title: Mediterranean and western dietary patterns are related to markers of testicular function among healthy men.
abstract: OBJECTIVE
  Are there any associations of dietary patterns with semen quality, reproductive hormone levels, and testicular volume, as markers of testicular function?
  
  
  CONCLUSIONS
  These results suggest that traditional Mediterranean diets may have a positive impact on male reproductive potential.
  
  
  BACKGROUND
  The Mediterranean diet has been related to lower risk of multiple chronic diseases, but its effects on reproduction potential are unclear.
  
  
  METHODS
  Cross-sectional sample of 215 male university students recruited from October 2010 to November 2011 in Murcia Region (Spain).
  
  
  METHODS
  Two hundred and nine healthy men aged 18-23 years were finally included in this analysis. Diet was assessed using a validated food frequency questionnaire, and dietary patterns were identified by factor analysis. Linear regression was used to analyze the relation between diet patterns with semen quality parameters, reproductive hormone levels and testicular volume adjusting for potential confounders.
  
  
  RESULTS
  We identified two dietary patterns: a Mediterranean (characterized by high intakes of vegetables, fruits and seafood) and a Western pattern (characterized by high intakes of processed meats, French fries and snacks). The Mediterranean pattern was positively associated with total sperm count (P, trend = 0.04). The Western pattern was positively related to the percentage of morphologically normal sperm (P, trend = 0.008). We found an inverse association between adherence to the Western pattern and sperm concentration among overweight or obese men (P, trend = 0.04).
  
  
  CONCLUSIONS
  As with all cross-sectional studies, causal inference is limited. However, participants were blinded to the study outcomes thus reducing the potential influenced their report of diet. Although we adjusted for a large number of known and suspected confounders, we cannot exclude the possibility of residual confounding or chance findings.
  
  
  CONCLUSIONS
  This study was carried out on healthy and young men, so it is difficult to predict whether and how the observed differences in semen quality translate into reproductive success for men in couples trying to conceive. These results suggest that traditional Mediterranean diets may have a positive impact on male reproductive potential.
authors.affiliation: Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain ana.c.t@um.es.
authors.forename: A
authors.initials: A
authors.lastname: Cutillas-Tolín
authors.affiliation: Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Mínguez-Alarcón
authors.affiliation: Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Mendiola
authors.affiliation: Center of Operations Research, Miguel Hernandez University, Elche Campus, Elche 03202, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: López-Espín
authors.affiliation: University Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, Copenhagen DK-20100, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Jørgensen
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain Department of Public Health, Miguel Hernández University, San Joan d'Alacant, Alicante 03550, Spain.
authors.forename: E M
authors.initials: EM
authors.lastname: Navarrete-Muñoz
authors.affiliation: Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Murcia 30100, Spain Department of Preventive Medicine, Reina Sofía University Hospital, Murcia 30003, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: Torres-Cantero
authors.affiliation: Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Chavarro
mesh_terms: D000293:Adolescent; D048430:Cell Shape / Q000502:physiology; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D066273:Diet, Western; D006801:Humans; D008297:Male; D055101:Semen Analysis; D013076:Sperm Count; D013094:Spermatozoa / Q000166:cytology*; D055815:Young Adult
keywords: Mediterranean pattern; Western pattern; diet; male reproductive health; male reproductive hormones; semen quality