{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T08:47:02Z","timestamp":1791708422340,"version":"4.3.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Hebei Province famous traditional Chinese medicine inheritance studio construction project","award":["grant no. 37 [2024]"],"award-info":[{"award-number":["grant no. 37 [2024]"]}]},{"name":"Hebei Provincial Administration of Traditional and Chinese Medicine 2027 Traditional Chinese Medicine research","award":["grant no. 2027165"],"award-info":[{"award-number":["grant no. 2027165"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between adherence to the Planetary Health Diet Index and self-reported infertility among U.S. women of reproductive age and, secondarily, to explore adiposity-related indirect associations involving the body mass index, waist-to-height ratio, weight-adjusted waist index, and body roundness index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 2256 women aged 18\u201344 years from the 2013\u20132018 National Health and Nutrition Examination Survey. Planetary Health Diet Index scores were derived from two 24-h dietary recalls, and infertility was identified based on self-reported Reproductive Health Questionnaire responses. Associations were estimated using multivariable logistic regression that incorporated survey weights, strata, and primary sampling units. Restricted cubic spline analyses were performed to assess functional form. Exploratory survey-replicate statistical decompositions were used to evaluate adiposity-related indirect probability contrasts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 2256 female study participants, 310 reported infertility. In the fully adjusted model, a 10-point higher Planetary Health Diet Index score was associated with an odds ratio of 0.895 for self-reported infertility (95% confidence interval, 0.768\u20131.043;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.149). Compared with women in the lowest weighted Planetary Health Diet Index quartile, those in the highest quartile had lower odds of self-reported infertility (odds ratio, 0.536; 95% confidence interval, 0.309\u20130.931;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.028). Restricted cubic spline analyses did not provide clear evidence of a nonlinear association. Exploratory statistical decompositions yielded negative indirect estimates through all four adiposity indices; however, every corresponding 95% confidence interval included the null.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher Planetary Health Diet Index scores demonstrated an inverse association with self-reported infertility, with the clearest evidence observed for the highest-versus-lowest weighted quartile; however, the continuous association was imprecisely estimated, and no clear exposure\u2013response pattern was identified. Adiposity-related indirect estimates were exploratory and imprecise. Given the cross-sectional design, causal and temporal interpretations cannot be derived. Prospective studies are needed to clarify the temporality and potential explanatory processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261493759","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:33:07Z","timestamp":1791430387000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the Planetary Health Diet Index with self-reported infertility among U.S. women: An exploratory analysis of adiposity indices"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4081-6168","authenticated-orcid":false,"given":"Rongze","family":"Sun","sequence":"first","affiliation":[{"name":"Cangzhou Integrated Traditional Chinese and Western Medicine Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0685-7094","authenticated-orcid":false,"given":"Jian","family":"Liu","sequence":"additional","affiliation":[{"name":"Cangzhou Integrated Traditional Chinese and Western Medicine Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1888-0673","authenticated-orcid":false,"given":"Xiaoyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Cangzhou Central Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boning","family":"Liu","sequence":"additional","affiliation":[{"name":"Cangzhou Integrated Traditional Chinese and Western Medicine Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cangzhou Integrated Traditional Chinese and Western Medicine Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzhi","family":"Fan","sequence":"additional","affiliation":[{"name":"Shanxi University of Chinese Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"Infertility prevalence estimates, 1990\u20132021","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. 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