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Title: Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability.
Authors: Lim, Shan Xuan
Loy, See Ling 
Colega, Marjorelee T 
Lai, Jun Shi
Godfrey, Keith M
Lee, Yung Seng 
Tan, Kok Hian 
Yap, Fabian
Shek, Lynette Pei-Chi 
Chong, Yap Seng 
Eriksson, Johan G 
Chan, Jerry Kok Yen 
Chan, Shiao-Yng
Chong, Mary Foong-Fong 
Keywords: diet indices
dietary patterns
plant-based diet
Issue Date: 9-Feb-2022
Publisher: Oxford University Press (OUP)
Citation: Lim, Shan Xuan, Loy, See Ling, Colega, Marjorelee T, Lai, Jun Shi, Godfrey, Keith M, Lee, Yung Seng, Tan, Kok Hian, Yap, Fabian, Shek, Lynette Pei-Chi, Chong, Yap Seng, Eriksson, Johan G, Chan, Jerry Kok Yen, Chan, Shiao-Yng, Chong, Mary Foong-Fong (2022-02-09). Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability.. Am J Clin Nutr 115 (2) : 559-569. ScholarBank@NUS Repository.
Abstract: BACKGROUND: Modest associations have been reported between specific food groups or nutrients and fecundability [measured by time to pregnancy (TTP)]. Examining overall diets provides a more holistic approach towards understanding their associations with fecundability. It is not known whether plant-based diets indices or exploratory dietary patterns are associated with fecundability. OBJECTIVES: We examine the associations between adherence to 1) plant-based diet indices; and 2) exploratory dietary patterns and fecundability among women planning pregnancy. METHODS: Data were analyzed from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) study. Prepregnancy diet was assessed using a semi-quantitative FFQ from which the overall, healthful, and unhealthful plant-based diet indices (oPDI, hPDI, and uPDI, respectively) were calculated. Exploratory dietary patterns were derived using factor analysis based on 44 predefined food groups. Participants were categorized into quintiles based on their dietary pattern scores. TTP (expressed in menstrual cycles) was ascertained within a year from the prepregnancy dietary assessment. Discrete-time proportional hazard models, adjusted for confounders, were used to estimate fecundability ratios (FRs) and 95% CIs, with FR > 1 indicating a shorter TTP. RESULTS: Among 805 women, 383 pregnancies were confirmed by ultrasound scans. Compared with women in the lowest quintile, those in the highest quintile of the uPDI had reduced fecundability (FR of Q5 compared with Q1, 0.65; 95% CI, 0.46-0.91; P trend, 0.009). Conversely, greater adherence to the hPDI was associated with increased fecundability (1.46; 95% CI, 1.02-2.07; P trend, 0.036). The oPDI was not associated with fecundability. Among the 3 exploratory dietary patterns, only greater adherence to the Fast Food and Sweetened Beverages (FFSB) pattern was associated with reduced fecundability (0.61; 95% CI, 0.40-0.91; P trend, 0.018). CONCLUSIONS: Greater adherence to the uPDI or the FFSB dietary pattern was associated with reduced fecundability among Asian women. Greater adherence to the hPDI may be beneficial for fecundability, though this requires confirmation by future studies.
Source Title: Am J Clin Nutr
ISSN: 00029165
DOI: 10.1093/ajcn/nqab344
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