Does diet have a role to play in erectile function?

Erectile dysfunction (ED) affects around 18 million men in the US alone (1).  It is associated with reduced sexual intimacy and quality of life, as well as psychological distress for both the affected person and their partners.  Modifiable factors for ED are largely similar to those of cardiovascular disease and include smoking, obesity, inactivity, diabetes and high cholesterol (1,2,3,4,5,6,7,8).

 The Mediterranean Diet (MD) has been hailed countless times for being the most beneficial eating regime due to its strong evidence base in protecting against cardiovascular health, diabetes, cancer and other inflammatory conditions (9,10).

It is then no surprise that the same nutrients that go in the body to help protect against these conditions should also help in other areas, such as ED (11). Bauer et al (Jama Network, 13th November 2020) carried out a cohort study on 21,469 men to investigate whether diet quality is associated with risk of ED.

Diet quality was assessed by MD score and the Alternative Healthy Eating Index 2010 (AHEI-2010) score (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810369/).  A  higher score indicates a healthier diet.  The results of the study found that men that scored higher on the MD scale had a lower incidence of erectile dysfunction.  The healthy components of the diet were:

  • Vegetable servings (the more servings the greater the positive effect)
  • Fruits and nuts
  • Grains (unrefined)
  • Legumes
  • Fish
  • The ratio of polyunsaturated to saturated fat

The unhealthy parts of the diet were:

  • Red or processed meats (the more servings the greater the negative effect)
  • Dairy

The moderate component was alcohol (the higher and lower consumption indicates higher risk and moderate consumption indicates healthier).  The amount of alcohol that was deemed protective was not specified in this study (however, the UK health guidelines recommend no more than 14 units of alcohol to be consumed per week).

The study concluded that there is an inverse association between a healthy diet (e.g. MD or AHEI-2010) and the risk of developing ED.  The diet regimes emphasise the high consumption of vegetables, fruits, nuts, legumes, fish (rich in omega fatty acids) and the reduction in red/processed meats and dairy products. 

It is therefore important that a diet analysis should be included in the whole assessment of ED in order to help minimise or reverse this health condition.

References:

1.  Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med, 2007; 120(2):151-157.

2.  Litwin MS, Nied RJ, Dhanani N.  Health-related quality of life in men with erectile dysfunction. J Gen Intern Med. 1998;13(3):159-166.

3Paige NM, Hays RD, Litwin MS, Rajfer J, Shapiro MF.  Improvement in emotional wellbeing and relationships of users of sildenafil.  J Urol. 2001;166(5):1774-1778.

4.  Wessells H, Joyce GF, Wise M, Wilt TJ. Erectile dysfunction. J Urol.2007;177(5):1675-1681

5.  Derby CA, Mohr BA, Goldstein I, Feldman HA, Johannes CB, McKinlay JB.  Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology.2000;56(2):302-306.

6.  Saigal CS, Wessells H, Pace J, Schonlau M, Wilt TJ; Urologic diseases in America Project.  Predictors and prevalence of erectile dysfunction in a racially diverse population.  Arch Intern Med. 2006;166(2):207-212.

7.Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB. Incidence of erectile dysfunction in men 40-69 years old: longitudinal results from the Massachusetts male aging study.  J Urol. 2000; 163(2): 460-463.

8.  Dong JY, Zhang YH, Qin LQ.  Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies.  J Am Coll Cardiol. 2011;58(13):1378-1385.

9. Eckel RH, Jakicic JM, Ard JD, et al; American College of Cardiology/American Heart Association Task Force on  Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.  Circulation. 2014; 129(25)(suppl 2): S76-S99.

10.  Estruch R, Ros E, Salas-Salvado J, et al; PREDIMED Study Investigators.  Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts.  N Engl J Med. 2018;378(25):e34.

11.  Scott R. et al; Association of Diet with Erectile Dysfunction Among Men in the Health Professionals’ Follow-up Study. JAMA Network Open. 2020:3(11):e2021701.

Does diet have a role to play in erectile function?

Erectile dysfunction (ED) affects around 18 million men in the US alone (1).  It is associated with reduced sexual intimacy and quality of life, as well as psychological distress for both the affected person and their partners.  Modifiable factors for ED are largely similar to those of cardiovascular disease and include smoking, obesity, inactivity, diabetes and high cholesterol (1,2,3,4,5,6,7,8).

 The Mediterranean Diet (MD) has been hailed countless times for being the most beneficial eating regime due to its strong evidence base in protecting against cardiovascular health, diabetes, cancer and other inflammatory conditions (9,10).

It is then no surprise that the same nutrients that go in the body to help protect against these conditions should also help in other areas, such as ED (11). Bauer et al (Jama Network, 13th November 2020) carried out a cohort study on 21,469 men to investigate whether diet quality is associated with risk of ED.

Diet quality was assessed by MD score and the Alternative Healthy Eating Index 2010 (AHEI-2010) score (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810369/).  A  higher score indicates a healthier diet.  The results of the study found that men that scored higher on the MD scale had a lower incidence of erectile dysfunction.  The healthy components of the diet were:

  • Vegetable servings (the more servings the greater the positive effect)
  • Fruits and nuts
  • Grains (unrefined)
  • Legumes
  • Fish
  • The ratio of polyunsaturated to saturated fat

The unhealthy parts of the diet were:

  • Red or processed meats (the more servings the greater the negative effect)
  • Dairy

The moderate component was alcohol (the higher and lower consumption indicates higher risk and moderate consumption indicates healthier).  The amount of alcohol that was deemed protective was not specified in this study (however, the UK health guidelines recommend no more than 14 units of alcohol to be consumed per week).

The study concluded that there is an inverse association between a healthy diet (e.g. MD or AHEI-2010) and the risk of developing ED.  The diet regimes emphasise the high consumption of vegetables, fruits, nuts, legumes, fish (rich in omega fatty acids) and the reduction in red/processed meats and dairy products. 

It is therefore important that a diet analysis should be included in the whole assessment of ED in order to help minimise or reverse this health condition.

References:

1.  Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med, 2007; 120(2):151-157.

2.  Litwin MS, Nied RJ, Dhanani N.  Health-related quality of life in men with erectile dysfunction. J Gen Intern Med. 1998;13(3):159-166.

3Paige NM, Hays RD, Litwin MS, Rajfer J, Shapiro MF.  Improvement in emotional wellbeing and relationships of users of sildenafil.  J Urol. 2001;166(5):1774-1778.

4.  Wessells H, Joyce GF, Wise M, Wilt TJ. Erectile dysfunction. J Urol.2007;177(5):1675-1681

5.  Derby CA, Mohr BA, Goldstein I, Feldman HA, Johannes CB, McKinlay JB.  Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology.2000;56(2):302-306.

6.  Saigal CS, Wessells H, Pace J, Schonlau M, Wilt TJ; Urologic diseases in America Project.  Predictors and prevalence of erectile dysfunction in a racially diverse population.  Arch Intern Med. 2006;166(2):207-212.

7.Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB. Incidence of erectile dysfunction in men 40-69 years old: longitudinal results from the Massachusetts male aging study.  J Urol. 2000; 163(2): 460-463.

8.  Dong JY, Zhang YH, Qin LQ.  Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies.  J Am Coll Cardiol. 2011;58(13):1378-1385.

9. Eckel RH, Jakicic JM, Ard JD, et al; American College of Cardiology/American Heart Association Task Force on  Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.  Circulation. 2014; 129(25)(suppl 2): S76-S99.

10.  Estruch R, Ros E, Salas-Salvado J, et al; PREDIMED Study Investigators.  Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts.  N Engl J Med. 2018;378(25):e34.

11.  Scott R. et al; Association of Diet with Erectile Dysfunction Among Men in the Health Professionals’ Follow-up Study. JAMA Network Open. 2020:3(11):e2021701.

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