The effect of healthy dietary patterns on male semen quality: a systematic review and meta-analysis.

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• This Systematic Review and Meta Analysis showed that healthy dietary patterns had beneficial effects on sperm concentration, total sperm count, and progressive sperm motility in males, which affect male fertility.
• Authors concluded that healthy dietary patterns may promote male reproductive health and thus improve semen quality in the population.
• Healthy dietary patterns meant the Mediterranean diet for 4 out of 6 studies. All healthy diet patterns were determined by the authors to be rich in plant-based foods, where saturated fats provide only a small percentage of the total energy intake.

Introduction

• This study aimed to determine the effects of healthy dietary patterns on semen quality.

Methodology

• This meta-analysis was performed following PRISMA guidelines and included 6 cross-sectional studies with 1244 participants
• The included cross-sectional studies examined the influence of the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and prudent diet patterns on semen quality parameters.
• In 4 of the studies participants were divided into groups based on their scores for the Mediterranean diet from low to high adherence.
• 2 studies examined the DASH diet and the prudent diet and used food frequency questionnaires to compare high consumption with low consumption of healthy dietary patterns.
• The PICOS (Participants, Intervention, Comparison, Outcomes, and Study design) criteria that were used to structure the research question.
• 11 Checklists were used to assess the quality of included studies.

Results: By comparing high consumption with low consumption of healthy dietary patterns, the results of the meta-analysis showed:

• significantly higher sperm concentrations (mean difference [MD] = 6.88 × 106 ml−1, 95% confidence interval [CI]: 1.26 × 106 ml−1–12.49 × 106 ml−1; P < 0.05)
• significant increase in total sperm count (MD = 16.70 × 106, 95% CI: 2.37 × 106–31.03 × 106; P < 0.05)
• significant increase in progressive sperm motility (MD = 5.85%, 95% CI: 2.59%–9.12%; P < 0.01) but there was no significant correlation between healthy dietary patterns and total sperm motility (MD: 6.86%, 95% CI: −0.25%–13.96%; P > 0.05).
• there was no significant association between a healthy dietary pattern and normal sperm morphology (MD: 0.28%, 95% CI: −0.33%–0.90%; P > 0.05)
• there was no significant association between a healthy dietary pattern and semen volume (MD: 0.04 ml, 95% CI: −0.20 ml–0.28 ml; P > 0.05).

Limitations:

• Included studies were all cross-sectional studies, and it is impossible to determine the causal relationship between the high intake of healthy dietary patterns and semen quality.
• The number of studies included was small, and there was not enough literature to support authors in drawing reliable conclusions.
• No comparison was made between specific diets such as dash vs Mediterranean.

• The authors concluded that dietary interventions should be considered in clinical work as part of the therapies improving male semen quality.
• Dietary interventions for men should be included as part of preconceptional clinical management,
• Dietary interventions for men should also be considered in infertility clinical management.

• Randomised Clinical Trials should be conducted to build on these findings.