Infertility affects roughly 1 in 7 couples, and rates are only getting worse, especially in regards to male fertility. A recent global study found that sperm counts fell by sightly more than 1% per year between 1973 and 2018, and the global average sperm count had fallen by 52% by 2018. While there is no one cause for the decline, researchers hypothesize that ultra processed diets, high exposure to chemicals like phthalates and parabens (read more HERE), obesity and lack of physical exercise are all likely culprits (Levine, et al., 2022).
One of the main reasons I'm so passionate about healthy, daily habits and lifestyle changes to promote fertility is that modern medicine often jumps to harsh medicine and risky procedures to "solve problems" rather than get to the root of the issue. One of those root issues for almost every disease process is poor nutrition, and yet diet changes are one of the simplest and least expensive ways to promote health. Though it might take some tweaking in your grocery budget, diet changes can go a significant distance in health improvement, including fertility, while not breaking your bank, and has ZERO side effects (as long as you stay away from foods you’re allergic to, of course).
One of the most well researched and respected diets in today's world is the Mediterranean diet, which is also known as the best diet for fertility by many leaders in the industry. This diet is rich in nutrients that are important for healthy hormones and fertility support. In this article, we'll talk about what the Mediterranean diet is, the many benefits of this diet, particularly when it comes to benefits for male and female fertility, and, of course, ideas for meals and snacks throughout the week. I've even included a free 7 day Mediterranean meal plan at the bottom of this post, complete with a recipe bundle and shopping list to make it as easy as possible for you to start implementing these health promoting foods into your daily routine.
What is the Mediterranean Diet?
The Mediterranean diet is a way of eating that is based on the eating patterns of the people who live around the Mediterranean Sea. Originally, the diet was based on the cuisines of Italy, Greece and Spain, but since has been expanded to include the cuisine of North Africa. It is comprised mostly of plant-based foods including whole grains, lentils, vegetables, fruits, seeds, nuts, herbs and olive oil. It also includes fish, seafood, fermented dairy and poultry in moderation, and a limited amount of red meats, sweets and processed foods. Many would say the Mediterranean diet is more of a way of life than a diet, promoting the ideas of cooking at home, sharing meals with friends, and getting regular exercise. It focuses less on calorie counting and weight loss, and more on filling your plate with delicious, nutritious foods. Because of the many foods that are included in the diet, it is easy to customize meals based on individual habits and food preferences.
Benefits of the Mediterranean Diet
The healthy fats found in olive oil, avocado, nuts, seeds and fatty fish like salmon and sardines provide the building blocks for our hormones, help lower cholesterol, and support overall heart health. They are also high in omega-3 fatty acids which help our bodies fight inflammation, an important factor to address in couples trying to conceive.
Antioxidant-rich foods, like berries, cherries, leafy greens, beans, and apples, that are a major part of the Mediterranean diet, support healthy cells throughout the body. Antioxidants remove chemicals known as free radicals from the body. While free radicals are a natural product of food breakdown and exercise, high levels of free radicals can damage cells and genetic material, like DNA, which is especially important for egg and sperm cells, which will go on to create an entire new human life. Antioxidants, some of which you know, like vitamin C and vitamin E, bind to free radicals to prevent damage, and have roles in repairing DNA and maintaining healthy cells.
The Mediterranean Diet and Infertility
The Mediterranean diet is also known as an anti-inflammatory diet. While inflammation is a normal process and is essential for fighting infection and protecting the body from foreign substances like plant pollen an chemicals, unchecked inflammation can lead to chronic health conditions. Many diseases, like cancer and diabetes, are linked to chronic inflammation, and high inflammation has been associated with PCOS, endometriosis, and undiagnosed infertility, the top three causes of infertility in women. Although the exact mechanism is unknown, Inflammation is also a key factor in infertility. Many studies have shown that strict adherence to an anti-inflammatory diet improves fertility for both men and women.
The Mediterranean diet has been scientifically proven to improve semen count, quality, and motility. It has also been shown to improve the chances of pregnancy and live birth, including women who are undergoing IVF treatment. The European Society of Human Reproduction and Embryology found that women who adhered to a strict Mediterranean diet in the six months leading up to IVF were 65-68% more likely to conceive and give birth to a live baby than those who had the lowest adherence to the same diet.
Other benefits of the Mediterranean diet include a reduced risk of heart disease, cancer, including breast cancer, and stroke. It has been shown to aid in weight loss and help maintain blood sugar levels, which are both important factors in improving natural conception. Additionally, the Mediterranean diet has been shown to improve eye, bone and brain health, and reduce oxidative stress. For four years in a row the Mediterranean diet has been voted the best diet according to the U.S. News and World Report’s annual ranking - can you see why?
What to Eat and How Often
Whole grains, lentils, fruits, and vegetables should be the base for every meal. These provide plenty of fiber, which help manage blood sugar levels, a variety of vitamins and minerals to promote healthy cellular functioning, and antioxidants to fight free radicals. Choose non-gmo and organic fruits and vegetables, especially for those without thick skins (i.e. melons, avocado, bananas), as these are often sprayed heavily with pesticides that can disrupt hormones.
Replace butter, margarine and unhealthy oils with olive oil, preferably extra virgin olive oil (EVOO). Olive oil is high in monounsaturated fat, which supports a balance of estrogen and progesterone, is rich in antioxidants and has anti-inflammatory properties. Oleic acid, the main active ingredient in olive oil, has been found to improve sperm count and motility.
Fish and seafood should be eaten 2 to 3 times per week, as they're high in omega 3 fatty acids, which help fight inflammation in the body. Be sure to avoid large fish like shark and mackerel due to their high mercury content, and choose wild caught fish over farmed.
Eggs, poultry, yogurt, cheese and dairy should be eaten in moderation. Rather than making main dishes around these items, try using them to season your meals instead. For example, topping your hearty stew with parmesan, or adding a some chicken to a whole grain pasta and vegetable dish. Choose organic, grass fed dairy products, and corn and soy free poultry and eggs when possible.
Red meats should only be eaten occasionally, no more than once a week. Most people who live in the Mediterranean region use red meats to season their food, rather than consume meat as the main dish. Again, choosing organic, grass fed beef is ideal!
Sweets should be consumed only occasionally. If you are a dessert lover like I am, try eating fresh fruit, a few walnuts candied with honey and orange juice, or a piece of dark chocolate to replace your usual treat.
7 Tips for Boosting Your Fertility With Food
Focus on whole grains. One of the most common reasons for poor egg quality and anovulatory infertility is due to high blood sugar and insulin resistance (one of the hallmarks of PCOS). One of the best ways to keep your blood sugar more even is to ditch white breads, pastas and cereals for whole grains. Some of the best whole grains for fertility are oats, quinoa, einkorn and whole wheat.
Add protein. Similar to the first tip, adding protein to your meals and snacks will keep your body from blood sugar spikes and support insulin levels. Some of the best proteins to add to your meals are lean meats like chicken and turkey, fatty fish, nuts and nut butters and Greek yogurt.
Aim for an extra serving of greens. For every woman of childbearing age, especially those trying to conceive, it's recommended to get at least 400 mcg of folate daily. While a prenatal vitamin generally has this in it (and I recommend you take one), leafy greens are also a great source, as well as being rich in iron, calcium and antioxidants. If you're tired of salads, throw your spinach and/or kale in the freezer, and add it to your favorite smoothies. I also love adding this SuperGreens powder to mine for an extra boost of veggies.
Swap it for olive oil. One of the key ingredients of the Mediterranean diet is olive oil, which is rich in oleic acid and monounsaturated fats as mentioned above, as well as vitamin E. Vitamin E is a powerful antioxidant that helps protect against free radicals and supports the production of healthy eggs and sperm. Use olive oil in place of butter and other oils, as a base for salad dressings, and to dip your bread in. I love olive oil with Zaatar spice for mine!
Choose healthy fats. Unlike we've been told for our whole lives quite possibly, not all fats are created equal. Healthy fats found in olive oil, fatty fish like tuna and salmon, and nuts are actually a powerhouse for supporting balanced hormones. Try adding nuts to your yogurt with some granola and fruit, or trying a new fish recipe once/week. I recently found a Thai salmon recipe with mango salsa that my whole house is loving! Email me for the recipe : )
Spice it up. There is no need for healthy food to taste bland, because spices have some of the best benefits for fertility. Cinnamon, turmeric, ginger, and cardamom for example are incredibly beneficial for those trying to conceive, as they're anti-inflammatory, while cinnamon has the added benefit of helping to balance blood sugar levels. Add spices to your favorite dishes for more flavor, dress up your oatmeal or latte with cinnamon and vanilla, opt for a homemade chai latte, or try an anti-inflammatory powerhouse drink called Golden Milk. You can check it out here on my IG account. The recipe is in the comments.
Eat dessert. I hope you don't need permission, but in case you do, please eat dessert. Life is better with dessert : ) Dark chocolate is my absolute go to, as it's low in sugar, and high in magnesium and antioxidants. Other great options for Mediterranean friendly desserts are frozen Greek yogurt bars with strawberries (or your favorite berry), fruit salad, or any combination of dark chocolate and nut butter. *Be sure to look at the label and avoid additives like palm oil and added sugars, as they're super common!
If you want to try my Greek yogurt bars, simply add 1 cup of plain, Greek yogurt, 2 cups of strawberries (fresh or frozen) and 2 Tbsp of raw honey or maple syrup to a blender, pour into popsicle molds and place in the freezer until set.
Mediterranean Diet Meal Plan
For more recipes, and a weekly meal plan, here is your FREE 7 Day Mediterranean meal plan as promised. I was sure to include leftover days, because I know you don't want to cook three meals per day! I didn't include snacks, but some easy, healthy options are veggies with hummus, fruit and almond butter, and raw or dry roasted nuts and trail mix.
Have a question, comment, or a recipe to share? Do so in the comments below!
References
American Heart Association, (2020). What is the Mediterranean Diet? Retrieved from: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet European Society of Human Reproduction and Embryology. (2018, January 29). Mediterranean diet may help women receiving IVF to achieve successful pregnancies. ScienceDaily. Retrieved October 17, 2021 from www.sciencedaily.com/releases/2018/01/180129223846.htm Karayiannis, D., Kontogianni, M. D., Mendorou, C., Douka, L., Mastrominas, M., & Yiannakouris, N. (2017). Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility. Human reproduction (Oxford, England), 32(1), 215–222. https://doi.org/10.1093/humrep/dew288
Hagai Levine, Niels Jørgensen, Anderson Martino-Andrade, Jaime Mendiola, Dan Weksler-Derri, Maya Jolles, Rachel Pinotti, Shanna H Swan, Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries, Human Reproduction Update, Volume 29, Issue 2, March-April 2023, Pages 157–176, https://doi.org/10.1093/humupd/dmac035
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