An empirical dietary inflammatory pattern and fecundability in a multi-ethnic Asian preconception cohort
An empirical dietary inflammatory pattern and fecundability in a multi-ethnic Asian preconception cohort
Background: inflammation is known to adversely affect fertility but few studies have related dietary inflammatory potential to conception in women without known infertility.
Objectives: this study aimed to empirically derive a dietary inflammatory pattern score for Singaporean women (EDIP-SGW) and examined its association with fecundability in women from the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) study.
Methods: the EDIP-SGW score was calculated based on a dietary pattern (derived from food frequency questionnaire data using reduced rank regression) most predictive of 2 inflammatory markers: high-sensitivity C-reactive protein and glycoprotein acetyls. We validated the score in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Fecundability (measured by time-to-pregnancy in menstrual cycles within a year of enrolment) for increasing EDIP-SGW score was estimated using discrete-time proportional hazards models adjusted for covariates (n = 890). Interaction with insulin resistance [homeostatic model assessment for insulin resistance (HOMA-IR)] was explored.
Results: increasing concentrations of high-sensitivity C-reactive protein and glycoprotein acetyls were observed across EDIP-SGW score quartiles in both the S-PRESTO and GUSTO, demonstrating the score’s validity. Fecundability was 34% lower in the highest quartile of EDIP-SGW scores compared with the lowest quartile (fecundability ratio: 0.66, 95% confidence interval: 0.48, 0.93), and each SD increase in EDIP-SGW score was associated with a 13% lower fecundability [0.87 (0.77, 0.99)]. Among women with low HOMA-IR (<2.5), those in the highest quartile of EDIP-SGW scores appeared to have a 34% lower fecundability [0.66 (0.46, 0.94); P-interaction = 0.004], but this was not evident in women with high HOMA-IR (≥2.5).
Conclusions: a proinflammatory diet is associated with lower fecundability in multiethnic Asian women without known infertility. Further studies are needed to clarify the role of insulin resistance in this relationship.
Loh, Jason
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Yu, Guoqi
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Colega, Marjorelee T.
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Tan, Karen
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Chong, Yap-Seng
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Godfrey, Keith M.
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Chan, Jerry Kok Yen
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Chan, Shiao-Yng
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Eriksson, Johan G.
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Chong, Mary Foong-Fong
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Loy, See Ling
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Lai, Jun S.
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19 January 2026
Loh, Jason
b503ae6a-0e60-4e4e-a1da-8002c9982975
Yu, Guoqi
cbecf040-5a1e-4ad3-acb0-266589925eec
Colega, Marjorelee T.
75c5e6c9-9b67-46b9-90e6-e63632163ed8
Tan, Karen
9f6b690c-1480-4a39-a344-8a827a483314
Chong, Yap-Seng
7043124b-e892-4d4b-8bb7-6d35ed94e136
Godfrey, Keith M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Chan, Jerry Kok Yen
42e59d61-c3d1-486b-b33a-22c4645acf12
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Chong, Mary Foong-Fong
1e188259-b1ab-4448-9e65-5b6a0fd99502
Loy, See Ling
6fd10b64-1de2-419e-a5f4-b505be233e6e
Lai, Jun S.
1fd69464-147f-4220-ab67-f9d76437cf3b
Loh, Jason, Yu, Guoqi, Colega, Marjorelee T., Tan, Karen, Chong, Yap-Seng, Godfrey, Keith M., Chan, Jerry Kok Yen, Chan, Shiao-Yng, Eriksson, Johan G., Chong, Mary Foong-Fong, Loy, See Ling and Lai, Jun S.
(2026)
An empirical dietary inflammatory pattern and fecundability in a multi-ethnic Asian preconception cohort.
The Journal of nutrition, 156 (2), [101283].
(doi:10.1016/j.tjnut.2025.101283).
Abstract
Background: inflammation is known to adversely affect fertility but few studies have related dietary inflammatory potential to conception in women without known infertility.
Objectives: this study aimed to empirically derive a dietary inflammatory pattern score for Singaporean women (EDIP-SGW) and examined its association with fecundability in women from the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) study.
Methods: the EDIP-SGW score was calculated based on a dietary pattern (derived from food frequency questionnaire data using reduced rank regression) most predictive of 2 inflammatory markers: high-sensitivity C-reactive protein and glycoprotein acetyls. We validated the score in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Fecundability (measured by time-to-pregnancy in menstrual cycles within a year of enrolment) for increasing EDIP-SGW score was estimated using discrete-time proportional hazards models adjusted for covariates (n = 890). Interaction with insulin resistance [homeostatic model assessment for insulin resistance (HOMA-IR)] was explored.
Results: increasing concentrations of high-sensitivity C-reactive protein and glycoprotein acetyls were observed across EDIP-SGW score quartiles in both the S-PRESTO and GUSTO, demonstrating the score’s validity. Fecundability was 34% lower in the highest quartile of EDIP-SGW scores compared with the lowest quartile (fecundability ratio: 0.66, 95% confidence interval: 0.48, 0.93), and each SD increase in EDIP-SGW score was associated with a 13% lower fecundability [0.87 (0.77, 0.99)]. Among women with low HOMA-IR (<2.5), those in the highest quartile of EDIP-SGW scores appeared to have a 34% lower fecundability [0.66 (0.46, 0.94); P-interaction = 0.004], but this was not evident in women with high HOMA-IR (≥2.5).
Conclusions: a proinflammatory diet is associated with lower fecundability in multiethnic Asian women without known infertility. Further studies are needed to clarify the role of insulin resistance in this relationship.
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Accepted/In Press date: 22 December 2025
e-pub ahead of print date: 27 December 2025
Published date: 19 January 2026
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Local EPrints ID: 508847
URI: http://eprints.soton.ac.uk/id/eprint/508847
ISSN: 0022-3166
PURE UUID: 685efd1b-42a8-4bd3-8012-40b994b538b3
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Date deposited: 04 Feb 2026 17:57
Last modified: 05 Feb 2026 02:33
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Contributors
Author:
Jason Loh
Author:
Guoqi Yu
Author:
Marjorelee T. Colega
Author:
Karen Tan
Author:
Yap-Seng Chong
Author:
Jerry Kok Yen Chan
Author:
Shiao-Yng Chan
Author:
Johan G. Eriksson
Author:
Mary Foong-Fong Chong
Author:
See Ling Loy
Author:
Jun S. Lai
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