Presentation Authors: Scott R. Bauer*, San Francisco, CA, Meir J. Stampfer, Edward Giovannucci, Eric B. Rimm, Boston, MA, Stacey A. Kenfield, San Francisco, CA
Introduction: Erectile dysfunction (ED) affects more than half of men over age 70 and leads to decreased quality of life. Non-pharmacologic treatments, such as smoking cessation and weight loss, are attractive options because they are inexpensive, well tolerated, and have additional health benefits, such as decreased cardiovascular risk. However, it remains unknown whether heart healthy dietary patterns are associated with ED.
Methods: We conducted a prospective analysis of 26,246 men aged 40 to 75 years old enrolled in the Health Professionals Follow-Up Study. Erectile function was assessed with questionnaires in 2000, 2004, and 2008. Men were included if they reported 'good' or 'very good' erectile function in 2000 and incident ED was defined as 'poor' or 'very poor' function during follow-up. Dietary data was self-reported on validated food-frequency questionnaires completed every 4 years and used to calculate Mediterranean Diet and Alternative Health Eating Index (AHEI) scores, which were cumulatively updated. We used multivariable Cox proportional hazards models to adjust for confounders and compute hazard ratios (HR) for incident ED (N = 2,931). We evaluated for a priori effect modification by age.
Results: Higher Mediterranean Diet and AHEI scores were both associated with decreased risk of incident ED. Men in the highest, compared to the lowest, category of Mediterranean Diet score had a 14% lower risk of developing ED (HR = 0.86; 95% CI 0.82 - 0.91). Similarly, men in the highest quintile of AHEI score had a 17% lower risk of developing ED (HR = 0.83, 95% CI 0.77 - 0.89), compared to men in the lowest quintile. The inverse associations between Mediterranean Diet score or AHEI and incident ED were strongest among men aged < 60 years (p-interaction = 0.004 and 0.006, respectively). When associations with individual score components were examined, higher intakes of legumes, fruit, vegetables, fish, and long-chain (n-3) fats were associated with decreased risk of ED. Conversely, total, red, and processed meat and trans fat intakes were positively associated with risk of ED. Other score components, including dairy, nuts, sugar-sweetened beverages, whole grains or cereals, and alcohol were not associated with ED.
Conclusions: Heart health dietary patterns, including Mediterranean Diet and AHEI, are associated with decreased risk of incident ED in this prospective cohort study. Our findings support the evaluation of dietary interventions for the prevention or treatment of ED.
Source of Funding: Dr. Bauer was supported by grant 1K12DK111028 from the National Institute of Diabetes, Digestive, and Kidney Disorders.