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Dietary factors in erectile dysfunction


The role of dietary factors in erectile dysfunction (ED) has never been addressed. In the present case–control study, we investigated the relation of the Mediterranean diet with ED. A total of 100 men with ED were compared with 100 age-matched men without ED. A scale indicating the degree of adherence to the Mediterranean diet was constructed: the total Mediterranean diet score ranged from 0 (minimal adherence to the Mediterranean diet) to 9 (maximal adherence). The percentage of physical inactivity was greater in the ED group (35 vs 19%, P=0.04), whereas the diet score was lower (4.7±0.5 vs 5.4±0.5, P<0.01), indicating a reduced adherence to the Mediterranean diet. In analyses adjusted for the prevalence of associated risk factors (hypertension, hypercholesterolemia), body mass index, waist, physical inactivity and total energy intake, the intake of fruits and nuts, and the ratio of monounsaturated lipids to saturated lipids remained the only individual measures associated with ED. In conclusion, the results of the present study show that dietary factors may be important in the development of ED: adoption of healthy diets would hopefully help preventing ED.

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  1. Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo AB et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000; 30: 328–338.

    Article  CAS  Google Scholar 

  2. Fung MM, Bettencourt R, Barrett-Connor H . Heart disease risk factors predict erectile dysfunction 25 years later. J Am Coll Cardiol 2004; 43: 1405–1411.

    Article  Google Scholar 

  3. Roumeguère T, Wespes E, Carpentier Y, Hoffmann P, Schulman CC . Erectile dysfunction is associated with a high prevalence of hyperlipidemia and coronary heart disease risk. Eur Urol 2003; 44: 355–359.

    Article  Google Scholar 

  4. Kostis JB, Jackson G, Rosen R, Barrett-Connor E, Billups K, Burnett AL et al. Sexual dysfunction and cardiac risk – the second Princeton consensus conference. Am J Cardiol 2005; 96: 313–321.

    Article  Google Scholar 

  5. Kaiser DR, Billups K, Mason C, Wetterling R, Lundberg JL, Bank AJ . Impaired brachial artery endothelium-dependent and -independent vasodilation in man with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004; 43: 179–184.

    Article  Google Scholar 

  6. Cheitlin MD . Erectile dysfunction. The earliest sign of generalized vascular disease? J Am Coll Cardiol 2004; 43: 185–186.

    Article  Google Scholar 

  7. Blumentals WA, Gomez-Caminero A, Joo S, Vannappagari V . Should erectile dysfunction be considered as a marker for acute myocardial infarction? Int J Impot Res 2004; 16: 350–353.

    Article  CAS  Google Scholar 

  8. Sullivan ME, Thompson CS, Dashwood MR, Khan MA, Jeremy JY, Morgan RJ et al. Nitric oxide and penile erections: is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res 1999; 43: 658–665.

    Article  CAS  Google Scholar 

  9. Hu FB, Willett WC . Optimal diets for prevention of coronary heart disease. JAMA 2002; 288: 2569–2578.

    Article  CAS  Google Scholar 

  10. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D . Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599–2608.

    Article  Google Scholar 

  11. Panagiotakos DB, Pitsavos C, Chrysohoou C, Skoumas J, Stefanadis C . Status and management of hypertension in Greece. The role of the adoption of Mediterranean diet: the ATTICA Study. J Hypertens 2003; 21: 1483–1489.

    Article  CAS  Google Scholar 

  12. Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA 2004; 292: 1433–1439.

    Article  Google Scholar 

  13. Chrysohoou C, Panagiotakos DB, Pitsavos C, Das UN, Stefanidis C . Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults. The ATTICA Study. J Am Coll Cardiol 2004; 44: 152–158.

    Article  Google Scholar 

  14. Singh RB, Rastogi SS, Verma R, Laxmi B, Singh R, Ghosh S et al. Randomised controlled trial of cardioprotective diet in patients with recent acute myocardial infarction: results of one year follow-up. BMJ 1992; 302: 1012–1019.

    Google Scholar 

  15. de lorgeril M, Salen P, Martin JL, Monjaud I, Boucher P, Mamelle N . Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet heart Study. Circulation 1999; 99: 779–785.

    Article  CAS  Google Scholar 

  16. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004; 292: 1440–1446.

    Article  CAS  Google Scholar 

  17. Carluccio MA, Siculella L, Ancora MA, Massaro M, Scoditti E, Storelli C et al. Olive oil and red wine antioxidant polyphenols inhibit endothelial activation: antiatherogenic properties of Mediterranean diet phytochemicals. Arterioscler Thromb Vasc Biol 2003; 23: 622–629.

    Article  CAS  Google Scholar 

  18. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  Google Scholar 

  19. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C et al. Physical activity and public health. A recommendation from the centers for disease control and prevention and the American college of sports medicine. JAMA 1995; 273: 402–407.

    Article  CAS  Google Scholar 

  20. Esposito K, Giugliano D . The metabolic syndrome and inflammation: association or causation? Nutr Metab Cardiovasc Dis 2004; 14: 228–232.

    Article  CAS  Google Scholar 

  21. Bhagat K, Balance P . Inflammatory cytokines impair endothelium dependent dilatation in human veins in vivo. Circulation 1997; 96: 3042–3047.

    Article  CAS  Google Scholar 

  22. Lopez-Garcia E, Hu FB . Nutrition and the endothelium. Curr Diab Rep 2004; 4: 253–259.

    Article  Google Scholar 

  23. Esposito K, Giugliano D . Diet and inflammation: a link to metabolic and cardiovascular disease. Eur Heart J 2005 doi:10.1093/eurheartj/ehj605.

  24. Hu FB . Dietary patterns analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13: 3–9.

    Article  CAS  Google Scholar 

  25. Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC et al. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 2001; 72: 61–67.

    Article  Google Scholar 

  26. Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE et al. Major dietary patterns are related to plasma concentrations of inflammatory and endothelial dysfunction markers. Am J Clin Nutr 2004; 80: 1029–1035.

    Article  CAS  Google Scholar 

  27. Schulze MB, Hoffman K, Manson JE, Willett WC, Meigs JB, Weikert C et al. Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr 2005; 82: 675–684.

    Article  CAS  Google Scholar 

  28. Esposito K, Giugliano D . Obesity, the metabolic syndrome, and sexual dysfunction. Int J Impot Res 2005; 17: 391–398.

    Article  CAS  Google Scholar 

  29. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995; 61 (Suppl 6): S1402–S1406.

    Article  Google Scholar 

  30. Eyre H, Kahn R, Robertson RM . Preventing cancer, cardiovascular disease and diabetes. Circulation 2004; 109: 244–3255.

    Article  Google Scholar 

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Esposito, K., Giugliano, F., De Sio, M. et al. Dietary factors in erectile dysfunction. Int J Impot Res 18, 370–374 (2006).

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  • healthy diet
  • erectile dysfunction
  • prevention

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