Men who consume a heart-healthy diet may reduce their risk for developing erectile dysfunction as they age, a new study suggests. In an analysis of data from more than 20,000 men participating in the long-term Health Professionals Follow-Up Study, researchers found a 22% decrease in the risk of erectile dysfunction (ED) in those who consumed the healthiest diets, according to the results published in JAMA Network Open. "The key finding from our study was that men who follow a healthy dietary pattern, by eating more vegetables, fruits, nuts, legumes and fish, as well as less red and processed meats, are less likely to develop erectile dysfunction," said the study's lead author, Dr. Scott Bauer, an assistant professor of medicine and urology at the University of California, San Francisco, and a primary care physician at the San Francisco VA Medical Center. "Although randomized controlled trials are needed to prove that ED can be prevented or treated with dietary interventions, men who are concerned about maintaining their erectile function should be counseled regarding the potential contribution of diet to their risk of ED," Dr. Bauer said in an email. Exactly how a healthy diet lowers ED risk isn't yet known, Dr. Bauer said, however, "ED is an early warning sign of cardiovascular disease, especially among younger men, and ED and cardiovascular disease share many of the same risk factors. This relationship is what led our team to hypothesize that healthier dietary patterns, which we know can prevent and treat cardiovascular disease, may prevent ED via similar mechanisms such as improved endothelial function." To explore the possibility that diet might impact the risk for ED, Dr. Bauer and his colleagues analyzed data on 21,469 U.S. male health professionals who were aged 40-75 at enrollment, starting in 1986, and whose mean age at baseline for the current analysis (1998) was 62. Average follow-up was 10.8 years. Participants in this prospective study filled out a food frequency questionnaire (FFQ) every four years and other questionnaires about lifestyle factors, health outcomes and medications every two years. Incident erectile dysfunction was assessed with questionnaires in 2000, 2004, 2008, and 2012. Diet quality was assessed based on Alternative Healthy Eating Index 2010 (AHEI) and Mediterranean Diet scores. Participants were scored on 11 items with predefined criteria for complete adherence versus nonadherence. Higher intake of fruits, vegetables, whole grains, nuts and legumes, polyunsaturated fats, and omega-3 fatty acids, and lower intake of red and processed meats, sugar-sweetened beverages, trans fatty acids, and sodium contributed to a higher (healthier) dietary index score. Moderate alcohol intake (0.5-2 drinks/d) also contributed to a higher index score. Men in the highest quintiles of Mediterranean Diet and AHEI scores had the lowest risk of incident erectile dysfunction compared to those in the lowest quintile, particularly among men younger 60 (Hazard Ratio 0.78). A similar trend was seen for the highest Mediterranean Diet scores among men aged 60 to <70 (HR 0.82) and those aged 70 and older (HR 0.93). "This large observational study supports the current thinking that erectile function, especially in men under 60, mirrors the condition of the blood vessels," said Dr. Ronald Tamler, director of Digital Health Implementation, Mount Sinai Health System and a professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. "A healthful diet can contribute to other heart-healthy behaviors, such as physical activity, that have been shown to improve erectile function," said Dr. Tamler in an email. "The message to men is clear: Engage in a healthy lifestyle not only for better cardiovascular health, but also for better sexual health." —Linda Carroll Source
