Adherence to Mediterranean diet and erectile dysfunction in men with type 2 diabetes.

Introduction: There are no reported studies assessing the relation between diet and erectile dysfunction (ED) in men with diabetes.

Aim: In the present study, we explored the relation between consumption of a Mediterranean-type diet and ED in a population of type 2 diabetic men.

Methods: Patients with type 2 diabetes were enrolled if they had a diagnosis of type 2 diabetes for at least six months but less than 10 years, age 35-70 years, body mass index (BMI) of 24 or higher, HbA1c of 6.5% or higher, treatment with diet or oral drugs. All diabetic patients were invited to complete a food-frequency questionnaire and self-report measures of sexual function. A total of 555 (90.8%) of the 611 diabetic men completed both questionnaires and were analyzed in the present study.

Main Outcome Measures: Adherence to a Mediterranean diet was assessed by a 9-point scale that incorporated the salient characteristics of this diet (range of scores, 0-9, with higher scores indicating greater adherence). ED was assessed with the International Index of Erectile Function-5.

Results: Diabetic men with the highest scores (6-9) had lower BMI, waist circumference, and waist-to-hip ratio, a lower prevalence of obesity and metabolic syndrome, a higher level of physical activity, and better glucose and lipid profiles than the diabetic men who scored <3 points on the scale. The proportion of sexually active men showed a significant increase across tertiles of adherence to Mediterranean diet (from 65.1% to 74.4%, P = 0.01). Moreover, men with the highest score of adherence were more likely to have a lower prevalence of global ED (51.9% vs. 62%, P = 0.01) and severe ED (16.5% vs. 26.4%, P = 0.01) as compared with low adherers.

Conclusions: In men with type 2 diabetes, greater adherence to Mediterranean diet is associated with a lower prevalence of ED.