Dietary patterns are positively associated with semen quality

Adherence to four dietary indexes is associated with higher overall sperm quality, with the Alternative Healthy Eating Index best associated and thus recommended as a clinical and practical nutritional tool for semen health.

Volume 109, Issue 5, Pages 809–816


Michal Efrat, M.Sc., Anat Stein, Ph.D., Haim Pinkas, M.D., Ron Unger, Ph.D., Ruth Birk, Ph.D.



To study association of semen quality with a priori whole dietary pattern indexes, which reflect real-world dietary practices and the numerous combinations by which foods are consumed: Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet score (aMED), and Alternative Healthy Eating Index (AHEI).


A cross-sectional single-center study.


Hospital fertility center and university.


A total of 280 men attending fertility center from 2012 to 2015.


Food frequency questionnaire (FFQ) and semen and sperm analysis.

Main Outcome Measure(s)

Food consumption with the use of FFQ and HEI, AHEI, aMED, DASH nutritional individual scoring indexes. Semen parameters, including semen volume, sperm concentration, motility, total count, and morphology.


Comparing the highest and lowest quartiles of the nutritional indexes, men in the highest quartiles of HEI, AHEI, aMed, and DASH indexes had significantly higher adjusted means of sperm concentration (by 10%, 45%, and 24% for HEI, AHEI, and DASH, respectively), normal sperm morphology (by 21% and 8% for AHEI and DASH, respectively), total sperm count (by 29% for AHEI), and sperm motility (by 6% and 11% for aMed and HEI, respectively).


Adherence to any of the four dietary indexes is associated with better overall sperm quality, with AHEI best associated. Following our novel findings, we recommend using AHEI as a clinical and practical tool for public whole nutritional recommendation for semen quality.

Read the full text here.


Go to the profile of Mary Samplaski
about 4 years ago

While I believe that a healthy diet is important for overall health, it is hard to tease out exactly its contribution to male fertility. When men go on diets, they often to several other "healthy" things, such as take vitamins, exercise, cut back on alcohol, and stop smoking. Were the authors able to account for these factors?