{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:13:20Z","timestamp":1788491600086,"version":"build-2803163510"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recurrent pregnancy loss (RPL) presents a major challenge in reproductive medicine, with lifestyle factors, especially dietary patterns, potentially influencing pregnancy outcomes. This study aimed to explore the relationship between adherence to preconception dietary patterns and pregnancy outcomes in women with RPL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 475 women with RPL at Renji Hospital, Shanghai Jiao Tong University School of Medicine. Participants completed a semi-quantitative food frequency questionnaire (FFQ) to assess adherence to six pre-defined dietary patterns at preconception: the American Heart Association Diet (AHA), Trichopoulou Mediterranean Diet (TMED), Panagiotakos Mediterranean Diet (PMED), Alternate Mediterranean Diet (AMED), Healthy Eating Index-2015 (HEI-2015), and Dietary Approaches to Stop Hypertension (DASH). Pregnancy loss, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and other adverse pregnancy outcomes (APO) (e.g., preterm birth, low birth weight) were ascertained using medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant associations were observed between adherence to the AHA diet and reduced risks of pregnancy loss [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.36 (0.17, 0.78), P-trend\u202f=\u202f0.043], GDM [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.28 (0.10, 0.75), P-trend\u202f=\u202f0.006], HDP [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.12 (0.03, 0.57), P-trend\u202f=\u202f0.008], and other adverse pregnancy outcomes [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.04 (0.01, 0.35), P-trend\u202f=\u202f0.001]. Similar associations were found for the AHEI, AMED, and TMED diets regarding pregnancy loss, GDM, and HDP, while the PMED and DASH diets showed no significant associations. Additionally, higher levels of moderate-to-vigorous physical activity and lower energy and fat intake were associated with increased live birth rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Greater adherence to the AHA diet during the preconception period was linked to lower risks of pregnancy loss, and adverse pregnancy outcomes. These findings support the AHA diet for patients with recurrent pregnancy loss, indicating that healthy dietary patterns may improve pregnancy outcomes and highlight the need for further research on their impact on fertility.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1565107","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T04:14:34Z","timestamp":1749010474000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Dietary patterns and recurrent pregnancy loss: a comparison of the American Heart Association diet, Mediterranean diet and others"],"prefix":"10.3389","volume":"12","author":[{"given":"Yan","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangjing","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2428","DOI":"10.1093\/humrep\/dew169","article-title":"Recurrent pregnancy loss: what is the impact of consecutive versus non-consecutive losses?","volume":"31","author":"Egerup","year":"2016","journal-title":"Hum Reprod"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1038\/s41572-020-00228-z","article-title":"Recurrent pregnancy loss","volume":"6","author":"Dimitriadis","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1097\/OGX.0b013e31828aca19","article-title":"Current concepts and new trends in the diagnosis and management of recurrent miscarriage","volume":"68","author":"Alijotas-Reig","year":"2013","journal-title":"Obstet Gynecol Surv"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2542","DOI":"10.1001\/jama.2016.7491","article-title":"Dietary intake among US adults, 1999-2012","volume":"315","author":"Rehm","year":"2016","journal-title":"JAMA"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/j.bpobgyn.2014.12.001","article-title":"Recurrent pregnancy loss and obesity","volume":"29","author":"Sugiura-Ogasawara","year":"2015","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref6","volume-title":"Chinese dietary guidelines","year":"2016"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"567.e1","DOI":"10.1016\/j.ajog.2019.02.004","article-title":"Dietary patterns and outcomes of assisted reproduction","volume":"220","author":"Gaskins","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1093\/humupd\/dmx006","article-title":"Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies","volume":"23","author":"Salas-Huetos","year":"2017","journal-title":"Hum Reprod Update"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/j.tjnut.2023.12.013","article-title":"Periconceptional dietary patterns and adverse pregnancy and birth outcomes","volume":"154","author":"Bodnar","year":"2024","journal-title":"J Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1093\/ajcn\/nqab145","article-title":"Healthy dietary patterns and common pregnancy complications: a prospective and longitudinal study","volume":"114","author":"Li","year":"2021","journal-title":"Am J Clin Nutr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e2329982","DOI":"10.1001\/jamanetworkopen.2023.29982","article-title":"Women's adherence to healthy dietary patterns and outcomes of infertility treatment","volume":"6","author":"Salas-Huetos","year":"2023","journal-title":"JAMA Netw Open"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2599","DOI":"10.1056\/NEJMoa025039","article-title":"Adherence to a Mediterranean diet and survival in a Greek population","volume":"348","author":"Trichopoulou","year":"2003","journal-title":"N Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.ypmed.2006.12.009","article-title":"Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the med diet score","volume":"44","author":"Panagiotakos","year":"2007","journal-title":"Prev Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1161\/CIRCULATIONAHA.108.816736","article-title":"Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women","volume":"119","author":"Fung","year":"2009","journal-title":"Circulation"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1016\/j.jand.2018.05.021","article-title":"Update of the healthy eating index: HEI-2015","volume":"118","author":"Krebs-Smith","year":"2018","journal-title":"J Acad Nutr Diet"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1001\/archinte.168.7.713","article-title":"Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women","volume":"168","author":"Fung","year":"2008","journal-title":"Arch Intern Med"},{"key":"ref17","first-page":"311","volume-title":"China food composition tables","author":"Yang","year":"2019"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.fertnstert.2023.04.011","article-title":"The association between dietary patterns and risk of miscarriage: a systematic review and meta-analysis","volume":"120","author":"Chung","year":"2023","journal-title":"Fertil Steril"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e2248165","DOI":"10.1001\/jamanetworkopen.2022.48165","article-title":"Association of a Mediterranean Diet Pattern with Adverse Pregnancy Outcomes among US women","volume":"5","author":"Makarem","year":"2022","journal-title":"JAMA Netw Open"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e2330255","DOI":"10.1001\/jamanetworkopen.2023.30255","article-title":"Effect of a Mediterranean diet or mindfulness-based stress reduction during pregnancy on child neurodevelopment: a Prespecified analysis of the IMPACT BCN randomized clinical trial","volume":"6","author":"Crovetto","year":"2023","journal-title":"JAMA Netw Open"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e199","DOI":"10.1016\/j.ejim.2012.08.002","article-title":"Adherence index to the American Heart Association diet and lifestyle recommendation is associated with the metabolic syndrome in Japanese male workers","volume":"23","author":"Kuroki","year":"2012","journal-title":"Eur J Intern Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1080\/07315724.2021.1880987","article-title":"The association among maternal index of nutritional quality, dietary antioxidant index, and odds of miscarriage incidence: case-control study","volume":"41","author":"Vahid","year":"2022","journal-title":"J Am Nutr Assoc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1186\/s12884-022-05256-z","article-title":"Insulin resistance in women with recurrent miscarriage: a systematic review and meta-analysis","volume":"22","author":"Cai","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2013\/576926","article-title":"High fasting insulin levels and insulin resistance may be linked to idiopathic recurrent pregnancy loss: a case-control study","volume":"2013","author":"Ispasoiu","year":"2013","journal-title":"Int J Endocrinol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2700","DOI":"10.3390\/jcm9092700","article-title":"The prevalence and impact of polycystic ovary syndrome in recurrent miscarriage: a retrospective cohort study and Meta-analysis","volume":"9","author":"Mayrhofer","year":"2020","journal-title":"J Clin Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"5591","DOI":"10.1038\/s41467-024-49749-1","article-title":"Systematic review and meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome","volume":"15","author":"Bahri Khomami","year":"2024","journal-title":"Nat Commun"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"R277","DOI":"10.1530\/REP-16-0453","article-title":"Sterile inflammation and pregnancy complications: a review","volume":"152","author":"Nadeau-Vall\u00e9e","year":"2016","journal-title":"Reproduction"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1530\/REP-12-0217","article-title":"Endometrial inflammation and effect on implantation improvement and pregnancy outcome","volume":"144","author":"Granot","year":"2012","journal-title":"Reproduction"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1017\/S0007114524001028","article-title":"Maternal pre-pregnancy diet and prenatal depression: the mediating role of pre-pregnancy weight status and prenatal inflammation","volume":"132","author":"Vaghef-Mehrabani","year":"2024","journal-title":"Br J Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1770","DOI":"10.1016\/j.clnu.2024.05.042","article-title":"Inflammatory markers as diagnostic and precision nutrition tools for metabolic dysfunction-associated steatotic liver disease: results from the fatty liver in obesity trial","volume":"43","author":"Mogna-Pel\u00e1ez","year":"2024","journal-title":"Clin Nutr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1016\/j.ajcnut.2023.08.017","article-title":"Cholesterol-rich dietary pattern during early pregnancy and genetic variations of cholesterol metabolism genes in predicting gestational diabetes mellitus: a nested case-control study","volume":"118","author":"Cui","year":"2023","journal-title":"Am J Clin Nutr"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1136\/jech-2020-215716","article-title":"Dietary patterns and birth outcomes in the ELSPAC pregnancy cohort","volume":"76","author":"Mike\u0161","year":"2022","journal-title":"J Epidemiol Community Health"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1097\/GCO.0000000000000629","article-title":"Preconception diet, fertility, and later health in pregnancy","volume":"32","author":"Grieger","year":"2020","journal-title":"Curr Opin Obstet Gynecol"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1565107\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T04:14:35Z","timestamp":1749010475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1565107\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":33,"alternative-id":["10.3389\/fnut.2025.1565107"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1565107","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,4]]},"article-number":"1565107"}}