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Association between dietary quality indices and female infertility: a population-based study using NHANES 2013-2020
Donglin Chen1, Lixia Xu1, Lin Cheng1
1Department of Gynecology, Jinhua Maternal and Child Health Hospital, Jinhua, China.
Human Fertility (Cambridge, England)
|June 18, 2026
Summary
Higher quality diets, including the Alternate Mediterranean Diet, Healthy Eating Index-2020, Alternate Healthy Eating Index, and DASH diet, are linked to lower infertility odds in US women. These findings suggest diet plays a role in reproductive health.
Area of Science:
- Nutrition Science
- Reproductive Health
- Epidemiology
Background:
- Female infertility is a significant global health concern.
- Dietary patterns are increasingly recognized for their influence on reproductive outcomes.
- Understanding the link between diet quality and infertility is crucial for public health initiatives.
Purpose of the Study:
- To investigate the association between multiple dietary quality indices and female infertility.
- To examine dose-response relationships between diet quality scores and infertility.
- To provide insights into the role of nutrition in female reproductive health.
Main Methods:
- Analysis of data from 5,477 women aged 18-59 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2020.
- Assessment of dietary quality using four indices: Alternate Mediterranean Diet score (MED), Healthy Eating Index-2020 (HEI-2020), Alternate Healthy Eating Index (AHEI), and DASH score, based on 24-hour dietary recalls.
- Weighted logistic regression and restricted cubic spline (RCS) analyses were employed, adjusting for numerous covariates.
Main Results:
- Higher scores for MED, HEI-2020, AHEI, and DASH were inversely associated with infertility.
- RCS analyses indicated approximately linear inverse associations between these dietary indices and infertility.
- These associations remained significant after adjusting for various demographic, lifestyle, and health factors.
Conclusions:
- Higher overall diet quality is associated with reduced odds of infertility in adult women in the US.
- Dietary interventions focusing on improving overall diet quality may support female reproductive health.
- The cross-sectional nature of the study limits causal inference, highlighting the need for further research.
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