Association between healthy beverage index and odds of diminished ovarian reserve in a case-control study

Diminished ovarian reserve, linked to reduced fertility and adverse reproductive outcomes, can be influenced by a number of modifiable factors while it's not clearly known that whether the quality of beverage intake can affect ovarian reserve. So, we aimed to assess the association of the Healthy Beverage Index (HBI), which offers an innovative approach, with the risk of DOR among a group of women attending a fertility clinic. This case-control study recruited 370 women (120 DOR and 250 with normal ovarian reserve as controls), matched by age and body mass index (BMI). Dietary intakes were assessed using a reliable semi-quantitative food frequency questionnaire (FFQ). The antral follicle count (AFC), and serum anti-Müllerian hormone (AMH) levels were measured as markers of ovarian reserve. The multivariable logistic regression was applied to calculate the association between HBI and risk of DOR. The study findings indicated that in the unadjusted model, there was no significant association between HBI score and the risk of DOR (OR: 0.81; 95% CI: 0.36-1.36). However, after adjusting for confounders such as energy intake, physical activity, and fat mass (FM), women in the highest tertile of HBI score exhibited an 8% reduction in odds of DOR, with an adjusted OR of 0.92 (95% CI: 0.41-0.96). Our findings suggest that greater adherence to the HBI may be modestly associated with reduced odds of DOR. However, given the small effect size and borderline statistical significance, the clinical implications of this association remain uncertain. Further validation through well-designed prospective studies and clinical trials is needed to better understand this potential relationship.