The association between Diet Quality Index-International score and risk of diminished ovarian reserve: a case-control study

Rahele Ziaei; Hatav Ghasemi-Tehrani; Minoo Movahedi; Maryam Kalatehjari; Mahdi Vajdi; Amin Mokari-Yamchi; Mahshid Elyasi; Abed Ghavami

doi:10.3389/fnut.2023.1277311

The association between Diet Quality Index-International score and risk of diminished ovarian reserve: a case-control study

Front Nutr. 2023 Nov 29:10:1277311. doi: 10.3389/fnut.2023.1277311. eCollection 2023.

Authors

Rahele Ziaei¹, Hatav Ghasemi-Tehrani², Minoo Movahedi³, Maryam Kalatehjari⁴, Mahdi Vajdi⁵, Amin Mokari-Yamchi⁶, Mahshid Elyasi⁷, Abed Ghavami¹

Affiliations

¹ Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
² Fertility Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
⁷ Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Introduction: Although limited evidence exists on the beneficial reproductive effects of diet quality indices, the association is still largely unknown. We aimed to investigate the association between Diet Quality Index-International (DQI-I) and antral follicle count (AFC) and serum antimullerian hormone (AMH) as precise and sensitive markers of ovarian reserve and to assess the risk of diminished ovarian reserve (DOR) in women seeking fertility treatments.

Methods: In a case-control study, 370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and body mass index (BMI), were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The quality of diets was assessed using DQI-I, which included four major dietary components: variety (0-20 points), adequacy (0-40 points), moderation (0-30 points), and overall balance (0-10 points). DQI-I score was categorized by quartiles based on the distribution of controls. AFC, serum AMH and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of DQI-I score.

Results: Increased adherence to DQI-I was associated with higher AFC in women with DOR. After adjusting for potential confounders, the odds of DOR decreased with increasing DQI-I score (0.39; 95% CI: 0.18-0.86).

Conclusion: Greater adherence to DQI-I, as a food and nutrient-based quality index, may decrease the risk of DOR and improve the ovarian reserve in women already diagnosed with DOR. Our findings, though, need to be verified through prospective studies and clinical trials.

Keywords: Diet Quality Index-International; antimullerian; antral follicle count; diminished ovarian reserve; infertility.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The present study was supported by a grant from Vice-Chancellor for Research, Isfahan University of Medical Sciences (Grant No: 2401257).