Dietary flavonoid intake and incidence of erectile dysfunction.
Level 3 - non-randomized controlled study
Prospective observational cohort study
PubMed 26762373 · doi:10.3945/ajcn.115.122010
What was done
A prospective cohort study tracked 25,096 male participants from the Health Professionals Follow-Up Study over 10 years. Dietary flavonoid and subclass intakes were calculated from food-frequency questionnaires administered every 4 years. Erectile function was self-assessed in 2000 (including historical recall from 1986), 2004, and 2008. The analysis evaluated the relationship between habitual flavonoid subclass intake and incident erectile dysfunction (ED), adjusting for cardiovascular risk factors and overall diet quality.
What was found
Incident ED occurred in 35.6% of participants during follow-up. Comparing extreme intake categories after multivariate adjustment, reduced risk of ED was observed for flavones (relative risk [RR] = 0.91; 95% CI: 0.85, 0.97; P-trend = 0.006), flavanones (RR = 0.89; 95% CI: 0.83, 0.95; P-trend = 0.0009), and anthocyanins (RR = 0.91; 95% CI: 0.85, 0.98; P-trend = 0.002). Total fruit intake was associated with a 14% risk reduction (RR = 0.86; 95% CI: 0.79, 0.92; P = 0.002). In age-stratified analyses, the 11% to 16% risk reductions for these flavonoid subclasses were statistically significant only in men under 70 years old (P-interactions: 0.002 to 0.03).
Why it matters
This study provides large-scale prospective evidence linking habitual intake of specific dietary flavonoids, notably from fruit, to a lower incidence of vascular-related erectile dysfunction in middle-aged and younger men.
Limits
The study relies on self-reported food-frequency questionnaires and subjective ratings of erectile function, including retrospective recall. The cohort consisted exclusively of male health professionals, which may limit generalizability. Observational design leaves potential for residual confounding, and the observed protective associations did not extend to men aged 70 and older.
Cited by
- partial Regular consumption of blueberries is associated with an approximately 20% improvement in erectile function.