Mediterranean diet may increase the success rate of IVF

New research has found that women who follow a "Mediterranean" diet in the six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

Researchers asked women about their diet before in vitro fertilisation (IVF) treatment and found that those who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil, and less red meat, had a 65-68% greater likelihood of achieving a successful pregnancy and birth compared to women with the lowest adherence to the Mediterranean-style diet.

Researchers assessed the diet of different women through a food frequency questionnaire when they enrolled at an Assisted Conception Unity in Athens, Greece, for their first IVF treatment. The questionnaire asked them about how often they ate certain groups of food in the preceding six months; the results gave the women a MedDiet Score, which ranged from 0-55 with higher scores indicating greater adherence to the Mediterranean diet. The women were aged between 22-41 and were non-obese (body mass index of less than 30 kg/m 2 ).

Researchers, led by Associate Professor Nikos Yiannakouris at the Department of Nutrition and Dietetics at Harokopio University of Athens, divided the women into three groups depending on their MedDiet Score: the first group had scores between 18 to 30, the second scored between 31-35 and the third group scored between 36 to 47.

They found that compared to the 86 women in the highest scoring group, the 79 women in the lowest scoring group had significantly lower rates of pregnancies (29% versus 50%) and live births (26.6% versus 48.8%). When the researchers looked at women younger than 35 years old, they found that every five-point improvement in the MedDiet Score was linked with an approximately 2.7 times higher likelihood of achieving a successful pregnancy and live birth.

Overall, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby. Women attempting fertility should be encouraged to eat a healthy diet, such as the Mediterranean diet, because greater adherence to this healthy dietary pattern may increase the chances of successful pregnancy and delivering healthy baby.

Adherence to the Mediterranean diet may also help improve semen quality. Taken together, these findings highlight the importance of dietary influences and diet quality on fertility, and support a favourable role for the Mediterranean diet on assisted reproduction performance. The researchers did not find any association between diet and the chances of successful pregnancies and live births among women aged 35 and older. However, they believe this is because hormonal changes, fewer available eggs and other changes that women experience as they get older could mask the influences of environmental factors such as diet.
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Lupus increases the risk of dementia

Lupus is a chronic autoimmune disease that causes the body to attack its own healthy cells. It is thought to be caused by genetic and environmental factors. Environmental factors can trigger attacks or 'flare ups. 'Flare ups vary from person to person and are not the same each time. They can be marked by fatigue that can be mild or debilitating. Fatigue is often an early indicator that an attack is about to set in.

Attacks can cause joint and muscle pain and swelling, particularly at the wrists, hands, elbows, knees and ankles. Many people with lupus experience skin problems. The most distinctive marker of lupus is a butterfly-shaped rash on the face. Lupus may also cause light sensitivity, fever, changes in weight and swollen glands. People with lupus sometimes complain of a 'fog,' that can feel like depression or anxiety and sometimes causes them to have difficulty focusing and expressing themselves.

It causes the body’s immune system to break cells in parts of the body including the kidneys, lungs, skin and blood vessels. Lupus may impair memory and cognitive functions. Researchers analyzed data from more than 7,000 people and found that dementia was far more common among people with dementia than those without the disease. Lupus is best known for the damage it does to the kidneys, but its symptoms can be extremely varied, making it very difficult to diagnose.

Experts have identified numerous forms of the disease, including nineteen variations of neuropsychiatric lupus, which affects the central nervous system, including cognitive and memory functions and can even cause psychological and psychiatric symptoms. Some patients refer to a ‘lupus fog,’ a catchall description of the experience of difficulty concentrating, remembering facts, and expressing oneself.

The fog can also come with depression and anxiety, all of which may signal a lupus flare up. Patients who do not have a neuropsychiatric form of lupus are at a greater risk of dementia. Steroids are also associated with memory loss and cognitive impairment in lupus patients.
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Genes and environment can increase the risk of congenital heart defects

Infants of mothers with diabetes have increased risk of congenital heart defects. Such developmental defects are likely caused by a combination of genetic and environmental factors. The molecular mechanisms by which maternal diabetes disrupts normal heart development in genetically susceptible individuals remain unclear.

The Cardiovascular Research describe a gene-environment interaction resulting in congenital heart defects in both mouse and fly model systems. Interaction between two genes, Endothelial Nitric Oxide Synthase and Notch1, would result in more severe types of congenital heart defects in animal models. Diabetes is known to be associated with decreased nitric oxide levels in blood vessels.

Maternal diabetes, in combination with a mutation in Notch1, would result in a higher risk of congenital heart disease.
Researchers showed that maternal hyperglycemia reduces the chromatin accessibility of the Endothelial Nitric Oxide Synthase gene, resulting in decreased nitric oxide production.

This loss of nitric oxide is associated with an increase in expression of Jarid2, a known repressor of the Notch1 gene. This directly inhibited Notch1 expression to levels below a critical threshold necessary for normal heart development. This study lends support to a gene-environment interaction model where maternal hyperglycemia raises the risk of congenital heart defects by reducing Notch1 expression.

The results reveal the epigenetic machinery by which maternal hyperglycemia disrupts the Nitric Oxide and Notch1 signaling pathways, leading to congenital heart defects. Infants that are exposed to hyperglycemia develop a congenital heart defect, which supports the idea that there are genetically susceptible individuals.
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