Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

The association of popular diets and erectile function among men in the United States

International Journal of Impotence Research volume 33, pages 548–555 (2021)Cite this article

Subjects

Abstract

To determine the relationship between popular diets and erectile function we queried the National Health and Nutrition Examination Survey, a cross-sectional dataset, between 2001 and 2004. All men aged 18–85 who answered the prostate and dietary questionnaires were included. Diets were categorized as Mediterranean, low-fat, low-carbohydrate, or nonrestrictive. Multivariable models were created to determine the relationship between erectile function and each diet. Among 4027 men, 649 (16.1%) met criteria for a low-fat diet, 1085 (26.9%) for a Mediterranean diet, and 0 (0%) for a low-carbohydrate diet. 1999 men (49.6%) had some degree of erectile dysfunction. Men with nonrestrictive diets were more likely to endorse normal erectile function compared with those adhering to the Mediterranean or low-fat diets (both p < 0.05) on univariable analysis. Multivariable analysis controlling for age, comorbidities, activity level, and body mass index showed no differences in erectile function among men adhering to a low-fat, Mediterranean diet, or nonrestrictive diet. There was no association between specific diets and erectile function. While additional prospective research is required to corroborate these findings, these data support the notion that individualized diets should be tailored toward goals of weight loss and reduction of comorbidity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED. et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7:1598–607.

    Article  PubMed  Google Scholar 

  2. McKinlay JB. The worldwide prevalence and epidemiology of erectile dysfunction. Int J Impot Res. 2000;12 Suppl 4:S6–11.

    Article  PubMed  Google Scholar 

  3. Latini DM, Penson DF, Wallace KL, Lubeck DP, Lue TF. Clinical and psychosocial characteristics of men with erectile dysfunction: baseline data from ExCEED. J Sex Med. 2006;3:1059–67.

    Article  PubMed  Google Scholar 

  4. Lee JH, Ngengwe R, Jones P, Tang F, O’Keefe JH. Erectile dysfunction as a coronary artery disease risk equivalent. J Nucl Cardiol. 2008;15:800–3.

    Article  PubMed  Google Scholar 

  5. Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200:633–41.

    Article  PubMed  Google Scholar 

  6. Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF, Burgos-Rodriguez R. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. J Urol. 2001;166:569–74. discussion 574-575

    Article  CAS  PubMed  Google Scholar 

  7. Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI. Effects of cigarette smoking on erectile dysfunction. Andrologia. 2015;47:1087–92.

    Article  CAS  PubMed  Google Scholar 

  8. Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291:2978–84.

    Article  CAS  PubMed  Google Scholar 

  9. Esposito K, Ciotola M, Giugliano F, De Sio M, Giugliano G, D’armiento M, et al. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int J Impot Res. 2006;18:405–10.

    Article  CAS  PubMed  Google Scholar 

  10. Khoo J, Piantadosi C, Worthley S, Wittert GA. Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men. Int J Obes. 2010;34:1396–403.

    Article  CAS  Google Scholar 

  11. Kałka D, Domagała Z, Dworak J, Womperski K, Rusiecki L, Marciniak W, et al. Association between physical exercise and quality of erection in men with ischaemic heart disease and erectile dysfunction subjected to physical training. Kardiol Pol. 2013;71:573–80.

    Article  PubMed  Google Scholar 

  12. Searing L. The Big Number: 45 million Americans go on a diet each year. The Washington Post [Internet]. 2018 Jan 1[cited 2020 May 26]. Available from: https://www.washingtonpost.com/national/health-science/the-big-number-45-million-americans-go-on-a-diet-each-year/2017/12/29/04089aec-ebdd-11e7-b698-91d4e35920a3_story.html.

  13. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–41.

    Article  CAS  PubMed  Google Scholar 

  14. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, et al. AHA Dietary Guidelines: revision 2000: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Stroke. 2000;31:2751–66.

    Article  CAS  PubMed  Google Scholar 

  15. WILLETT W EAT, DRINK, AND BE HEALTHY: the harvard medical school guide to healthy eating. Place of publication not identified: FREE Press; New York, NY; 2017.

  16. Atkins RC. Dr. Atkins’ new diet revolution. 1st Avon pbk. ed. New York: Avon Books; 2002. 540 p.

  17. Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C. Update on NHANES dietary data: focus on collection, release, analytical considerations, and uses to inform public policy. Adv Nutr. 2016;7:121–34.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Dwyer J, Picciano MF, Raiten DJ, Members of the Steering Committee. Estimation of Usual Intakes: What We Eat in America–NHANES. J Nutr. 2003;133:609S–23S.

    Article  PubMed  Google Scholar 

  19. Raper N, Perloff B, Ingwersen L, Steinfeldt L, Anand J. An overview of USDA’s dietary intake data system. J Food Composition Anal. 2004;17:545–55.

    Article  Google Scholar 

  20. He Z, Charness N, Bian J, Hogan WR Assessing the comorbidity gap between clinical studies and prevalence in elderly patient populations. In: 2016 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI) [Internet]. Las Vegas, NV, USA: IEEE; 2016 [cited 7 Dec 2018]. p. 136–9. http://ieeexplore.ieee.org/document/7455853/.

  21. NHANES 2001–2002 Laboratory Methods [Internet]. CDC, National Center for Health Statistics; [cited 20 Mar 2019]. https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/labmethods.aspx?BeginYear=2001.

  22. NHANES 2003–2004 Laboratory Methods [Internet]. CDC, National Center for Health Statistics; [cited 20 Mar 2019]. https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/labmethods.aspx?BeginYear=2001.

  23. Pirkle J. Laboratory Procedure Manual: Total Testosterone [Internet]. CDC; 2011-2012 [cited 2020 May 26]. Available from: https://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/tst_g_met.pdf.

  24. Mirel LB, Mohadjer LK, Dohrmann SM, Clark J, Burt VL, Johnson CL, et al. National Health and Nutrition Examination Survey: estimation procedures, 2007–2010. Vital Health Stat. 2013;2:1–17.

    Google Scholar 

  25. La J, Roberts NH, Yafi FA. Diet and Men’s Sexual Health. Sex Med Rev.2018;6:54–68.

    Article  PubMed  Google Scholar 

  26. Wing RR, Rosen RC, Fava JL, Bahnson J, Brancati F, Gendrano Iii INC, et al. Effects of weight loss intervention on erectile function in older men with type 2 diabetes in the Look AHEAD trial. J Sex Med. 2010;7:156–65.

    Article  PubMed  Google Scholar 

  27. Khoo J, Piantadosi C, Duncan R, Worthley SG, Jenkins A, Noakes M, et al. Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men. J Sex Med. 2011;8:2868–75.

    Article  CAS  PubMed  Google Scholar 

  28. Maiorino MI, Bellastella G, Caputo M, Castaldo F, Improta MR, Giugliano D, et al. Effects of Mediterranean diet on sexual function in people with newly diagnosed type 2 diabetes: The MÈDITA trial. J Diabetes Complicat. 2016;30:1519–24.

    Article  Google Scholar 

  29. Moran LJ, Brinkworth GD, Martin S, et al. Long-term effects of a randomised controlled trial comparing high protein or high carbohydrate weight loss diets on testosterone, SHBG, erectile and urinary function in overweight and obese men. Shore N, editor. PLoS One. 2016;11:e0161297.

  30. de Souza ILL, Barros BC, de Oliveira GA, Queiroga FR, Toscano LT, Silva AS, et al. Hypercaloric diet establishes erectile dysfunction in rat: mechanisms underlying the endothelial damage. Front Physiol. 2017;8:760.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Alves-Pereira JL, Frantz EDC, Pires LAS, Babinski MA, da Fonte, Ramos C. Effects of a high energy density diet in the “corpus cavernosum” of mice. Int J Impot Res. 2019;31:126–31.

    Article  CAS  PubMed  Google Scholar 

  32. Yeşilli Ç, Yaman Ö, Anafarta K. Effect of experimental hypercholesterolemia on cavernosal structures. Urology. 2001;57:1184–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA

    Richard J. Fantus

  2. Department of Surgery, NorthShore University Health System, Chicago, IL, USA

    Richard J. Fantus, Cecilia Chang & Brian T. Helfand

  3. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Joshua A. Halpern, Mary Kate Keeter, Robert E. Brannigan & Nelson E. Bennett

Authors
  1. Richard J. Fantus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joshua A. Halpern
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cecilia Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mary Kate Keeter
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert E. Brannigan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Brian T. Helfand
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nelson E. Bennett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nelson E. Bennett.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fantus, R.J., Halpern, J.A., Chang, C. et al. The association of popular diets and erectile function among men in the United States. Int J Impot Res 33, 548–555 (2021). https://doi.org/10.1038/s41443-020-0313-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-020-0313-x

Search

Advanced search

Quick links