Original Article

International Journal of Impotence Research (2006) 18, 405–410. doi:10.1038/sj.ijir.3901447; published online 5 January 2006

Mediterranean diet improves erectile function in subjects with the metabolic syndrome

K Esposito1, M Ciotola1, F Giugliano2, M De Sio2, G Giugliano3, M D'armiento2 and D Giugliano1

  1. 1Division of Metabolic Diseases, University of Naples SUN, Naples, Italy
  2. 2Division of Urology, University of Naples SUN, Naples, Italy
  3. 3Plastic and Reconstructive Surgery, University of Rome 'La Sapienza', Rome, Italy

Correspondence: Dr K Esposito, Division of Metabolic Diseases, University of Naples SUN, Piazza Miraglia, Naples 80138, Italy. E-mail: katherine.esposito@unina2.it

Received 14 November 2005; Revised 5 December 2005; Accepted 5 December 2005; Published online 5 January 2006.



Men with the metabolic syndrome demonstrate an increased prevalence of erectile dysfunction (ED). In the present study, we tested the effect of a Mediterranean-style diet on ED in men with the metabolic syndrome. Men were identified in our database of subjects participating in controlled trials evaluating the effect of lifestyle changes and were included if they had a diagnosis of ED associated with a diagnosis of metabolic syndrome, complete follow-up in the study trial, and intervention focused mainly on dietary changes. Sixty-five men with the metabolic syndrome met the inclusion/exclusion criteria; 35 out of them were assigned to the Mediterranean-style diet and 30 to the control diet. After 2 years, men on the Mediterranean diet consumed more fruits, vegetables, nuts, whole grain, and olive oil as compared with men on the control diet. Endothelial function score and inflammatory markers (C-reactive protein) improved in the intervention group, but remained stable in the control group. There were 13 men in the intervention group and two in the control group (P=0.015) that reported an IIEF score of 22 or higher. Mediterranean-style diet rich in whole grain, fruits, vegetables, legumes, walnut, and olive oil might be effective per se in reducing the prevalence of ED in men with the metabolic syndrome.


metabolic syndrome, erectile dysfunction, mediterranean diet, endothelial function, inflammation, C-reactive protein

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