Food is far more significant in fertility than many realize. A fertility diet isn’t just another trending eating plan—it’s a thoughtful approach to nourishing your body and optimising your reproductive health. As more couples face fertility challenges, understanding the connection between diet and fertility has become increasingly important. Ms. Sarah Sinaram, a registered dietitian, explains the key principles that define a fertility diet.
How is diet linked to fertility?
Research shows that dietary choices can significantly influence fertility. While no single diet guarantees conception, proper nutrition supports overall reproductive health and helps maintain a healthy BMI – crucial for both partners.
“Men and women with body mass index (BMI) more than have a higher risk of infertility. This same risk extends to underweight women, with a BMI less than 20,” she said.
“A combined analysis of several studies showed that women who followed a healthy diet and exercise regularly had a higher chance of becoming pregnant than those who didn’t. For men, although there are fewer studies, one showed that a healthy diet and exercise improved sperm quality in men who had fertility issues,” she added.
Certain diets have been shown to affect fertility, but experts are still learning how diet and infertility are connected. One important cause of infertility is inflammation, which can lead to problems like irregular periods, difficulty with embryo implantation, and other fertility issues. For men, long-term inflammation can negatively affect sperm quality. Eating foods that lower inflammation might help improve fertility.
“A growing body of evidence shows that following anti-inflammatory diets such as the American Heart Association (AHA) diet, a low glycemic index (GI) plant-based diet and DASH (dietary approach to stop hypertension), and the Mediterranean diet (MedDiet) improve fertility and assisted reproductive technology (ART) success in both men and women,” Sarah said.
“A recent cross-sectional study conducted on a group of 209 healthy men revealed that those with a higher saturated and trans-fat intake had lower total testosterone with lower testicular volume than men with higher intakes of healthier fat, including Omega 3s,” she added.
“These diets’ main sources of harmful fatty acids come from fast-food products, salty and sweet snacks, ready-made confectionery, and processed red meat.”
The Mediterranean diet
While no single proven “fertility diet ” exists, the Mediterranean diet is one dietary pattern with evidence of fertility benefits.
“Interestingly, we found that most recent studies that showed a positive association between diet and fertility focused on MedDiet. The MedDiet is characterised by daily consumption of fruits and vegetables, legumes, whole grains, nuts, and olive oil, especially virgin and extra virgin olive oil, which represent the major sources of fats in a person’s diet,” Sarah explained.
Sarah recommends consuming 1-2 tablespoons of extra virgin olive oil daily. “You can add olive oil to your diet by using it when cooking, drizzle it into your meal just before you eat, or use it as a salad dressing,” she added.
Though Omega 3s is recommended, Sarah advises to be mindful of mercury levels when eating fish. “this is the case when consuming larger and longer-lived fish like swordfish and fresh tuna. Fish oil, like anchovies and cod liver oil, can also be found in seafood. Aim for 2-3 fish meals a week.”
Seeds and nuts, such as flax, chia, and walnuts, are good sources of omega-3 fatty acids. However, they mainly provide a type of omega-3 called Alpha-linolenic acid (ALA).
“ALA is different from the omega-3s found in fish, called EPA and DHA. The body can convert ALA into EPA and DHA, but this process is inefficient. So, while seeds and nuts are healthy and beneficial, they are not as rich in the more directly usable omega-3 fatty acids as fish oil.”
Here are her recommended dietary components of MedDiet:
| Healthier Fats | Proteins | Carbohydrates | Micro-nutrients | Limit Your Intake |
|---|---|---|---|---|
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Extra virgin olive oil has a fundamental role in fertility.
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Eat at least three servings of legumes a week. Options include lentils, chickpeas, beans, and peas.
Include up to two to four eggs every week. Prepare omelets and scrambled or boiled eggs. Choose whole grains such as brown rice, barley, oats and quinoa. |
Choose whole grains such as brown rice, barley, oats and quinoa.
Include whole grain wheat and rye bread and products made with whole grain flour e.g. chapati, etc
|
Have a variety of vegetables in your diet. Add an extra serving of vegetables to both lunch and dinner, aiming for three to four servings a day. Try a new vegetable every week. |
Alcohol -You don’t have to drink alcohol to follow the MedDiet especially if its culturally not acceptable or if there’s a family history of dependence.
Mediterranean alcohol-drinking pattern suggests alcohol intake in moderation, preference for red wine drinking with meals, and avoidance of binge drinking.
Health Promotion Board recommends men have no more than two standard drinks a day, and women, no more than one.
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| Omega 3 is found in oily fish like salmon, tuna, and herring. |
Eat less meat. Choose lean poultry in moderate, 90 to 120 grams. Save red meat for occasional consumption or use meat as a condiment, accompanied by lots of vegetables, as in stews, stir-fries, and soups.
Include low fat milk and alternatives daily. Choose two servings of low-fat milk (skim, 1% or 2%), lower fat cheese (20% milk fat or less) and low fat fermented dairy foods such as kefir and yogurt.
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Avoid potatoes that are fried. |
Eat a variety of fruits such as berries, apples, pears, melon, plums, peaches and bananas.
Add diced olives to salads, stews or sandwiches.
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Limit sweets such as candies, pastries, desserts and sweetened beverages or sweetened juice to two servings per week or less or save them for special occasions. |
Adapting the Singapore diet to follow the MedDiet
A Singaporean adaptation might include familiar dishes with a MedDiet twist. Instead of regular chicken rice, opt for steamed chicken with brown rice. Here are more variety and easier tips to help you adapt the typical Singaporean diet to a Mediterranean one.
| Typical Singapore Diet | MedDiet Friendly Alternatives |
|---|---|
| White rice or bread or potato
Kaya Toast Cream based soups Salted, spiced, flavoured nuts and seeds |
Brown, red, black rice or wholemeal, multigrain bread or sweet potato
Peanut butter Toast Broth or clear soup Unsalted nuts and seeds |
| Higher fat milk, creamer, ice cream, cheese and yogurt | Low fat milk, yogurt and cheese |
| Red meat (including lamb, goat and pork), processed meats (sausages, luncheon meats, bacon) | Oil Fish and seafood, poultry (including chicken and turkey)
Include soya products e.g. tofu, tau key, tempeh, soymilk Consider baked beans and legumes I.e. lentils, red bean, green beans, peas |
| Vegetable oil, butter or margarine | Olive oil or olive oil spread |
| Salt | Herbs, spices, tumeric, ginger, garlic, onion |
| Juice, fruit drinks, carbonated beverages, specialty coffee, and tea with sugar | Water, herbal tea (without sugar) |
One question that often arises is about caffeine consumption. In our fast-paced society, that morning ‘kopi’ or afternoon ‘teh’ has become a must-have for many. The good news is that you don’t need to give up caffeine entirely.
“While many studies suggest that there is no potential link between caffeine consumption and the development of infertility among women, some studies show a dose-dependent relationship between caffeine and fertility. As such, it is recommended that women trying to conceive limit their caffeine intake to the equivalent of 1-2 cups of coffee per day,” she advised.
References
- Alesi S, Villani A, Mantzioris E, Takele WW, Cowan S, Moran LJ, Mousa A. Anti-Inflammatory Diets in Fertility: An Evidence Review. Nutrients. 2022; 14(19):3914. https://doi.org/10.3390/nu14193914
- Skoracka K, Eder P, Łykowska-Szuber L, Dobrowolska A, Krela-Kaźmierczak I. Diet and Nutritional Factors in Male (In)fertility—Underestimated Factors. Journal of Clinical Medicine. 2020; 9(5):1400. https://doi.org/10.3390/jcm9051400
