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

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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.
IJIR: Your Sexual Medicine Journal (2021) 33:548555
https://doi.org/10.1038/s41443-020-0313-x
ARTICLE
The association of popular diets and erectile function among men
in the United States
Richard J. Fantus 1,2 Joshua A. Halpern3Cecilia Chang2Mary Kate Keeter3Robert E. Brannigan3
Brian T. Helfand2Nelson E. Bennett3
Received: 20 March 2020 / Revised: 29 April 2020 / Accepted: 19 May 2020 / Published online: 2 June 2020
© The Author(s), under exclusive licence to Springer Nature Limited 2020
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 1885 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 specic diets and erectile function. While additional prospective research is required to corroborate
these ndings, these data support the notion that individualized diets should be tailored toward goals of weight loss and
reduction of comorbidity.
Introduction
Erectile dysfunction (ED) is a common condition that
affects up to 40% of men by the age of 70, and roughly
30 million men in the United States (US) [1,2]. ED can
have a detrimental impact upon a wide range of psycho-
social domains, interpersonal relationships, and overall
mental health [3]. Furthermore, ED may serve as a har-
binger of serious adverse cardiovascular events [4,5]. The
intimate relationship between cardiovascular morbidity and
ED highlights the overlapping, modiable risk factors
between these two entities: diabetes, hyperlipidemia,
sedentary lifestyle, and smoking [5,6].
The recently published American Urological Association
Guidelines on ED recommend a multifaceted, patient-
tailored treatment approach that includes lifestyle mod-
ication [5]. Lifestyle modication such as smoking ces-
sation has reproducibly shown a decrease in ED [5,7].
However, the effects of diet and exercise are somewhat
unclear. The downstream impact of these interventions such
as weight loss and subsequent reduction of comorbidity
appear to impact erectile function, yet the specic effect of
dietary composition remains unknown [5,811]. Further-
more, many of the studies examining the relationship
between diet and erectile function have been subject to
criticism due to concerns regarding generalizability of
ndingsmany examined very specic populations such as
overweight men, type II diabetics, and men with ischemic
heart disease, and the ndings from these cohorts may not
be applicable to the general population [5,811].
With the increased emphasis on the importance of living
a healthy lifestyle, ~45 million Americans will try a new
*Nelson E. Bennett
Nelson.Bennett@nm.org
1Section of Urology, Department of Surgery, University of Chicago
Medicine, Chicago, IL, USA
2Department of Surgery, NorthShore University Health System,
Chicago, IL, USA
3Department of Urology, Northwestern University Feinberg School
of Medicine, Chicago, IL, USA
Supplementary information The online version of this article (https://
doi.org/10.1038/s41443-020-0313-x) contains supplementary
material, which is available to authorized users.
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