Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 33185675 · doi:10.1001/jamanetworkopen.2020.21701
What was done
This prospective cohort study analyzed 21,469 US male health professionals aged 40 to 75 years from the Health Professionals Follow-up Study followed from 1998 through 2014. Men with baseline erectile dysfunction, myocardial infarction, diabetes, stroke, or genitourinary cancer were excluded. Dietary intake was assessed every 4 years via food frequency questionnaires to calculate cumulative Mediterranean Diet and Alternative Healthy Eating Index 2010 (AHEI-2010) scores. Incident erectile dysfunction was assessed via questionnaires in 2000, 2004, 2008, and 2012. Cox proportional hazards regression stratified by age estimated hazard ratios across dietary score categories.
What was found
Over a mean follow-up of 10.8 years (232,522 person-years), 9,464 incident erectile dysfunction cases occurred (968 in men <60 years, 3,703 in men 60 to <70 years, and 4,793 in men ≥70 years). Men under 60 in the highest category of Mediterranean Diet score had a lower risk of erectile dysfunction compared with those in the lowest category (HR, 0.78; 95% CI, 0.66-0.92). Higher Mediterranean Diet scores were also inversely associated with incident risk in men aged 60 to <70 (HR, 0.82; 95% CI, 0.76-0.89) and men aged ≥70 (HR, 0.93; 95% CI, 0.86-1.00). Highest vs lowest quintile of AHEI-2010 similarly showed a reduced risk among men younger than 60 years (HR, 0.78; 95% CI, 0.63-0.97).
Why it matters
This study provides large-scale prospective evidence that adhering to healthy dietary patterns is associated with lower long-term risk of erectile dysfunction, with the strongest protective association seen in men under 60.
Limits
The observational design cannot establish causality. Dietary intake and erectile dysfunction were both assessed by self-reported questionnaires rather than clinical examination or biomarkers. The cohort consisted exclusively of male health professionals, which may limit generalizability to other demographic and socioeconomic populations.
Cited by
- supports In the Health Professionals Follow-up Study of 20,000 men, adherence to a Mediterranean diet was associated with a 22% lower risk of erectile dysfunction.