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Mediterranean diet food pyramid (made by author, based on Bach-Faig et al., 2011; Davis et al., 2015)
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... While diet has become a focus to enhance human health, the attention on what types of diets yield the best outcomes is paramount from the perspective of consumers. The "Mediterranean or Eastern" diets versus a "Western diet" have gained popularity to increase the general health status and well-being and address many diseases and disorders [8,30,[61][62][63][64][65]. For example, the Mediterranean diet is one of the most widely described and evaluated dietary patterns in the scientific literature with validated health benefits [8,61,62,64,65]. ...
... The "Mediterranean or Eastern" diets versus a "Western diet" have gained popularity to increase the general health status and well-being and address many diseases and disorders [8,30,[61][62][63][64][65]. For example, the Mediterranean diet is one of the most widely described and evaluated dietary patterns in the scientific literature with validated health benefits [8,61,62,64,65]. It is characterized by high intakes of vegetables, legumes, fruits, nuts, whole grains, fish, some olive oil, moderate intake of red wine, where most proteins and fats are derived from vegetable sources with low intake of red meat, potatoes, processed meat, refined carbohydrates, and sweets [62,64,65]. ...
... For example, the Mediterranean diet is one of the most widely described and evaluated dietary patterns in the scientific literature with validated health benefits [8,61,62,64,65]. It is characterized by high intakes of vegetables, legumes, fruits, nuts, whole grains, fish, some olive oil, moderate intake of red wine, where most proteins and fats are derived from vegetable sources with low intake of red meat, potatoes, processed meat, refined carbohydrates, and sweets [62,64,65]. Additionally, the Eastern (Asian) diet has high intake of plant-based foods (source of protein from vegetables like bean sprouts, 9 spinach, eggplant, bok choy, cabbage, kale, snow peas, leeks, and mushrooms). ...
Lifestyle health has been recognized as an evidence-based innovation that defines how daily habits and practices impact both the prevention and treatment of disease and provides an important adjunctive component to overall health. Specifically, an approach with small changes over time can have a dramatic impact on the health and well-being of individuals not only, in general, but also can be applied to skin health. However, lifestyle health factors to improve skin well-being have not been discussed extensively and/or well promulgated. The narrative for this overview focuses on providing a summary for topic background information, but more importantly, presents four lifestyle factors that can improve dermal health [i.e., factor 1: nutrition - diet; factor 2: rest (sleep); factor 3: movement/physical exercise, and factor 4: social and community associations]. This was accomplished by identifying previous journal articles and reviews with emphasis over the last five years (from January 2018 through July 2023; 156 out of 190 references cited or 82 %) using scientific search databases. The main conclusions of this overview encourage the concept that lifestyle health factors such as nutrition/diet, rest/sleep, movement/physical exercise, and community/social interactions support enhanced skin health and well-being with aging. Plus, social media interventions that aim to promote dietary, sleep and physical activity changes might be an application to improve skin health in the future.
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STUDY QUESTION
Is there a difference in dietary patterns among subfertile South Asian women undergoing frozen embryo transfer (FET)?
SUMMARY ANSWER
Significant regional differences in dietary pattern exist among subfertile South Asian women undergoing FET.
WHAT IS KNOWN ALREADY
Preconception consumption of certain food groups or adopting specific dietary patterns, such as the ‘Mediterranean diet’, and its level of adherence have been shown to enhance the odds of achieving a successful pregnancy in women undergoing ART. However, differences in geographic location, individual preference, cultural beliefs and local availability contribute to such dietary choices. There is also a predisposition to a vitamin B12 deficiency in those of South Asian ethnicity and a predominant pattern of vegetarian food intake. There is a paucity of studies analysing the type of dietary pattern followed by South Asian women, their vitamin B12 levels and the potential impact on ART treatment outcomes.
STUDY DESIGN, SIZE, DURATION
This is a cross-sectional study of 159 South Asian women aged 21–37 years, belonging to the Eastern (n = 75) and Southern (n = 84) regions of India plus Bangladesh, and undergoing a FET cycle at a tertiary level infertility clinic between February 2019 and March 2020.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women underwent dietary assessment using ‘24-hour dietary recall’ to capture daily nutrient consumption. A ‘Food Frequency Questionnaire’ listing commonly consumed foods was used to record frequency of intake. The primary outcome was the characterisation of regional dietary patterns in the cohorts using principal component analysis (PCA). Secondary outcomes included association of vitamin B12 intake and serum levels with clinical and ongoing pregnancy.
MAIN RESULTS AND THE ROLE OF CHANCE
Four components contributing to overall variance in dietary pattern were identified, namely: meat, poultry and seafood; green leafy vegetables and root tubers; fruits, dairy and sugar; nuts and oilseeds. PCA analysis showed a significantly higher consumption of two components in the East—meat, poultry and fish (P < 0.001); green leafy vegetables and root tubers (P < 0.001). All women reported taking preconception oral folic acid supplementation. The dietary intake of vitamin B12 and serum concentration correlated, showing a good validity of measured dietary intake (r = 0.398; P ≤ 0.001). Compared to the Southern region, participants from the East showed a higher daily median intake of vitamin B12 (1.11 versus 0.28 mcg, respectively; P < 0.001) and a higher serum vitamin B12 levels (441 versus 239 pg/ml, respectively; P < 0.001). Ongoing pregnancy showed no association with dietary vitamin B12 intake (relative risk 0.90; 95% CI, 0.68 to 1.19) or serum vitamin B12 levels (relative risk 0.99; 95% CI, 0.73 to 1.33) after adjustments for female age, body mass index (BMI) and geographic differences. Women belonging to different quartiles of serum vitamin B12 concentration had a similar likelihood of ongoing pregnancy.
LIMITATIONS, REASONS FOR CAUTION
Self-reported dietary assessment is prone to measurement errors owing to its subjective nature and recall bias. The study was not adequately powered to detect the impact of geographic differences in vitamin B12 intake and serum levels on FET treatment outcomes, the second objective. We adjusted for potential confounders, such as female age and BMI, but it is possible that residual confounders, such as physical activity, stress and use of dietary supplements, may have influenced the results. Extrapolation of the study findings to women undergoing ART in other populations should be made with caution.
WIDER IMPLICATIONS OF THE FINDINGS
Our study findings suggest important differences in local dietary patterns within the South Asian region. Hence a personalised approach to dietary assessment and intervention when undergoing ART based on population dynamics is warranted. The geographic differences in the vitamin B12 intake or serum levels did not have an impact on the FET outcomes. There is also a need to further investigate the impact of such dietary differences on ART treatment outcomes in a large study population.
STUDY FUNDING/COMPETING INTEREST(S)
No grant from funding agencies in the public, commercial, or not-for-profit sectors was obtained. The authors have nothing to disclose.
TRIAL REGISTRATION NUMBER
N/A
Lifestyle health has been recognized as an evidence-based innovation that defines how everyday behaviors and routines influence the avoidance and therapy of illness and provides an important adjunctive component to overall health. Specifically, an approach with small changes over time can have a dramatic impact on the health and well-being of individuals not only, in general, but also can be applied to skin health. However, lifestyle health factors to improve skin well-being have not been discussed extensively and/or well promulgated. The narrative for this overview focuses on providing a summary for topic background information, but more importantly, presents four lifestyle factors that can improve dermal health [i.e., factor 1: nutrition—diet; factor 2: rest (sleep); factor 3: movement/physical exercise, and factor 4: social and community associations]. This was accomplished by identifying preceding journal reports/reviews covering especially the last five years (January 2018 to July 2023; 164 out of 205 references cited or 80%) using scientific search databases. The main conclusions of this overview encourage the concept that lifestyle health factors such as nutrition/diet, rest/sleep, movement/physical exercise, and community/social interactions support enhanced skin health and well-being with aging. Plus, social media interventions that aim to promote dietary, sleep and physical activity changes might be an application to improve skin health in the future.
