The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States
Open accessAbstract
Despite growing evidence of the impact of diet on human fertility, few studies have examined the public health implications of this association in the United States (U.S.). This narrative review summarizes current scientific evidence on associations between dietary intake and fertility, discusses challenges in the public health landscape surrounding infertility, and proposes evidence-based recommendations to address these issues. Diets high in unsaturated fats, whole grains, vegetables, and fish have been associated with improved fertility in both women and men. While current evidence on the role of dairy, alcohol, and caffeine is inconsistent, saturated fats and sugar have been associated with poorer fertility outcomes in women and men. Furthermore, women and men with obesity (body mass index (BMI) ≥ 30kg/m2) have a higher risk of infertility. This risk is extended to women who are underweight (BMI <20 kg/m2). Diet and BMI influence outcomes during clinical treatment for infertility. Further, women in the U.S. who belong to an underrepresented minority group, have low income, or have low educational attainment, have significantly higher rates of infertility outcomes as compared to women who are non-Hispanic white, have high income, or have high educational attainment. Given this, it may be prudent to integrate nutrition counseling into both clinical guidelines for infertility as well as national dietary guidelines for individuals of reproductive age. Further studies on diet and reproductive health may enhance our ability to improve existing fertility programs across the U.S. and to deliver tailored care to women and men within at-risk groups.
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It is well-established that obesity is related to menstrual disorders, infertility, miscarriage, obstetric complications, live birth rate and can affect the success of assisted reproductive technology.
“It is well-established that obesity is related to menstrual disorders, infertility, miscarriage, obstetric complications, live birth rate and can affect the success of assisted reproductive technology.29–32”
From Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles (2019) · cites this paper as [31]
The 'Evidence on diet and fertility > Body mass index' section (page unavailable) links obesity to ovulatory-disorder infertility and lower ART treatment success. It does not establish a relationship with menstrual disorders generally, miscarriage, obstetric complications, or live-birth rate; those additional outcomes are unsupported by our copy. (LLM, conf=0.88)
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Abdullah, A. A., Ahmed, M., & Oladokun, A. (2023) · World Journal of Methodology · doi:10.5662/wjm.v13.i3.98 · Cited by 10 · see citing works
Mediterranean diet: Woman fertility and pregnancy
Elexpuru-Zabaleta, M. (2020) · Mediterranean Journal of Nutrition and Metabolism · doi:10.3233/mnm-200402 · Cited by 10 · see citing works
Unisa, S., Negi, K., Pujari, S., & Chaurasia, V. (2021) · Journal of Biosocial Science · doi:10.1017/s0021932021000274 · Cited by 9 · see citing works
“Healthy diets are beneficial for reproduction among men and women of reproductive age (Sharma et al. , 2013; Panth et al. , 2018).”
BackgroundTorna, E., Fitzgerald, J. D., Nelson, D. S., & Andrade, J. (2021) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-020-00674-6 · Cited by 8 · see citing works
“, breast, colon, prostate) [1, 2]; gastrointestinal disorders such as irritable bowel disease [3, 4]; renal disease [5–8]; inflammatory conditions such as rheumatoid arthritis [9, 10]; reproductive issues such as infertility [11, 12] and irregular menstrual cycles [13]; and mental health problems such as Alzheimer’s […”
BackgroundDeshpande, S., Patel, K. D., Parulkar, T., Mahabalesh, K., Madhusudhan, P., Madhusudhan, D. K., & Thimmapuram, J. (2023) · Journal of Ayurveda and Integrative Medicine · doi:10.1016/j.jaim.2023.100793 · Cited by 8 · see citing works
The Contribution of Precision Nutrition Intervention in Subfertile Couples
Monteiro, J., Bicho, M., & Valente, A. (2024) · Nutrients · doi:10.3390/nu17010103 · Cited by 7 · see citing works
Food Insecurity: A Barrier to Reproductive Justice Globally
Fledderjohann, J., Patterson, S., & Owino, M. (2023) · International Journal of Sexual Health · doi:10.1080/19317611.2023.2201841 · Cited by 7 · see citing works
“Malnutrition has been linked to subfecundity (Panth et al., 2018) ; operating through nutritional risks, food insecurity (particularly severe, chronic food insecurity) may reduce one’s ability to conceive.”
BackgroundKackley, M. L., Buga, A., Brownlow, M. L., O’Connor, A., Sapper, T. N., Crabtree, C. D., Robinson, B. T., Stoner, J. T., Decker, D. D., Soma, L., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0293670 · Cited by 7 · see citing works
Infertility and lifestyle factors: how habits shape reproductive health
Choudhary, P., Dogra, P., & Sharma, K. (2025) · Middle East Fertility Society Journal · doi:10.1186/s43043-025-00228-7 · Cited by 13 · see citing works
“The ability to reproduce is a fundamental aspect of reproductive health, and when this capacity is impaired, it can have profound implications on mental and social well-being [41].”
Dietary Energy Density and Fertility: Results from the Lifestyle and Fertility Study
Hartman, T. J., Fung, J. L., Hsiao, P. Y., Fan, W., Mitchell, D. C., & GOLDMAN, M. B. (2021) · Current Developments in Nutrition · doi:10.1093/cdn/nzab075 · Cited by 7 · see citing works
Crohn’s Disease and Female Infertility: Can Nutrition Play a Supporting Role?
Vincenti, A., Loperfido, F., Giuseppe, R. D., Manuelli, M. C., Bosoni, D., Righi, A., Nappi, R. E., & Cena, H. (2022) · Nutrients · doi:10.3390/nu14122423 · Cited by 7 · see citing works
“The role of diet and nutrition education in supporting wellbeing outcome and fertility in women is well-known [20,21]; however, despite evidence, no effective efforts have been made to tailor specific interventions in women affected by CD.”
BackgroundRoba, K. T., Abate, K. H., Wilfong, T., Legese, N., Darsene, H., Zewdu, G., Negese, T., Yifru, B., Mohammed, E., & Raru, T. B. (2022) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2022.1049404 · Cited by 7 · see citing works
“This is explained by the reason that the nutritional intake among poor women were less and this makes poor women highly infertile (38).”
BackgroundGheflati, A., Mirjalili, S. A. M., Kaviani, M., Salehi-Abargouei, A., Hosseini-Marnani, E., & Nadjarzade`h, A. (2021) · Journal of Nutrition and Food Security · doi:10.18502/jnfs.v6i1.5298 · Cited by 7 · see citing works
Deierlein, A. L., Litvak, J., Liu, C., & Stein, C. R. (2023) · Public Health Nutrition · doi:10.1017/s1368980023001222 · Cited by 6 · see citing works
“Nutrient intakes during adolescence and early adulthood are particularly important for reproductive health outcomes (1) , mental health and cognitive function (2) and cardiometabolic health risk factors (3) .”
BackgroundGu, X., Li, Q., & Wang, X. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1586828 · Cited by 6 · see citing works
Klobodu, C., Deutsch, J. M., Vitolins, M. Z., Fisher, K. M., Nasser, J. A., Stott, D., & Milliron, B. (2023) · Integrative Cancer Therapies · doi:10.1177/15347354231191984 · Cited by 6 · see citing works
“The following themes were identified: (1) Lack of nutrition-related resources and detailed guidance, (2) Work-life balance, (3) Perceived rigidity of dietary guidance, (4) Treatment-related fatigue, (5) Having trust in healthcare providers, (6) Higher motivation to change nutrition behavior, and (7) Recognizing the ad…”
BackgroundSenanayake, C. M., Hapugaswatta, H., Samarawickrama, G. R., Jayathilaka, N., & Seneviratne, K. N. (2021) · Journal of Food Biochemistry · doi:10.1111/jfbc.13664 · Cited by 6 · see citing works
Widhiantara, G., Permatasari, A. A. A. P., & Wiradana, P. A. (2021) · PLANT ARCHIVES · doi:10.51470/plantarchives.2021.v21.no1.049 · Cited by 6 · see citing works
Nkechika, V., Zhang, N., & Belsham, D. D. (2024) · Genes · doi:10.3390/genes15040397 · Cited by 6 · see citing works
“In contrast, diets enriched in unsaturated fatty acids are associated with better reproductive health [1].”
BackgroundGender Differences and Relationships among Lifestyle and Reproductive Health in University Students
Nho, J., & Kim, H. S. (2019) · Korean journal of women health nursing/Yeoseong geon'gang ganho hag'hoeji/Yeoseong geon-gang ganho hakoeji · doi:10.4069/kjwhn.2019.25.4.446 · Cited by 5 · see citing works
Mediterranean diet and female fertility: Cross-talk of an evidence-based approach
Grammatikopoulou, M. G., Lampropoulou, M., & Goulis, D. G. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-818649-7.00041-2 · Cited by 5 · see citing works
Ahmadi, P., Bayat, N., & Abbasi, B. (2024) · Journal of Nutritional Science · doi:10.1017/jns.2024.81 · Cited by 4 · see citing works
Sadowska, J., Dudzińska, W., & Dziaduch, I. (2022) · Nutrients · doi:10.3390/nu14204350 · Cited by 4 · see citing works
Examining the Role of Nutrition in Cancer Survivorship and Female Fertility: A Narrative Review
Klobodu, C., Vitolins, M. Z., Deutsch, J. M., Fisher, K. M., Nasser, J. A., Stott, D., Murray, M. J., Curtis, L., & Milliron, B. (2024) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2024.102134 · Cited by 3 · see citing works
The importance of healthy lifestyles in helping achieving wellbeing
Abellán, M. V., Márquez, F., & Martínez, P. A. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818309-0.00020-4 · Cited by 6 · see citing works
Hasanabad, M. S., Ghorbanlou, M., Masoumi, R., Shokri, S., Rostami, B., Alamouti, H. M., Catt, S. L., Green, M. P., & Nejatbakhsh, R. (2022) · Andrologia · doi:10.1111/and.14598 · Cited by 3 · see citing works
“…addition to metabolic consequences of dietary oils/fats (Assy et al., 2009; Ferramosca et al., 2008; Ferramosca & Zara, 2014; Wang et al., 2002), high-fat diets and obesity have deleterious outcomes on male reproduction via different mechanisms (Mehrdad Ghorbanlou et al., 2020; Panth et al., 2018).”
BackgroundThe Role of Food Additives in Reproductive Endocrine Disruption: a Revised Perspective
Kavitha, L., & Sangeetha, M. K. (2025) · Current Pharmacology Reports · doi:10.1007/s40495-024-00389-5 · Cited by 4 · see citing works
“…plays a vital role in the food industry which attracts people by its color and taste so that the potential health risks are not considered [13] The food additives reviewed are soybean lecithin, humectant glycerin, sweetener aspar-tame, acesulfame potassium, synthetic food color, flavoring…”
The Era of Precision Nutrition in the Field of Reproductive Health and Pregnancy
Ahmad, F., Calabrese, C. M., & Terranegra, A. (2023) · Nutrients · doi:10.3390/nu15143128 · Cited by 3 · see citing works
From the Ground Up: A Multidisciplinary Approach to Past Fertility and Population Narratives
McFadden, C. (2023) · Human Nature · doi:10.1007/s12110-023-09459-x · Cited by 2 · see citing works
Fallahi, A., Rahmani, A., Yousif, P. H. A., Gheshlagh, R. G., Allahqoli, L., Nemat, B., & Alkatout, İ. (2023) · Journal of Education and Community Health · doi:10.34172/jech.2291 · Cited by 2 · see citing works
“In fact, vigorous EB was observed in a mere 14–19% of infertile women (12,,13).”
BackgroundThe relationship between overweight and female infertility
da Costa, M. M., Andrade, C. B., Soares, F. V. G., & Belfort, G. P. (2021) · REVISTA CIÊNCIAS EM SAÚDE · doi:10.21876/rcshci.v11i4.1167 · Cited by 2 · see citing works
I Had to Go in a Bubble: Investigating the Effects of COVID-19 on Fertility Treatments and Nutrition
Claydon, E. A., Davidson, D. L., McCarty, K. M., & Wang, J. Y. (2022) · Women s Health Reports · doi:10.1089/whr.2022.0028 · Cited by 2 · see citing works
Oyelowo, O., Taire, E., & Ajao, O. (2022) · Current Research in Physiology · doi:10.1016/j.crphys.2022.10.001 · Cited by 2 · see citing works
Young Adults’ Understanding of Modifiable Risk Factors of Infertility
Lim, L. M., Hoppe, M., Kennedy, L., Gunderson, A., Wang, L., & Etezadi-Amoli, N. (2024) · Women s Health Reports · doi:10.1089/whr.2024.0058 · Cited by 2 · see citing works
Cui, S., Li, L., Qin, W., Liu, W., & Zhong, X. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1451030 · Cited by 2 · see citing works
Fares, K. S., Tayeh, G. A., Whaibeh, E. R., Louis, R. J., Jaalouk, L. Y., Matar, Y. M., & Nakhlé, M. M. (2025) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.18502/ijrm.v23i1.18188 · Cited by 2 · see citing works
“A diet that includes eating a lot of whole grains, vegetables, fruits, fish, and mono-or polyunsaturated oils has been linked to increased semen quality in men and improved fertility in women (5).”
Fawcett, K., Martinez, A., Crimmins, M. R., Sims, C. R., Børsheim, E., & Andres, A. (2021) · BMC Nutrition · doi:10.1186/s40795-021-00454-y · Cited by 2 · see citing works
“Future collaboration between research institutions, clinical practice, and communities will enable the implementation of more evidence-based recommendations and interventions such as counseling to improve dietary behaviors or nutritional programs aimed at reproductive aged populations and at risk groups like those und…”
BackgroundThe Effect of Fat Consumption Intake, Obesity and Cholesterol Level On Fertility Of Women
Mudlikah, S., Suprapti, S., & Shoihah, K. (2021) · JURNAL MIDPRO · doi:10.30736/md.v13i2.303 · Cited by 2 · see citing works
Wada, Y., Kamioka, H., Shimpo, M., & Shimada, M. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.04.005 · Cited by 2 · see citing works
Self-reported diagnoses of dietary allergens and fecundability in a North American cohort
Willis, S. K., Kuan, K. E., Hatch, E. E., Crowe, H. M., Wesselink, A. K., Rothman, K. J., Mumford, S. L., & Wise, L. A. (2024) · Human Reproduction · doi:10.1093/humrep/deae277 · Cited by 1 · see citing works
Nutrition in Maternal, Child, and Adolescent Health: A Global Perspective
Agbozo, F., Müller, O., & Jahn, A. (2026) · Springer eBooks · doi:10.1007/978-1-0716-5432-3_6 · Cited by 1 · see citing works
Nutrition and exercise intervention for female fertility
Hackney, A. C., Vaamonde, D., & Manso, J. M. G. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818309-0.00024-1 · Cited by 1 · see citing works
Choudhuri, S., Sarkar, S., Chowdhury, P. R., Choudhuri, D., & Das, S. R. (2023) · Nutrire · doi:10.1186/s41110-023-00243-6 · Cited by 1 · see citing works
“Dietary patterns have an effective role in the regulation of human fertility because a proper diet with adequate nutrients can improve reproductive functions [1].”
BackgroundÇelebi, A., Kaplan, E., Zeyneloğlu, S., Kara, P., Nazik, E., Can, A. A., Buldum, A., Emül, T. G., Aksu, A., Karadağ, G., et al. (2021) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.856 · Cited by 1 · see citing works
Jardim, N. S., Müller, S. G., & Nogueira, C. W. (2021) · Cell Biochemistry and Function · doi:10.1002/cbf.3631 · Cited by 1 · see citing works
Phytotherapeutic support for infertility: evaluating the evidence
Dillard, D. M. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818309-0.00010-1 · Cited by 1 · see citing works
Tailored Dietary Plan to Sustain Healthy Lifestyle of Adults with Restrained Mobility
Khawandanah, J. (2022) · Food Science & Nutrition Technology · doi:10.23880/fsnt-16000286
Abdulhadi, F. S. (2020) · Medico-Legal Update · doi:10.37506/mlu.v20i4.2104
Perkins, A. (2021) · Nursing Made Incredibly Easy! · doi:10.1097/01.nme.0000732000.30192.94
Guards! Guards! How innate lymphoid cells ensure local law and order
Häfner, S. J. (2021) · Biomedical Journal · doi:10.1016/j.bj.2021.04.007
“The attribution of stimulating powers to natural products, often with suggestive forms, is nearly as old as humanity, but some contain a grain of truth e especially if it is whole grains, officially recommended to improve fertility [32].”
BackgroundPhytochemical and Nutritional Quality of Abelmoschus Esculentus (L) (Okra) LeafPreprint
Borokini, F. B., Oladipo, G. O., Komolafe, O. Y., & Ajongbolo, K. F. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4001147
How can diet influence women’s reproductive health?
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The impact of nutritional status and maternal behavior on infant growth
Mulyani, E. Y., Jus’at, I., & Mustika, A. B. (2022) · Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) · doi:10.21927/ijnd.2022.10(1).37-45
Sănătatea orală şi tratamentele pentru fertilitate – o asociere bidirecţională
Părlătescu, I., Georgescu, C. E., Roxana Georgiana, B. O. R. S., Varlas, V. N., Mehedințu, C., Cîrstoiu, M. M., & Epistatu, D. (2023) · Obstetrica şi Ginecologia · doi:10.26416/obsgin.70.1.2023.8134
Nutritional habits in Spanish female students of childbearing age
López, M. T. I., Abreu, A., Ramos‐Pichardo, J. D., & Martínez, E. F. (2023) · Journal of King Saud University - Science · doi:10.1016/j.jksus.2023.102820
Detrimental Effects of Saccharum officinarum Juice on Reproductive Functions of Female Wistar Rats
Ogunwole, E., Ebong, J. E., & Audu, L. A. (2023) · Nigerian Journal of Physiological Sciences · doi:10.54548/njps.v38i1.15
“The human diet has been related to adverse effects on fertility (Panth et al., 2018: Skoracka et al., 2021).”
BackgroundConsequences of Changing Lifestyle amongst Indian Millennials on Procreation: An Overview
Raj, P., Bhardwaj, G., & Podder, L. (2023) · Indian Journal of Continuing Nursing Education · doi:10.4103/ijcn.ijcn_12_22
Impact of pre-conception diet on female infertility
Kahan, W., Poborowska, D., Szafrańska, W., Polańska, K., Wojaczek, M., Niedbał, P., Kosińska, A., Kras, M., Lelek, K., & Łata, M. (2024) · Quality in Sport · doi:10.12775/qs.2024.20.54127
influence of lifestyle on female fertility. Review of the literature
Śmigielska-Mikołajczyk, M. J., Szostak, A., Szeliga, A., Szopińska, K., Graca, M., Korta, K., Oluszczak, K., Dyląg, L., Wawszkowicz, K., & Łowicka, W. (2024) · Quality in Sport · doi:10.12775/qs.2024.21.53937
A Delphi Study on the Management of Female Infertility by Homeopaths in South Africa
Anderson, R., Pellow, J., Tsele-Tebakang, T., & Solomon, E. M. (2024) · Health SA Gesondheid · doi:10.4102/hsag.v29i0.2771
“Literature highlights a diet of vegetables, whole grains, unsaturated fats and fish is associated with improved fertility outcomes (Panth et al. 2018; Skoracka et al. 2021).”
Nutraceuticals and Infertility
Sureda, A., Monserrat-Mesquida, M., & Tejada, S. (2024) · Food bioactive ingredients · doi:10.1007/978-3-031-76481-3_10
- Authors
- Panth, N., Gavarkovs, A., Tamez, M., & Mattei, J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Mattei, Josiemer
- Venue
- Frontiers in Public Health
- Publisher
- Frontiers Media SA
- Published
- 2018-07-31
- Volume
- 6
- Pages
- 211-211
- ISSN
- 2296-2565 (ISSN-L)
- PMC
- PMC6079277
- OpenAlex
- W2883048904
- Cited by
- 113
- References
- 45
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 18 · 2023: 21 · 2022: 22 · 2021: 18 · 2020: 8 · 2019: 7
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Frontiers in Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Consejo Nacional de Ciencia y Tecnología
- National Heart, Lung, and Blood Institute (HL120951)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- diet and fertility, infertility, public health nutrition, unsaturated fat, whole grains, fish consumption, saturated fat, sugar consumption, obesity, underweight, body mass index, socioeconomic disparities, underrepresented minorities, nutrition counseling, infertility treatment outcomes, dietary guidelines, reproductive health
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