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Intake of Sugar-sweetened Beverages and Fecundability in a North American Preconception Cohort

Hatch, Elizabeth, E.a; Wesselink, Amelia, K.a; Hahn, Kristen, A.a; Michiel, James, J.a; Mikkelsen, Ellen, M.b; Sorensen, Henrik, Toftb; Rothman, Kenneth, J.a,c; Wise, Lauren, A.a

doi: 10.1097/EDE.0000000000000812
Reproductive and Perinatal

Background: Dietary factors, including sugar-sweetened beverages, may have adverse effects on fertility. Sugar-sweetened beverages were associated with poor semen quality in cross-sectional studies, and female soda intake has been associated with lower fecundability in some studies.

Methods: We evaluated the association of female and male sugar-sweetened beverage intake with fecundability among 3,828 women planning pregnancy and 1,045 of their male partners in a North American prospective cohort study. We followed participants until pregnancy or for up to 12 menstrual cycles. Eligible women were aged 21–45 (male partners ≥21), attempting conception for ≤6 cycles, and not using fertility treatments. Participants completed a comprehensive baseline questionnaire, including questions on sugar-sweetened beverage consumption during the previous 4 weeks. We estimated time-to-pregnancy from follow-up questionnaires completed every 2 months by the female partner. We calculated adjusted fecundability ratios (FR) and 95% confidence intervals (CIs) according to intake of sugar- sweetened beverages using proportional probabilities regression.

Results: Both female and male intakes of sugar-sweetened beverages were associated with reduced fecundability (FR = 0.81; 95% CI = 0.70, 0.94 and 0.78; 95% CI = 0.63, 0.95 for ≥7 sugar-sweetened beverages per week compared with none, for females and males, respectively). Fecundability was further reduced among those who drank ≥7 servings per week of sugar-sweetened sodas (FR = 0.75, 95% CI = 0.59, 0.95 for females and 0.67, 95% CI = 0.51, 0.89 for males).

Conclusions: Sugar-sweetened beverages, particularly sodas and energy drinks, were associated with lower fecundability, but diet soda and fruit juice had little association.

From the aDepartment of Epidemiology, Boston University School of Public Health, Boston, MA; bDepartment of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark; CRTI Health Solutions, Research Triangle Park, NC.

Submitted April 18, 2017; accepted January 29, 2018.

The computing code and deidentified data are available by contacting the first or last author.

Supported by NICHD (R21-HD072326, R01-HD086742, R03-HD090315, and T32-HD052458).

The authors report no conflicts of interest.

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Correspondence: Elizabeth E. Hatch, Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118. E-mail:

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