Adherence to healthy dietary patterns such as the Mediterranean diet rich in fruits and vegetables, nuts, seeds, whole-grain and fiber-rich foods, antioxidants, fish and seafood, poultry, and low-fat dairy is associated with improved semen quality parameters, including sperm motility and sperm concentration. Fish intake is positively related to sperm morphology and total sperm count. Additionally, a greater intake of fruits and vegetables, dark green vegetables, skim milk, poultry, and seafood was associated with a lower risk of asthenozoospermia. Conversely, a higher risk was associated with processed meat and sweets intake.

The Western dietary pattern is associated with increased dietary fat. Certain fats, especially trans-fat and saturated fat may negatively impact sperm parameters. High intakes of red and processed meat, high-fat products, and confectionery are inversely associated with semen quality. High dietary intake of saturated fat is associated with lower sperm concentration and total sperm count. Processed meat intake is negatively associated with sperm morphology. Moreover, overconsumption of trans fatty acids and saturated fatty acids may result in their accumulation in testicular cells, affecting the process of spermatogenesis and sperm plasma membrane composition. It may also reduce testosterone production.

An adequate supply of PUFAs or essential fatty acids from the diet is needed as metabolic substrates for the sperm cell membrane. Nuts, seeds, and vegetable oils contain linoleic acid and ɑ-linolenic acid. Seafood is a rich source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Consuming foods rich in DHA can modify the fatty acid composition of the sperm cell membrane and improve semen quality.

There is a direct link between obesity and various sperm quality parameters and hormonal disturbances, including lower testosterone. Weight loss can improve sperm morphology and reduce DNA fragmentation. Additionally, there is an inverse correlation between body weight and sperm quality parameters, including sperm count, concentration, motility, morphology, and vitality.

Antioxidants such as vitamin C, vitamin E, zinc, selenium, β-carotene, lycopene, coenzyme Q10, and N-acetyl cysteine (NAC) counteract oxidative stress that is damaging to sperm. Additionally, vitamin C and β-carotene are associated with higher sperm count, concentration, and motility. Some antioxidants, such as zinc, selenium, omega-3 fatty acids, coenzyme Q10, and carnitine, are related to sperm quality and may help improve fertility. Moreover, carnitines, such as L-acetyl carnitine and L-carnitine, help provide an energy source for spermatozoa, positively affecting sperm motility.

Nuts are energy-dense foods rich in nutrients, including vitamin E, omega-3 fatty acids, and omega-6 fatty acids, which researchers have suggested are beneficial for sperm quality. Consuming walnuts daily may improve sperm vitality, motility, and morphology. Additionally, mixed nuts, including walnuts, hazelnuts, and almonds, may improve total sperm count, vitality, motility, and morphology. In addition, antioxidants in nuts may decrease ROS and oxidative stress levels, providing additional benefits for sperm count, motility, and vitality.