | High |
Gaskins et al. [108] (United States) | Prospective cohort study Women with at least one cycle of ART | n = 357 35.3 ± 4.0 years | MD score | Higher probability of live birth. | Medium |
Ricci et al. [109] (Italy) | Prospective cohort study Women before IVF treatment | n = 474 36.6 ± 3.6 years | MD score | Protective effect of intermediate adherence to MD on oocyte number and clinical pregnancy in women > 35 years. | Medium |
Gaskins et al. [110] (United States) | Prospective cohort study Women with no history of pregnancy loss and who reported at least one pregnancy | Total n = 11,072 Q1 n = 2356 30.0 (28.0–33.0) years Q4 n = 2677 32.0 (30.0–35.0) years | Adapted MD score | No effect on the risk of pregnancy loss. | High |
Vujkovic et al. [111] (Netherlands) | Cross-sectional study Women undergoing IVF treatment | LMD n = 54 35.2 (23.2–43.7) years IMD n = 54 33.9 (23.7–40.6) years HMD n = 53 37.2 (29.3–42.1) years | MD pattern | Significantly increased probability of pregnancy. | High |
5. Beneficial Effects of MD on Women’s Reproductive Health: Impact of Single Components or Synergistic Effect?
6. Implications for Future Research
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Szmidt, M.K.; Granda, D.; Madej, D.; Sicinska, E.; Kaluza, J. Adherence to the Mediterranean Diet in Women and Reproductive Health across the Lifespan: A Narrative Review. Nutrients 2023, 15, 2131. https://doi.org/10.3390/nu15092131
Szmidt MK, Granda D, Madej D, Sicinska E, Kaluza J. Adherence to the Mediterranean Diet in Women and Reproductive Health across the Lifespan: A Narrative Review. Nutrients. 2023; 15(9):2131. https://doi.org/10.3390/nu15092131
Chicago/Turabian StyleSzmidt, Maria Karolina, Dominika Granda, Dawid Madej, Ewa Sicinska, and Joanna Kaluza. 2023. "Adherence to the Mediterranean Diet in Women and Reproductive Health across the Lifespan: A Narrative Review" Nutrients 15, no. 9: 2131. https://doi.org/10.3390/nu15092131