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Dietary fatty acid intakes and the risk of ovulatory infertility
Open accessAbstract
Background Pharmacologic activation of the peroxisome proliferator-activated receptor gamma (PPAR-gamma) improves ovulatory function in women with polycystic ovary syndrome, and specific dietary fatty acids can affect PPAR-gamma activity. Objective The objective of the study was to assess whether the intakes of total fat, cholesterol, and major types of fatty acids affect the risk of ovulatory infertility. Design We conducted a prospective cohort study of 18 555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant between 1991 and 1999. Diet was assessed twice during follow-up by using a food-frequency questionnaire. Results During follow-up, 438 incidents of ovulatory infertility were reported. In logistic regression analyses, intakes of total fat, cholesterol, and most types of fatty acids were not related to ovulatory infertility. Each 2% increase in the intake of energy from trans unsaturated fats, as opposed to that from carbohydrates, was associated with a 73% greater risk of ovulatory infertility after adjustment for known and suspected risk factors for this condition [relative risk (RR) = 1.73; 95% CI: 1.09, 2.73]. Obtaining 2% of energy intake from trans fats rather than from n-6 polyunsaturated fats was associated with a similar increase in the risk of ovulatory infertility (RR = 1.79; 95% CI: 1.11, 2.89). In addition, obtaining 2% of energy from trans fats rather than from monounsaturated fats was associated with a more than doubled risk of ovulatory infertility (RR = 2.31; 95% CI: 1.09, 4.87). Conclusion trans Unsaturated fats may increase the risk of ovulatory infertility when consumed instead of carbohydrates or unsaturated fats commonly found in nonhydrogenated vegetable oils.
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“Consuming trans fats and unsaturated lipids with double bonds that exhibit internal resonance has been associated in recent studies with a higher risk of ovulatory infertility [103].”
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“Higher TFA intake has been associated with incidence of cholelithiasis (Tsai et al., 2005) and anovulatory infertility (Chavarro et al., 2007), both conditions associated with insulin resistance.”
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“Previous work with Nurses’ Health Study II (NHSII) data has shown that increased intake of trans-unsaturated fats like those found in commercially fried and baked products increases the risk of ovulatory infertility(27).”
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Chavarro, J. E., Rich-Edwards, J. W., ROSNER, B. A., & Willett, W. C. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.06.057 · Cited by 187
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BackgroundResultInfluentialSelf-citationAdherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility
Karayiannis, D., Kontogianni, M. D., Mendorou, C., Mastrominas, M., & Yiannakouris, N. (2018) · Human Reproduction · doi:10.1093/humrep/dey003 · Cited by 155
“…study among premenopausal women without a history of infertility have suggested that replacing unsaturated fats, commonly found in vegetable oils, with trans fatty acids may increase the risk of ovulatory infertility (Chavarro et al., 2007) and is likely to also impact on IVF clinical outcome.”
BackgroundObesity and Reproductive Function
Jungheim, E. S., Travieso, J. L., Carson, K. R., & Moley, K. H. (2012) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2012.09.002 · Cited by 151
Female Fertility and the Nutritional Approach: The Most Essential Aspects
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“study (39) comprising 18,555 women planning a pregnancy or who became pregnant during the study demonstrated that increasing the intake of TFAs by even 2% resulted in a significant increase in infertility risk due to ovulation disorders.”
BackgroundHigh-Fat Diet and Female Fertility
Hohos, N. M., & Skaznik-Wikiel, M. E. (2017) · Endocrinology · doi:10.1210/en.2017-00371 · Cited by 142
“Although the intake of dietary fat in this population is unsettled, feeding women with PCOS either a high-fat or low-fat meal decreased testosterone levels.”
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Lyall, K., Munger, K. L., O'Reilly, É. J., Santangelo, S. L., & Ascherio, A. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws433 · Cited by 128
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“Dietary TFA, assessed by FFQ, have recently been associated with ovulatory infertility [Chavarro et al., 2007], fetal loss [Morrison et al., 2008], lowered birth weight and head circumference [Hornstra et al., 2006; van Eijsden et al., 2008].”
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PALM OIL AND PALM KERNEL OIL: VERSATILE INGREDIENTS FOR FOOD APPLICATIONS
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Łakoma, K., Kukharuk, O., & Śliż, D. (2023) · Nutrients · doi:10.3390/nu15051180 · Cited by 113
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“…of weight loss in obese women who exercised regularly (Palomba et al., 2014), and an association between poorer diet composition and infertility independent of weight changes (Chavarro et al., 2007, 2008) as well as adverse effects on ongoing pregnancy (Tsagareli et al., 2006; Twigt et al., 2012).”
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Wise, L. A., Wesselink, A. K., Tucker, K. L., Saklani, S., Mikkelsen, E. M., Cueto, H. T., Riis, A. H., Trolle, E., McKinnon, C. J., Hahn, K. A., et al. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx204 · Cited by 91
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“This is consistent with prior research in ART that an elevated follicular fluid saturated fat to polyunsaturated fat ratio was inversely associated with the number of mature oocytes [4] but in contrast to findings in observational studies of no association with PUFA intake and ovulatory infertility incidence [12].”
Metabolism of fatty acids in follicular cells, oocytes, and blastocysts
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The association between trans fatty acids, infertility and fetal life: a review
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“It follows that when consumed instead of carbohydrates (Chavarro et al., 2007), TFAs can increase the risk of infertility.”
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“[53] revealed no correlation between SFA consumption and the relative risk of anovulation.”
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Stanhiser, J., Jukic, A. M. Z., McConnaughey, D. R., & Steiner, A. Z. (2022) · Human Reproduction · doi:10.1093/humrep/deac027 · Cited by 38
Dietary Patterns and Fertility
Cristodoro, M., Zambella, E., Fietta, I., Inversetti, A., & Simone, N. D. (2024) · Biology · doi:10.3390/biology13020131 · Cited by 47
“Some studies showed that PUFAs have beneficial effects on fertility by reducing the risk of anovulation and increasing progesterone concentrations [13,14].”
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“Evidence also suggests links to type-2 diabetes, sudden cardiac death, and infertility (Hu et al. 2001; van Dam et al. 2002; Stender and Dyerberg 2003; Mozaffarian et al. 2006; Chavarro et al. 2007).”
BackgroundPPARα protects against trans-fatty-acid-containing diet-induced steatohepatitis
Hu, X., Tanaka, N., Guo, R., Yu, L., Nakajima, T., Gonzalez, F. J., & Aoyama, T. (2016) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2016.09.015 · Cited by 36
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“- Increased intake is associated with an increased risk of infertility (20)”
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“A series of studies using data from the Nurses’ Health Study has suggested associations of protein source((11)), Fe((12)), dairy products((13)), trans-fatty acids((14)) and B-vitamins((15)) with ovulatory infertility.”
Omega-3 polyunsaturated fatty acids and IVF treatment
Lass, A., & Belluzzi, A. (2018) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2018.10.008 · Cited by 33
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“Further support for the role of fatty acids in reproductive health comes from data obtained as part of the Nurses’ Health study, in which it was clearly demonstrated that with each 2% increase in energy intake from trans fats when substituted for unsaturated fats or carbohydrates, the risk of ovulatory infertility inc…”
Replacements for Trans Fats—Will There Be an Oil Shortage?
Klonoff, D. C. (2007) · Journal of Diabetes Science and Technology · doi:10.1177/193229680700100316 · Cited by 32
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BackgroundSerum omega-3 and omega-6 fatty acid concentrations and natural fertility
Stanhiser, J., Jukic, A. M. Z., & Steiner, A. Z. (2020) · Human Reproduction · doi:10.1093/humrep/dez305 · Cited by 30
“Research in humans in natural fertility is inconclusive and currently limited to studies on dietary fatty acid intake alone (Mumford et al., 2016; Chavarro et al., 2007; Wise et al., 2018; Al-Safi et al., 2016; Chiu et al., 2018a).”
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“:3) ve: increasing TFAs (total, in place of n-6 PUFAs) (Chavarro et al ., 2007c).”
BackgroundThe Role of Avocados in Maternal Diets during the Periconceptional Period, Pregnancy, and Lactation
Comerford, K. B., Ayoob, K. T., Murray, R. D., & Atkinson, S. A. (2016) · Nutrients · doi:10.3390/nu8050313 · Cited by 31
“, red and processed meat, and foods that contain trans fats) [8].”
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Muhammed Saeed, A. A., Noreen, S., Awlqadr, F. H., Farooq, M. I., Qadeer, M., Rai, N., Farag, H. A., & Saeed, M. N. (2025) · Journal of Health, Population and Nutrition · doi:10.1186/s41043-025-00899-y · Cited by 29
“Consum-ing trans fats and unsaturated lipids with double bonds that exhibit internal resonance has been associated in recent studies with a higher risk of ovulatory infertility [103].”
Abodi, M., Cosmi, V. D., Parazzini, F., & Agostoni, C. V. (2022) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2022.06.019 · Cited by 26
Dietary trans fatty acid intake is associated with increased fetal loss
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The association between fatty acid index and in vitro fertilization outcomes
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“Work done previously with the Nurses’ Health Study II showed that increasing amounts of transunsaturated fats increases the risk of ovulatory infertility [19].”
BackgroundResultThe association between fertility diet score and polycystic ovary syndrome: A Case-Control study
Noormohammadi, M., Eslamian, G., Malek, S., Shoaibinobarian, N., & Mirmohammadali, S. N. (2021) · Health Care For Women International · doi:10.1080/07399332.2021.1886298 · Cited by 27
D’Argenio, V., Dittfeld, L., Lazzeri, P., Tomaiuolo, R., & Tasciotti, E. (2021) · Genes · doi:10.3390/genes12040605 · Cited by 24
“A study showed that consuming trans fat instead of carbohydrates or other unsaturated fat was associated with higher risks of ovulatory infertility [200].”
BackgroundEskew, A. M., Bedrick, B. S., Chavarro, J. E., Riley, J. K., & Jungheim, E. S. (2022) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-022-00907-4 · Cited by 24
“During the follow up period, women who consumed higher amounts of trans fats as opposed to monounsaturated or polyunsaturated fats had a significantly higher risk of ovulatory infertility [40].”
BackgroundSelf-citationDoes different BMI influence oocyte and embryo quality by inducing fatty acid in follicular fluid?
Mirabi, P., Chaichi, M. J., Esmaeilzadeh, S., Jorsaraei, S. G. A., Bijani, A., & Ehsani, M. (2017) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2016.11.005 · Cited by 24
Associations Between Preconception Plasma Fatty Acids and Pregnancy Outcomes
Kim, K., Browne, R. W., Nobles, C. J., Radin, R. G., Holland, T. L., Omosigho, U. R., Connell, M. T., Plowden, T. C., Wilcox, B. D., Silver, R. M., et al. (2019) · Epidemiology · doi:10.1097/ede.0000000000001066 · Cited by 23
“Daily 24 (7) 18 (5) 14 (4) 16 (5) 16 (5) 24 (7)”
InfluentialDietary effects on fertility treatment and pregnancy outcomes
Lim, S. S., Noakes, M., & Norman, R. J. (2007) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e3282f1cfc6 · Cited by 21
Alibeigi, Z., Jafari-Dehkordi, E., Kheiri, S., Nemati, M., Mohammadi-Farsani, G., & Tansaz, M. (2020) · Complementary Medicine Research · doi:10.1159/000505016 · Cited by 20
Evidence-Based Management of Infertility in Women With Polycystic Ovary Syndrome
Bergh, C., Moore, M., & Gundell, C. (2015) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2015.10.001 · Cited by 22
Skowrońska, M., Pawłowski, M., & Milewski, R. J. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12196275 · Cited by 21
“It has also been shown that following the obesity-promoting Western diet, rich in saturated fats, animal protein, and simple sugars, is associated with an increased risk of ovulatory infertility [41–43 , 45 ].”
BackgroundYu, D., Li, X., Wang, Y., Zou, D., Hu, L., Zheng, H., Jiang, L., Wang, L., & Elfalleh, W. (2017) · Journal of the American Oil Chemists Society · doi:10.1007/s11746-017-3001-3 · Cited by 18
Khorrami, A., Ghanbarzadeh, S., Ziaee, M., Arami, S., Hokmabad, R. V., & Garjani, A. (2014) · Andrologia · doi:10.1111/and.12262 · Cited by 17
“, 2008) and infertility due to anovulation (Chavarro et al., 2007) and in addition may affect spermatogenesis in rodents (Chavarro et al.”
BackgroundRessler, I. B., Grayson, B. E., & Seeley, R. J. (2014) · Obesity Surgery · doi:10.1007/s11695-013-1153-2 · Cited by 17
“One study suggests that dietary trans fatty acids increase the risk of ovulatory infertility [57].”
Preconception plasma phospholipid fatty acids and fecundability
Mumford, S. L., Browne, R. W., Kim, K., Nichols, C. M., Wilcox, B. D., Silver, R. M., Connell, M. T., Holland, T. L., Kuhr, D. L., Omosigho, U. R., et al. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-00448 · Cited by 18
Reisner, K., Lehtonen, M., Storvik, M., Jantson, T., Lakso, M., Callaway, J. C., & Wong, G. (2011) · Journal of Biochemical and Molecular Toxicology · doi:10.1002/jbt.20386 · Cited by 18
“Recent evidence suggests links to type2 diabetes [14], cardiovascular diseases [15], and infertility [16].”
BackgroundDo Popular Diets Impact Fertility?
Salvaleda-Mateu, M., Rodríguez-Varela, C., & Labarta, E. (2024) · Nutrients · doi:10.3390/nu16111726 · Cited by 17
“It has been observed that when 2% energy is derived from TFAs instead of from carbohydrates, omega-6 fatty acids, and monounsaturated fats, the ovulatory infertility risk increases (RR 1.73, 95%CI 1.09–2.73; RR 1.79, 95%CI 1.11–2.89; and RR 2.31, 95%CI 1.09–4.87, respectively) [99].”
BackgroundInfluentialBiesiekierska, M., Strigini, M., Śliwińska, A., Pirola, L., & Balcerczyk, A. (2025) · Nutrition Reviews · doi:10.1093/nutrit/nuaf010 · Cited by 18
“141,142 This emphasizes that the composition of the KD must be adjusted to accommodate the patient’s needs, especially when the regimen is planned over the long term.”
Palm (Elaeis guineensis Jacq.) Oil
Choudhary, M., & Grover, K. (2019) · Springer eBooks · doi:10.1007/978-3-030-12473-1_42 · Cited by 16
Polycystic ovarian syndrome in adolescents: From diagnostic criteria to therapeutic management.
Nicolaides, N. C., Matheou, A., Vlachou, F., Neocleous, V., & Skordis, N. (2020) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · doi:10.23750/abm.v91i3.10162 · Cited by 14
“that excessive amounts of trans fats negatively affect fertility and enhance insulin resistance (76).”
BackgroundHissanaga, V. M., Proença, R. P. D. C., & Block, J. M. (2012) · Revista de Nutrição · doi:10.1590/s1415-52732012000400009 · Cited by 16
Association of Dietary Factors With Male and Female Infertility: Review of Current Evidence
Hosseini, B., & Eslamian, G. (2014) · Thrita · doi:10.5812/thrita.20953 · Cited by 14
“Intake of trans fatty acids (TFAs) rather than carbohydrate and polyunsaturated fatty acids (PUFAs) have been associated with greater insulin resistance and risk of infertility (10).”
BackgroundBalancing nutrition for successful reproduction in ruminants
Ding, Y., Liu, X., Guan, Y., Li, Z., Luo, M., Wu, D., Ye, L., Guo, L., Wang, L., & Guan, Y. (2024) · Modern Agriculture · doi:10.1002/moda.29 · Cited by 15
“44,45 Therefore, the Mediterranean diet is likely to be a favourable diet for optimised reproduction.”
BackgroundThe Association between Seafood Intake and Fecundability: Analysis from Two Prospective Studies
Wise, L. A., Willis, S. K., Mikkelsen, E. M., Wesselink, A. K., Sørensen, H. T., Rothman, K. J., Tucker, K. L., Trolle, E., Vinceti, M., & Hatch, E. E. (2020) · Nutrients · doi:10.3390/nu12082276 · Cited by 13
The impact of preconceptual diet on the outcome of reproductive treatments
Mmbaga, N., & Luk, J. (2012) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e3283530524 · Cited by 12
Nut Consumption and Fertility: a Systematic Review and Meta-Analysis
Cardoso, B. R., Fratezzi, I., & Kellow, N. J. (2023) · Advances in Nutrition · doi:10.1016/j.advnut.2023.100153 · Cited by 11
“Further, an observational study of over 18,000 females without fertility problems demonstrated that swapping 2% of energy intake from trans fatty acids with MUFA was associated with less than half of risk of ovulatory infertility [42].”
BackgroundFood, nutrition, and fertility: from soil to fork
Maitin‐Shepard, M., Werner, E. F., Feig, L. A., Chavarro, J. E., Mumford, S. L., Wylie, B. J., Rando, O. J., Gaskins, A. J., Sakkas, D., Arora, M., et al. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.12.005 · Cited by 14
Self-citationFat intake pattern in women with polycystic ovary syndrome
Navarro-Lafuente, F., Árense-Gonzalo, J. J., Sánchez-Ferrer, M. L., Prieto‐Sánchez, M. T., Cutillas-Tolín, A., Mendiola, J., Adoamnei, E., Gazabat-Barbado, E., Vioqué, J., & Torres-Cantero, A. M. (2021) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2021.08.015 · Cited by 10
Ancel, C., Evans, M. C., Kerbus, R. I., Wallace, E. G., & Anderson, G. M. (2021) · Endocrinology · doi:10.1210/endocr/bqab266 · Cited by 9
Gender Obesity Report – Einfluss von Adipositas auf Reproduktion und Schwangerschaft
Harreiter, J., & Kautzky‐Willer, A. (2015) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-015-0410-5 · Cited by 9
Noventa, M., Quaranta, M., Vitagliano, A., Cinthya, V., Valentini, R., Campagnaro, T., Marci, R., Paola, R. D., Alviggi, C., Gangemi, M., et al. (2015) · Reproductive Sciences · doi:10.1177/1933719115620496 · Cited by 9
“If, on one hand, the adverse effects of simple sugar intake on fertility are well confirmed by a great deal of literature considering n women affected with polycystic ovarian disease and diabetic disease,(8,22,23) on the other hand, our data confirm evidence suggesting the potential role of dietary trans fatty acids i…”
ResultImpact of Trans ‐Fats on Heat‐Shock Protein Expression and the Gut Microbiota Profile of Mice
Carvalho, G. C. B. C., Moura, C. S., Roquetto, A. R., Arellano, D. B., Yamada, A. T., Santos, A., Saad, M. J. A., & Amaya-Farfán, J. (2018) · Journal of Food Science · doi:10.1111/1750-3841.13997 · Cited by 9
Nutritive value and trans fatty acid content of fast foods in Qena city, Egypt
Sadek, M., DAOUD, J. R., Ahmed, H. Y., & Mosaad, G. M. M. (2018) · Nutrition & Food Science · doi:10.1108/nfs-11-2017-0235 · Cited by 10
Theoretical and Practical Aspects of the Development of a Balanced Lipid Complex of Fat Compositions
Tereshchuk, L. (2014) · Foods and raw materials · doi:10.12737/5461 · Cited by 8
“In the organisms, hormone-like organic compounds prostaglandins, which are involved in regulation of intracellular metabolism, blood pressure, and platelet aggregation, are synthesized from arachidonic acid and influence smooth musculature and vitally important secretory functions [8].”
BackgroundCan Complementary/Alternative Medicine be used to Treat Infertility?
Bennington, L. K. (2010) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0b013e3181d76594 · Cited by 8
“Being overweight reduces the odds of successful in vitro fertilization, increases the probability of miscarriage, and puts a woman at risk during pregnancy for pregnancy-induced hypertension and gestational diabetes (Chavarro et al., 2008). Suboptimal nutritional status caused by eating disorders or excessive exercise…”
BackgroundInfluentialGene expression after dietary intervention with trans fatty acids (trans‐11/trans‐12 18:1) in humans
Kuhnt, K., Flotho, S., Benjamin, S., Boerchers, T., Schubert, R., Jahreis, G., & Spener, F. (2009) · European Journal of Lipid Science and Technology · doi:10.1002/ejlt.200800217 · Cited by 8
“On the other hand, the intake of dietary FA is associated with the risk of ovulatory infertility [26], indicating interactions between FA and hormone status.”
Background
Metadata
- Authors
- Chavarro, J. E., Rich-Edwards, J. W., Rosner, B. A., & Willett, W. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Chavarro, Jorge E
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2007-01
- Volume
- 85
- Issue
- 1
- Pages
- 231-237
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2161583600
- Cited by
- 203
- References
- 52
- Citations by year
- 2026: 5 · 2025: 21 · 2024: 11 · 2023: 10 · 2022: 12 · 2021: 9 · 2020: 7 · 2019: 7 · 2018: 15 · 2017: 15 · 2016: 10 · 2015: 13 · 2014: 9 · 2013: 6 · 2012: 10
- FWCI
- 8.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (CA67262, CA55075)
- National Institute on Aging (AG/CA14742)
- National Heart, Lung, and Blood Institute (K08HL003804, R01HL064108, HL-03804, HL64108)
- National Cancer Institute (R01CA065725, CA-55075, CA67262, CA 65725, CA50385, R01CA067883, CA67883, R01CA050385)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK052866, DK52866, T32DK007703, P30DK040561)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- ovulatory infertility, dietary fatty acids, monounsaturated fatty acids, total fat intake, dietary cholesterol, PPARγ, polycystic ovary syndrome, premenopausal women, vegetable oils, carbohydrate intake
- MeSH terms
- Adult, Diet Surveys, Dietary Fats, Dietary Fats, Unsaturated, Female, Humans, Infertility, Female, Ovulation, Prospective Studies, Surveys and Questionnaires, Risk Factors, Cohort Studies, Logistic Models, Trans Fatty Acids, PPAR gamma
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