Mediterranean Journal of Nutrition and Metabolism 13 (2020) 101–111 DOI:10.3233/MNM-200402 IOS Press 101 Review Paper Mediterranean diet: Woman fertility and pregnancy Mar´ ıa El´ expuru Zabaleta * Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy Received 26 January 2020 Accepted 31 January 2020 Abstract. The Mediterranean diet (MDiet) is the most studied dietary pattern worldwide. For more than almost 60 years numerous studies have surveyed its association with human health revealing its beneficial properties, like anti-inflammatory and anti-oxidant features, on multiple diseases and disorders thanks to its bioactive components. Changes in our lifestyle and dietary habits have provoked an increase of overweight and obesity and, consequently, the development and worsening of its correlated outcomes derived from inflammation and oxidative stress. Particularly, many observational studies have shown that the adhesion to MDiet is associated with the improvement of female infertility decreasing the incidence of metabolic disorders such as polycystic ovary syndrome among other related dysfunctions. Moreover, adhering to MDiet during the peri- conceptional and gestational period meliorates the health of the mother and her offspring decreasing the risk of developing pregnancy-associated complications, like gestational diabetes mellitus or hypertension conditions such as preeclampsia. Most of these disorders are correlated with obesity, thus it is essential to promote, through prevention and counseling, a change in women’s dietary routines and lifestyle in order to reduce the incidence of infertility and pregnancy-related complications. The adhesion to MDiet seems to be the best choice to overcome this challenge. Keywords: Mediterranean diet, obesity, gestational diabetes mellitus, preeclampsia, infertility, metabolic disorders, antioxi- dant, monounsaturated fatty acids, polyunsaturated fatty acids, extra-virgin olive oil 1. General benefits of the Mediterranean diet The Mediterranean diet (MDiet) is considered the most widely noted dietary pattern in the world [1]. It has been of interest since the early sixties of the twentieth century, defined by Dr Ancel Keys when he published a study about the effect of a low-fat diet, typical of the Mediterranean region, on the reduced risk of coronary heart disease (CHD) [2–5]. Since then, numerous reports have described the favorable benefits of MDiet on health and on the increase of life expectancy [4, 6, 7]. It is important mentioning that MDiet is a combination of the dietary patterns of the Mediterranean countries, together with their social behavior and life culture. Even among their cultural, economic, ethnic and religious differences, we can find common features in their dietary routine: the consumption of local and seasonable ingredients, traditional methods of conservation and cooking, and eating behavior in a social and familiar context [3, 4, 7]. MDiet is characterized by intake of high quality and limited processed foods: extra virgin olive oil, high intakes of fruit and vegetables, legumes, nuts and unrefined * Corresponding author: Mar´ ıa El´ expuru Zabaleta, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10/A, Torrette di Ancona, 60126, Ancona, Italy. Tel.: +39 071 220 6063; Fax: +39 071 220 6062; E-mail: mariaelexpuru@gmail.com. ISSN 1973-798X/20/$35.00 © 2020 – IOS Press and the authors. All rights reserved