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    Original Investigation
    February 21, 2020

    Association of Dietary Patterns With Testicular Function in Young Danish Men

    Author Affiliations
    • 1Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
    • 2Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
    • 3Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
    • 4Odense Patient Data Explorative Network (OPEN), Odense, Denmark
    • 5Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
    • 6Centre for Foetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
    • 7Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík
    • 8Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
    • 9Channing Division of Network Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
    JAMA Netw Open. 2020;3(2):e1921610. doi:10.1001/jamanetworkopen.2019.21610
    Key Points español 中文 (chinese)

    Question  What is the association of dietary patterns with testicular function in men?

    Findings  In a cross-sectional study of 2935 young Danish men unaware of their fertility status, higher adherence to the Western diet pattern was associated with lower sperm quality than that of men with the lowest adherence. Conversely, higher adherence to the prudent diet pattern was associated with higher sperm quality.

    Meaning  These findings suggest that adherence to healthy diet patterns, a potentially modifiable lifestyle factor, is associated with better semen quality and potentially more favorable fertility potential among young men.


    Importance  Diet may play a role in testicular function, but data on how adherence to different diet patterns influences human testicular function are scarce.

    Objective  To determine whether adherence to specific dietary patterns is associated with testicular function in young men.

    Design, Setting, and Participants  This cross-sectional study included 2935 young Danish men unselected regarding fertility status who were enrolled from April 1, 2008, through May 31, 2017. Data were analyzed from July 1, 2017, to January 30, 2019.

    Exposures  Dietary patterns identified with principal component analysis based on responses to a validated food frequency questionnaire.

    Main Outcomes and Measures  Standard semen quality assessment; serum concentrations of testosterone, free testosterone, estradiol, inhibin B, follicle-stimulating hormone, luteinizing hormone, and sex hormone–binding globulin; and testicular volume measured with ultrasonography.

    Results  Among the 2935 participants included in the analysis, median age was 19 (interquartile range, 19-20) years and 2290 (78.0%) had normal body mass index. The 4 dietary patterns identified included Western, prudent, open-sandwich (a traditional Danish eating pattern), and vegetarianlike. The greatest adherence to the prudent pattern was associated with the highest total sperm count (median, 167 [95% CI, 146-183] million), followed by adherence to vegetarianlike (median, 151 [95% CI, 134-168] million) and open-sandwich (median, 146 [95% CI, 131-163] million) patterns. Adherence to the Western pattern was associated with the lowest total sperm count (median, 122 [95% CI, 109-138] million), which was significantly lower than sperm count in the other 3 diet patterns. After adjusting for confounders, the median total sperm count for men in the highest quintile of adherence to the Western pattern was 26 million lower (95% CI, –42 to –9 million) than for men in the lowest quintile of adherence to this pattern. Conversely, the median total sperm count of men in the highest quintile of adherence to the prudent pattern was 43 million (95% CI, 23-63 million) higher than that of men in the lowest quintile. Men with the highest adherence to the Western pattern had a lower median ratio of inhibin B to follicle-stimulating hormone (–12 [95% CI, –20 to –3]) and higher median ratio of free testosterone to luteinizing hormone (10 [95% CI, 2-19]) compared with men with lowest adherence to this pattern.

    Conclusions and Relevance  In this cross-sectional study, adherence to generally healthy diet patterns was associated with better semen quality, with potentially more favorable fertility potential among adult men.